Nursing Elites

1. A patient with Hodgkin lymphoma is receiving chemotherapy. Which side effect is the nurse most concerned about?

• A. Nausea and vomiting
• B. Alopecia
• C. Fatigue
• D. Peripheral neuropathy

Correct answer: D

Rationale: The correct answer is D, Peripheral neuropathy. This can be a serious and dose-limiting side effect of chemotherapy for Hodgkin lymphoma. Peripheral neuropathy can cause tingling, numbness, and pain in the hands and feet due to nerve damage. While nausea and vomiting, alopecia, and fatigue are common side effects of chemotherapy, they are not typically as concerning or dose-limiting as peripheral neuropathy in the context of Hodgkin lymphoma treatment.

2. When working with clients experiencing alopecia, what is the best method for a nurse to help them manage the psychosocial impact of this issue?

• A. Assisting the client in pre-planning for this event.
• B. Reassuring the client that alopecia is temporary.
• C. Teaching the client ways to protect the scalp.
• D. Telling the client that there are worse side effects.

Correct answer: A

Rationale: Assisting the client in pre-planning for alopecia is the best method to help them manage the psychosocial impact of the issue. By helping clients anticipate and prepare for the challenges associated with alopecia, they can cope better with the psychological impact. Reassuring the client that alopecia is temporary (choice B) may provide false hope as some types of alopecia are permanent. Teaching ways to protect the scalp (choice C) is important but not the most effective method for managing the psychosocial impact. Telling the client that there are worse side effects (choice D) is dismissive of the client's feelings and not helpful in addressing the psychosocial impact of alopecia.

3. Which of the following management strategies is not included for a patient taking chemotherapeutic drugs?

• A. Limit exposure of pregnant visitors
• B. Protect client from infection
• C. Allow client to use makeup and wig
• D. Administer IV fluids as ordered

Correct answer: C

Rationale: The correct answer is C. Chemotherapy can lead to hair loss, and while using wigs is common, it is not a primary management strategy. The focus should be on limiting exposure to pregnant visitors to prevent harm to the fetus, protecting the client from infections due to a compromised immune system, and administering IV fluids as ordered to maintain hydration levels. Allowing the client to use makeup and wigs is not a primary concern when managing a patient taking chemotherapeutic drugs.

4. A client is having a catheter placed to deliver chemotherapy beads into a liver tumor via the femoral artery. What action by the nurse is most important?

• A. Assessing the client’s abdomen beforehand.
• B. Ensuring that informed consent is on the chart.
• C. Marking the client’s bilateral pedal pulses.
• D. Reviewing client teaching done previously.

Correct answer: B

Rationale: Before any invasive procedure, such as placing a catheter to deliver chemotherapy beads into a liver tumor, it is essential to ensure that informed consent has been obtained from the client. This is a legal and ethical requirement that ensures the client understands the procedure, its risks, benefits, and alternatives. Ensuring that the signed consent is on the chart is the most important action the nurse can take before the procedure, as the procedure cannot legally proceed without it.

5. A nurse at a long-term care facility is amending the care plan of a resident who has just been diagnosed with essential thrombocythemia (ET). The nurse should anticipate the administration of what medication?

• A. Dalteparin
• B. Allopurinol
• C. Hydroxyurea
• D. Hydrochlorothiazide

Correct answer: C

Rationale: Hydroxyurea is effective in lowering the platelet count for patients with ET.

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