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. The nurse is assessing a client with leukemia who is receiving chemotherapy. Which of the following findings would be of most concern?

• A. Alopecia
• B. Fatigue
• C. Nausea and vomiting
• D. Mouth sores

Correct answer: D

Rationale: The correct answer is D, 'Mouth sores.' Mouth sores (stomatitis) are a common and potentially serious side effect of chemotherapy. They can lead to difficulty eating, increased risk of infection, and overall decreased quality of life for the client. While alopecia, fatigue, and nausea/vomiting are also common side effects of chemotherapy, they are generally manageable and do not pose the same level of immediate concern as the development of mouth sores in a client undergoing chemotherapy.

3. A client with breast cancer is receiving doxorubicin (Adriamycin). The nurse monitors the client closely for:

• A. Pulmonary fibrosis
• B. Cardiotoxicity
• C. Hepatotoxicity
• D. Nephrotoxicity

Correct answer: B

Rationale: Doxorubicin (Adriamycin) is an anthracycline chemotherapy agent commonly used to treat various cancers, including breast cancer. One of the significant side effects associated with doxorubicin is cardiotoxicity, which can lead to serious complications such as heart failure and arrhythmias. The risk of cardiotoxicity is dose-dependent, meaning that higher cumulative doses increase the likelihood of cardiac damage. Therefore, it is essential for nurses to monitor cardiac function closely through assessments such as echocardiograms or monitoring for signs and symptoms of heart failure, such as shortness of breath, fatigue, and edema.

4. A nurse enters the room of a patient with bladder cancer. The patient asks the nurse about the actions of chemotherapeutic drugs. Which of the following statements by the nurse is correct?

• A. Chemotherapeutic drugs will kill all of your cancer cells
• B. Chemotherapeutic medications are attracted mostly to slowly dividing cells
• C. Chemotherapy can cure cancer
• D. Chemotherapy is specifically destroying cancer cells

Correct answer: D

Rationale: Chemotherapy drugs are designed to target and destroy rapidly dividing cells, which include cancer cells. Cancer cells often divide more quickly than normal cells, and chemotherapeutic agents exploit this characteristic to inhibit their growth and promote cell death. While chemotherapy can also affect other rapidly dividing normal cells (such as those in the bone marrow, gastrointestinal tract, and hair follicles), the primary goal is to target cancerous cells.

5. What advice should the oncology nurse give to a client planning a beach vacation after completing radiation treatments for cancer?

• A. Avoid getting salt water on the radiation site.
• B. Do not expose the radiation area to direct sunlight.
• C. Have a wonderful time and enjoy your vacation!
• D. Remember you should not drink alcohol for a year.

Correct answer: B

Rationale: The correct answer is B because the skin at the radiation site is sensitive to sunlight, and exposure can cause further damage. It is crucial to protect the area from direct sunlight to prevent skin irritation or burns. Choice A is incorrect as salt water typically does not pose a significant risk to the radiation site. Choice C is a positive and encouraging response but does not provide necessary advice for post-radiation care. Choice D, while important in some cases, is not directly related to the client's beach vacation after completing radiation treatments.

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