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. A client is diagnosed with multiple myeloma and the client asks the nurse about the diagnosis. The nurse bases the response on which description of this disorder?

• A. Altered red blood cell production
• B. Altered production of lymph nodes
• C. Malignant exacerbation in the number of leukocytes
• D. Malignant proliferation of plasma cells within the bone

Correct answer: D

Rationale: Multiple myeloma is a type of cancer that involves the malignant proliferation of plasma cells, which are a type of white blood cell that produces antibodies. In multiple myeloma, these abnormal plasma cells accumulate in the bone marrow, where they interfere with the production of normal blood cells and lead to the formation of tumors in the bones. This can cause bone pain, fractures, anemia, and impaired immune function. The excessive production of abnormal antibodies can also result in kidney damage and other systemic complications.

3. A patient with a myelodysplastic syndrome is being treated on the medical unit. What assessment finding should prompt the nurse to contact the patients primary care provider?

• A. The patient is experiencing a frontal lobe headache.
• B. The patient has an episode of urinary incontinence.
• C. The patient has an oral temperature of 37.5C (99.5F).
• D. The patients SpO2 is 91% on room air.

Correct answer: C

Rationale: Patients with myelodysplastic syndrome (MDS) have a dysfunctional bone marrow that leads to ineffective blood cell production, including white blood cells, which are crucial for fighting infections. As a result, they are at high risk for infections. Even a slight elevation in temperature, such as 37.5°C (99.5°F), could be an early sign of infection in an immunocompromised patient. Early detection and treatment of infections are critical in MDS patients, as infections can quickly become severe or life-threatening due to their compromised immune system.

4. A client is receiving chemotherapy through a peripheral IV line. What action by the nurse is most important?

• A. Assessing the IV site and blood return every hour.
• B. Educating the client on side effects.
• C. Monitoring the client for nausea.
• D. Providing warm packs for comfort.

Correct answer: A

Rationale: Chemotherapy drugs are often vesicants, meaning they can cause severe tissue damage if they leak (extravasate) outside of the vein. When chemotherapy is administered through a peripheral IV line, it is crucial for the nurse to frequently assess the IV site for signs of complications such as redness, swelling, or pain, which could indicate extravasation. Checking for blood return ensures the IV catheter is still in the vein and functioning properly. Preventing tissue damage from chemotherapy extravasation is a top priority, and frequent monitoring helps ensure the infusion is proceeding safely.

5. The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the client identifies which item as an associated risk factor?

• A. Age younger than 50 years
• B. History of colorectal polyps
• C. Family history of colorectal cancer
• D. Chronic inflammatory bowel disease

Correct answer: A

Rationale: The correct answer is A: Age younger than 50 years. Colorectal cancer is more commonly diagnosed in individuals over the age of 50, so being younger than 50 is not typically considered a significant risk factor. Choice B, history of colorectal polyps, is a known risk factor as polyps can develop into cancer over time. Choice C, family history of colorectal cancer, is a well-established risk factor due to genetic predisposition. Choice D, chronic inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, increases the risk of developing colorectal cancer. Therefore, the incorrect choice is A as age younger than 50 years is not a common risk factor for colorectal cancer.

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