Nursing Elites

1. A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months after radiation therapy for breast cancer. What response by the nurse is most appropriate?

• A. Are you getting adequate rest and sleep each day?
• B. It is normal to be fatigued even for months afterward.
• C. This is not normal and I’ll let the primary health care provider know.
• D. Try adding more vitamins B and C to your diet.

Correct answer: B

Rationale: Radiation-induced fatigue can last for months; it’s important to normalize this for the client.

2. A client with a history of prostate cancer is in the clinic and reports new onset of severe low back pain. What action by the nurse is most important?

• A. Assess the client’s gait and balance.
• B. Ask the client about any changes in urinary symptoms.
• C. Document the report thoroughly.
• D. Inquire about the client’s recent activities.

Correct answer: A

Rationale: The correct action by the nurse is to assess the client’s gait and balance. Severe low back pain in a client with a history of prostate cancer may indicate spinal cord compression, a serious complication. Assessing gait and balance can help determine if there is any spinal cord involvement, which requires immediate medical attention. Asking about changes in urinary symptoms (choice B) is important to assess for possible urinary obstruction, but assessing gait and balance takes precedence due to the risk of spinal cord compression. Documenting the report thoroughly (choice C) is essential but not the most immediate action needed. Inquiring about recent activities (choice D) is not as critical as assessing for spinal cord involvement.

3. The nurse is caring for a client who is postoperative following a pelvic exenteration, and the health care provider changes the client's diet from NPO status to clear liquids. The nurse should check which priority item before administering the diet?

• A. Bowel sounds
• B. Ability to ambulate
• C. Incision appearance
• D. Urine specific gravity

Correct answer: A

Rationale: The correct answer is A: Bowel sounds. Checking for bowel sounds is crucial before administering any diet to ensure the gastrointestinal tract is functioning properly following surgery. This assessment helps prevent complications such as paralytic ileus. Choices B, C, and D are not the priority in this situation. While the ability to ambulate, incision appearance, and urine specific gravity are important assessments, ensuring bowel function takes precedence in this postoperative scenario.

4. Gastric cancer is known to have numerous risk factors. Which of the following is not a risk factor?

• A. Diet high in sodium
• B. Diet with high amounts of chili garlic
• C. Smoking
• D. Diet high in fiber

Correct answer: D

Rationale: A diet high in fiber is not a risk factor for gastric cancer; in fact, it is generally considered protective against cancers. High sodium intake (Choice A) has been associated with an increased risk of gastric cancer. Diets with high amounts of chili garlic (Choice B) may irritate the stomach lining, potentially contributing to the development of gastric cancer. Smoking (Choice C) is a well-established risk factor for various types of cancers, including gastric cancer.

5. 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.

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