Nursing Elites

1. A nurse works with clients who have alopecia from chemotherapy. What action by the nurse takes priority?

• A. Helping clients adjust to their appearance.
• B. Reassuring clients that this change is temporary.
• C. Referring clients to a reputable wig shop.
• D. Teaching measures to prevent scalp injury.

Correct answer: D

Rationale: The correct answer is D: Teaching measures to prevent scalp injury. Alopecia makes the scalp more vulnerable to injury, so educating clients on protective measures is crucial. Choices A and B focus on emotional support and reassurance, which are important but secondary to physical safety. Referring clients to a wig shop (choice C) addresses appearance but does not directly address the physical risk associated with scalp vulnerability.

2. A nurse is caring for a client with thrombocytopenia. Which action is the highest priority to reduce the risk of bleeding?

• A. Use an electric razor instead of a straight razor.
• B. Apply pressure to any bleeding sites for at least 5 minutes.
• C. Avoid invasive procedures unless absolutely necessary.
• D. Monitor for signs of internal bleeding.

Correct answer: C

Rationale: The highest priority action to reduce the risk of bleeding in a client with thrombocytopenia is to avoid invasive procedures unless absolutely necessary. Thrombocytopenia is a condition characterized by a low platelet count, which impairs the blood's ability to clot properly. By avoiding invasive procedures, the nurse minimizes the potential for bleeding episodes that could be challenging to control due to the low platelet count. Using an electric razor instead of a straight razor (Choice A) is a good practice to prevent cuts, but it is not as critical as avoiding invasive procedures in this scenario. Applying pressure to bleeding sites (Choice B) and monitoring for signs of internal bleeding (Choice D) are important interventions but are secondary to the priority of preventing bleeding by avoiding invasive procedures.

3. Nurse Ben is reviewing the laboratory results of a client undergoing chemotherapy. Which of the following values would require immediate intervention?

• A. Platelet count of 150,000/mm3
• B. White blood cell count of 6,000/mm3
• C. Hemoglobin level of 14 g/dL
• D. Absolute neutrophil count of 500/mm3

Correct answer: D

Rationale: An absolute neutrophil count of 500/mm3 indicates severe neutropenia, putting the client at high risk for infection. Neutrophils are crucial in fighting off infections; a low count increases susceptibility to infections. Platelet count, white blood cell count, and hemoglobin levels are within normal ranges and do not require immediate intervention in this scenario.

4. The nurse is teaching a client about the signs of infection after chemotherapy. Which of the following should the nurse emphasize?

• A. Frequent urination
• B. Increased thirst
• C. Chills and shaking
• D. Fever over 100.4°F (38°C)

Correct answer: D

Rationale: In clients undergoing chemotherapy, the immune system is often compromised due to the effects of treatment, making them more susceptible to infections. A fever over 100.4°F (38°C) is considered a critical sign of infection in these patients and requires immediate medical evaluation. Fever may indicate the presence of an infection that could escalate quickly in immunocompromised individuals, so it is vital for patients to recognize this symptom and seek prompt medical attention.

5. Which of the following is a correct statement by the nurse to a patient under radiation therapy?

• A. Brachytherapy can be performed by a pregnant nurse.
• B. Teletherapy makes the patient radioactive.
• C. Brachytherapy is an internal radiation therapy.
• D. Teletherapy requires proper disposal of feces since it can be a source of radiation.

Correct answer: C

Rationale: The correct answer is C: 'Brachytherapy is an internal radiation therapy.' Brachytherapy involves the placement of radioactive sources inside or next to the area requiring treatment. This differs from teletherapy, which is external radiation therapy. Choice A is incorrect as pregnant individuals should avoid exposure to radiation. Choice B is incorrect because teletherapy does not make the patient radioactive; the radiation source is external. Choice D is incorrect as feces is not a significant source of radiation during teletherapy.

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