Nursing Elites

1. Nurse Casey is preparing to administer chemotherapy to a client with leukemia. The nurse wears gloves and a gown to administer the medication and to prevent exposure to the agent by which of the following routes?

• A. By ingestion
• B. By skin contact
• C. By absorption
• D. By inhalation

Correct answer: D

Rationale: Chemotherapeutic agents can be hazardous to healthcare workers if they are exposed to the drugs during preparation or administration. One of the primary risks is inhalation, where small particles or aerosols of the drug can become airborne and be inhaled, potentially causing harm to the nurse. Protective gear such as gloves and a gown, as well as masks or respirators in some cases, helps prevent this type of exposure.

2. Diagnostic testing has resulted in a diagnosis of acute myeloid leukemia (AML) in an adult patient who is otherwise healthy. The patient and the care team have collaborated and the patient will soon begin induction therapy. The nurse should prepare the patient for which of the following?

• A. Daily treatment with targeted therapy medications
• B. Radiation therapy on a daily basis
• C. Hematopoietic stem cell transplantation
• D. An aggressive course of chemotherapy

Correct answer: D

Rationale: Attempts are made to achieve remission of AML by the aggressive administration of chemotherapy.

3. A nurse is caring for a patient who has been diagnosed with leukemia. The nurse's most recent assessment reveals the presence of ecchymoses on the patient's sacral area and petechiae on her forearms. In addition to informing the patient's primary care provider, what action should the nurse take?

• A. Initiate measures to prevent venous thromboembolism (VTE).
• B. Check the patient's most recent platelet level.
• C. Place the patient on protective isolation.
• D. Ambulate the patient to promote circulatory function.

Correct answer: B

Rationale: The patient's signs of ecchymoses and petechiae are suggestive of thrombocytopenia, which is a common complication of leukemia. Thrombocytopenia is a condition characterized by a low platelet count, leading to abnormal bleeding. Checking the patient's most recent platelet level is crucial to assess the severity of thrombocytopenia and guide further interventions. Initiating measures to prevent venous thromboembolism (VTE) (Choice A) is not directly related to the patient's current signs. Placing the patient on protective isolation (Choice C) is not necessary for ecchymoses and petechiae. Ambulating the patient (Choice D) is not appropriate without addressing the underlying cause of abnormal bleeding.

4. A client hospitalized for chemotherapy has a hemoglobin of 6.1 mg/dL (61 mmol/L). The client is symptomatic but refuses blood transfusions. What medication does the nurse prepare to administer?

• A. Epoetin alfa.
• B. Filgrastim.
• C. Mesna.
• D. Dexrazoxane.

Correct answer: A

Rationale: Epoetin alfa stimulates the production of red blood cells, which is important for a client who refuses blood transfusions.

5. Which of the following descriptions of chemotherapy is correct?

• A. Chemotherapy is externally given through high energy waves
• B. Chemotherapy is known to have fatigue as a common side effect
• C. Chemotherapy spreads throughout the body
• D. Chemotherapy attacks cancer cells only

Correct answer: C

Rationale: Chemotherapy drugs are typically administered systemically, meaning they circulate throughout the body via the bloodstream. This allows them to target cancer cells that may have spread beyond the original tumor site, making chemotherapy an effective treatment for cancers that are metastatic (have spread to other parts of the body). However, because chemotherapy is not selective, it can also affect healthy cells that divide rapidly, leading to a range of side effects.

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