Nursing Elites

1. A patient has been found to have an indolent neoplasm. The nurse should recognize what implication of this condition?

• A. The patient faces a significant risk of malignancy.
• B. The patient has a myeloid form of leukemia.
• C. The patient has a lymphocytic form of leukemia.
• D. The patient has a major risk factor for hemophilia.

Correct answer: A

Rationale: The correct answer is A: 'The patient faces a significant risk of malignancy.' Indolent neoplasms are characterized by their slow growth and relatively low malignancy potential; however, they do have the capability to progress to malignancy over time. Choices B, C, and D are incorrect because they make assumptions about specific types of leukemia and hemophilia, which are not necessarily related to the presence of an indolent neoplasm.

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. Traditionally, nurses have been involved with tertiary cancer prevention. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention?

• A. Yearly Pap tests
• B. Testicular self-examination
• C. Teaching patients to wear sunscreen
• D. Screening mammograms

Correct answer: C

Rationale: Primary prevention involves actions taken to reduce the risk of developing cancer by preventing exposure to known risk factors or promoting healthy behaviors. Teaching patients to wear sunscreen is an example of primary prevention because it aims to reduce the risk of skin cancer by minimizing exposure to harmful ultraviolet (UV) radiation from the sun. Encouraging protective measures such as wearing sunscreen, avoiding tanning beds, and wearing protective clothing are all steps to prevent skin cancer before it develops.

4. The nurse is caring for a client who is at risk for tumor lysis syndrome. Which laboratory value requires the nurse to intervene?

• A. Decreased blood urea nitrogen (BUN)
• B. Increased serum calcium
• C. Increased creatinine level
• D. Increased blood glucose level

Correct answer: C

Rationale: Tumor lysis syndrome (TLS) is a potentially life-threatening condition that occurs when large numbers of cancer cells die rapidly, releasing their contents into the bloodstream. This can overwhelm the kidneys and lead to acute kidney injury. Creatinine is a waste product filtered out of the blood by the kidneys, and an elevated creatinine level is a sign of kidney dysfunction or damage. In TLS, increased creatinine levels indicate that the kidneys are struggling to filter out the excess waste products from cell breakdown, requiring immediate intervention to prevent further complications, such as acute renal failure.

5. A client with breast cancer is receiving doxorubicin (Adriamycin). The nurse monitors the client closely for:

• A. Pulmonary fibrosis
• B. Cardiotoxicity
• C. Hepatotoxicity
• D. Nephrotoxicity

Correct answer: B

Rationale: Doxorubicin (Adriamycin) is an anthracycline chemotherapy agent commonly used to treat various cancers, including breast cancer. One of the significant side effects associated with doxorubicin is cardiotoxicity, which can lead to serious complications such as heart failure and arrhythmias. The risk of cardiotoxicity is dose-dependent, meaning that higher cumulative doses increase the likelihood of cardiac damage. Therefore, it is essential for nurses to monitor cardiac function closely through assessments such as echocardiograms or monitoring for signs and symptoms of heart failure, such as shortness of breath, fatigue, and edema.

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