Nursing Elites

1. 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.

2. 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.

3. A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection-related death in oncology patients?

• A. Encourage several small meals daily.
• B. Provide skin care to maintain skin integrity.
• C. Assist the patient with hygiene, as needed.
• D. Assess the integrity of the patient’s oral mucosa regularly.

Correct answer: B

Rationale: In oncology patients, particularly those undergoing chemotherapy or radiation therapy, myelosuppression (the decrease in bone marrow activity that leads to reduced white blood cells, red blood cells, and platelets) increases the risk of infection. Maintaining skin integrity is crucial because the skin acts as the body's first line of defense against infections. If the skin becomes compromised, such as through radiation burns, rashes, or breakdowns, it provides a potential entry point for pathogens, increasing the risk of infection. Since infections in oncology patients can quickly become severe due to their weakened immune systems, maintaining skin integrity is a critical intervention to reduce infection risk, especially for patients who are immunosuppressed.

4. A young adult patient has received the news that her treatment for Hodgkin lymphoma has been deemed successful and that no further treatment is necessary at this time. The care team should ensure that the patient receives regular health assessments in the future due to the risk of what complication?

• A. Iron-deficiency anemia
• B. Hemophilia
• C. Hematologic cancers
• D. Genitourinary cancers

Correct answer: C

Rationale: The correct answer is C: Hematologic cancers. Survivors of Hodgkin lymphoma are at a high risk of developing second cancers, with hematologic cancers being the most common complication. Regular health assessments are crucial for early detection and management. Iron-deficiency anemia (A) is not a typical long-term complication of Hodgkin lymphoma treatment. Hemophilia (B) is a genetic bleeding disorder unrelated to Hodgkin lymphoma. Genitourinary cancers (D) are not the most common complication seen in survivors of Hodgkin lymphoma.

5. A patient from the oncology unit asks the nurse about metastasis. Which of the following statements by the nurse requires immediate intervention by the head nurse?

• A. Metastasis is the replication of cells
• B. Metastasis can happen in most parts of the body
• C. The replication of cancer cells and travel from one area to another
• D. Metastasis is the spread of cancer cells

Correct answer: A

Rationale: The correct answer is A because metastasis refers to the spread of cancer cells to distant parts of the body, not the replication of cells. Choice B is correct as metastasis can indeed occur in various body parts. Choice C is incorrect as it inaccurately combines the concepts of replication and travel of cancer cells. Choice D is also correct as it accurately defines metastasis as the spread of cancer cells.

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