Nursing Elites

1. Hormonal agents are used to treat some cancers. An example is:

• A. thyroxine to treat thyroid cancer.
• B. ACTH to treat adrenal carcinoma.
• C. estrogen antagonists to treat breast cancer.
• D. glucagon to treat pancreatic carcinoma.

Correct answer: C

Rationale: Estrogen antagonists are commonly used to treat estrogen hormone-dependent cancers such as breast carcinoma. One well-known estrogen antagonist used in breast cancer therapy is Tamoxifen (Nolvadex). This drug, in combination with surgery and other chemotherapeutic drugs, reduces breast cancer recurrence by 30%. Estrogen antagonists can also be administered to prevent breast cancer in women who have a strong family history. Thyroxine is a thyroid hormone used to treat hypothyroidism, not thyroid cancer. ACTH is an anterior pituitary hormone that stimulates the adrenal glands to release glucocorticoids; it does not treat adrenal cancer. Glucagon is a pancreatic alpha cell hormone that stimulates glycogenolysis and gluconeogenesis; it does not treat pancreatic cancer.

2. The licensed practical nurse is working with a registered nurse and a patient care assistant. Which of the following clients should be cared for by the registered nurse?

• A. A client 2 days post-appendectomy
• B. A client 1 week post-thyroidectomy
• C. A client 3 days post-splenectomy
• D. A client 2 days post-thoracotomy

Correct answer: D

Rationale: The correct answer is a client 2 days post-thoracotomy because this client is the most critical and requires the expertise of a registered nurse. Clients A and B are stable and ready for discharge after their respective surgeries (appendectomy and thyroidectomy). Client C, who is 3 days post-splenectomy, is also stable enough to be cared for by a licensed practical nurse as they are in a stable condition and do not have immediate critical needs. Therefore, the registered nurse should care for the client 2 days post-thoracotomy due to the critical nature of the procedure and the immediate postoperative care required.

3. What can the nurse instruct the mother of a teething 9-month-old infant to relieve discomfort?

• A. Rub the infant's gums with baby aspirin dissolved in water.
• B. Obtain an over-the-counter (OTC) topical medication for gum pain relief.
• C. Schedule an appointment with a dentist for a dental evaluation.
• D. Give the infant cool liquids or a Popsicle and hard foods such as dry toast.

Correct answer: D

Rationale: Teething in infants can cause discomfort, but it is a normal process. Symptoms may include nighttime awakening, daytime restlessness, excess drooling, and temporary loss of appetite. The recommended approach to relieve teething discomfort includes providing cool liquids, a Popsicle, or hard foods like dry toast for chewing. These items can help soothe the infant's gums. Rubbing the gums with baby aspirin dissolved in water is not recommended as it can be harmful. OTC topical medications are unnecessary for teething discomfort. Scheduling a dental evaluation is not required solely for teething. It's important to avoid home remedies like baby aspirin and opt for safer options like cool liquids. If necessary, acetaminophen (Tylenol) can be used under healthcare provider guidance to alleviate discomfort.

4. A client with acute leukemia develops a low white blood cell count. In addition to the institution of isolation, the nurse should:

• A. Request that foods be provided in sealed single-serving packages
• B. Ask the client to wear a mask when visitors are present
• C. Prep IV sites with mild soap and water and alcohol
• D. Provide foods in sealed single-serving packages

Correct answer: D

Rationale: For a client with acute leukemia and a low white blood cell count, preventing exposure to food contaminants is crucial due to immune suppression. Providing foods in sealed single-serving packages helps reduce the risk of contamination. Choice B is incorrect as it introduces the potential of infection from visitors. Choice A, suggesting disposable utensils, is not as effective as sealed containers in preventing food contamination. Choice C, using alcohol for prepping IV sites, is less suitable due to its drying effect and potential for skin breakdown, making sealed packages a better option for food safety.

5. There are many types of torts that can be committed against clients. They include all of the following except:

• A. assault.
• B. battery.
• C. negligence.
• D. felony.

Correct answer: D

Rationale: The correct answer is 'felony.' Felonies are serious crimes punishable by time in prison and are not considered types of torts. Types of torts include assault, battery, negligence, as well as other examples like slander, invasion of privacy, false imprisonment, and fraud. Assault involves the threat of harm, battery involves physical harm, and negligence involves a failure to exercise reasonable care. These are all civil wrongs (torts) rather than criminal offenses (felonies), making 'felony' the correct choice.

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