Nursing Elites

1. The cells of a normal individual can replicate in a specified rate. If the rate of replication becomes uncontrollable, which of the following is lacking from the patient?

• A. Apoptosis
• B. Contact inhibition
• C. Stable cells
• D. Labile cells

Correct answer: B

Rationale: Contact inhibition is a regulatory mechanism that prevents cells from proliferating once they reach a certain density. Normally, when cells grow and touch each other (such as in a monolayer), they stop dividing, maintaining tissue integrity and structure. When contact inhibition is lacking, as in many cancerous cells, cells continue to grow and divide uncontrollably, leading to tumor formation. This loss of regulation is a hallmark of cancerous growth.

2. A patient who is undergoing consolidation therapy for the treatment of leukemia has been experiencing debilitating fatigue. How can the nurse best meet this patients needs for physical activity?

• A. Teach the patient about the risks of immobility and the benefits of exercise.
• B. Assist the patient to a chair during awake times, as tolerated.
• C. Collaborate with the physical therapist to arrange for stair exercises.
• D. Teach the patient to perform deep breathing and coughing exercises.

Correct answer: B

Rationale: For patients undergoing consolidation therapy for leukemia, severe fatigue is a common side effect of treatment due to factors such as anemia, decreased nutritional intake, and the body’s response to chemotherapy. While exercise is beneficial, the patient's fatigue may limit their ability to engage in strenuous activity. Assisting the patient to sit in a chair during awake times is a practical way to encourage some physical activity while respecting their fatigue levels. This intervention helps prevent complications associated with immobility, such as muscle atrophy and venous stasis, without overwhelming the patient. It allows the patient to engage in light activity that is manageable and promotes recovery.

3. 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.

4. A patient with myelofibrosis is being treated with ruxolitinib. What should the nurse monitor to assess the effectiveness of this treatment?

• A. Blood pressure
• B. White blood cell count
• C. Hemoglobin and hematocrit
• D. Spleen size

Correct answer: C

Rationale: Monitoring hemoglobin and hematocrit is essential to assess the effectiveness of ruxolitinib in treating myelofibrosis. Ruxolitinib works by inhibiting JAK1 and JAK2, which are involved in the signaling pathways that regulate blood cell production. Therefore, monitoring hemoglobin and hematocrit levels can provide valuable information on how well the drug is managing the disease. Blood pressure, white blood cell count, and spleen size are not direct indicators of the treatment's effectiveness in myelofibrosis.

5. Nurse Kate is reviewing the complications of conization with a client who has microinvasive cervical cancer. Which complication, if identified by the client, indicates a need for further teaching?

• A. Infection
• B. Hemorrhage
• C. Cervical stenosis
• D. Ovarian perforation

Correct answer: D

Rationale: The correct answer is D, 'Ovarian perforation.' Ovarian perforation is not a complication associated with conization; therefore, if the client identifies this as a potential complication, it indicates a need for further teaching. Choices A, B, and C are incorrect: Infection, hemorrhage, and cervical stenosis are potential complications of conization, so identifying them would not necessarily indicate a need for further teaching.

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