Nursing Elites

1. A patient with myelofibrosis is being treated with ruxolitinib. What should the nurse monitor to assess the effectiveness of this treatment?

• A. Blood pressure
• B. White blood cell count
• C. Hemoglobin and hematocrit
• D. Spleen size

Correct answer: C

Rationale: Monitoring hemoglobin and hematocrit is essential to assess the effectiveness of ruxolitinib in treating myelofibrosis. Ruxolitinib works by inhibiting JAK1 and JAK2, which are involved in the signaling pathways that regulate blood cell production. Therefore, monitoring hemoglobin and hematocrit levels can provide valuable information on how well the drug is managing the disease. Blood pressure, white blood cell count, and spleen size are not direct indicators of the treatment's effectiveness in myelofibrosis.

2. 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.

3. All of the following are warning signs of cancer except:

• A. Patient palpates a bump on the side of the breast
• B. Bruises are found on the body that the client cannot explain
• C. Patient often complains of impaired digestion
• D. Patient has blood-tinged sputum

Correct answer: D

Rationale: The correct answer is D. Blood-tinged sputum is not a typical warning sign of cancer but rather a symptom that can indicate other serious conditions like respiratory issues or infections. Choices A, B, and C are common warning signs of cancer: palpable lumps or bumps, unexplained bruises, and persistent digestive issues are often associated with cancer and should be evaluated by a healthcare professional for further assessment and diagnosis.

4. The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient?

• A. Impaired nutritional status
• B. Cognitive changes
• C. Diarrhea
• D. Alopecia

Correct answer: A

Rationale: Corrected Rationale: Impaired nutritional status is a potential adverse effect of radiotherapy to the head and neck due to alterations in oral mucosa and taste. While cognitive changes, diarrhea, and alopecia can be side effects of other treatments or conditions, they are not typically associated with external radiation for a malignant tumor of the neck. Therefore, the nurse should primarily focus on discussing the risk of impaired nutritional status with the patient.

5. The nurse is teaching a client about the signs of infection after chemotherapy. Which of the following should the nurse emphasize?

• A. Frequent urination
• B. Increased thirst
• C. Chills and shaking
• D. Fever over 100.4°F (38°C)

Correct answer: D

Rationale: In clients undergoing chemotherapy, the immune system is often compromised due to the effects of treatment, making them more susceptible to infections. A fever over 100.4°F (38°C) is considered a critical sign of infection in these patients and requires immediate medical evaluation. Fever may indicate the presence of an infection that could escalate quickly in immunocompromised individuals, so it is vital for patients to recognize this symptom and seek prompt medical attention.

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