Nursing Elites

1. The nurse is caring for a female client experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. The nurse plans to:

• A. Restrict all visitors
• B. Restrict fluid intake
• C. Teach the client and family about the need for hand hygiene
• D. Insert an indwelling urinary catheter to prevent skin breakdown

Correct answer: C

Rationale: In clients experiencing neutropenia due to chemotherapy, the immune system is significantly compromised, leaving the client highly susceptible to infections. Meticulous hand hygiene is one of the most effective ways to prevent infections in neutropenic patients. Teaching the client and their family the importance of frequent and proper handwashing helps reduce the transmission of harmful pathogens that could lead to severe infections in the neutropenic client. This simple but essential intervention is crucial in maintaining a safe environment.

2. A nurse is preparing to administer filgrastim to a client undergoing chemotherapy. What is the primary purpose of this medication?

• A. Increase white blood cell production.
• B. Reduce the risk of infection.
• C. Enhance red blood cell production.
• D. Control chemotherapy-induced nausea and vomiting.

Correct answer: A

Rationale: Filgrastim is primarily used to increase white blood cell production in clients undergoing chemotherapy.

3. A patient with myelofibrosis is being treated with ruxolitinib. What should the nurse monitor to assess the effectiveness of this treatment?

• A. Blood pressure
• B. White blood cell count
• C. Hemoglobin and hematocrit
• D. Spleen size

Correct answer: C

Rationale: Monitoring hemoglobin and hematocrit is essential to assess the effectiveness of ruxolitinib in treating myelofibrosis. Ruxolitinib works by inhibiting JAK1 and JAK2, which are involved in the signaling pathways that regulate blood cell production. Therefore, monitoring hemoglobin and hematocrit levels can provide valuable information on how well the drug is managing the disease. Blood pressure, white blood cell count, and spleen size are not direct indicators of the treatment's effectiveness in myelofibrosis.

4. A client with cancer is receiving palliative care. Which statement by the client indicates an understanding of palliative care?

• A. Palliative care focuses on managing symptoms and improving quality of life.
• B. Palliative care is only provided when curative treatment is no longer an option.
• C. Palliative care includes interventions to prolong life at all costs.
• D. Palliative care provides support for both the client and their family.

Correct answer: A

Rationale: The correct answer is A. Palliative care focuses on managing symptoms and improving the quality of life for clients with serious illnesses like cancer. Choice B is incorrect as palliative care can be provided alongside curative treatments. Choice C is incorrect because palliative care does not aim to prolong life at all costs; it focuses on improving the quality of life. Choice D is partially correct but does not fully capture the essence of palliative care, which includes symptom management and holistic support for the client and their family.

5. After undergoing mastectomy, a patient demonstrates understanding of the nurse's instructions by doing which of the following?

• A. Dangle arms at the bedside
• B. Lie down on the affected chest
• C. Drink plenty of fluids immediately after surgery
• D. Elevate the affected arm

Correct answer: D

Rationale: The correct answer is to elevate the affected arm. Elevating the affected arm helps prevent lymphedema after a mastectomy. Choices A, B, and C are incorrect. 'Dangling arms at the bedside' does not provide any benefit after a mastectomy. 'Lying down on the affected chest' can cause discomfort and possible complications. 'Drinking plenty of fluids immediately after surgery' is not related to preventing lymphedema post-mastectomy.

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