Nursing Elites

1. The nurse is reviewing the medication record for a client receiving chemotherapy and notes that the client is receiving epoetin alfa (Epogen). The nurse determines that this medication has been prescribed to:

• A. Increase white blood cell production
• B. Treat anemia
• C. Reduce pain
• D. Prevent infection

Correct answer: B

Rationale: Epoetin alfa (Epogen) is a synthetic form of erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow. Chemotherapy often leads to anemia due to its effects on rapidly dividing cells, including those in the bone marrow responsible for red blood cell production. By administering epoetin alfa, the healthcare provider aims to increase the red blood cell count and improve hemoglobin levels, thereby alleviating symptoms associated with anemia, such as fatigue and weakness.

2. A nurse is caring for a patient with myelodysplastic syndrome (MDS) who is receiving erythropoietin therapy. What should the nurse monitor to evaluate the effectiveness of this treatment?

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

Correct answer: B

Rationale: Erythropoietin therapy is used to stimulate the production of red blood cells in patients with myelodysplastic syndrome (MDS), a disorder characterized by ineffective blood cell production, including red blood cells. The primary goal of erythropoietin therapy is to increase red blood cell count, improving the patient's oxygen-carrying capacity and reducing symptoms of anemia, such as fatigue and weakness. Monitoring hemoglobin levels is the best way to evaluate the effectiveness of this therapy because it directly reflects the patient's red blood cell count and the success of erythropoiesis (red blood cell production).

3. The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?

• A. Monthly self-breast exams
• B. Smoking cessation
• C. Annual colonoscopies
• D. Monthly testicular exams

Correct answer: B

Rationale: In North America, lung cancer is the leading cause of cancer deaths among both men and women, and the primary risk factor for lung cancer is smoking. Therefore, promoting smoking cessation is a critical public health intervention that directly addresses this significant health issue. By helping individuals quit smoking, healthcare providers can significantly reduce the incidence of lung cancer and associated deaths, making this intervention a priority in cancer prevention efforts.

4. You are caring for a patient who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the patient the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer?

• A. Palliative
• B. Reconstructive
• C. Salvage
• D. Prophylactic

Correct answer: A

Rationale: The correct answer is A: Palliative. Palliative surgery is aimed at relieving symptoms and improving quality of life when a cure is not possible. In this scenario, where the cancer has recurred and metastasized, the goal of surgery would be to alleviate symptoms rather than to cure the disease. Choices B, C, and D are incorrect because reconstructive surgery aims to restore function or appearance, salvage surgery aims to remove or salvage tissue to prevent further complications, and prophylactic surgery aims to prevent the development of a condition rather than treat its progression.

5. A client hospitalized for chemotherapy has a hemoglobin of 6.1 mg/dL (61 mmol/L). The client is symptomatic but refuses blood transfusions. What medication does the nurse prepare to administer?

• A. Epoetin alfa.
• B. Filgrastim.
• C. Mesna.
• D. Dexrazoxane.

Correct answer: A

Rationale: Epoetin alfa stimulates the production of red blood cells, which is important for a client who refuses blood transfusions.

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