Nursing Elites

1. A patient has a diagnosis of multiple myeloma and the nurse is preparing health education in preparation for discharge from the hospital. What action should the nurse promote?

• A. Daily performance of weight-bearing exercise to prevent muscle atrophy
• B. Close monitoring of urine output and kidney function
• C. Daily administration of warfarin (Coumadin) as ordered
• D. Safe use of supplementary oxygen in the home setting

Correct answer: B

Rationale: Renal function must be monitored closely in the patient with multiple myeloma.

2. A 60-year-old patient with chronic myeloid leukemia will be treated in the home setting and the nurse is preparing appropriate health education. What topic should the nurse emphasize?

• A. The importance of adhering to the prescribed drug regimen
• B. The need to ensure that vaccinations are up to date
• C. The importance of daily physical activity
• D. The need to avoid shellfish and raw foods

Correct answer: A

Rationale: Chronic myeloid leukemia (CML) is typically treated with targeted therapies, such as tyrosine kinase inhibitors (TKIs), which can help control the disease and prolong survival. The effectiveness of these medications relies heavily on strict adherence to the prescribed drug regimen. Patients need to take their medication consistently and as directed to maintain therapeutic drug levels and effectively manage the disease. Non-adherence can lead to disease progression or resistance to treatment, which is why it is crucial for the nurse to emphasize this point during health education.

3. 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.

4. The home health care nurse is caring for a client with cancer who is complaining of acute pain. The most appropriate determination of the client's pain should include which assessment?

• A. The client's pain rating
• B. Nonverbal cues from the client
• C. The nurse's impression of the client's pain
• D. Pain relief after appropriate nursing intervention

Correct answer: A

Rationale: The correct answer is A: The client's pain rating. Pain assessment should primarily rely on the client's self-report for the most accurate determination of pain intensity. Nonverbal cues from the client (choice B) can provide additional information but should not replace the client's self-report. The nurse's impression of the client's pain (choice C) may be subjective and less reliable than the client's self-assessment. Pain relief after appropriate nursing intervention (choice D) is an important outcome but does not replace the initial assessment of the client's pain.

5. The healthcare professional working with oncology clients understands that which age-related change increases the older client’s susceptibility to infection during chemotherapy?

• A. Decreased immune function.
• B. Diminished nutritional stores.
• C. Existing cognitive deficits.
• D. Poor physical reserves.

Correct answer: A

Rationale: The correct answer is A: Decreased immune function. Aging leads to a decline in immune function, which increases susceptibility to infections during chemotherapy. This decline is due to changes in the immune system that occur with age. Choices B, C, and D are incorrect because while they may impact overall health in older clients, they do not directly increase susceptibility to infections during chemotherapy like decreased immune function does.

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