Nursing Elites

1. A patient who is undergoing consolidation therapy for the treatment of leukemia has been experiencing debilitating fatigue. How can the nurse best meet this patients needs for physical activity?

• A. Teach the patient about the risks of immobility and the benefits of exercise.
• B. Assist the patient to a chair during awake times, as tolerated.
• C. Collaborate with the physical therapist to arrange for stair exercises.
• D. Teach the patient to perform deep breathing and coughing exercises.

Correct answer: B

Rationale: For patients undergoing consolidation therapy for leukemia, severe fatigue is a common side effect of treatment due to factors such as anemia, decreased nutritional intake, and the body’s response to chemotherapy. While exercise is beneficial, the patient's fatigue may limit their ability to engage in strenuous activity. Assisting the patient to sit in a chair during awake times is a practical way to encourage some physical activity while respecting their fatigue levels. This intervention helps prevent complications associated with immobility, such as muscle atrophy and venous stasis, without overwhelming the patient. It allows the patient to engage in light activity that is manageable and promotes recovery.

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. An oncology patient will begin a course of chemotherapy and radiation therapy for the treatment of bone metastases. What is one means by which malignant disease processes transfer cells from one place to another?

• A. Adhering to primary tumor cells
• B. Inducing mutation of cells of another organ
• C. Phagocytizing healthy cells
• D. Invading healthy host tissues

Correct answer: D

Rationale: The correct answer is D: Invading healthy host tissues. Invasion is the process where malignant cells grow into surrounding healthy tissues, allowing the cancer to spread to other parts of the body. Choices A, B, and C are incorrect. Adhering to primary tumor cells does not involve the transfer of cells to other locations, inducing mutation of cells of another organ is not a mechanism of cell transfer, and phagocytizing healthy cells refers to the process of engulfing and digesting cells, which is not a method of cancer cell transfer.

4. A 60-year-old patient with chronic myeloid leukemia will be treated in the home setting and the nurse is preparing appropriate health education. What topic should the nurse emphasize?

• A. The importance of adhering to the prescribed drug regimen
• B. The need to ensure that vaccinations are up to date
• C. The importance of daily physical activity
• D. The need to avoid shellfish and raw foods

Correct answer: A

Rationale: Chronic myeloid leukemia (CML) is typically treated with targeted therapies, such as tyrosine kinase inhibitors (TKIs), which can help control the disease and prolong survival. The effectiveness of these medications relies heavily on strict adherence to the prescribed drug regimen. Patients need to take their medication consistently and as directed to maintain therapeutic drug levels and effectively manage the disease. Non-adherence can lead to disease progression or resistance to treatment, which is why it is crucial for the nurse to emphasize this point during health education.

5. What advice should the oncology nurse give to a client planning a beach vacation after completing radiation treatments for cancer?

• A. Avoid getting salt water on the radiation site.
• B. Do not expose the radiation area to direct sunlight.
• C. Have a wonderful time and enjoy your vacation!
• D. Remember you should not drink alcohol for a year.

Correct answer: B

Rationale: The correct answer is B because the skin at the radiation site is sensitive to sunlight, and exposure can cause further damage. It is crucial to protect the area from direct sunlight to prevent skin irritation or burns. Choice A is incorrect as salt water typically does not pose a significant risk to the radiation site. Choice C is a positive and encouraging response but does not provide necessary advice for post-radiation care. Choice D, while important in some cases, is not directly related to the client's beach vacation after completing radiation treatments.

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