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 cancer who has been receiving cisplatin (Platinol-AQ). Which laboratory result requires an intervention by the nurse?

• A. White blood cell count of 6000 cells/microL
• B. Serum potassium level of 3.5 mEq/L
• C. Blood urea nitrogen (BUN) of 18 mg/dL
• D. Platelet count of 150,000 cells/microL

Correct answer: C

Rationale: The correct answer is C. A BUN level of 18 mg/dL is within the normal range; however, since cisplatin is nephrotoxic, it requires close monitoring. Elevated BUN levels can indicate impaired kidney function. Choices A, B, and D are within normal ranges and do not directly relate to cisplatin therapy or require immediate intervention.

3. 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.

4. Which of the following is not a manifestation of breast cancer?

• A. Peau d'orange
• B. Painless breast mass
• C. Alopecia
• D. Breast enlargement

Correct answer: C

Rationale: Alopecia (hair loss) is not a direct manifestation of breast cancer but rather a common side effect of chemotherapy used in breast cancer treatment. Peau d'orange refers to the dimpling or pitting of the skin resembling an orange peel, which can be a sign of breast cancer due to blockage of lymphatic vessels. A painless breast mass and breast enlargement can both be manifestations of breast cancer, with a painless mass being a common symptom and breast enlargement sometimes occurring due to tumor growth.

5. A client has been prescribed epoetin alfa for anemia related to chemotherapy. What lab value should the nurse monitor to determine the effectiveness of this medication?

• A. Hemoglobin level.
• B. Hematocrit level.
• C. White blood cell count.
• D. Platelet count.

Correct answer: A

Rationale: Epoetin alfa is a medication used to treat anemia, particularly anemia related to chemotherapy or chronic kidney disease. It stimulates the bone marrow to produce more red blood cells, which increases the hemoglobin level. Monitoring hemoglobin is the best way to assess the effectiveness of epoetin alfa, as an increase in hemoglobin indicates that the body is producing more red blood cells and the anemia is improving.

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