Nursing Elites

1. The nurse has taught a client with cancer ways to prevent infection. What statement by the client indicates that more teaching is needed?

• A. I should take my temperature daily and when I don’t feel well.
• B. I will discard perishable liquids after sitting out for over an hour.
• C. I won’t let anyone share any of my personal toiletries.
• D. It’s alright for me to keep my pets and change the litter box.

Correct answer: D

Rationale: Clients with cancer, especially those undergoing chemotherapy or other immunosuppressive treatments, are at increased risk for infections due to a weakened immune system. Changing a litter box exposes the client to pathogens such as Toxoplasma gondii and other harmful bacteria or parasites found in cat feces, which could lead to serious infections. It is recommended that immunocompromised individuals avoid activities like changing litter boxes to reduce their risk of exposure to infectious agents. A family member or caregiver should handle this task to protect the client.

2. An oncology nurse educator is providing health education to a patient who has been diagnosed with skin cancer. The patient’s wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?

• A. Malignant cells contain more fibronectin than normal body cells.
• B. Malignant cells contain proteins called tumor-specific antigens.
• C. Chromosomes contained in cancer cells are more durable and stable than those of normal cells.
• D. The nuclei of cancer cells are unusually large, but regularly shaped.

Correct answer: B

Rationale: Malignant (cancer) cells often express tumor-specific antigens (TSAs), which are proteins or markers on the surface of cancer cells that are not found on normal cells. These antigens are produced due to genetic mutations in cancer cells and can sometimes be used to help the immune system recognize and attack cancerous cells. Tumor-specific antigens play a key role in cancer diagnosis, monitoring, and targeted therapies.

3. A nurse works with clients who have alopecia from chemotherapy. What action by the nurse takes priority?

• A. Helping clients adjust to their appearance.
• B. Reassuring clients that this change is temporary.
• C. Referring clients to a reputable wig shop.
• D. Teaching measures to prevent scalp injury.

Correct answer: D

Rationale: The correct answer is D: Teaching measures to prevent scalp injury. Alopecia makes the scalp more vulnerable to injury, so educating clients on protective measures is crucial. Choices A and B focus on emotional support and reassurance, which are important but secondary to physical safety. Referring clients to a wig shop (choice C) addresses appearance but does not directly address the physical risk associated with scalp vulnerability.

4. When working with clients experiencing alopecia, what is the best method for a nurse to help them manage the psychosocial impact of this issue?

• A. Assisting the client in pre-planning for this event.
• B. Reassuring the client that alopecia is temporary.
• C. Teaching the client ways to protect the scalp.
• D. Telling the client that there are worse side effects.

Correct answer: A

Rationale: Assisting the client in pre-planning for alopecia is the best method to help them manage the psychosocial impact of the issue. By helping clients anticipate and prepare for the challenges associated with alopecia, they can cope better with the psychological impact. Reassuring the client that alopecia is temporary (choice B) may provide false hope as some types of alopecia are permanent. Teaching ways to protect the scalp (choice C) is important but not the most effective method for managing the psychosocial impact. Telling the client that there are worse side effects (choice D) is dismissive of the client's feelings and not helpful in addressing the psychosocial impact of alopecia.

5. The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the client identifies which item as an associated risk factor?

• A. Age younger than 50 years
• B. History of colorectal polyps
• C. Family history of colorectal cancer
• D. Chronic inflammatory bowel disease

Correct answer: A

Rationale: The correct answer is A: Age younger than 50 years. Colorectal cancer is more commonly diagnosed in individuals over the age of 50, so being younger than 50 is not typically considered a significant risk factor. Choice B, history of colorectal polyps, is a known risk factor as polyps can develop into cancer over time. Choice C, family history of colorectal cancer, is a well-established risk factor due to genetic predisposition. Choice D, chronic inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, increases the risk of developing colorectal cancer. Therefore, the incorrect choice is A as age younger than 50 years is not a common risk factor for colorectal cancer.

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