Nursing Elites

1. When educating a patient with multiple myeloma who is being discharged home, what should the nurse emphasize regarding the management of this condition?

• A. Increasing fluid intake
• B. Avoiding sunlight exposure
• C. Monitoring for signs of infection
• D. Managing pain

Correct answer: C

Rationale: The correct answer is C: Monitoring for signs of infection. Patients with multiple myeloma have a compromised immune system, making them more susceptible to infections. Emphasizing the importance of monitoring for signs of infection helps in early detection and prompt treatment. Increasing fluid intake (choice A) is essential for many health conditions but is not the priority in managing multiple myeloma. Avoiding sunlight exposure (choice B) may be relevant for certain skin conditions or medications but is not a key aspect of multiple myeloma management. Managing pain (choice D) is important, but in the context of multiple myeloma, monitoring for signs of infection takes precedence due to the increased risk of infections in these patients.

2. A patient with non-Hodgkin lymphoma (NHL) is receiving treatment. What is the most important assessment for the nurse to make in this patient?

• A. Skin integrity
• B. Nutritional status
• C. Respiratory function
• D. Cognitive function

Correct answer: C

Rationale: The correct answer is C: Respiratory function. In a patient with non-Hodgkin lymphoma (NHL), monitoring respiratory function is crucial due to the potential for complications such as pleural effusion or pneumonia. Assessing skin integrity (choice A) is important but not as critical as monitoring respiratory function in this case. Nutritional status (choice B) and cognitive function (choice D) are also important aspects of care but do not take precedence over assessing respiratory function in a patient with NHL undergoing treatment.

3. A client is admitted to the hospital with a suspected diagnosis of Hodgkin’s disease. Which assessment finding would the nurse expect to note specifically in the client?

• A. Fatigue
• B. Weakness
• C. Weight gain
• D. Enlarged lymph nodes

Correct answer: D

Rationale: Hodgkin’s disease (Hodgkin’s lymphoma) is a type of cancer that originates in the lymphatic system, particularly affecting the lymph nodes. A hallmark sign of Hodgkin’s disease is the painless enlargement of lymph nodes, often in the neck, armpit, or groin. These enlarged lymph nodes are typically firm and rubbery to the touch. This is one of the most distinctive and common early signs that healthcare providers look for when diagnosing the disease.

4. The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient?

• A. Impaired nutritional status
• B. Cognitive changes
• C. Diarrhea
• D. Alopecia

Correct answer: A

Rationale: Corrected Rationale: Impaired nutritional status is a potential adverse effect of radiotherapy to the head and neck due to alterations in oral mucosa and taste. While cognitive changes, diarrhea, and alopecia can be side effects of other treatments or conditions, they are not typically associated with external radiation for a malignant tumor of the neck. Therefore, the nurse should primarily focus on discussing the risk of impaired nutritional status with the patient.

5. A client is receiving rituximab and asks how it works. What response by the nurse is best?

• A. It causes rapid lysis of the cancer cell membranes.
• B. It destroys the enzymes needed to create cancer cells.
• C. It prevents the start of cell division in the cancer cells.
• D. It sensitizes certain cancer cells to chemotherapy.

Correct answer: C

Rationale: Rituximab is a monoclonal antibody that targets CD20, a protein found on the surface of certain B-cells, including some cancerous B-cells, such as in non-Hodgkin's lymphoma and chronic lymphocytic leukemia (CLL). Rituximab works by binding to the CD20 protein, which leads to the destruction of the cancerous B-cells through various mechanisms, including preventing the initiation of cell division. By blocking the division process, rituximab helps slow the growth and proliferation of cancer cells, allowing the immune system and additional treatments to clear them more effectively.

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