The student nurse is conducting a health history for a patient recently diagnosed with cancer. What statement made by the student would require remediation by the clinical faculty?

“Tell me about your support system at home."

"What treatment options has your doctor spoke with you about?""

“I am sure you are scared. Everything will be okay."

“This must be a hard time for you. How are you coping."

Answer and Explanation

The Correct Answer is C

A. "Tell me about your support system at home." This is an open-ended, therapeutic question that encourages the patient to discuss their support network.

B. "What treatment options has your doctor spoken with you about?" This is an appropriate way to assess the patient's understanding of their diagnosis and plan of care.

C. “I am sure you are scared. Everything will be okay." This statement is nontherapeutic because it offers false reassurance and dismisses the patient’s emotions rather than acknowledging their concerns.

D. "This must be a hard time for you. How are you coping?" This is an empathetic statement that acknowledges the patient's feelings and invites them to express their emotions.

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Correct Answer is A

Explanation

A. 46-year-old with a low neutrophil count: Neutrophils are essential for fighting infection. A low neutrophil count (neutropenia) significantly increases infection risk, making this the highest-priority patient.

B. 59-year-old seven days post abdominal surgery: While postoperative patients are at risk for infection, the greatest risk is within the first few days after surgery. By day seven, the risk decreases if no signs of infection are present.

C. 82-year-old with a history of leukemia ten years ago: While leukemia can affect the immune system, a history of leukemia from ten years ago is less concerning than an active condition causing immunosuppression.

D. 62-year-old on antibiotic therapy: While antibiotics can disrupt normal flora and increase the risk of infections like Clostridioides difficile, this risk is lower than that of a patient with neutropenia.

A. A 58-year-old patient with uncontrolled diabetes mellitus type two and intact skin. B. A 48-year-old patient with poor nutrition, warmth and edema to the coccyx. C. An 82-year-old patient with a surgical incision and approximated wound edges. D. A 69 year old patient with a colostomy and blanchable erythema to the sacrum.

Correct Answer is B

Explanation

A. 58-year-old patient with uncontrolled diabetes mellitus type 2 and intact skin: While diabetes increases the risk of delayed wound healing and infection, intact skin is not an immediate concern.

B. 48-year-old patient with poor nutrition, warmth, and edema to the coccyx: Warmth and edema at a pressure site may indicate the beginning of a pressure injury or infection (e.g., cellulitis). Poor nutrition further increases the risk of skin breakdown and impaired healing, making this patient the priority for assessment.

C. 82-year-old patient with a surgical incision and approximated wound edges: A well-approximated surgical incision suggests healing is progressing normally, making this patient lower priority.

D. 69-year-old patient with a colostomy and blanchable erythema to the sacrum: Blanchable erythema is an early sign of pressure injury, but it is less concerning than warmth and edema, which suggest possible infection or worsening tissue damage.

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The student nurse is conducting a health history for a patient recently diagnosed with cancer. What statement made by the student would require remediation by the clinical faculty?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing care for the following patients. Which patient is at highest risk of developing an infection?

Correct Answer is A

Explanation

You have received a report and are providing skin care for the following patients. Which patient do you want to assess first?

Correct Answer is B

Explanation

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