Nursing Elites

1. A patient with leukemia has developed stomatitis and is experiencing a nutritional deficit. An oral anesthetic has consequently been prescribed. What health education should the nurse provide to the patient?

• A. Chew with care to avoid inadvertently biting the tongue.
• B. Use the oral anesthetic 1 hour prior to meal time.
• C. Brush teeth before and after eating.
• D. Swallow slowly and deliberately.

Correct answer: A

Rationale: If oral anesthetics are used, the patient must be warned to chew with extreme care to avoid inadvertently biting the tongue or buccal mucosa.

2. Which of the following is a correct statement by the nurse to a patient under radiation therapy?

• A. Brachytherapy can be administered by a pregnant nurse
• B. Teletherapy makes the patient radioactive
• C. Brachytherapy is an internal radiation therapy
• D. Teletherapy requires proper disposal of feces since feces is not a source of radiation

Correct answer: C

Rationale: The correct statement is that Brachytherapy is an internal radiation therapy. Brachytherapy involves placing radioactive sources inside or near the tumor, delivering a high radiation dose to the targeted area while minimizing exposure to surrounding healthy tissues. Choices A and B are incorrect because pregnant nurses should not administer radiation therapy and brachytherapy does not make the patient radioactive. Choice D is incorrect as feces is not a source of radiation in teletherapy, and it does not require special disposal.

3. The client is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care?

• A. I change my pouch every week.
• B. I change the appliance in the morning.
• C. I empty the urinary collection bag when it is two-thirds full.
• D. When I'm in the shower, I direct the flow of water away from my stoma.

Correct answer: D

Rationale: The correct answer is D because directing water away from the stoma while showering is incorrect. The stoma can and should be cleaned with water. Choices A, B, and C demonstrate proper stoma care practices, such as changing the pouch regularly, changing the appliance in the morning, and emptying the collection bag when it is two-thirds full, which are all appropriate actions for caring for a urinary stoma.

4. A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should the nurse prioritize when addressing the patients severe bone pain?

• A. Implementing distraction techniques
• B. Educating the patient about the effective use of hot and cold packs
• C. Teaching the patient to use NSAIDs effectively
• D. Helping the patient manage the opioid analgesic regimen

Correct answer: D

Rationale: Multiple myeloma causes severe bone pain due to the proliferation of malignant plasma cells in the bone marrow, leading to osteolytic lesions and bone destruction. Opioid analgesics are often required to manage this level of pain effectively, especially in cases where the pain is severe and chronic. The nurse's priority should be helping the patient manage their opioid regimen, ensuring they understand proper dosing, side effects, and safe use of the medication. Opioids are generally necessary in such cases because they provide stronger pain relief compared to other types of analgesics, such as NSAIDs or non-opioid medications.

5. Nurse Lisa is assessing a client who has just completed radiation therapy to the neck area. Which of the following findings is most concerning?

• A. Erythema in the treated area
• B. Difficulty swallowing
• C. Dry, peeling skin
• D. Hoarseness

Correct answer: B

Rationale: Difficulty swallowing (dysphagia) following radiation therapy to the neck area is a significant concern because it can indicate serious complications such as esophageal stricture, inflammation, or damage to the surrounding tissues, including the esophagus. This can lead to malnutrition, dehydration, or aspiration, all of which require prompt intervention. Radiation therapy can cause irritation and scarring in the esophageal and throat tissues, which may progressively worsen if not treated. Therefore, dysphagia should be addressed immediately to prevent further complications.

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