Nursing Elites

1. The nurse is instructing a client to perform a testicular self-examination (TSE). What information should the nurse provide about the procedure?

• A. To examine the testicles while lying down
• B. That the best time for the examination is after a shower
• C. To gently feel the testicle with one finger to feel for a growth
• D. That testicular self-examinations should be done at least every 6 months

Correct answer: B

Rationale: The correct answer is B. The best time to perform a testicular self-examination is after a warm shower when the scrotal skin is relaxed. This makes it easier to detect any abnormalities. Choice A is incorrect because the examination should ideally be done while standing. Choice C is incorrect as the client should use both hands to roll each testicle between the thumb and fingers to feel for any lumps or changes in size. Choice D is incorrect because testicular self-examinations are recommended to be done monthly, not every 6 months, to monitor changes in the testicles.

2. 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.

3. What advice should the oncology nurse give to a client planning a beach vacation after completing radiation treatments for cancer?

• A. Avoid getting salt water on the radiation site.
• B. Do not expose the radiation area to direct sunlight.
• C. Have a wonderful time and enjoy your vacation!
• D. Remember you should not drink alcohol for a year.

Correct answer: B

Rationale: The correct answer is B because the skin at the radiation site is sensitive to sunlight, and exposure can cause further damage. It is crucial to protect the area from direct sunlight to prevent skin irritation or burns. Choice A is incorrect as salt water typically does not pose a significant risk to the radiation site. Choice C is a positive and encouraging response but does not provide necessary advice for post-radiation care. Choice D, while important in some cases, is not directly related to the client's beach vacation after completing radiation treatments.

4. During a health promotion program on testicular cancer, a community health nurse finds that more information is necessary if a community member says which of the following is a sign of testicular cancer?

• A. Alopecia
• B. Back pain
• C. Painless testicular swelling
• D. Heavy sensation in the scrotum

Correct answer: A

Rationale: The correct answer is A, 'Alopecia.' Alopecia is not a sign of testicular cancer; it can occur due to chemotherapy. Back pain (choice B) is not typically associated with testicular cancer. Painless testicular swelling (choice C) and a heavy sensation in the scrotum (choice D) can be actual signs of testicular cancer, so they do not require further information.

5. The nurse is caring for a client who is at risk for tumor lysis syndrome. Which laboratory value requires the nurse to intervene?

• A. Decreased blood urea nitrogen (BUN)
• B. Increased serum calcium
• C. Increased creatinine level
• D. Increased blood glucose level

Correct answer: C

Rationale: Tumor lysis syndrome (TLS) is a potentially life-threatening condition that occurs when large numbers of cancer cells die rapidly, releasing their contents into the bloodstream. This can overwhelm the kidneys and lead to acute kidney injury. Creatinine is a waste product filtered out of the blood by the kidneys, and an elevated creatinine level is a sign of kidney dysfunction or damage. In TLS, increased creatinine levels indicate that the kidneys are struggling to filter out the excess waste products from cell breakdown, requiring immediate intervention to prevent further complications, such as acute renal failure.

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