Nursing Elites

1. A nurse is planning care for a patient with leukemia who has been experiencing severe fatigue. What is the most appropriate intervention to include in the care plan?

• A. Encouraging the patient to remain in bed
• B. Scheduling frequent rest periods
• C. Providing a high-calorie diet
• D. Administering blood transfusions

Correct answer: B

Rationale: In patients with leukemia, severe fatigue is a common symptom due to factors such as anemia, the disease process itself, and the effects of treatments like chemotherapy. The most appropriate intervention is to schedule frequent rest periods to help manage fatigue while encouraging a balance between rest and activity. This approach allows the patient to conserve energy for essential tasks and prevent exhaustion, without promoting complete inactivity, which can lead to deconditioning.

2. A nurse in the oncology clinic is providing preoperative education to a client just diagnosed with cancer. The client has been scheduled for surgery in 3 days. What action by the nurse is best?

• A. Call the client at home the next day to review teaching.
• B. Give the client information about a cancer support group.
• C. Provide all the preoperative instructions in writing.
• D. Reassure the client that surgery will be over soon.

Correct answer: A

Rationale: Clients are often overwhelmed by a sudden cancer diagnosis; therefore, it is best for the nurse to call the client at home the next day to review teaching. This approach allows the client time to process the information before the surgery. Choice B may be beneficial but is not the priority at this time. Providing written instructions (Choice C) is helpful but does not offer the personalized interaction needed. Reassuring the client (Choice D) is important but does not address the educational aspect of preoperative preparation.

3. A healthcare professional is assessing a female client who is taking hormone therapy for breast cancer. What assessment finding requires the healthcare professional to notify the primary health care provider immediately?

• A. Irregular menses.
• B. Edema in the lower extremities.
• C. Ongoing breast tenderness.
• D. Red, warm, swollen calf.

Correct answer: D

Rationale: The correct answer is D. A red, warm, swollen calf may indicate a deep vein thrombosis, which is a medical emergency. This finding requires immediate notification of the primary health care provider to prevent potential complications such as pulmonary embolism. Choices A, B, and C are not indicative of life-threatening conditions and should be monitored but do not require immediate notification like a suspected deep vein thrombosis.

4. A client undergoing chemotherapy is at risk for developing mucositis. What nursing intervention is most appropriate to help manage this condition?

• A. Encourage the client to drink plenty of fluids.
• B. Administer antifungal mouthwash.
• C. Teach the client to avoid spicy or acidic foods.
• D. Apply a topical anesthetic to the oral mucosa before meals.

Correct answer: C

Rationale: Avoiding spicy or acidic foods can help prevent irritation of the mucosa, which is already sensitive during mucositis.

5. Following an extensive diagnostic workup, an older adult patient has been diagnosed with a secondary myelodysplastic syndrome (MDS). What assessment question most directly addresses the potential etiology of this patient's health problem?

• A. Were you ever exposed to toxic chemicals in any of the jobs that you held?
• B. When you were younger, did you tend to have recurrent infections of any kind?
• C. Have your parents or siblings had any disease like this?
• D. Would you say that you've had a lot of sun exposure in your lifetime?

Correct answer: A

Rationale: The correct answer is A. Secondary MDS can occur at any age and results from prior toxic exposure to chemicals, including chemotherapeutic medications. Asking about exposure to toxic chemicals in previous jobs directly addresses the potential etiology of this patient's health problem. Choices B, C, and D are not as directly related to the etiology of secondary MDS. Recurrent infections (Choice B) are not a known cause of MDS. Family history (Choice C) is more pertinent to primary MDS, which has a genetic component, while sun exposure (Choice D) is not associated with the etiology of MDS.

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