Nursing Elites

1. During the admission assessment of a client with advanced ovarian cancer, the nurse recognizes which symptom as typical of the disease?

• A. Diarrhea
• B. Hypermenorrhea
• C. Abnormal bleeding
• D. Abdominal distention

Correct answer: D

Rationale: Abdominal distention is a common symptom in advanced ovarian cancer due to several factors, including the accumulation of ascites (fluid in the abdominal cavity) and the presence of tumors that can increase abdominal girth. As the disease progresses, the pressure from growing masses or fluid buildup can lead to noticeable swelling and discomfort in the abdomen. This symptom often prompts further evaluation and can significantly impact the patient’s quality of life.

2. A client is receiving chemotherapy through a peripheral IV line. What action by the nurse is most important?

• A. Assessing the IV site and blood return every hour.
• B. Educating the client on side effects.
• C. Monitoring the client for nausea.
• D. Providing warm packs for comfort.

Correct answer: A

Rationale: Chemotherapy drugs are often vesicants, meaning they can cause severe tissue damage if they leak (extravasate) outside of the vein. When chemotherapy is administered through a peripheral IV line, it is crucial for the nurse to frequently assess the IV site for signs of complications such as redness, swelling, or pain, which could indicate extravasation. Checking for blood return ensures the IV catheter is still in the vein and functioning properly. Preventing tissue damage from chemotherapy extravasation is a top priority, and frequent monitoring helps ensure the infusion is proceeding safely.

3. The nurse is caring for a client following radical neck dissection and creation of a tracheostomy. Which assessment finding would indicate an immediate need for intervention?

• A. Frequent swallowing
• B. Presence of mucous membranes
• C. Bubbling in the water-seal chamber
• D. Inspiratory stridor

Correct answer: D

Rationale: Inspiratory stridor is the correct answer as it suggests airway obstruction, a critical issue requiring immediate intervention. Frequent swallowing (choice A) is a common postoperative finding and does not indicate an immediate need for intervention. The presence of mucous membranes (choice B) is a normal finding and does not require immediate intervention. Bubbling in the water-seal chamber (choice C) of a chest tube drainage system is an expected finding and indicates proper functioning of the system, not an immediate need for intervention.

4. An oncology nurse is caring for a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patient's most recent blood tests, the nurse should anticipate what imbalance?

• A. Hypercalcemia
• B. Hyperproteinemia
• C. Elevated serum viscosity
• D. Elevated RBC count

Correct answer: A

Rationale: The correct answer is A, Hypercalcemia. In multiple myeloma, bone destruction can lead to the release of calcium from the bones into the bloodstream, causing hypercalcemia. This imbalance is commonly seen in patients with multiple myeloma. Choice B, Hyperproteinemia, is not typically associated with bone destruction in multiple myeloma. Choice C, Elevated serum viscosity, and Choice D, Elevated RBC count, are not directly related to the bone destruction seen in multiple myeloma.

5. The home health care nurse is caring for a client with cancer who is complaining of acute pain. The most appropriate determination of the client's pain should include which assessment?

• A. The client's pain rating
• B. Nonverbal cues from the client
• C. The nurse's impression of the client's pain
• D. Pain relief after appropriate nursing intervention

Correct answer: A

Rationale: The correct answer is A: The client's pain rating. Pain assessment should primarily rely on the client's self-report for the most accurate determination of pain intensity. Nonverbal cues from the client (choice B) can provide additional information but should not replace the client's self-report. The nurse's impression of the client's pain (choice C) may be subjective and less reliable than the client's self-assessment. Pain relief after appropriate nursing intervention (choice D) is an important outcome but does not replace the initial assessment of the client's pain.

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