Nursing Elites

1. A nurse at a long-term care facility is amending the care plan of a resident who has just been diagnosed with essential thrombocythemia (ET). The nurse should anticipate the administration of what medication?

• A. Dalteparin
• B. Allopurinol
• C. Hydroxyurea
• D. Hydrochlorothiazide

Correct answer: C

Rationale: Hydroxyurea is effective in lowering the platelet count for patients with ET.

2. Which of the following statements by the oncology nurse displays understanding about antineoplastic medications?

• A. Chemotherapy is not going to spread throughout the body
• B. Chemotherapy affects the immune system
• C. Chemotherapy is specific to cancer cells only
• D. Chemotherapy makes the patient radioactive

Correct answer: B

Rationale: Chemotherapy targets rapidly dividing cells, which include both cancerous and healthy cells, such as those in the bone marrow, hair follicles, and the lining of the digestive tract. Since the bone marrow produces immune cells (white blood cells), chemotherapy can weaken the immune system by reducing the body’s ability to produce these cells, making patients more susceptible to infections. This is why close monitoring and supportive measures to protect immune function are important during chemotherapy treatment.

3. What is a characteristic of normal cells?

• A. They have no functions
• B. They have a larger nucleus
• C. They undergo apoptosis
• D. They have a dark-colored nucleus

Correct answer: C

Rationale: The correct answer is that normal cells undergo apoptosis, which is a programmed cell death process essential for maintaining tissue homeostasis. Choice A is incorrect as normal cells do have specific functions. Choice B is incorrect as the size of the nucleus may vary but is not a defining characteristic of normal cells. Choice D is incorrect as the color of the nucleus is not a standard characteristic of normal cells.

4. A nurse is caring for a patient with myelodysplastic syndrome (MDS) who is at risk for anemia. What is the most appropriate intervention to address this risk?

• A. Administering iron supplements
• B. Administering blood transfusions
• C. Providing a high-iron diet
• D. Administering erythropoietin

Correct answer: D

Rationale: In myelodysplastic syndrome (MDS), the bone marrow does not produce enough healthy blood cells, leading to conditions such as anemia. Administering erythropoietin is an effective intervention to manage anemia in MDS patients because it stimulates the production of red blood cells. This can help improve the patient’s hemoglobin levels, reducing symptoms such as fatigue and weakness associated with anemia. Erythropoietin is commonly used in MDS to enhance red blood cell production and reduce the need for frequent blood transfusions.

5. The nurse is monitoring a client for signs and symptoms related to superior vena cava syndrome. Which is an early sign of this oncological emergency?

• A. Cyanosis
• B. Arm edema
• C. Periorbital edema
• D. Mental status changes

Correct answer: C

Rationale: Superior vena cava syndrome (SVCS) occurs when the superior vena cava, the large vein that carries blood from the upper body to the heart, becomes compressed or obstructed, often by a tumor or enlarged lymph nodes, typically in cancers like lung cancer or lymphoma. The obstruction leads to increased venous pressure and reduced blood flow, resulting in swelling and edema in areas drained by the superior vena cava. Periorbital edema (swelling around the eyes) is one of the earliest signs of SVCS. This occurs because the impaired venous return causes fluid to accumulate in the soft tissues of the face, especially around the eyes. As the condition progresses, facial swelling can worsen, and other symptoms develop.

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