Nursing Elites

1. A nurse provides care on a bone marrow transplant unit and is preparing a female patient for a hematopoietic stem cell transplantation (HSCT) the following day. What information should the nurse emphasize to the patient’s family and friends?

• A. Your family should gather at the bedside in case there is a negative outcome.
• B. Ensure she abstains from eating any food 24 hours before the procedure.
• C. Wear a hospital gown when entering the patient's room.
• D. Avoid visiting if you've had a recent infection.

Correct answer: D

Rationale: The correct answer is D: 'Avoid visiting if you've had a recent infection.' Before a hematopoietic stem cell transplantation, it is essential for visitors to refrain from visiting if they have had a recent illness or vaccination to minimize the risk of infection to the patient. Choice A is incorrect because emphasizing a negative outcome is not beneficial to the patient or their family. Choice B is incorrect as it is not necessary to abstain from food for a hematopoietic stem cell transplantation. Choice C is irrelevant to the situation as wearing a hospital gown is not the key information for family and friends to be aware of.

2. A patient with non-Hodgkin's lymphoma is receiving information from the oncology nurse. The patient asks the nurse why she should stop drinking and smoking and stay out of the sun. What would be the nurse's best response?

• A. Everyone should do these things because they are health promotion activities that apply to everyone.
• B. You don't want to develop a second cancer, do you?
• C. You need to do this just to be on the safe side.
• D. It's important to reduce other factors that increase the risk of second cancers.

Correct answer: D

Rationale: The nurse should encourage patients to reduce other factors that increase the risk of developing second cancers, such as the use of tobacco and alcohol and exposure to environmental carcinogens and excessive sunlight. Choice A is too general and does not address the specific concerns of a cancer patient. Choice B uses fear tactics, which may not be the most effective approach. Choice C is vague and does not provide a clear rationale for the behavior change, unlike Choice D which specifically links the behaviors to reducing the risk of second cancers.

3. A client with breast cancer is receiving doxorubicin (Adriamycin). The nurse monitors the client closely for:

• A. Pulmonary fibrosis
• B. Cardiotoxicity
• C. Hepatotoxicity
• D. Nephrotoxicity

Correct answer: B

Rationale: Doxorubicin (Adriamycin) is an anthracycline chemotherapy agent commonly used to treat various cancers, including breast cancer. One of the significant side effects associated with doxorubicin is cardiotoxicity, which can lead to serious complications such as heart failure and arrhythmias. The risk of cardiotoxicity is dose-dependent, meaning that higher cumulative doses increase the likelihood of cardiac damage. Therefore, it is essential for nurses to monitor cardiac function closely through assessments such as echocardiograms or monitoring for signs and symptoms of heart failure, such as shortness of breath, fatigue, and edema.

4. A nurse is caring for a patient with myelodysplastic syndrome (MDS) who is at risk for anemia. What is the most appropriate intervention to address this risk?

• A. Administering iron supplements
• B. Administering blood transfusions
• C. Providing a high-iron diet
• D. Administering erythropoietin

Correct answer: D

Rationale: In myelodysplastic syndrome (MDS), the bone marrow does not produce enough healthy blood cells, leading to conditions such as anemia. Administering erythropoietin is an effective intervention to manage anemia in MDS patients because it stimulates the production of red blood cells. This can help improve the patient’s hemoglobin levels, reducing symptoms such as fatigue and weakness associated with anemia. Erythropoietin is commonly used in MDS to enhance red blood cell production and reduce the need for frequent blood transfusions.

5. A nurse is caring for a patient diagnosed with essential thrombocythemia (ET) who is at risk for thromboembolic events. What nursing intervention is most appropriate for this patient?

• A. Encouraging regular physical activity
• B. Administering anticoagulant therapy
• C. Monitoring for signs of bleeding
• D. Monitoring for signs of infection

Correct answer: B

Rationale: Administering anticoagulant therapy is crucial to prevent thromboembolic events in patients with ET.

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