Nursing Elites

1. A patient with acute lymphocytic leukemia (ALL) is undergoing chemotherapy and develops neutropenia. What is the most important nursing intervention for this patient?

• A. Administering antipyretics
• B. Restricting visitors
• C. Maintaining a sterile environment
• D. Administering prophylactic antibiotics

Correct answer: C

Rationale: Maintaining a sterile environment is crucial to prevent infection in neutropenic patients.

2. Which of the following is considered correct in dealing with a patient who has gastric cancer?

• A. After total gastrectomy, patient will have to increase fluids during meals
• B. After total gastrectomy, patient will need lots of fiber in the diet
• C. After total gastrectomy, patient will have to walk about after meals
• D. After total gastrectomy, patient will have to lie flat on bed after meals

Correct answer: D

Rationale: After a total gastrectomy, where the entire stomach is removed, patients can experience dumping syndrome due to the rapid passage of food into the small intestine. This condition can lead to symptoms such as nausea, vomiting, diarrhea, and abdominal cramps. Lying flat after meals can help slow down the movement of food into the intestines, reducing the risk of dumping syndrome. It's important for patients to follow dietary recommendations and positioning strategies to manage symptoms effectively.

3. The nurse is assessing the perineal wound in a client who has returned from the operating room following an abdominal perineal resection and notes serosanguineous drainage from the wound. Which nursing intervention is most appropriate?

• A. Clamp the Penrose drain.
• B. Change the dressing as prescribed.
• C. Notify the healthcare provider (HCP).
• D. Remove and replace the perineal packing.

Correct answer: B

Rationale: In this scenario, the appropriate nursing intervention for serosanguineous drainage from the wound is to change the dressing as prescribed. This helps in maintaining wound cleanliness, preventing infection, and promoting proper wound healing. Clamping the Penrose drain (Choice A) is not indicated as the drainage is from the wound itself, not the drain. Notifying the healthcare provider (Choice C) may be necessary if there are signs of infection or other concerning issues, but changing the dressing should be done first. Removing and replacing the perineal packing (Choice D) is not the priority in this situation unless specifically prescribed by the healthcare provider after assessing the wound.

4. The home health nurse is performing a home visit for an oncology patient discharged 3 days ago after completing treatment for non-Hodgkin lymphoma. The nurse's assessment should include examination for the signs and symptoms of what complication?

• A. Tumor lysis syndrome (TLS)
• B. Syndrome of inappropriate antidiuretic hormone (SIADH)
• C. Disseminated intravascular coagulation (DIC)
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Tumor lysis syndrome (TLS). Tumor lysis syndrome is a potential complication after treatment for certain cancers, including non-Hodgkin lymphoma. The rapid breakdown of cancer cells in response to treatment can lead to metabolic abnormalities, such as hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia, which can be life-threatening. Choice B, Syndrome of inappropriate antidiuretic hormone (SIADH), is not typically associated with non-Hodgkin lymphoma treatment. Choice C, Disseminated intravascular coagulation (DIC), is more commonly seen in conditions such as sepsis or trauma, not directly related to non-Hodgkin lymphoma treatment. Choice D, Hypercalcemia, is not a common complication following treatment for non-Hodgkin lymphoma.

5. A client in the emergency department reports difficulty breathing. The nurse assesses the client’s appearance as depicted below: What action by the nurse is most important?

• A. Assess blood pressure and pulse.
• B. Attach the client to a pulse oximeter.
• C. Have the client rate his or her pain.
• D. Facilitate urgent radiation therapy.

Correct answer: A

Rationale: The correct action by the nurse is to assess the client's blood pressure and pulse. Difficulty breathing can be a sign of various conditions, including cardiac issues. Assessing blood pressure and pulse helps in determining the client's hemodynamic status and identifying any cardiovascular compromise. Option B is less crucial as attaching the client to a pulse oximeter may provide oxygen saturation levels but does not directly assess cardiac output. Option C is not the priority in this situation as the client's difficulty breathing is a more urgent concern. Option D is incorrect as urgent radiation therapy is not indicated based on the client's presentation.

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