Nursing Elites

1. A patient with multiple myeloma is receiving chemotherapy and is at risk for bone fractures. What intervention should the nurse prioritize to reduce this risk?

• A. Encouraging bed rest
• B. Promoting bed rest to avoid injury
• C. Encouraging weight-bearing exercises
• D. Ensuring adequate hydration

Correct answer: B

Rationale: The correct answer is B: 'Promoting bed rest to avoid injury.' In patients with multiple myeloma undergoing chemotherapy, encouraging bed rest can lead to muscle weakness and bone loss, increasing the risk of fractures. Promoting bed rest to avoid injury means advising the patient on safe movement and activities to prevent fractures. Encouraging weight-bearing exercises (choice C) would be more beneficial than bed rest as it helps in maintaining bone density and strength. Ensuring adequate hydration (choice D) is essential for overall health but does not directly address the risk of bone fractures associated with multiple myeloma and chemotherapy. Choice A, 'Encouraging bed rest,' is incorrect as it may worsen the risk of fractures rather than reduce it.

2. A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?

• A. Administer an antiemetic.
• B. Administer an antimetabolite.
• C. Administer a tumor antibiotic.
• D. Administer an anticoagulant.

Correct answer: A

Rationale: The correct answer is A: Administer an antiemetic. Chemotherapy commonly causes nausea and vomiting as adverse effects. Antiemetics are medications specifically used to prevent or treat these symptoms. Choices B, C, and D are incorrect because administering an antimetabolite, a tumor antibiotic, or an anticoagulant would not directly address the most common adverse effects of chemotherapy, which are nausea and vomiting.

3. Nurse Rose is caring for a client with cancer who has developed spinal cord compression. Which of the following symptoms would the nurse expect to find?

• A. Decreased deep tendon reflexes
• B. Severe headache
• C. Back pain
• D. Loss of bladder control

Correct answer: C

Rationale: The correct answer is C: 'Back pain.' Back pain is a common symptom of spinal cord compression in cancer patients. This condition can cause localized or radiating back pain due to the compression of the spinal cord or nerves. While symptoms such as decreased deep tendon reflexes, severe headache, and loss of bladder control can occur in other conditions, back pain is specifically associated with spinal cord compression in cancer patients.

4. The nurse should plan to implement which intervention in the care of a client experiencing neutropenia as a result of chemotherapy?

• A. Restrict all visitors.
• B. Restrict fluid intake.
• C. Teach the client and family about the need for hand hygiene.
• D. Insert an indwelling urinary catheter to prevent skin breakdown.

Correct answer: C

Rationale: In clients experiencing neutropenia, particularly due to chemotherapy, the immune system is significantly compromised, increasing the risk of infections. Hand hygiene is one of the most effective methods for preventing the spread of pathogens that can lead to infections. Teaching both the client and their family about the importance of frequent and proper handwashing helps create a safer environment and reduces the risk of infections, which can be critical in neutropenic patients.

5. 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.

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