Nursing Elites

1. An oncology nurse educator is providing health education to a patient who has been diagnosed with skin cancer. The patient’s wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?

• A. Malignant cells contain more fibronectin than normal body cells.
• B. Malignant cells contain proteins called tumor-specific antigens.
• C. Chromosomes contained in cancer cells are more durable and stable than those of normal cells.
• D. The nuclei of cancer cells are unusually large, but regularly shaped.

Correct answer: B

Rationale: Malignant (cancer) cells often express tumor-specific antigens (TSAs), which are proteins or markers on the surface of cancer cells that are not found on normal cells. These antigens are produced due to genetic mutations in cancer cells and can sometimes be used to help the immune system recognize and attack cancerous cells. Tumor-specific antigens play a key role in cancer diagnosis, monitoring, and targeted therapies.

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. Nurse Farah is caring for a client following a mastectomy. Which assessment finding indicates that the client is experiencing a complication related to the surgery?

• A. Pain at the incision site
• B. Arm edema on the operative side
• C. Sanguineous drainage in the Jackson-Pratt drain
• D. Complaints of decreased sensation near the operative site

Correct answer: B

Rationale: Arm edema on the operative side (lymphedema) is a known complication after a mastectomy. This can indicate impaired lymphatic drainage, leading to fluid accumulation in the arm. Pain at the incision site is expected postoperatively and may not necessarily indicate a complication. Sanguineous drainage in the Jackson-Pratt drain is a common finding in the immediate postoperative period. Complaints of decreased sensation near the operative site could be related to nerve damage or surgical manipulation, but it is not a typical complication after a mastectomy.

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. A client is receiving chemotherapy for the treatment of cancer. The nurse monitors the client for which of the following signs indicating a complication of the therapy?

• A. Alopecia
• B. Weight gain
• C. Elevated temperature
• D. Decreased hemoglobin level

Correct answer: C

Rationale: The correct answer is C: Elevated temperature. A fever may indicate infection, a common and serious complication of chemotherapy, requiring prompt intervention. Choice A, Alopecia, is a common side effect of chemotherapy but not a sign of a complication. Choice B, Weight gain, is not typically a sign of a complication of chemotherapy. Choice D, Decreased hemoglobin level, may occur due to chemotherapy but is not a direct sign of a complication.

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