Nursing Elites

1. The nurse is caring for a client with multiple myeloma and is monitoring the client for signs of hypercalcemia. Which symptom would be an early indication?

• A. Polyuria
• B. Polyphagia
• C. Polydipsia
• D. Weight loss

Correct answer: A

Rationale: In patients with multiple myeloma, hypercalcemia is a common complication due to the release of calcium from the bones as a result of osteolytic lesions. One of the early symptoms of hypercalcemia is polyuria, or increased urine output. This occurs because elevated calcium levels can lead to impaired renal function and increased renal excretion of calcium, which results in increased urine production. Early recognition of polyuria can help prompt further evaluation and management of hypercalcemia, as untreated hypercalcemia can lead to more severe complications.

2. A nurse in the oncology clinic is providing preoperative education to a client just diagnosed with cancer. The client has been scheduled for surgery in 3 days. What action by the nurse is best?

• A. Call the client at home the next day to review teaching.
• B. Give the client information about a cancer support group.
• C. Provide all the preoperative instructions in writing.
• D. Reassure the client that surgery will be over soon.

Correct answer: A

Rationale: Clients are often overwhelmed by a sudden cancer diagnosis; therefore, it is best for the nurse to call the client at home the next day to review teaching. This approach allows the client time to process the information before the surgery. Choice B may be beneficial but is not the priority at this time. Providing written instructions (Choice C) is helpful but does not offer the personalized interaction needed. Reassuring the client (Choice D) is important but does not address the educational aspect of preoperative preparation.

3. A client has been prescribed epoetin alfa for anemia related to chemotherapy. What lab value should the nurse monitor to determine the effectiveness of this medication?

• A. Hemoglobin level.
• B. Hematocrit level.
• C. White blood cell count.
• D. Platelet count.

Correct answer: A

Rationale: Epoetin alfa is a medication used to treat anemia, particularly anemia related to chemotherapy or chronic kidney disease. It stimulates the bone marrow to produce more red blood cells, which increases the hemoglobin level. Monitoring hemoglobin is the best way to assess the effectiveness of epoetin alfa, as an increase in hemoglobin indicates that the body is producing more red blood cells and the anemia is improving.

4. You are caring for a patient who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the patient the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer?

• A. Palliative
• B. Reconstructive
• C. Salvage
• D. Prophylactic

Correct answer: A

Rationale: The correct answer is A: Palliative. Palliative surgery is aimed at relieving symptoms and improving quality of life when a cure is not possible. In this scenario, where the cancer has recurred and metastasized, the goal of surgery would be to alleviate symptoms rather than to cure the disease. Choices B, C, and D are incorrect because reconstructive surgery aims to restore function or appearance, salvage surgery aims to remove or salvage tissue to prevent further complications, and prophylactic surgery aims to prevent the development of a condition rather than treat its progression.

5. The healthcare professional working with oncology clients understands that which age-related change increases the older client’s susceptibility to infection during chemotherapy?

• A. Decreased immune function.
• B. Diminished nutritional stores.
• C. Existing cognitive deficits.
• D. Poor physical reserves.

Correct answer: A

Rationale: The correct answer is A: Decreased immune function. Aging leads to a decline in immune function, which increases susceptibility to infections during chemotherapy. This decline is due to changes in the immune system that occur with age. Choices B, C, and D are incorrect because while they may impact overall health in older clients, they do not directly increase susceptibility to infections during chemotherapy like decreased immune function does.

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