Nursing Elites

1. A client has been prescribed epoetin alfa for anemia related to chemotherapy. What lab value should the nurse monitor to determine the effectiveness of this medication?

• A. Hemoglobin level.
• B. Hematocrit level.
• C. White blood cell count.
• D. Platelet count.

Correct answer: A

Rationale: Epoetin alfa is a medication used to treat anemia, particularly anemia related to chemotherapy or chronic kidney disease. It stimulates the bone marrow to produce more red blood cells, which increases the hemoglobin level. Monitoring hemoglobin is the best way to assess the effectiveness of epoetin alfa, as an increase in hemoglobin indicates that the body is producing more red blood cells and the anemia is improving.

2. A healthcare professional is assessing a female client who is taking hormone therapy for breast cancer. What assessment finding requires the healthcare professional to notify the primary health care provider immediately?

• A. Irregular menses.
• B. Edema in the lower extremities.
• C. Ongoing breast tenderness.
• D. Red, warm, swollen calf.

Correct answer: D

Rationale: The correct answer is D. A red, warm, swollen calf may indicate a deep vein thrombosis, which is a medical emergency. This finding requires immediate notification of the primary health care provider to prevent potential complications such as pulmonary embolism. Choices A, B, and C are not indicative of life-threatening conditions and should be monitored but do not require immediate notification like a suspected deep vein thrombosis.

3. A patient with advanced leukemia is responding poorly to treatment. The nurse finds the patient tearful and trying to express his feelings, but he is clearly having difficulty. What is the nurses most appropriate action?

• A. Tell him that you will give him privacy and leave the room.
• B. Offer to call pastoral care.
• C. Ask if he would like you to sit with him while he collects his thoughts.
• D. Tell him that you can understand how hes feeling.

Correct answer: C

Rationale: Providing emotional support and discussing the uncertain future are crucial.

4. Nurse Joy is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which of the following principles?

• A. Limit the time with the client to 1 hour per shift
• B. Do not allow pregnant women into the client’s room
• C. Remove the dosimeter badge when entering the client’s room
• D. Individuals younger than 16 years old may be allowed to go in the room as long as they are 6 feet away from the client

Correct answer: B

Rationale: Clients with internal radiation implants (also known as brachytherapy) emit a small amount of radiation, which can pose a risk to others. Pregnant women are particularly vulnerable to the harmful effects of radiation because it can affect both the mother and the developing fetus. Radiation exposure can lead to birth defects, miscarriage, or other developmental issues, so pregnant women should avoid any exposure by not entering the client's room.

5. A patient admitted with cancer asks the nurse about the difference between chemotherapy and radiation therapy. Which of the following responses by the nurse indicates a need for further teaching?

• A. Chemotherapy kills cancer cells
• B. Radiation therapy can be internal or external
• C. Radiation therapy is often external
• D. Chemotherapy is more likely to kill normal cells

Correct answer: D

Rationale: While chemotherapy does affect normal, healthy cells—particularly those that divide rapidly—it is not "more likely" to kill normal cells compared to cancer cells. Chemotherapy targets rapidly dividing cells, which includes both cancer cells and some normal cells (like those in hair follicles, the gastrointestinal tract, and bone marrow). However, its primary goal is to kill cancer cells, and its effects on normal cells are a side effect, not the main function. Therefore, the statement that chemotherapy is "more likely" to kill normal cells is inaccurate and indicates a need for further teaching.

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