Nursing Elites

1. A nurse is preparing to administer filgrastim to a client undergoing chemotherapy. What is the primary purpose of this medication?

• A. Increase white blood cell production.
• B. Reduce the risk of infection.
• C. Enhance red blood cell production.
• D. Control chemotherapy-induced nausea and vomiting.

Correct answer: A

Rationale: Filgrastim is primarily used to increase white blood cell production in clients undergoing chemotherapy.

2. Four clients are receiving tyrosine kinase inhibitors (TKIs). Which of these four clients would the nurse assess first?

• A. Dry, itchy, peeling skin.
• B. Serum calcium of 9.2 mg/dL (2.3 mmol/L).
• C. Serum potassium of 2.8 mEq/L (2.8 mmol/L).
• D. Weight gain of 0.5 lb (1.1 kg) in 1 day.

Correct answer: C

Rationale: A potassium level of 2.8 mEq/L is critically low and requires immediate intervention.

3. The nurse has taught a client with cancer ways to prevent infection. What statement by the client indicates that more teaching is needed?

• A. I should take my temperature daily and when I don’t feel well.
• B. I will discard perishable liquids after sitting out for over an hour.
• C. I won’t let anyone share any of my personal toiletries.
• D. It’s alright for me to keep my pets and change the litter box.

Correct answer: D

Rationale: Clients with cancer, especially those undergoing chemotherapy or other immunosuppressive treatments, are at increased risk for infections due to a weakened immune system. Changing a litter box exposes the client to pathogens such as Toxoplasma gondii and other harmful bacteria or parasites found in cat feces, which could lead to serious infections. It is recommended that immunocompromised individuals avoid activities like changing litter boxes to reduce their risk of exposure to infectious agents. A family member or caregiver should handle this task to protect the client.

4. A client has been prescribed epoetin alfa for anemia related to chemotherapy. What lab value should the nurse monitor to determine the effectiveness of this medication?

• A. Hemoglobin level.
• B. Hematocrit level.
• C. White blood cell count.
• D. Platelet count.

Correct answer: A

Rationale: Epoetin alfa is a medication used to treat anemia, particularly anemia related to chemotherapy or chronic kidney disease. It stimulates the bone marrow to produce more red blood cells, which increases the hemoglobin level. Monitoring hemoglobin is the best way to assess the effectiveness of epoetin alfa, as an increase in hemoglobin indicates that the body is producing more red blood cells and the anemia is improving.

5. A patient has been found to have an indolent neoplasm. The nurse should recognize what implication of this condition?

• A. The patient faces a significant risk of malignancy.
• B. The patient has a myeloid form of leukemia.
• C. The patient has a lymphocytic form of leukemia.
• D. The patient has a major risk factor for hemophilia.

Correct answer: A

Rationale: The correct answer is A: 'The patient faces a significant risk of malignancy.' Indolent neoplasms are characterized by their slow growth and relatively low malignancy potential; however, they do have the capability to progress to malignancy over time. Choices B, C, and D are incorrect because they make assumptions about specific types of leukemia and hemophilia, which are not necessarily related to the presence of an indolent neoplasm.

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