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. What advice should the oncology nurse give to a client planning a beach vacation after completing radiation treatments for cancer?

• A. Avoid getting salt water on the radiation site.
• B. Do not expose the radiation area to direct sunlight.
• C. Have a wonderful time and enjoy your vacation!
• D. Remember you should not drink alcohol for a year.

Correct answer: B

Rationale: The correct answer is B because the skin at the radiation site is sensitive to sunlight, and exposure can cause further damage. It is crucial to protect the area from direct sunlight to prevent skin irritation or burns. Choice A is incorrect as salt water typically does not pose a significant risk to the radiation site. Choice C is a positive and encouraging response but does not provide necessary advice for post-radiation care. Choice D, while important in some cases, is not directly related to the client's beach vacation after completing radiation treatments.

3. The nurse is caring for a client with multiple myeloma and is monitoring the client for signs of hypercalcemia. Which symptom would be an early indication?

• A. Polyuria
• B. Polyphagia
• C. Polydipsia
• D. Weight loss

Correct answer: A

Rationale: In patients with multiple myeloma, hypercalcemia is a common complication due to the release of calcium from the bones as a result of osteolytic lesions. One of the early symptoms of hypercalcemia is polyuria, or increased urine output. This occurs because elevated calcium levels can lead to impaired renal function and increased renal excretion of calcium, which results in increased urine production. Early recognition of polyuria can help prompt further evaluation and management of hypercalcemia, as untreated hypercalcemia can lead to more severe complications.

4. A public health nurse has formed an interdisciplinary team that is developing an educational program entitled Cancer: The Risks and What You Can Do About Them. Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity?

• A. Disease prophylaxis
• B. Risk reduction
• C. Secondary prevention
• D. Tertiary prevention

Correct answer: C

Rationale: Secondary prevention involves screening and early detection activities that seek to identify early-stage cancer in individuals who lack symptoms.

5. The home health nurse is performing a home visit for an oncology patient discharged 3 days ago after completing treatment for non-Hodgkin lymphoma. The nurse's assessment should include examination for the signs and symptoms of what complication?

• A. Tumor lysis syndrome (TLS)
• B. Syndrome of inappropriate antidiuretic hormone (SIADH)
• C. Disseminated intravascular coagulation (DIC)
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Tumor lysis syndrome (TLS). Tumor lysis syndrome is a potential complication after treatment for certain cancers, including non-Hodgkin lymphoma. The rapid breakdown of cancer cells in response to treatment can lead to metabolic abnormalities, such as hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia, which can be life-threatening. Choice B, Syndrome of inappropriate antidiuretic hormone (SIADH), is not typically associated with non-Hodgkin lymphoma treatment. Choice C, Disseminated intravascular coagulation (DIC), is more commonly seen in conditions such as sepsis or trauma, not directly related to non-Hodgkin lymphoma treatment. Choice D, Hypercalcemia, is not a common complication following treatment for non-Hodgkin lymphoma.

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