Nursing Elites

1. When working with clients experiencing alopecia, what is the best method for a nurse to help them manage the psychosocial impact of this issue?

• A. Assisting the client in pre-planning for this event.
• B. Reassuring the client that alopecia is temporary.
• C. Teaching the client ways to protect the scalp.
• D. Telling the client that there are worse side effects.

Correct answer: A

Rationale: Assisting the client in pre-planning for alopecia is the best method to help them manage the psychosocial impact of the issue. By helping clients anticipate and prepare for the challenges associated with alopecia, they can cope better with the psychological impact. Reassuring the client that alopecia is temporary (choice B) may provide false hope as some types of alopecia are permanent. Teaching ways to protect the scalp (choice C) is important but not the most effective method for managing the psychosocial impact. Telling the client that there are worse side effects (choice D) is dismissive of the client's feelings and not helpful in addressing the psychosocial impact of alopecia.

2. A nursing student is caring for a patient with acute myeloid leukemia who is preparing to undergo induction therapy. In preparing a plan of care for this patient, the student should assign the highest priority to which nursing diagnosis?

• A. Activity Intolerance
• B. Risk for Infection
• C. Acute Confusion
• D. Risk for Spiritual Distress

Correct answer: B

Rationale: The correct answer is B: Risk for Infection. Induction therapy for acute myeloid leukemia suppresses the immune system, making the patient highly susceptible to infections due to neutropenia. Preventing infections is crucial in these patients to avoid complications. Activity Intolerance (Choice A) may be a concern, but infection prevention is of higher priority. Acute Confusion (Choice C) and Risk for Spiritual Distress (Choice D) are not the immediate priorities in this situation.

3. 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.

4. The hospice nurse is caring for a patient with cancer in her home. The nurse has explained to the patient and the family that the patient is at risk for hypercalcemia and has educated them on the signs and symptoms of this health problem. What else should the nurse teach this patient and family to do to reduce the patient’s risk of hypercalcemia?

• A. Stool softeners are contraindicated.
• B. Laxatives should be taken daily.
• C. Consume 2 to 4 L of fluid daily.
• D. Restrict calcium intake.

Correct answer: C

Rationale: The nurse should encourage the patient to consume 2 to 4 liters of fluid daily to reduce the risk of hypercalcemia.

5. A nurse in the oncology clinic is providing preoperative education to a client just diagnosed with cancer. The client has been scheduled for surgery in 3 days. What action by the nurse is best?

• A. Call the client at home the next day to review teaching.
• B. Give the client information about a cancer support group.
• C. Provide all the preoperative instructions in writing.
• D. Reassure the client that surgery will be over soon.

Correct answer: A

Rationale: Clients are often overwhelmed by a sudden cancer diagnosis; therefore, it is best for the nurse to call the client at home the next day to review teaching. This approach allows the client time to process the information before the surgery. Choice B may be beneficial but is not the priority at this time. Providing written instructions (Choice C) is helpful but does not offer the personalized interaction needed. Reassuring the client (Choice D) is important but does not address the educational aspect of preoperative preparation.

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