Nursing Elites

1. The nurse is admitting an oncology patient to the unit prior to surgery. The nurse reads in the electronic health record that the patient has just finished radiation therapy. With knowledge of the consequent health risks, the nurse should prioritize assessments related to what health problem?

• A. Cognitive deficits
• B. Impaired wound healing
• C. Cardiac tamponade
• D. Tumor lysis syndrome

Correct answer: B

Rationale: The correct answer is B: Impaired wound healing. Patients who have undergone radiation therapy are at risk for impaired wound healing due to tissue damage. While cognitive deficits, cardiac tamponade, and tumor lysis syndrome can be concerns for oncology patients, the immediate priority following radiation therapy is assessing for impaired wound healing to prevent complications post-surgery.

2. A client with a history of prostate cancer is in the clinic and reports new onset of severe low back pain. What action by the nurse is most important?

• A. Assess the client’s gait and balance.
• B. Ask the client about any changes in urinary symptoms.
• C. Document the report thoroughly.
• D. Inquire about the client’s recent activities.

Correct answer: A

Rationale: The correct action by the nurse is to assess the client’s gait and balance. Severe low back pain in a client with a history of prostate cancer may indicate spinal cord compression, a serious complication. Assessing gait and balance can help determine if there is any spinal cord involvement, which requires immediate medical attention. Asking about changes in urinary symptoms (choice B) is important to assess for possible urinary obstruction, but assessing gait and balance takes precedence due to the risk of spinal cord compression. Documenting the report thoroughly (choice C) is essential but not the most immediate action needed. Inquiring about recent activities (choice D) is not as critical as assessing for spinal cord involvement.

3. A nurse is planning care for a patient with leukemia who has been experiencing severe fatigue. What is the most appropriate intervention to include in the care plan?

• A. Encouraging the patient to remain in bed
• B. Scheduling frequent rest periods
• C. Providing a high-calorie diet
• D. Administering blood transfusions

Correct answer: B

Rationale: In patients with leukemia, severe fatigue is a common symptom due to factors such as anemia, the disease process itself, and the effects of treatments like chemotherapy. The most appropriate intervention is to schedule frequent rest periods to help manage fatigue while encouraging a balance between rest and activity. This approach allows the patient to conserve energy for essential tasks and prevent exhaustion, without promoting complete inactivity, which can lead to deconditioning.

4. A public health nurse has formed an interdisciplinary team that is developing an educational program entitled Cancer: The Risks and What You Can Do About Them. Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity?

• A. Disease prophylaxis
• B. Risk reduction
• C. Secondary prevention
• D. Tertiary prevention

Correct answer: C

Rationale: Secondary prevention involves screening and early detection activities that seek to identify early-stage cancer in individuals who lack symptoms.

5. An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do?

• A. Periodically apply ice to the area.
• B. Keep the area cleanly shaven.
• C. Apply petroleum jelly to the affected area.
• D. Avoid using soap on the treatment area.

Correct answer: D

Rationale: The correct answer is D. When a patient develops erythema following radiation therapy, it is essential to avoid further irritation and potential infection. Using soap on the affected area can exacerbate the condition. Applying ice (choice A) may provide temporary relief for discomfort but does not address the underlying issue. Keeping the area cleanly shaven (choice B) is not necessary and may increase the risk of skin irritation. Applying petroleum jelly (choice C) can trap heat and worsen the erythema, so it is not recommended.

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