Nursing Elites

1. The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?

• A. Monthly self-breast exams
• B. Smoking cessation
• C. Annual colonoscopies
• D. Monthly testicular exams

Correct answer: B

Rationale: In North America, lung cancer is the leading cause of cancer deaths among both men and women, and the primary risk factor for lung cancer is smoking. Therefore, promoting smoking cessation is a critical public health intervention that directly addresses this significant health issue. By helping individuals quit smoking, healthcare providers can significantly reduce the incidence of lung cancer and associated deaths, making this intervention a priority in cancer prevention efforts.

2. Traditionally, nurses have been involved with tertiary cancer prevention. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention?

• A. Yearly Pap tests
• B. Testicular self-examination
• C. Teaching patients to wear sunscreen
• D. Screening mammograms

Correct answer: C

Rationale: Primary prevention involves actions taken to reduce the risk of developing cancer by preventing exposure to known risk factors or promoting healthy behaviors. Teaching patients to wear sunscreen is an example of primary prevention because it aims to reduce the risk of skin cancer by minimizing exposure to harmful ultraviolet (UV) radiation from the sun. Encouraging protective measures such as wearing sunscreen, avoiding tanning beds, and wearing protective clothing are all steps to prevent skin cancer before it develops.

3. A nurse knows that all of the following are managements of breast cancer except:

• A. Administer chemotherapy as ordered
• B. Let the patient lie down with 1-2 pillows
• C. Give patient Tamoxifen as ordered
• D. Let the patient elevate affected arm post op

Correct answer: B

Rationale: In the management of breast cancer, particularly after procedures such as a mastectomy, it is important to position the patient in a way that promotes healing and comfort. However, lying down with 1-2 pillows is not a standard practice for postoperative care. Instead, patients are often advised to elevate the affected arm to reduce swelling and promote drainage, and they may benefit from sleeping in a more upright position if they are experiencing discomfort. The focus should be on facilitating recovery rather than simply lying down.

4. Mina, who is suspected of an ovarian tumor is scheduled for a pelvic ultrasound. The nurse provides which preprocedure instruction to the client?

• A. Eat a light breakfast only
• B. Maintain an NPO status before the procedure
• C. Wear comfortable clothing and shoes for the procedure
• D. Drink six to eight glasses of water without voiding before the test

Correct answer: D

Rationale: A pelvic ultrasound requires the client to have a full bladder because the bladder acts as a window through which pelvic organs, such as the uterus and ovaries, can be visualized more clearly. The full bladder pushes the intestines out of the way and provides a better acoustic pathway for the ultrasound waves. Without this, the pelvic organs might be obscured, and the images would be less accurate.

5. A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem?

• A. The patient requests that her family bring her makeup and wig.
• B. The patient begins to discuss the future with her family.
• C. The patient reports less disruption from pain and discomfort.
• D. The patient cries openly when discussing her disease.

Correct answer: A

Rationale: When a patient experiences alopecia due to chemotherapy, it can significantly impact their self-esteem and body image, particularly in adolescents who are especially sensitive to physical changes. A request for makeup and a wig indicates that the patient is actively taking steps to enhance her appearance and cope with the changes brought on by her treatment. This action reflects a positive engagement with her body image and suggests a desire to feel more comfortable and confident in her appearance, signaling an improvement in her self-esteem.

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