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. Diagnostic testing has resulted in a diagnosis of acute myeloid leukemia (AML) in an adult patient who is otherwise healthy. The patient and the care team have collaborated and the patient will soon begin induction therapy. The nurse should prepare the patient for which of the following?

• A. Daily treatment with targeted therapy medications
• B. Radiation therapy on a daily basis
• C. Hematopoietic stem cell transplantation
• D. An aggressive course of chemotherapy

Correct answer: D

Rationale: Attempts are made to achieve remission of AML by the aggressive administration of chemotherapy.

3. A patient from the oncology unit asks the nurse about metastasis. Which of the following statements by the nurse requires immediate intervention by the head nurse?

• A. Metastasis is the replication of cells
• B. Metastasis can happen in most parts of the body
• C. The replication of cancer cells and travel from one area to another
• D. Metastasis is the spread of cancer cells

Correct answer: A

Rationale: The correct answer is A because metastasis refers to the spread of cancer cells to distant parts of the body, not the replication of cells. Choice B is correct as metastasis can indeed occur in various body parts. Choice C is incorrect as it inaccurately combines the concepts of replication and travel of cancer cells. Choice D is also correct as it accurately defines metastasis as the spread of cancer cells.

4. The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would the nurse expect to note specifically in this disorder?

• A. Increased calcium level
• B. Increased white blood cells
• C. Decreased blood urea nitrogen level
• D. Decreased number of plasma cells in the bone marrow

Correct answer: A

Rationale: In multiple myeloma, the nurse would expect to note an increased calcium level in the laboratory results. This elevation is due to bone destruction caused by the disease, releasing calcium into the bloodstream. Increased white blood cells (Choice B) are not typically associated with multiple myeloma. Additionally, a decreased blood urea nitrogen level (Choice C) is not a common finding in this disorder. Multiple myeloma is characterized by the proliferation of abnormal plasma cells in the bone marrow, leading to an increased number of plasma cells, not a decreased number (Choice D). Therefore, the correct answer is an increased calcium level.

5. The clinical nurse educator is presenting health promotion education to a patient who will be treated for non-Hodgkin lymphoma on an outpatient basis. The nurse should recommend which of the following actions?

• A. Avoiding direct sun exposure in excess of 15 minutes daily
• B. Avoiding grapefruit juice and fresh grapefruit
• C. Avoiding highly crowded public places
• D. Using an electric shaver rather than a razor

Correct answer: C

Rationale: Patients with non-Hodgkin lymphoma (NHL) often experience a compromised immune system due to both the disease itself and the effects of treatments like chemotherapy and radiation, which cause myelosuppression (decreased production of blood cells, including white blood cells). This puts them at significant risk for infections. Avoiding crowded places is a crucial preventive measure, as it reduces the patient's exposure to pathogens that could lead to infections, which can be particularly severe due to their weakened immune system.

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