Nursing Elites

1. The nurse should plan to implement which intervention in the care of a client experiencing neutropenia as a result of chemotherapy?

• A. Restrict all visitors.
• B. Restrict fluid intake.
• C. Teach the client and family about the need for hand hygiene.
• D. Insert an indwelling urinary catheter to prevent skin breakdown.

Correct answer: C

Rationale: In clients experiencing neutropenia, particularly due to chemotherapy, the immune system is significantly compromised, increasing the risk of infections. Hand hygiene is one of the most effective methods for preventing the spread of pathogens that can lead to infections. Teaching both the client and their family about the importance of frequent and proper handwashing helps create a safer environment and reduces the risk of infections, which can be critical in neutropenic patients.

2. A patient with non-Hodgkin's lymphoma is receiving information from the oncology nurse. The patient asks the nurse why she should stop drinking and smoking and stay out of the sun. What would be the nurse's best response?

• A. Everyone should do these things because they are health promotion activities that apply to everyone.
• B. You don't want to develop a second cancer, do you?
• C. You need to do this just to be on the safe side.
• D. It's important to reduce other factors that increase the risk of second cancers.

Correct answer: D

Rationale: The nurse should encourage patients to reduce other factors that increase the risk of developing second cancers, such as the use of tobacco and alcohol and exposure to environmental carcinogens and excessive sunlight. Choice A is too general and does not address the specific concerns of a cancer patient. Choice B uses fear tactics, which may not be the most effective approach. Choice C is vague and does not provide a clear rationale for the behavior change, unlike Choice D which specifically links the behaviors to reducing the risk of second cancers.

3. A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months after radiation therapy for breast cancer. What response by the nurse is most appropriate?

• A. Are you getting adequate rest and sleep each day?
• B. It is normal to be fatigued even for months afterward.
• C. This is not normal and I’ll let the primary health care provider know.
• D. Try adding more vitamins B and C to your diet.

Correct answer: B

Rationale: Radiation-induced fatigue can last for months; it’s important to normalize this for the client.

4. The nurse knows that all of the following are risk factors for breast cancer except:

• A. Family history
• B. Nulliparity
• C. Chest xray
• D. Multiple sex partners

Correct answer: D

Rationale: Multiple sex partners are not a recognized risk factor for breast cancer. Breast cancer is primarily influenced by hormonal, genetic, and environmental factors, not sexual activity or the number of sexual partners. Established risk factors for breast cancer include family history, hormonal factors such as early menarche, late menopause, and nulliparity (having no children), as well as certain environmental exposures.

5. The nurse is teaching a client about the signs of infection after chemotherapy. Which of the following should the nurse emphasize?

• A. Frequent urination
• B. Increased thirst
• C. Chills and shaking
• D. Fever over 100.4°F (38°C)

Correct answer: D

Rationale: In clients undergoing chemotherapy, the immune system is often compromised due to the effects of treatment, making them more susceptible to infections. A fever over 100.4°F (38°C) is considered a critical sign of infection in these patients and requires immediate medical evaluation. Fever may indicate the presence of an infection that could escalate quickly in immunocompromised individuals, so it is vital for patients to recognize this symptom and seek prompt medical attention.

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