Nursing Elites

1. Nurse Joy is caring for a client with cancer who has been receiving cisplatin (Platinol-AQ). Which laboratory result requires an intervention by the nurse?

• A. White blood cell count of 6000 cells/microL
• B. Serum potassium level of 3.5 mEq/L
• C. Blood urea nitrogen (BUN) of 18 mg/dL
• D. Platelet count of 150,000 cells/microL

Correct answer: C

Rationale: The correct answer is C. A BUN level of 18 mg/dL is within the normal range; however, since cisplatin is nephrotoxic, it requires close monitoring. Elevated BUN levels can indicate impaired kidney function. Choices A, B, and D are within normal ranges and do not directly relate to cisplatin therapy or require immediate intervention.

2. A nurse is caring for a patient whose diagnosis of multiple myeloma is being treated with bortezomib. The nurse should assess for what adverse effect of this treatment?

• A. Stomatitis
• B. Nephropathy
• C. Cognitive changes
• D. Peripheral neuropathy

Correct answer: D

Rationale: The correct answer is D: Peripheral neuropathy. Bortezomib, used in the treatment of multiple myeloma, is known to cause peripheral neuropathy as a significant adverse effect. Stomatitis (Choice A), which is inflammation of the mouth and lips, is not a common adverse effect of bortezomib. Nephropathy (Choice B), referring to kidney disease, is not a typical adverse effect of bortezomib. Cognitive changes (Choice C) are not a commonly reported adverse effect of bortezomib treatment.

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. A patient was admitted with gastric cancer. The patient asks the nurse about things to expect while receiving chemotherapy. Which of the following statements of the nurse shows incompetence?

• A. You can expect hair loss, but do not worry it will grow back immediately
• B. You may be infected easily, so avoid going to overpopulated places
• C. We may need to monitor your uric acid levels
• D. We may need to monitor your RBCs

Correct answer: A

Rationale: While hair loss (alopecia) is a common side effect of chemotherapy due to the damage to rapidly dividing hair follicle cells, the statement that hair will grow back "immediately" is inaccurate and misleading. Hair regrowth after chemotherapy takes time, typically starting a few weeks to months after treatment ends. The new hair may also have a different texture or color initially. Therefore, this statement indicates a lack of understanding and could give the patient unrealistic expectations, which is why it shows incompetence.

5. A patient with non-Hodgkin lymphoma (NHL) is receiving treatment. What is the most important assessment for the nurse to make in this patient?

• A. Skin integrity
• B. Nutritional status
• C. Respiratory function
• D. Cognitive function

Correct answer: C

Rationale: The correct answer is C: Respiratory function. In a patient with non-Hodgkin lymphoma (NHL), monitoring respiratory function is crucial due to the potential for complications such as pleural effusion or pneumonia. Assessing skin integrity (choice A) is important but not as critical as monitoring respiratory function in this case. Nutritional status (choice B) and cognitive function (choice D) are also important aspects of care but do not take precedence over assessing respiratory function in a patient with NHL undergoing treatment.

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