Nursing Elites

1. 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.

2. 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.

3. A patient with multiple myeloma has developed hypercalcemia. What symptoms should the nurse monitor for in this patient?

• A. Increased heart rate
• B. Decreased urine output
• C. Muscle weakness
• D. Hypertension

Correct answer: C

Rationale: The correct answer is C: Muscle weakness. In patients with multiple myeloma who have developed hypercalcemia, monitoring for muscle weakness is crucial. Hypercalcemia can lead to muscle weakness due to its effects on neuromuscular function. Choice A, increased heart rate, is more commonly associated with conditions like dehydration or anxiety rather than hypercalcemia. Choice B, decreased urine output, is commonly seen in conditions leading to acute kidney injury rather than hypercalcemia. Choice D, hypertension, is not a typical symptom of hypercalcemia and is more commonly associated with other conditions like uncontrolled high blood pressure.

4. Nurse Meredith is instructing a premenopausal woman about breast self-examination. The nurse should tell the client to do her self-examination:

• A. at the end of her menstrual cycle.
• B. on the same day each month.
• C. on the 1st day of the menstrual cycle.
• D. immediately after her menstrual period.

Correct answer: D

Rationale: For premenopausal women, the best time to perform a breast self-examination (BSE) is immediately after their menstrual period ends. This timing is ideal because hormonal fluctuations during the menstrual cycle can cause breast tissue to become swollen and tender, making it more difficult to detect any lumps or changes. After the menstrual period, breast tissue is usually softer and less lumpy, allowing for a more accurate assessment of any abnormalities.

5. The nurse is caring for a client with multiple myeloma and is monitoring the client for signs of hypercalcemia. Which symptom would be an early indication?

• A. Polyuria
• B. Polyphagia
• C. Polydipsia
• D. Weight loss

Correct answer: A

Rationale: In patients with multiple myeloma, hypercalcemia is a common complication due to the release of calcium from the bones as a result of osteolytic lesions. One of the early symptoms of hypercalcemia is polyuria, or increased urine output. This occurs because elevated calcium levels can lead to impaired renal function and increased renal excretion of calcium, which results in increased urine production. Early recognition of polyuria can help prompt further evaluation and management of hypercalcemia, as untreated hypercalcemia can lead to more severe complications.

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