Nursing Elites

1. The client is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care?

• A. I change my pouch every week.
• B. I change the appliance in the morning.
• C. I empty the urinary collection bag when it is two-thirds full.
• D. When I'm in the shower, I direct the flow of water away from my stoma.

Correct answer: D

Rationale: The correct answer is D because directing water away from the stoma while showering is incorrect. The stoma can and should be cleaned with water. Choices A, B, and C demonstrate proper stoma care practices, such as changing the pouch regularly, changing the appliance in the morning, and emptying the collection bag when it is two-thirds full, which are all appropriate actions for caring for a urinary stoma.

2. A patient’s most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the patient’s cancer cells spread?

• A. Hematologic spread
• B. Lymphatic circulation
• C. Invasion
• D. Angiogenesis

Correct answer: B

Rationale: In the case of lung cancer that has metastasized to the bones and liver, lymphatic circulation is a key mechanism by which cancer cells spread from the primary tumor site to distant organs. Cancer cells can invade nearby lymphatic vessels and travel through the lymphatic system, eventually reaching lymph nodes and spreading to other tissues and organs. This route is significant in the metastasis of many types of cancer, including lung cancer.

3. A nurse is preparing health education for a patient who has received a diagnosis of myelodysplastic syndrome (MDS). Which of the following topics should the nurse prioritize?

• A. Techniques for energy conservation and activity management
• B. Emergency management of bleeding episodes
• C. Technique for the administration of bronchodilators by metered-dose inhaler
• D. Techniques for self-palpation of the lymph nodes

Correct answer: B

Rationale: Because of patients risks of hemorrhage, patients with MDS should be taught techniques for managing emergent bleeding episodes.

4. Nurse Rose is caring for a client with cancer who has developed spinal cord compression. Which of the following symptoms would the nurse expect to find?

• A. Decreased deep tendon reflexes
• B. Severe headache
• C. Back pain
• D. Loss of bladder control

Correct answer: C

Rationale: The correct answer is C: 'Back pain.' Back pain is a common symptom of spinal cord compression in cancer patients. This condition can cause localized or radiating back pain due to the compression of the spinal cord or nerves. While symptoms such as decreased deep tendon reflexes, severe headache, and loss of bladder control can occur in other conditions, back pain is specifically associated with spinal cord compression in cancer patients.

5. A 62-year-old woman diagnosed with breast cancer is scheduled for a partial mastectomy. The oncology nurse explained that the surgeon will want to take tissue samples to ensure the disease has not spread to adjacent axillary lymph nodes. The patient has asked if she will have her lymph nodes dissected, like her mother did several years ago. What alternative to lymph node dissection will this patient most likely undergo?

• A. Lymphadenectomy
• B. Needle biopsy
• C. Open biopsy
• D. Sentinel node biopsy

Correct answer: D

Rationale: Sentinel lymph node biopsy is a minimally invasive alternative to more extensive lymph node dissection. This procedure involves identifying and removing the first lymph node(s) to which a tumor drains, known as the sentinel node(s), to determine if cancer has spread beyond the primary site. Choices A, B, and C are incorrect because lymphadenectomy refers to the surgical removal of lymph nodes, needle biopsy involves sampling tissue with a needle for analysis, and open biopsy refers to the surgical removal of a sample of tissue for examination, none of which specifically serve as an alternative to lymph node dissection in this context.

Similar Questions