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. After undergoing mastectomy, a patient demonstrates understanding of the nurse's instructions by doing which of the following?

• A. Dangle arms at the bedside
• B. Lie down on the affected chest
• C. Drink plenty of fluids immediately after surgery
• D. Elevate the affected arm

Correct answer: D

Rationale: The correct answer is to elevate the affected arm. Elevating the affected arm helps prevent lymphedema after a mastectomy. Choices A, B, and C are incorrect. 'Dangling arms at the bedside' does not provide any benefit after a mastectomy. 'Lying down on the affected chest' can cause discomfort and possible complications. 'Drinking plenty of fluids immediately after surgery' is not related to preventing lymphedema post-mastectomy.

3. The school nurse is teaching a nutrition class in the local high school. One student states that he has heard that certain foods can increase the incidence of cancer. The nurse responds, Research has shown that certain foods indeed appear to increase the risk of cancer. Which of the following menu selections would be the best choice for potentially reducing the risks of cancer?

• A. Smoked salmon and green beans
• B. Pork chops and fried green tomatoes
• C. Baked apricot chicken and steamed broccoli
• D. Liver, onions, and steamed peas

Correct answer: C

Rationale: The correct choice is 'Baked apricot chicken and steamed broccoli' because fruits and vegetables have been shown to reduce the risk of cancer. Option A, smoked salmon and green beans, although a healthy choice, does not incorporate as many cancer-fighting foods as the correct answer. Option B, pork chops and fried green tomatoes, contains fried food which is associated with increased cancer risk. Option D, liver, onions, and steamed peas, includes organ meats which are not considered beneficial for reducing cancer risk.

4. 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.

5. The nurse is developing a plan of care for the client with multiple myeloma and includes which priority intervention in the plan?

• A. Encouraging fluids
• B. Providing frequent oral care
• C. Coughing and deep breathing
• D. Monitoring the red blood cell count

Correct answer: A

Rationale: The correct answer is A: Encouraging fluids. In a client with multiple myeloma, encouraging fluids is a priority intervention to prevent kidney damage from high calcium levels. Adequate hydration helps maintain renal function and prevents complications. Providing frequent oral care (Choice B) is essential for clients at risk of mucositis or oral infections, such as those undergoing chemotherapy. Coughing and deep breathing exercises (Choice C) are commonly used for clients at risk of respiratory complications, like postoperative patients. Monitoring the red blood cell count (Choice D) is important for conditions like anemia but is not the priority in a client with multiple myeloma, where fluid management is crucial.

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