Nursing Elites

1. The nurse is reviewing the history of a client with bladder cancer. The nurse expects to note documentation of which most common symptom of this type of cancer?

• A. Dysuria
• B. Hematuria
• C. Urgency on urination
• D. Frequency of urination

Correct answer: B

Rationale: Hematuria, or blood in the urine, is the most common and distinctive symptom associated with bladder cancer. It can present as either gross hematuria (visible blood) or microscopic hematuria (detected only through urinalysis). The presence of blood in the urine often prompts further evaluation for potential underlying causes, including bladder cancer. It is crucial for healthcare providers to recognize this symptom, as early detection significantly impacts treatment outcomes.

2. Nurse Joy is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which of the following principles?

• A. Limit the time with the client to 1 hour per shift
• B. Do not allow pregnant women into the client’s room
• C. Remove the dosimeter badge when entering the client’s room
• D. Individuals younger than 16 years old may be allowed to go in the room as long as they are 6 feet away from the client

Correct answer: B

Rationale: Clients with internal radiation implants (also known as brachytherapy) emit a small amount of radiation, which can pose a risk to others. Pregnant women are particularly vulnerable to the harmful effects of radiation because it can affect both the mother and the developing fetus. Radiation exposure can lead to birth defects, miscarriage, or other developmental issues, so pregnant women should avoid any exposure by not entering the client's room.

3. An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do?

• A. Periodically apply ice to the area.
• B. Keep the area cleanly shaven.
• C. Apply petroleum jelly to the affected area.
• D. Avoid using soap on the treatment area.

Correct answer: D

Rationale: The correct answer is D. When a patient develops erythema following radiation therapy, it is essential to avoid further irritation and potential infection. Using soap on the affected area can exacerbate the condition. Applying ice (choice A) may provide temporary relief for discomfort but does not address the underlying issue. Keeping the area cleanly shaven (choice B) is not necessary and may increase the risk of skin irritation. Applying petroleum jelly (choice C) can trap heat and worsen the erythema, so it is not recommended.

4. Which of the following descriptions of chemotherapy is correct?

• A. Chemotherapy is externally given through high energy waves
• B. Chemotherapy is known to have fatigue as a common side effect
• C. Chemotherapy spreads throughout the body
• D. Chemotherapy attacks cancer cells only

Correct answer: C

Rationale: Chemotherapy drugs are typically administered systemically, meaning they circulate throughout the body via the bloodstream. This allows them to target cancer cells that may have spread beyond the original tumor site, making chemotherapy an effective treatment for cancers that are metastatic (have spread to other parts of the body). However, because chemotherapy is not selective, it can also affect healthy cells that divide rapidly, leading to a range of side effects.

5. An adult patient has presented to the health clinic with a complaint of a firm, painless cervical lymph node. The patient denies any recent infectious diseases. What is the nurse's most appropriate response to the patient's complaint?

• A. Call 911.
• B. Promptly refer the patient for medical assessment.
• C. Facilitate a radiograph of the patient's neck and have the results forwarded to the patient's primary care provider.
• D. Encourage the patient to track the size of the lymph node and seek care in 1 week.

Correct answer: B

Rationale: The most appropriate response for a patient presenting with a firm, painless cervical lymph node and denying recent infectious diseases is to promptly refer the patient for medical assessment. This is crucial to rule out serious underlying conditions such as malignancy or other concerning causes. Calling 911 is not necessary in this situation as it is not an emergency. Ordering a radiograph may not be the most immediate or appropriate action, as further evaluation by a healthcare provider is needed first. Encouraging the patient to wait and track the lymph node for a week is not advisable when a potential serious condition needs to be ruled out promptly.

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