Nursing Elites

1. The nurse is caring for a female client experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. The nurse plans to:

• A. Restrict all visitors
• B. Restrict fluid intake
• C. Teach the client and family about the need for hand hygiene
• D. Insert an indwelling urinary catheter to prevent skin breakdown

Correct answer: C

Rationale: In clients experiencing neutropenia due to chemotherapy, the immune system is significantly compromised, leaving the client highly susceptible to infections. Meticulous hand hygiene is one of the most effective ways to prevent infections in neutropenic patients. Teaching the client and their family the importance of frequent and proper handwashing helps reduce the transmission of harmful pathogens that could lead to severe infections in the neutropenic client. This simple but essential intervention is crucial in maintaining a safe environment.

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. Which of the following terms is another name for Billroth I?

• A. Gastroduodenostomy
• B. Gastrojejunostomy
• C. Gastroileostomy
• D. Gastrostomy

Correct answer: A

Rationale: The correct answer is Gastroduodenostomy. Billroth I procedure involves the removal of a part of the stomach (usually the distal portion) and anastomosis of the remaining stomach to the duodenum. This procedure is known as Gastroduodenostomy. Choices B, C, and D are incorrect as they refer to different surgical procedures involving connections with the jejunum, ileum, and creating an opening in the stomach, respectively, not the specific procedure described as Billroth I.

4. A nurse at a long-term care facility is amending the care plan of a resident who has just been diagnosed with essential thrombocythemia (ET). The nurse should anticipate the administration of what medication?

• A. Dalteparin
• B. Allopurinol
• C. Hydroxyurea
• D. Hydrochlorothiazide

Correct answer: C

Rationale: Hydroxyurea is effective in lowering the platelet count for patients with ET.

5. A nurse is caring for a patient diagnosed with chronic myeloid leukemia (CML) who is receiving the drug imatinib (Gleevec). What should the nurse monitor in this patient to assess for side effects of this therapy?

• A. Cardiac function
• B. Renal function
• C. Liver function
• D. Pulmonary function

Correct answer: A

Rationale: The correct answer is A: Cardiac function. Imatinib can cause fluid retention and heart failure, so cardiac function should be closely monitored. Renal function (choice B) is not typically affected by imatinib. Liver function (choice C) is not the primary concern with this medication. Pulmonary function (choice D) is not directly impacted by imatinib therapy.

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