Nursing Elites

1. The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient?

• A. Impaired nutritional status
• B. Cognitive changes
• C. Diarrhea
• D. Alopecia

Correct answer: A

Rationale: Corrected Rationale: Impaired nutritional status is a potential adverse effect of radiotherapy to the head and neck due to alterations in oral mucosa and taste. While cognitive changes, diarrhea, and alopecia can be side effects of other treatments or conditions, they are not typically associated with external radiation for a malignant tumor of the neck. Therefore, the nurse should primarily focus on discussing the risk of impaired nutritional status with the patient.

2. Nurse Lisa is assessing a client who has just completed radiation therapy to the neck area. Which of the following findings is most concerning?

• A. Erythema in the treated area
• B. Difficulty swallowing
• C. Dry, peeling skin
• D. Hoarseness

Correct answer: B

Rationale: Difficulty swallowing (dysphagia) following radiation therapy to the neck area is a significant concern because it can indicate serious complications such as esophageal stricture, inflammation, or damage to the surrounding tissues, including the esophagus. This can lead to malnutrition, dehydration, or aspiration, all of which require prompt intervention. Radiation therapy can cause irritation and scarring in the esophageal and throat tissues, which may progressively worsen if not treated. Therefore, dysphagia should be addressed immediately to prevent further complications.

3. A clinic patient is being treated for polycythemia vera, and the nurse is providing health education. What practice should the nurse recommend to prevent the complications of this health problem?

• A. Avoiding natural sources of vitamin K
• B. Avoiding altitudes of 1500 feet (457 meters)
• C. Performing active range of motion exercises daily
• D. Avoiding tight and restrictive clothing on the legs

Correct answer: D

Rationale: The correct answer is D: Avoiding tight and restrictive clothing on the legs. Patients with polycythemia vera are at risk of deep vein thrombosis (DVT), so it is essential to avoid tight and restrictive clothing that can impede circulation. Choices A, B, and C are incorrect because avoiding natural sources of vitamin K, altitudes of 1500 feet, and performing active range of motion exercises are not directly related to preventing complications of polycythemia vera.

4. A patient with multiple myeloma is receiving chemotherapy and is at risk for bone fractures. What intervention should the nurse prioritize to reduce this risk?

• A. Encouraging bed rest
• B. Promoting bed rest to avoid injury
• C. Encouraging weight-bearing exercises
• D. Ensuring adequate hydration

Correct answer: B

Rationale: The correct answer is B: 'Promoting bed rest to avoid injury.' In patients with multiple myeloma undergoing chemotherapy, encouraging bed rest can lead to muscle weakness and bone loss, increasing the risk of fractures. Promoting bed rest to avoid injury means advising the patient on safe movement and activities to prevent fractures. Encouraging weight-bearing exercises (choice C) would be more beneficial than bed rest as it helps in maintaining bone density and strength. Ensuring adequate hydration (choice D) is essential for overall health but does not directly address the risk of bone fractures associated with multiple myeloma and chemotherapy. Choice A, 'Encouraging bed rest,' is incorrect as it may worsen the risk of fractures rather than reduce it.

5. Which of the following statements by the oncology nurse displays understanding about antineoplastic medications?

• A. Chemotherapy is not going to spread throughout the body
• B. Chemotherapy affects the immune system
• C. Chemotherapy is specific to cancer cells only
• D. Chemotherapy makes the patient radioactive

Correct answer: B

Rationale: Chemotherapy targets rapidly dividing cells, which include both cancerous and healthy cells, such as those in the bone marrow, hair follicles, and the lining of the digestive tract. Since the bone marrow produces immune cells (white blood cells), chemotherapy can weaken the immune system by reducing the body’s ability to produce these cells, making patients more susceptible to infections. This is why close monitoring and supportive measures to protect immune function are important during chemotherapy treatment.

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