Nursing Elites

1. A client hospitalized for chemotherapy has a hemoglobin of 6.1 mg/dL (61 mmol/L). The client is symptomatic but refuses blood transfusions. What medication does the nurse prepare to administer?

• A. Epoetin alfa.
• B. Filgrastim.
• C. Mesna.
• D. Dexrazoxane.

Correct answer: A

Rationale: Epoetin alfa stimulates the production of red blood cells, which is important for a client who refuses blood transfusions.

2. 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.

3. The nurse is reviewing the medication record for a client receiving chemotherapy and notes that the client is receiving epoetin alfa (Epogen). The nurse determines that this medication has been prescribed to:

• A. Increase white blood cell production
• B. Treat anemia
• C. Reduce pain
• D. Prevent infection

Correct answer: B

Rationale: Epoetin alfa (Epogen) is a synthetic form of erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow. Chemotherapy often leads to anemia due to its effects on rapidly dividing cells, including those in the bone marrow responsible for red blood cell production. By administering epoetin alfa, the healthcare provider aims to increase the red blood cell count and improve hemoglobin levels, thereby alleviating symptoms associated with anemia, such as fatigue and weakness.

4. A nurse is caring for a client with thrombocytopenia. Which action is the highest priority to reduce the risk of bleeding?

• A. Use an electric razor instead of a straight razor.
• B. Apply pressure to any bleeding sites for at least 5 minutes.
• C. Avoid invasive procedures unless absolutely necessary.
• D. Monitor for signs of internal bleeding.

Correct answer: C

Rationale: The highest priority action to reduce the risk of bleeding in a client with thrombocytopenia is to avoid invasive procedures unless absolutely necessary. Thrombocytopenia is a condition characterized by a low platelet count, which impairs the blood's ability to clot properly. By avoiding invasive procedures, the nurse minimizes the potential for bleeding episodes that could be challenging to control due to the low platelet count. Using an electric razor instead of a straight razor (Choice A) is a good practice to prevent cuts, but it is not as critical as avoiding invasive procedures in this scenario. Applying pressure to bleeding sites (Choice B) and monitoring for signs of internal bleeding (Choice D) are important interventions but are secondary to the priority of preventing bleeding by avoiding invasive procedures.

5. 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.

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