Nursing Elites

1. The nurse on a bone marrow transplant unit is caring for a patient with cancer who is preparing for HSCT. What is a priority nursing diagnosis for this patient?

• A. Fatigue related to altered metabolic processes
• B. Altered nutrition: less than body requirements related to anorexia
• C. Risk for infection related to altered immunologic response
• D. Body image disturbance related to weight loss and anorexia

Correct answer: C

Rationale: Patients preparing for hematopoietic stem cell transplantation (HSCT) undergo intensive chemotherapy and/or radiation, which significantly suppresses their immune system. This immunosuppression leads to a heightened risk for infection, making it the most critical nursing diagnosis for these patients. As the body’s ability to fight off pathogens is compromised, close monitoring and interventions aimed at preventing infections are essential for their safety and recovery.

2. A client with neutropenia is admitted to the hospital. What precaution is most important for the nurse to implement?

• A. Strict hand hygiene.
• B. Limit visitor contact with the client.
• C. Administer prophylactic antibiotics as ordered.
• D. Administer blood products as ordered.

Correct answer: A

Rationale: The correct answer is A: Strict hand hygiene. Neutropenic clients have a low level of neutrophils, which are important in fighting infections. Therefore, maintaining strict hand hygiene is crucial in preventing the introduction of pathogens that could lead to infections. Limiting visitor contact (choice B) is important but not as critical as preventing the introduction of pathogens through proper hand hygiene. Administering prophylactic antibiotics (choice C) and blood products (choice D) are treatment measures and do not address the preventive aspect that hand hygiene provides.

3. The clinical nurse educator is presenting health promotion education to a patient who will be treated for non-Hodgkin lymphoma on an outpatient basis. The nurse should recommend which of the following actions?

• A. Avoiding direct sun exposure in excess of 15 minutes daily
• B. Avoiding grapefruit juice and fresh grapefruit
• C. Avoiding highly crowded public places
• D. Using an electric shaver rather than a razor

Correct answer: C

Rationale: Patients with non-Hodgkin lymphoma (NHL) often experience a compromised immune system due to both the disease itself and the effects of treatments like chemotherapy and radiation, which cause myelosuppression (decreased production of blood cells, including white blood cells). This puts them at significant risk for infections. Avoiding crowded places is a crucial preventive measure, as it reduces the patient's exposure to pathogens that could lead to infections, which can be particularly severe due to their weakened immune system.

4. Nurse Cecilia is caring for a client who has undergone a vaginal hysterectomy. The nurse avoids which of the following in the care of this client?

• A. Elevating the knee gatch on the bed
• B. Assisting with range-of-motion leg exercises
• C. Removal of antiembolism stockings twice daily
• D. Checking placement of pneumatic compression boots

Correct answer: A

Rationale: The correct answer is A. Elevating the knee gatch on the bed should be avoided in the care of a client who has undergone a vaginal hysterectomy. This action can inhibit venous return, increasing the risk of deep vein thrombosis or thrombophlebitis. Choices B, C, and D are appropriate nursing interventions for postoperative care to prevent complications and promote circulation.

5. When planning care for a 77-year-old male admitted with suspected acute myeloid leukemia (AML), what epidemiologic fact should the nurse be aware of?

• A. Early diagnosis is associated with good outcomes.
• B. Five-year survival for older adults is approximately 50%.
• C. Five-year survival for patients over 75 years old is less than 2%.
• D. Survival rates are wholly dependent on the patient's pre-illness level of health.

Correct answer: C

Rationale: In the context of AML, the 5-year survival rate significantly decreases with age. The 5-year survival rate for patients over 75 years old is less than 2% compared to 43% for those 50 years or younger, and 19% for those between 50 and 64 years. Choice A is incorrect as early diagnosis does not necessarily guarantee good outcomes in AML. Choice B is inaccurate as the 5-year survival rate is not approximately 50% for older adults with AML. Choice D is incorrect as survival rates for AML patients are influenced by various factors beyond just the pre-illness level of health.

Similar Questions