Nursing Elites

1. A young adult patient has received the news that her treatment for Hodgkin lymphoma has been deemed successful and that no further treatment is necessary at this time. The care team should ensure that the patient receives regular health assessments in the future due to the risk of what complication?

• A. Iron-deficiency anemia
• B. Hemophilia
• C. Hematologic cancers
• D. Genitourinary cancers

Correct answer: C

Rationale: The correct answer is C: Hematologic cancers. Survivors of Hodgkin lymphoma are at a high risk of developing second cancers, with hematologic cancers being the most common complication. Regular health assessments are crucial for early detection and management. Iron-deficiency anemia (A) is not a typical long-term complication of Hodgkin lymphoma treatment. Hemophilia (B) is a genetic bleeding disorder unrelated to Hodgkin lymphoma. Genitourinary cancers (D) are not the most common complication seen in survivors of Hodgkin lymphoma.

2. A client is admitted with superior vena cava syndrome. What action by the nurse is most appropriate?

• A. Administer a dose of allopurinol.
• B. Assess the client’s serum potassium level.
• C. Gently inquire about advance directives.
• D. Prepare the client for emergency surgery.

Correct answer: C

Rationale: The correct answer is to gently inquire about advance directives. Superior vena cava syndrome is often a late-stage manifestation, indicating a serious condition. Discussing advance directives with the client is crucial to ensure their wishes are known in case of deterioration. Administering allopurinol (Choice A) is not indicated for superior vena cava syndrome. Assessing the client’s serum potassium level (Choice B) is not the priority when managing this syndrome. Emergency surgery (Choice D) is not typically the initial treatment for superior vena cava syndrome.

3. A nurse is caring for a patient who has a diagnosis of acute leukemia. What assessment most directly addresses the most common cause of death among patients with leukemia?

• A. Monitoring for infection
• B. Monitoring nutritional status
• C. Monitoring electrolyte levels
• D. Monitoring liver function

Correct answer: A

Rationale: The correct answer is monitoring for infection. In patients with acute leukemia, the most common cause of death is usually infection or bleeding. By closely monitoring for signs of infection, such as fever, altered mental status, or elevated white blood cell count, healthcare providers can intervene promptly. Monitoring nutritional status (choice B) is important but does not directly address the most common cause of death among leukemia patients. Monitoring electrolyte levels (choice C) and liver function (choice D) are also important assessments in cancer patients; however, they are not the most direct assessment to address the leading cause of death in patients with leukemia.

4. 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.

5. A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia?

• A. Interrupted sleep pattern
• B. Hot flashes
• C. Epistaxis (nose bleed)
• D. Increased weight

Correct answer: C

Rationale: Thrombocytopenia is a condition characterized by a low platelet count, which increases the risk of bleeding and hemorrhage. Patients receiving chemotherapy agents like carmustine may experience thrombocytopenia as a significant side effect. Epistaxis (nosebleeds) is a common symptom associated with thrombocytopenia, as the blood vessels can become more fragile, and even minor trauma or spontaneous bleeding can occur. Therefore, assessing for signs of bleeding, including epistaxis, is crucial in patients at risk for thrombocytopenia.

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