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. The home health care nurse is caring for a client with cancer who is complaining of acute pain. The most appropriate determination of the client's pain should include which assessment?

• A. The client's pain rating
• B. Nonverbal cues from the client
• C. The nurse's impression of the client's pain
• D. Pain relief after appropriate nursing intervention

Correct answer: A

Rationale: The correct answer is A: The client's pain rating. Pain assessment should primarily rely on the client's self-report for the most accurate determination of pain intensity. Nonverbal cues from the client (choice B) can provide additional information but should not replace the client's self-report. The nurse's impression of the client's pain (choice C) may be subjective and less reliable than the client's self-assessment. Pain relief after appropriate nursing intervention (choice D) is an important outcome but does not replace the initial assessment of the client's pain.

3. An emergency department nurse is triaging a 77-year-old man who presents with uncharacteristic fatigue as well as back and rib pain. The patient denies any recent injuries. The nurse should recognize the need for this patient to be assessed for what health problem?

• A. Hodgkin disease
• B. Non-Hodgkin lymphoma
• C. Multiple myeloma
• D. Acute thrombocythemia

Correct answer: C

Rationale: The correct answer is multiple myeloma (choice C). Back pain is a common presenting symptom in multiple myeloma, especially in older patients. This malignancy can lead to bone pain due to bone destruction and fractures. Hodgkin disease (choice A) and Non-Hodgkin lymphoma (choice B) typically present with symptoms like painless lymph node enlargement, fever, and weight loss. Acute thrombocythemia (choice D) is characterized by an increase in platelet count but is not typically associated with the symptoms described by the patient.

4. Nurse Kent is teaching a male client to perform monthly testicular self-examinations. Which of the following points would be appropriate to make?

• A. Testicular cancer is a highly curable type of cancer
• B. Testicular cancer is very difficult to diagnose.
• C. Testicular cancer is the number one cause of cancer deaths in males.
• D. Testicular cancer is more common in older men.

Correct answer: A

Rationale: Testicular cancer is indeed highly treatable and curable, particularly when detected early through regular self-examinations. The survival rates for testicular cancer are very high, with many cases being treatable even if the cancer has spread, thanks to effective treatment options such as surgery, chemotherapy, and radiation therapy. Educating clients on the importance of early detection through monthly testicular self-examinations can empower them to recognize any changes early, increasing the likelihood of successful treatment.

5. A client with cancer is admitted to a short-term rehabilitation facility. The nurse prepares to administer the client’s oral chemotherapy medications. What action by the nurse is most appropriate?

• A. Crush the medications if the client cannot swallow them.
• B. Give one medication at a time with a full glass of water.
• C. No special precautions are needed for these medications.
• D. Wear personal protective equipment when handling the medications.

Correct answer: D

Rationale: Oral chemotherapy requires the same precautions as IV chemotherapy; personal protective equipment is necessary.

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