Nursing Elites

1. 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.

2. The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient?

• A. These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and x-ray studies.
• B. These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer.
• C. Try not to be concerned about these symptoms. Every patient feels this way after having radiation therapy.
• D. Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying.

Correct answer: A

Rationale: Fatigue and weakness are common side effects of radiation therapy, often due to the body’s response to radiation damage and the energy required to repair both cancerous and healthy cells affected by the treatment. Reassuring the patient that these symptoms are expected while also emphasizing ongoing monitoring (through lab and x-ray studies) provides both comfort and a sense of proactive care. It ensures the patient that their symptoms are being addressed in a safe and medically appropriate way.

3. When reviewing the safe administration of antineoplastic agents, what action should the nurse emphasize?

• A. Adjust the dose based on the patient's present symptoms.
• B. Wash hands with an alcohol-based cleanser before and after administration.
• C. Use gloves and a lab coat when preparing and administering the medication.
• D. Dispose of the antineoplastic wastes in the hazardous waste receptacle.

Correct answer: D

Rationale: The correct answer is to dispose of the antineoplastic wastes in the hazardous waste receptacle. Antineoplastic agents are hazardous materials, and proper disposal is crucial to prevent harm to individuals and the environment. Option A is incorrect because adjusting the dose based on the patient's present symptoms may not be safe without proper authorization. Option B is incorrect as hand hygiene should be performed both before and after administering medications. Option C is incorrect as gloves and a lab coat should be worn primarily during handling and administration, not just during preparation.

4. Nurse Ben is reviewing the laboratory results of a client undergoing chemotherapy. Which of the following values would require immediate intervention?

• A. Platelet count of 150,000/mm3
• B. White blood cell count of 6,000/mm3
• C. Hemoglobin level of 14 g/dL
• D. Absolute neutrophil count of 500/mm3

Correct answer: D

Rationale: An absolute neutrophil count of 500/mm3 indicates severe neutropenia, putting the client at high risk for infection. Neutrophils are crucial in fighting off infections; a low count increases susceptibility to infections. Platelet count, white blood cell count, and hemoglobin levels are within normal ranges and do not require immediate intervention in this scenario.

5. A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?

• A. Administer an antiemetic.
• B. Administer an antimetabolite.
• C. Administer a tumor antibiotic.
• D. Administer an anticoagulant.

Correct answer: A

Rationale: The correct answer is A: Administer an antiemetic. Chemotherapy commonly causes nausea and vomiting as adverse effects. Antiemetics are medications specifically used to prevent or treat these symptoms. Choices B, C, and D are incorrect because administering an antimetabolite, a tumor antibiotic, or an anticoagulant would not directly address the most common adverse effects of chemotherapy, which are nausea and vomiting.

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