Nursing Elites

1. A patient has a diagnosis of multiple myeloma and the nurse is preparing health education in preparation for discharge from the hospital. What action should the nurse promote?

• A. Daily performance of weight-bearing exercise to prevent muscle atrophy
• B. Close monitoring of urine output and kidney function
• C. Daily administration of warfarin (Coumadin) as ordered
• D. Safe use of supplementary oxygen in the home setting

Correct answer: B

Rationale: Renal function must be monitored closely in the patient with multiple myeloma.

2. Nurse Maria is preparing a care plan for a client receiving external radiation therapy. Which of the following interventions should be included?

• A. Use heating pads on the treated area
• B. Wear loose, soft clothing over the treated area
• C. Expose the treated area to sunlight
• D. Apply ice packs to the treated area

Correct answer: B

Rationale: Radiation therapy can cause skin irritation, dryness, and sensitivity in the treated area. Wearing loose, soft clothing helps minimize friction and pressure on the skin, reducing irritation and promoting comfort. The skin in the treated area is often more sensitive and vulnerable to damage, so this intervention helps protect the skin while maintaining the client’s comfort during the course of treatment.

3. A client who is at risk for disseminated intravascular coagulation (DIC) has a serum fibrinogen level of 110 mg/dL. The nurse should take which of the following actions first?

• A. Recheck the fibrinogen level in 4 hours
• B. Notify the health care provider
• C. Continue to monitor the client
• D. Administer cryoprecipitate as prescribed

Correct answer: B

Rationale: A serum fibrinogen level of 110 mg/dL indicates a low level, which puts the client at risk for bleeding in DIC. The priority action for the nurse is to notify the health care provider. Rechecking the fibrinogen level may delay necessary interventions, administering cryoprecipitate should be done based on the provider's prescription, and while monitoring is important, immediate notification of the provider is crucial to address the low fibrinogen level promptly.

4. A patient with acute myeloid leukemia (AML) is receiving induction therapy. What is the priority nursing intervention during this phase of treatment?

• A. Administering pain management
• B. Monitoring for signs of infection
• C. Providing emotional support
• D. Monitoring fluid balance

Correct answer: B

Rationale: Induction therapy for acute myeloid leukemia (AML) involves intensive chemotherapy aimed at achieving remission by eliminating a large number of cancerous cells. However, this aggressive treatment also severely reduces the production of healthy blood cells, including neutrophils, which leads to neutropenia (a dangerously low number of neutrophils). This makes the patient highly susceptible to infections, which can be life-threatening. Monitoring for signs of infection is critical during this phase, as infections may occur quickly and progress rapidly due to the compromised immune system. Early detection and prompt treatment of infections are vital to improving patient outcomes during induction therapy.

5. 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.

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