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. A client receiving chemotherapy is experiencing severe nausea and vomiting. Which intervention should the nurse implement first?

• A. Administer antiemetics 30 minutes before chemotherapy.
• B. Offer small, frequent meals that are bland and easy to digest.
• C. Encourage the client to rest after meals to reduce nausea.
• D. Instruct the client to use relaxation techniques.

Correct answer: A

Rationale: The correct answer is A: Administer antiemetics 30 minutes before chemotherapy. Administering antiemetics before chemotherapy is crucial to prevent nausea rather than treating it after it occurs. This proactive approach helps in minimizing the side effects. Choice B, offering small, frequent meals, can be beneficial but is not the first intervention for severe nausea and vomiting. Choice C, encouraging rest after meals, may help but is not the priority when the client is experiencing severe symptoms. Choice D, instructing the client to use relaxation techniques, is not the first-line intervention for severe nausea and vomiting in a client receiving chemotherapy.

3. A patient was admitted with gastric cancer. The patient asks the nurse about things to expect while receiving chemotherapy. Which of the following statements of the nurse shows incompetence?

• A. You can expect hair loss, but do not worry it will grow back immediately
• B. You may be infected easily, so avoid going to overpopulated places
• C. We may need to monitor your uric acid levels
• D. We may need to monitor your RBCs

Correct answer: A

Rationale: While hair loss (alopecia) is a common side effect of chemotherapy due to the damage to rapidly dividing hair follicle cells, the statement that hair will grow back "immediately" is inaccurate and misleading. Hair regrowth after chemotherapy takes time, typically starting a few weeks to months after treatment ends. The new hair may also have a different texture or color initially. Therefore, this statement indicates a lack of understanding and could give the patient unrealistic expectations, which is why it shows incompetence.

4. A patient with Hodgkin lymphoma is receiving radiation therapy. What side effect should the nurse monitor for that is most common with this type of treatment?

• A. Alopecia
• B. Fatigue
• C. Nausea
• D. Mucositis

Correct answer: D

Rationale: Mucositis is a common side effect of radiation therapy that should be closely monitored.

5. The nurse is monitoring a client for signs and symptoms related to superior vena cava syndrome. Which is an early sign of this oncological emergency?

• A. Cyanosis
• B. Arm edema
• C. Periorbital edema
• D. Mental status changes

Correct answer: C

Rationale: Superior vena cava syndrome (SVCS) occurs when the superior vena cava, the large vein that carries blood from the upper body to the heart, becomes compressed or obstructed, often by a tumor or enlarged lymph nodes, typically in cancers like lung cancer or lymphoma. The obstruction leads to increased venous pressure and reduced blood flow, resulting in swelling and edema in areas drained by the superior vena cava. Periorbital edema (swelling around the eyes) is one of the earliest signs of SVCS. This occurs because the impaired venous return causes fluid to accumulate in the soft tissues of the face, especially around the eyes. As the condition progresses, facial swelling can worsen, and other symptoms develop.

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