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. Which of the following is a correct statement by the nurse to a patient under radiation therapy?

• A. Brachytherapy can be administered by a pregnant nurse
• B. Teletherapy makes the patient radioactive
• C. Brachytherapy is an internal radiation therapy
• D. Teletherapy requires proper disposal of feces since feces is not a source of radiation

Correct answer: C

Rationale: The correct statement is that Brachytherapy is an internal radiation therapy. Brachytherapy involves placing radioactive sources inside or near the tumor, delivering a high radiation dose to the targeted area while minimizing exposure to surrounding healthy tissues. Choices A and B are incorrect because pregnant nurses should not administer radiation therapy and brachytherapy does not make the patient radioactive. Choice D is incorrect as feces is not a source of radiation in teletherapy, and it does not require special disposal.

3. A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem?

• A. The patient requests that her family bring her makeup and wig.
• B. The patient begins to discuss the future with her family.
• C. The patient reports less disruption from pain and discomfort.
• D. The patient cries openly when discussing her disease.

Correct answer: A

Rationale: When a patient experiences alopecia due to chemotherapy, it can significantly impact their self-esteem and body image, particularly in adolescents who are especially sensitive to physical changes. A request for makeup and a wig indicates that the patient is actively taking steps to enhance her appearance and cope with the changes brought on by her treatment. This action reflects a positive engagement with her body image and suggests a desire to feel more comfortable and confident in her appearance, signaling an improvement in her self-esteem.

4. A client is admitted to the hospital with a suspected diagnosis of Hodgkin’s disease. Which assessment finding would the nurse expect to note specifically in the client?

• A. Fatigue
• B. Weakness
• C. Weight gain
• D. Enlarged lymph nodes

Correct answer: D

Rationale: Hodgkin’s disease (Hodgkin’s lymphoma) is a type of cancer that originates in the lymphatic system, particularly affecting the lymph nodes. A hallmark sign of Hodgkin’s disease is the painless enlargement of lymph nodes, often in the neck, armpit, or groin. These enlarged lymph nodes are typically firm and rubbery to the touch. This is one of the most distinctive and common early signs that healthcare providers look for when diagnosing the disease.

5. 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.

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