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. Which of the following is a correct statement by the nurse to a patient under radiation therapy?

• A. Brachytherapy can be performed by a pregnant nurse.
• B. Teletherapy makes the patient radioactive.
• C. Brachytherapy is an internal radiation therapy.
• D. Teletherapy requires proper disposal of feces since it can be a source of radiation.

Correct answer: C

Rationale: The correct answer is C: 'Brachytherapy is an internal radiation therapy.' Brachytherapy involves the placement of radioactive sources inside or next to the area requiring treatment. This differs from teletherapy, which is external radiation therapy. Choice A is incorrect as pregnant individuals should avoid exposure to radiation. Choice B is incorrect because teletherapy does not make the patient radioactive; the radiation source is external. Choice D is incorrect as feces is not a significant source of radiation during teletherapy.

3. Which of the following is a correct statement by the nurse to a patient under radiation therapy?

• A. Brachytherapy can be administered by a pregnant nurse
• B. Teletherapy makes the patient radioactive
• C. Brachytherapy is an internal radiation therapy
• D. Teletherapy requires proper disposal of feces since feces is not a source of radiation

Correct answer: C

Rationale: The correct statement is that Brachytherapy is an internal radiation therapy. Brachytherapy involves placing radioactive sources inside or near the tumor, delivering a high radiation dose to the targeted area while minimizing exposure to surrounding healthy tissues. Choices A and B are incorrect because pregnant nurses should not administer radiation therapy and brachytherapy does not make the patient radioactive. Choice D is incorrect as feces is not a source of radiation in teletherapy, and it does not require special disposal.

4. 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.

5. A nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, what intervention should the nurse implement?

• A. Arrange for total parenteral nutrition (TPN).
• B. Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube.
• C. Provide the patient with several small, soft-textured meals each day.
• D. Assign responsibility for the patient's nutrition to the patient's friends and family.

Correct answer: C

Rationale: For patients experiencing difficulties with oral intake, the provision of small, easily chewed meals may be beneficial. Option A (TPN) and B (PEG tube placement) are more invasive interventions and should be considered if non-oral routes are necessary. Option D is not appropriate as the primary responsibility for a patient's nutrition should lie with healthcare professionals to ensure proper management and monitoring.

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