Nursing Elites

1. Nurse Maria is preparing a care plan for a client receiving external radiation therapy. Which of the following interventions should be included?

• A. Use heating pads on the treated area
• B. Wear loose, soft clothing over the treated area
• C. Expose the treated area to sunlight
• D. Apply ice packs to the treated area

Correct answer: B

Rationale: Radiation therapy can cause skin irritation, dryness, and sensitivity in the treated area. Wearing loose, soft clothing helps minimize friction and pressure on the skin, reducing irritation and promoting comfort. The skin in the treated area is often more sensitive and vulnerable to damage, so this intervention helps protect the skin while maintaining the client’s comfort during the course of treatment.

2. A nurse practitioner is assessing a patient who has a fever, malaise, and a white blood cell count that is elevated. Which of the following principles should guide the nurses management of the patients care?

• A. There is a need for the patient to be assessed for lymphoma.
• B. Infection is the most likely cause of the patients change in health status.
• C. The patient is exhibiting signs and symptoms of leukemia.
• D. The patient should undergo diagnostic testing for multiple myeloma.

Correct answer: B

Rationale: An elevated white blood cell (WBC) count, also known as leukocytosis, is most commonly a response to infection. When the body detects an infection, the immune system responds by increasing the production of white blood cells to fight off the invading pathogens. The accompanying symptoms of fever and malaise are typical signs of infection, supporting the likelihood that this patient’s health status is related to an infectious process rather than a more serious hematologic condition like lymphoma or leukemia.

3. An adult patient has presented to the health clinic with a complaint of a firm, painless cervical lymph node. The patient denies any recent infectious diseases. What is the nurse's most appropriate response to the patient's complaint?

• A. Call 911.
• B. Promptly refer the patient for medical assessment.
• C. Facilitate a radiograph of the patient's neck and have the results forwarded to the patient's primary care provider.
• D. Encourage the patient to track the size of the lymph node and seek care in 1 week.

Correct answer: B

Rationale: The most appropriate response for a patient presenting with a firm, painless cervical lymph node and denying recent infectious diseases is to promptly refer the patient for medical assessment. This is crucial to rule out serious underlying conditions such as malignancy or other concerning causes. Calling 911 is not necessary in this situation as it is not an emergency. Ordering a radiograph may not be the most immediate or appropriate action, as further evaluation by a healthcare provider is needed first. Encouraging the patient to wait and track the lymph node for a week is not advisable when a potential serious condition needs to be ruled out promptly.

4. Diagnostic testing has resulted in a diagnosis of acute myeloid leukemia (AML) in an adult patient who is otherwise healthy. The patient and the care team have collaborated and the patient will soon begin induction therapy. The nurse should prepare the patient for which of the following?

• A. Daily treatment with targeted therapy medications
• B. Radiation therapy on a daily basis
• C. Hematopoietic stem cell transplantation
• D. An aggressive course of chemotherapy

Correct answer: D

Rationale: Attempts are made to achieve remission of AML by the aggressive administration of chemotherapy.

5. A patient with non-Hodgkin's lymphoma is receiving information from the oncology nurse. The patient asks the nurse why she should stop drinking and smoking and stay out of the sun. What would be the nurse's best response?

• A. Everyone should do these things because they are health promotion activities that apply to everyone.
• B. You don't want to develop a second cancer, do you?
• C. You need to do this just to be on the safe side.
• D. It's important to reduce other factors that increase the risk of second cancers.

Correct answer: D

Rationale: The nurse should encourage patients to reduce other factors that increase the risk of developing second cancers, such as the use of tobacco and alcohol and exposure to environmental carcinogens and excessive sunlight. Choice A is too general and does not address the specific concerns of a cancer patient. Choice B uses fear tactics, which may not be the most effective approach. Choice C is vague and does not provide a clear rationale for the behavior change, unlike Choice D which specifically links the behaviors to reducing the risk of second cancers.

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