Nursing Elites

1. An oncology nurse is caring for a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patient's most recent blood tests, the nurse should anticipate what imbalance?

• A. Hypercalcemia
• B. Hyperproteinemia
• C. Elevated serum viscosity
• D. Elevated RBC count

Correct answer: A

Rationale: The correct answer is A, Hypercalcemia. In multiple myeloma, bone destruction can lead to the release of calcium from the bones into the bloodstream, causing hypercalcemia. This imbalance is commonly seen in patients with multiple myeloma. Choice B, Hyperproteinemia, is not typically associated with bone destruction in multiple myeloma. Choice C, Elevated serum viscosity, and Choice D, Elevated RBC count, are not directly related to the bone destruction seen in multiple myeloma.

2. The nurse is caring for a patient who has just been given a 6-month prognosis following a diagnosis of extensive-stage small-cell lung cancer. The patient states that he would like to die at home, but the team believes that the patient's care needs are unable to be met in a home environment. What might you suggest as an alternative?

• A. Discuss a referral for rehabilitation hospital.
• B. Panel the patient for a personal care home.
• C. Discuss a referral for acute care.
• D. Discuss a referral for hospice care.

Correct answer: D

Rationale: In this scenario, the most appropriate alternative to address the patient's desire to die at home while ensuring proper care is hospice care. Hospice care is specifically designed to provide support to patients and families in situations where the patient's needs cannot be met at home. Rehabilitation hospital (Choice A), personal care home (Choice B), and acute care (Choice C) are not the most suitable options in this case as they do not focus on end-of-life care and support like hospice care does.

3. A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The patient states, 'They tell me my cancer is malignant, while my coworker's breast tumor was benign. I just don't understand at all.' When preparing a response to this patient, the nurse should be cognizant of what characteristic that distinguishes malignant cells from benign cells of the same tissue type?

• A. Slow rate of mitosis of cancer cells
• B. Different proteins in the cell membrane
• C. Differing size of the cells
• D. Different molecular structure in the cells

Correct answer: B

Rationale: The correct answer is B. Malignant cells have different proteins in their membranes, such as tumor-specific antigens, which distinguish them from benign cells. Choice A is incorrect as cancer cells typically have a rapid and uncontrolled rate of mitosis. Choice C is incorrect as the size of cells alone does not distinguish between malignant and benign cells. Choice D is incorrect as the molecular structure is not the primary characteristic that distinguishes between malignant and benign cells.

4. After receiving a diagnosis of acute lymphocytic leukemia, a patient is visibly distraught, stating, I have no idea where to go from here. How should the nurse prepare to meet this patients psychosocial needs?

• A. Assess the patients previous experience with the health care system.
• B. Reassure the patient that treatment will be challenging but successful.
• C. Assess the patients specific needs for education and support.
• D. Identify the patients plan of medical care.

Correct answer: C

Rationale: In order to meets the patients needs, the nurse must first identify the specific nature of these needs.

5. A nurse is caring for a patient whose diagnosis of multiple myeloma is being treated with bortezomib. The nurse should assess for what adverse effect of this treatment?

• A. Stomatitis
• B. Nephropathy
• C. Cognitive changes
• D. Peripheral neuropathy

Correct answer: D

Rationale: The correct answer is D: Peripheral neuropathy. Bortezomib, used in the treatment of multiple myeloma, is known to cause peripheral neuropathy as a significant adverse effect. Stomatitis (Choice A), which is inflammation of the mouth and lips, is not a common adverse effect of bortezomib. Nephropathy (Choice B), referring to kidney disease, is not a typical adverse effect of bortezomib. Cognitive changes (Choice C) are not a commonly reported adverse effect of bortezomib treatment.

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