Nursing Elites

1. Nurse Jane is providing care for a client with superior vena cava syndrome. Which of the following interventions would be the priority?

• A. Elevate the head of the bed
• B. Administer steroids as prescribed
• C. Provide supplemental oxygen
• D. Administer diuretics as prescribed

Correct answer: A

Rationale: The correct answer is to elevate the head of the bed. Elevating the head of the bed can help reduce the pressure on the superior vena cava, improve venous return, and facilitate breathing in clients with superior vena cava syndrome. Administering steroids (Choice B) may be necessary in some cases, but it is not the priority in the immediate care of a client with superior vena cava syndrome. Providing supplemental oxygen (Choice C) may help improve oxygenation but does not directly address the underlying issue of venous congestion. Administering diuretics (Choice D) may be contraindicated as it can further decrease preload and worsen the condition in superior vena cava syndrome.

2. A client is diagnosed with multiple myeloma and the client asks the nurse about the diagnosis. The nurse bases the response on which description of this disorder?

• A. Altered red blood cell production
• B. Altered production of lymph nodes
• C. Malignant exacerbation in the number of leukocytes
• D. Malignant proliferation of plasma cells within the bone

Correct answer: D

Rationale: Multiple myeloma is a type of cancer that involves the malignant proliferation of plasma cells, which are a type of white blood cell that produces antibodies. In multiple myeloma, these abnormal plasma cells accumulate in the bone marrow, where they interfere with the production of normal blood cells and lead to the formation of tumors in the bones. This can cause bone pain, fractures, anemia, and impaired immune function. The excessive production of abnormal antibodies can also result in kidney damage and other systemic complications.

3. An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do?

• A. Periodically apply ice to the area.
• B. Keep the area cleanly shaven.
• C. Apply petroleum jelly to the affected area.
• D. Avoid using soap on the treatment area.

Correct answer: D

Rationale: The correct answer is D. When a patient develops erythema following radiation therapy, it is essential to avoid further irritation and potential infection. Using soap on the affected area can exacerbate the condition. Applying ice (choice A) may provide temporary relief for discomfort but does not address the underlying issue. Keeping the area cleanly shaven (choice B) is not necessary and may increase the risk of skin irritation. Applying petroleum jelly (choice C) can trap heat and worsen the erythema, so it is not recommended.

4. A client with cancer is receiving palliative care. Which statement by the client indicates an understanding of palliative care?

• A. Palliative care focuses on managing symptoms and improving quality of life.
• B. Palliative care is only provided when curative treatment is no longer an option.
• C. Palliative care includes interventions to prolong life at all costs.
• D. Palliative care provides support for both the client and their family.

Correct answer: A

Rationale: The correct answer is A. Palliative care focuses on managing symptoms and improving the quality of life for clients with serious illnesses like cancer. Choice B is incorrect as palliative care can be provided alongside curative treatments. Choice C is incorrect because palliative care does not aim to prolong life at all costs; it focuses on improving the quality of life. Choice D is partially correct but does not fully capture the essence of palliative care, which includes symptom management and holistic support for the client and their family.

5. A client with cancer is admitted to a short-term rehabilitation facility. The nurse prepares to administer the client’s oral chemotherapy medications. What action by the nurse is most appropriate?

• A. Crush the medications if the client cannot swallow them.
• B. Give one medication at a time with a full glass of water.
• C. No special precautions are needed for these medications.
• D. Wear personal protective equipment when handling the medications.

Correct answer: D

Rationale: Oral chemotherapy requires the same precautions as IV chemotherapy; personal protective equipment is necessary.

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