Nursing Elites

1. A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?

• A. Administer an antiemetic.
• B. Administer an antimetabolite.
• C. Administer a tumor antibiotic.
• D. Administer an anticoagulant.

Correct answer: A

Rationale: The correct answer is A: Administer an antiemetic. Chemotherapy commonly causes nausea and vomiting as adverse effects. Antiemetics are medications specifically used to prevent or treat these symptoms. Choices B, C, and D are incorrect because administering an antimetabolite, a tumor antibiotic, or an anticoagulant would not directly address the most common adverse effects of chemotherapy, which are nausea and vomiting.

2. Four clients are receiving tyrosine kinase inhibitors (TKIs). Which of these four clients would the nurse assess first?

• A. Dry, itchy, peeling skin.
• B. Serum calcium of 9.2 mg/dL (2.3 mmol/L).
• C. Serum potassium of 2.8 mEq/L (2.8 mmol/L).
• D. Weight gain of 0.5 lb (1.1 kg) in 1 day.

Correct answer: C

Rationale: A potassium level of 2.8 mEq/L is critically low and requires immediate intervention.

3. The clinic nurse is caring for a patient whose grandmother and sister have both had breast cancer. She requested a screening test to determine her risk of developing breast cancer and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response?

• A. Research has shown that eating a healthy diet can provide all the protection you need against breast cancer.
• B. Research has shown that taking the drug tamoxifen can reduce your chance of breast cancer.
• C. Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer.
• D. Research has shown that there is little you can do to reduce your risk of breast cancer if you have a genetic predisposition.

Correct answer: B

Rationale: Tamoxifen is a selective estrogen receptor modulator (SERM) that has been shown to significantly reduce the risk of developing breast cancer in women who are at high risk, particularly those with a family history of the disease or a positive genetic test for BRCA mutations. Large-scale studies have demonstrated that tamoxifen can reduce the incidence of breast cancer by up to 50% in high-risk women. It works by blocking estrogen receptors in breast tissue, which helps prevent the development of estrogen receptor-positive breast cancers.

4. 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.

5. A nurse is caring for a patient whose diagnosis of multiple myeloma is being treated with bortezomib. The nurse should assess for what adverse effect of this treatment?

• A. Stomatitis
• B. Nephropathy
• C. Cognitive changes
• D. Peripheral neuropathy

Correct answer: D

Rationale: The correct answer is D: Peripheral neuropathy. Bortezomib, used in the treatment of multiple myeloma, is known to cause peripheral neuropathy as a significant adverse effect. Stomatitis (Choice A), which is inflammation of the mouth and lips, is not a common adverse effect of bortezomib. Nephropathy (Choice B), referring to kidney disease, is not a typical adverse effect of bortezomib. Cognitive changes (Choice C) are not a commonly reported adverse effect of bortezomib treatment.

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