Nursing Elites

1. An oncology patient has just returned from the post-anesthesia care unit after an open hemicolectomy. This patient’s plan of nursing care should prioritize which of the following?

• A. Assess the patient hourly for signs of compartment syndrome.
• B. Assess the patient’s fine motor skills once per shift.
• C. Assess the patient’s wound for dehiscence every 4 hours.
• D. Maintain the patient’s head of bed at 45 degrees or more at all times.

Correct answer: C

Rationale: After an open hemicolectomy (surgical removal of part of the colon), monitoring the surgical wound for signs of dehiscence (wound reopening) is a critical nursing priority. Dehiscence is a serious postoperative complication that can occur if the surgical site does not heal properly. Regular wound assessments every 4 hours allow the nurse to identify early signs of complications, such as redness, swelling, increased drainage, or separation of the wound edges. Early detection is key to preventing further complications, such as infection or evisceration (protrusion of abdominal organs through the wound).

2. The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?

• A. Monthly self-breast exams
• B. Smoking cessation
• C. Annual colonoscopies
• D. Monthly testicular exams

Correct answer: B

Rationale: In North America, lung cancer is the leading cause of cancer deaths among both men and women, and the primary risk factor for lung cancer is smoking. Therefore, promoting smoking cessation is a critical public health intervention that directly addresses this significant health issue. By helping individuals quit smoking, healthcare providers can significantly reduce the incidence of lung cancer and associated deaths, making this intervention a priority in cancer prevention efforts.

3. A patient with non-Hodgkin lymphoma (NHL) is receiving monoclonal antibody therapy. What is the priority assessment during the infusion of this medication?

• A. Vital signs
• B. Skin reactions
• C. Respiratory status
• D. Renal function

Correct answer: A

Rationale: The correct answer is A: Vital signs. Monitoring vital signs is crucial during the infusion of monoclonal antibody therapy as there is a risk of infusion reactions such as fevers, chills, hypotension, and tachycardia. Assessing vital signs allows for early detection of any adverse reactions, enabling prompt intervention. Skin reactions (choice B), respiratory status (choice C), and renal function (choice D) are important assessments in general patient care but are not the priority during the infusion of monoclonal antibody therapy.

4. 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.

5. Nurse Jane is providing care for a client with superior vena cava syndrome. Which of the following interventions would be the priority?

• A. Elevate the head of the bed
• B. Administer steroids as prescribed
• C. Provide supplemental oxygen
• D. Administer diuretics as prescribed

Correct answer: A

Rationale: The correct answer is to elevate the head of the bed. Elevating the head of the bed can help reduce the pressure on the superior vena cava, improve venous return, and facilitate breathing in clients with superior vena cava syndrome. Administering steroids (Choice B) may be necessary in some cases, but it is not the priority in the immediate care of a client with superior vena cava syndrome. Providing supplemental oxygen (Choice C) may help improve oxygenation but does not directly address the underlying issue of venous congestion. Administering diuretics (Choice D) may be contraindicated as it can further decrease preload and worsen the condition in superior vena cava syndrome.

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