Nursing Elites

1. Gastric cancer is known to have numerous risk factors. Which of the following is not a risk factor?

• A. Diet high in sodium
• B. Diet with high amounts of chili garlic
• C. Smoking
• D. Diet high in fiber

Correct answer: D

Rationale: A diet high in fiber is not a risk factor for gastric cancer; in fact, it is generally considered protective against cancers. High sodium intake (Choice A) has been associated with an increased risk of gastric cancer. Diets with high amounts of chili garlic (Choice B) may irritate the stomach lining, potentially contributing to the development of gastric cancer. Smoking (Choice C) is a well-established risk factor for various types of cancers, including gastric cancer.

2. The nurse is teaching a client about the signs of infection after chemotherapy. Which of the following should the nurse emphasize?

• A. Frequent urination
• B. Increased thirst
• C. Chills and shaking
• D. Fever over 100.4°F (38°C)

Correct answer: D

Rationale: In clients undergoing chemotherapy, the immune system is often compromised due to the effects of treatment, making them more susceptible to infections. A fever over 100.4°F (38°C) is considered a critical sign of infection in these patients and requires immediate medical evaluation. Fever may indicate the presence of an infection that could escalate quickly in immunocompromised individuals, so it is vital for patients to recognize this symptom and seek prompt medical attention.

3. A client who is at risk for disseminated intravascular coagulation (DIC) has a serum fibrinogen level of 110 mg/dL. The nurse should take which of the following actions first?

• A. Recheck the fibrinogen level in 4 hours
• B. Notify the health care provider
• C. Continue to monitor the client
• D. Administer cryoprecipitate as prescribed

Correct answer: B

Rationale: A serum fibrinogen level of 110 mg/dL indicates a low level, which puts the client at risk for bleeding in DIC. The priority action for the nurse is to notify the health care provider. Rechecking the fibrinogen level may delay necessary interventions, administering cryoprecipitate should be done based on the provider's prescription, and while monitoring is important, immediate notification of the provider is crucial to address the low fibrinogen level promptly.

4. The nurse is developing a plan of care for the client with multiple myeloma and includes which priority intervention in the plan?

• A. Encouraging fluids
• B. Providing frequent oral care
• C. Coughing and deep breathing
• D. Monitoring the red blood cell count

Correct answer: A

Rationale: The correct answer is A: Encouraging fluids. In a client with multiple myeloma, encouraging fluids is a priority intervention to prevent kidney damage from high calcium levels. Adequate hydration helps maintain renal function and prevents complications. Providing frequent oral care (Choice B) is essential for clients at risk of mucositis or oral infections, such as those undergoing chemotherapy. Coughing and deep breathing exercises (Choice C) are commonly used for clients at risk of respiratory complications, like postoperative patients. Monitoring the red blood cell count (Choice D) is important for conditions like anemia but is not the priority in a client with multiple myeloma, where fluid management is crucial.

5. A client with cancer has anorexia and mucositis, and is losing weight. The client’s family members continually bring favorite foods to the client and are distressed when the client won’t eat them. What action by the nurse is best?

• A. Explain the pathophysiologic reasons behind the client not eating.
• B. Help the family show other ways to demonstrate love and caring.
• C. Suggest foods and liquids the client might be willing to try to eat.
• D. Tell the family the client isn’t able to eat now no matter what they bring.

Correct answer: B

Rationale: The best action for the nurse in this situation is to help the family show other ways to demonstrate love and caring. When a client with cancer is experiencing anorexia and mucositis, it can be challenging for them to eat even their favorite foods. By assisting the family in finding alternative ways to provide comfort and care, the nurse can help create a supportive environment for the client. Option A is not the best choice as explaining the pathophysiologic reasons may not address the emotional needs of the client and family. Option C, suggesting foods and liquids, might not be helpful if the client is unable to tolerate them due to their condition. Option D, telling the family that the client can't eat, may come across as dismissive and not supportive of the family's concerns.

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