Nursing Elites

1. A nurse is preparing health education for a patient who has received a diagnosis of myelodysplastic syndrome (MDS). Which of the following topics should the nurse prioritize?

• A. Techniques for energy conservation and activity management
• B. Emergency management of bleeding episodes
• C. Technique for the administration of bronchodilators by metered-dose inhaler
• D. Techniques for self-palpation of the lymph nodes

Correct answer: B

Rationale: Because of patients risks of hemorrhage, patients with MDS should be taught techniques for managing emergent bleeding episodes.

2. A nurse is caring for a patient whose diagnosis of multiple myeloma is being treated with bortezomib. The nurse should assess for what adverse effect of this treatment?

• A. Stomatitis
• B. Nephropathy
• C. Cognitive changes
• D. Peripheral neuropathy

Correct answer: D

Rationale: The correct answer is D: Peripheral neuropathy. Bortezomib, used in the treatment of multiple myeloma, is known to cause peripheral neuropathy as a significant adverse effect. Stomatitis (Choice A), which is inflammation of the mouth and lips, is not a common adverse effect of bortezomib. Nephropathy (Choice B), referring to kidney disease, is not a typical adverse effect of bortezomib. Cognitive changes (Choice C) are not a commonly reported adverse effect of bortezomib treatment.

3. A patient with advanced leukemia is responding poorly to treatment. The nurse finds the patient tearful and trying to express his feelings, but he is clearly having difficulty. What is the nurses most appropriate action?

• A. Tell him that you will give him privacy and leave the room.
• B. Offer to call pastoral care.
• C. Ask if he would like you to sit with him while he collects his thoughts.
• D. Tell him that you can understand how hes feeling.

Correct answer: C

Rationale: Providing emotional support and discussing the uncertain future are crucial.

4. The nurse is assessing the perineal wound in a client who has returned from the operating room following an abdominal perineal resection and notes serosanguineous drainage from the wound. Which nursing intervention is most appropriate?

• A. Clamp the Penrose drain.
• B. Change the dressing as prescribed.
• C. Notify the healthcare provider (HCP).
• D. Remove and replace the perineal packing.

Correct answer: B

Rationale: In this scenario, the appropriate nursing intervention for serosanguineous drainage from the wound is to change the dressing as prescribed. This helps in maintaining wound cleanliness, preventing infection, and promoting proper wound healing. Clamping the Penrose drain (Choice A) is not indicated as the drainage is from the wound itself, not the drain. Notifying the healthcare provider (Choice C) may be necessary if there are signs of infection or other concerning issues, but changing the dressing should be done first. Removing and replacing the perineal packing (Choice D) is not the priority in this situation unless specifically prescribed by the healthcare provider after assessing the wound.

5. The home health care nurse is caring for a client with cancer who is complaining of acute pain. The most appropriate determination of the client's pain should include which assessment?

• A. The client's pain rating
• B. Nonverbal cues from the client
• C. The nurse's impression of the client's pain
• D. Pain relief after appropriate nursing intervention

Correct answer: A

Rationale: The correct answer is A: The client's pain rating. Pain assessment should primarily rely on the client's self-report for the most accurate determination of pain intensity. Nonverbal cues from the client (choice B) can provide additional information but should not replace the client's self-report. The nurse's impression of the client's pain (choice C) may be subjective and less reliable than the client's self-assessment. Pain relief after appropriate nursing intervention (choice D) is an important outcome but does not replace the initial assessment of the client's pain.

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