Nursing Elites

1. Which of the following descriptions of chemotherapy is correct?

• A. Chemotherapy is externally given through high energy waves
• B. Chemotherapy is known to have fatigue as a common side effect
• C. Chemotherapy spreads throughout the body
• D. Chemotherapy attacks cancer cells only

Correct answer: C

Rationale: Chemotherapy drugs are typically administered systemically, meaning they circulate throughout the body via the bloodstream. This allows them to target cancer cells that may have spread beyond the original tumor site, making chemotherapy an effective treatment for cancers that are metastatic (have spread to other parts of the body). However, because chemotherapy is not selective, it can also affect healthy cells that divide rapidly, leading to a range of side effects.

2. A patient with chronic lymphocytic leukemia (CLL) is at risk for tumor lysis syndrome. What laboratory values should the nurse monitor to detect this complication?

• A. Creatinine and blood urea nitrogen (BUN)
• B. Electrolytes and uric acid levels
• C. Serum glucose and calcium levels
• D. Liver enzymes and bilirubin levels

Correct answer: B

Rationale: Electrolytes and uric acid levels are important to monitor for the development of tumor lysis syndrome.

3. A client with neutropenia is admitted to the hospital. What precaution is most important for the nurse to implement?

• A. Strict hand hygiene.
• B. Limit visitor contact with the client.
• C. Administer prophylactic antibiotics as ordered.
• D. Administer blood products as ordered.

Correct answer: A

Rationale: The correct answer is A: Strict hand hygiene. Neutropenic clients have a low level of neutrophils, which are important in fighting infections. Therefore, maintaining strict hand hygiene is crucial in preventing the introduction of pathogens that could lead to infections. Limiting visitor contact (choice B) is important but not as critical as preventing the introduction of pathogens through proper hand hygiene. Administering prophylactic antibiotics (choice C) and blood products (choice D) are treatment measures and do not address the preventive aspect that hand hygiene provides.

4. The client is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care?

• A. I change my pouch every week.
• B. I change the appliance in the morning.
• C. I empty the urinary collection bag when it is two-thirds full.
• D. When I'm in the shower, I direct the flow of water away from my stoma.

Correct answer: D

Rationale: The correct answer is D because directing water away from the stoma while showering is incorrect. The stoma can and should be cleaned with water. Choices A, B, and C demonstrate proper stoma care practices, such as changing the pouch regularly, changing the appliance in the morning, and emptying the collection bag when it is two-thirds full, which are all appropriate actions for caring for a urinary stoma.

5. The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would the nurse expect to note specifically in this disorder?

• A. Increased calcium level
• B. Increased white blood cells
• C. Decreased blood urea nitrogen level
• D. Decreased number of plasma cells in the bone marrow

Correct answer: A

Rationale: In multiple myeloma, the nurse would expect to note an increased calcium level in the laboratory results. This elevation is due to bone destruction caused by the disease, releasing calcium into the bloodstream. Increased white blood cells (Choice B) are not typically associated with multiple myeloma. Additionally, a decreased blood urea nitrogen level (Choice C) is not a common finding in this disorder. Multiple myeloma is characterized by the proliferation of abnormal plasma cells in the bone marrow, leading to an increased number of plasma cells, not a decreased number (Choice D). Therefore, the correct answer is an increased calcium level.

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