Nursing Elites

1. Nurse Joy is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which of the following principles?

• A. Limit the time with the client to 1 hour per shift
• B. Do not allow pregnant women into the client’s room
• C. Remove the dosimeter badge when entering the client’s room
• D. Individuals younger than 16 years old may be allowed to go in the room as long as they are 6 feet away from the client

Correct answer: B

Rationale: Clients with internal radiation implants (also known as brachytherapy) emit a small amount of radiation, which can pose a risk to others. Pregnant women are particularly vulnerable to the harmful effects of radiation because it can affect both the mother and the developing fetus. Radiation exposure can lead to birth defects, miscarriage, or other developmental issues, so pregnant women should avoid any exposure by not entering the client's room.

2. The clinic nurse is caring for a patient whose grandmother and sister have both had breast cancer. She requested a screening test to determine her risk of developing breast cancer and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response?

• A. Research has shown that eating a healthy diet can provide all the protection you need against breast cancer.
• B. Research has shown that taking the drug tamoxifen can reduce your chance of breast cancer.
• C. Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer.
• D. Research has shown that there is little you can do to reduce your risk of breast cancer if you have a genetic predisposition.

Correct answer: B

Rationale: Tamoxifen is a selective estrogen receptor modulator (SERM) that has been shown to significantly reduce the risk of developing breast cancer in women who are at high risk, particularly those with a family history of the disease or a positive genetic test for BRCA mutations. Large-scale studies have demonstrated that tamoxifen can reduce the incidence of breast cancer by up to 50% in high-risk women. It works by blocking estrogen receptors in breast tissue, which helps prevent the development of estrogen receptor-positive breast cancers.

3. The nurse knows that all of the following are risk factors for breast cancer except:

• A. Family history
• B. Nulliparity
• C. Chest xray
• D. Multiple sex partners

Correct answer: D

Rationale: Multiple sex partners are not a recognized risk factor for breast cancer. Breast cancer is primarily influenced by hormonal, genetic, and environmental factors, not sexual activity or the number of sexual partners. Established risk factors for breast cancer include family history, hormonal factors such as early menarche, late menopause, and nulliparity (having no children), as well as certain environmental exposures.

4. A nurse is caring for a client with thrombocytopenia. Which action is the highest priority to reduce the risk of bleeding?

• A. Use an electric razor instead of a straight razor.
• B. Apply pressure to any bleeding sites for at least 5 minutes.
• C. Avoid invasive procedures unless absolutely necessary.
• D. Monitor for signs of internal bleeding.

Correct answer: C

Rationale: The highest priority action to reduce the risk of bleeding in a client with thrombocytopenia is to avoid invasive procedures unless absolutely necessary. Thrombocytopenia is a condition characterized by a low platelet count, which impairs the blood's ability to clot properly. By avoiding invasive procedures, the nurse minimizes the potential for bleeding episodes that could be challenging to control due to the low platelet count. Using an electric razor instead of a straight razor (Choice A) is a good practice to prevent cuts, but it is not as critical as avoiding invasive procedures in this scenario. Applying pressure to bleeding sites (Choice B) and monitoring for signs of internal bleeding (Choice D) are important interventions but are secondary to the priority of preventing bleeding by avoiding invasive procedures.

5. All of the following are warning signs of cancer except:

• A. Patient palpates a bump on the side of the breast
• B. Bruises are found on the body that the client cannot explain
• C. Patient often complains of impaired digestion
• D. Patient has blood-tinged sputum

Correct answer: D

Rationale: The correct answer is D. Blood-tinged sputum is not a typical warning sign of cancer but rather a symptom that can indicate other serious conditions like respiratory issues or infections. Choices A, B, and C are common warning signs of cancer: palpable lumps or bumps, unexplained bruises, and persistent digestive issues are often associated with cancer and should be evaluated by a healthcare professional for further assessment and diagnosis.

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