Deck 22: Care of Patients with Cancer

Question 1

After receiving the hand-off report,which client should the oncology nurse see first?

A) Client who is afebrile with a heart rate of 108 beats/min
B) Older client on chemotherapy with mental status changes
C) Client who is neutropenic and in protective isolation
D) Client scheduled for radiation therapy today

Answer 1

Older client on chemotherapy with mental status changes

Question 2

A client is receiving chemotherapy through a peripheral IV line.What action by the nurse is most important?

A) Assessing the IV site every hour
B) Educating the client on side effects
C) Monitoring the client for nausea
D) Providing warm packs for comfort

Answer 2

Assessing the IV site every hour

Question 3

A nurse working with clients who experience alopecia knows that which is the best method of helping clients manage the psychosocial impact of this problem?

A) Assisting the client to pre-plan for this event
B) Reassuring the client that alopecia is temporary
C) Teaching the client ways to protect the scalp
D) Telling the client that there are worse side effects

Answer 3

Assisting the client to pre-plan for this event

Question 4

A client is receiving interleukins along with chemotherapy.What assessment by the nurse takes priority?

A) Blood pressure
B) Lung assessment
C) Oral mucous membranes
D) Skin integrity

Question 5

A client tells the oncology nurse about an upcoming vacation to the beach to celebrate completing radiation treatments for cancer.What response by the nurse is most appropriate?

A) "Avoid getting salt water on the radiation site."
B) "Do not expose the radiation area to direct sunlight."
C) "Have a wonderful time and enjoy your vacation!"
D) "Remember you should not drink alcohol for a year."

Question 6

A client hospitalized for chemotherapy has a hemoglobin of 6.1 mg/dL.What medication should the nurse prepare to administer?

A) Epoetin alfa (Epogen)
B) Filgrastim (Neupogen)
C) Mesna (Mesnex)
D) Oprelvekin (Neumega)

Question 7

The nurse has taught a client with cancer ways to prevent infection.What statement by the client indicates that more teaching is needed?

A) "I should take my temperature daily and when I don't feel well."
B) "I will wash my toothbrush in the dishwasher once a week."
C) "I won't let anyone share any of my personal items or dishes."
D) "It's alright for me to keep my pets and change the litter box."

Question 8

Four clients are receiving tyrosine kinase inhibitors (TKIs).Which of these four clients should the nurse assess first?

A) Client with dry, itchy, peeling skin
B) Client with a serum calcium of 9.2 mg/dL
C) Client with a serum potassium of 2.8 mEq/L
D) Client with a weight gain of 0.5 pound (1.1 kg) in 1 day

Question 9

A nurse works with clients who have alopecia from chemotherapy.What action by the nurse takes priority?

A) Helping clients adjust to their appearance
B) Reassuring clients that this change is temporary
C) Referring clients to a reputable wig shop
D) Teaching measures to prevent scalp injury

Question 10

A nurse in the oncology clinic is providing preoperative education to a client just diagnosed with cancer.The client has been scheduled for surgery in 3 days.What action by the nurse is best?

A) Call the client at home the next day to review teaching.
B) Give the client information about a cancer support group.
C) Provide all the preoperative instructions in writing.
D) Reassure the client that surgery will be over soon.

Question 11

A client is receiving rituximab (Rituxan)and asks how it works.What response by the nurse is best?

A) "It causes rapid lysis of the cancer cell membranes."
B) "It destroys the enzymes needed to create cancer cells."
C) "It prevents the start of cell division in the cancer cells."
D) "It sensitizes certain cancer cells to chemotherapy."

Question 12

A new nurse has been assigned a client who is in the hospital to receive iodine-131 treatment.Which action by the nurse is best?

A) Ensure the client is placed in protective isolation.
B) Hand off a pregnant client to another nurse.
C) No special action is necessary to care for this client.
D) Read the policy on handling radioactive excreta.

Question 13

A nurse reads on a hospitalized client's chart that the client is receiving teletherapy.What action by the nurse is best?

A) Coordinate continuation of the therapy.
B) Place the client on radiation precautions.
C) No action by the nurse is needed at this time.
D) Restrict visitors to only adults over age 18.

Question 14

A client with cancer is admitted to a short-term rehabilitation facility.The nurse prepares to administer the client's oral chemotherapy medications.What action by the nurse is most appropriate?

A) Crush the medications if the client cannot swallow them.
B) Give one medication at a time with a full glass of water.
C) No special precautions are needed for these medications.
D) Wear personal protective equipment when handling the medications.

Question 15

A client has received a dose of ondansetron (Zofran)for nausea.What action by the nurse is most important?

A) Assess the client for a headache.
B) Assist the client in getting out of bed.
C) Instruct the client to reduce salt intake.
D) Weigh the client daily before the client eats.

Question 16

A client has a platelet count of 9800/mm³.What action by the nurse is most appropriate?

A) Assess the client for calf pain, warmth, and redness.
B) Instruct the client to call for help to get out of bed.
C) Obtain cultures as per the facility's standing policy.
D) Place the client on protective isolation precautions.

Question 17

A nurse is assessing a female client who is taking progestins.What assessment finding requires the nurse to notify the provider immediately?

A) Irregular menses
B) Edema in the lower extremities
C) Ongoing breast tenderness
D) Red, warm, swollen calf

Question 18

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 years afterward."
C) "This is not normal and I'll let the provider know."
D) "Try adding more vitamins B and C to your diet."

Question 19

The nurse working with oncology clients understands that which age-related change increases the older client's susceptibility to infection during chemotherapy?

A) Decreased immune function
B) Diminished nutritional stores
C) Existing cognitive deficits
D) Poor physical reserves

Question 20

A client with a history of prostate cancer is in the clinic and reports new onset of severe low back pain.What action by the nurse is most important?

A) Assess the client's gait and balance.
B) Ask the client about the ease of urine flow.
C) Document the report completely.
D) Inquire about the client's job risks.

Question 21

A client has mucositis.What actions by the nurse will improve the client's nutrition? (Select all that apply.)

A) Assist with rinsing the mouth with saline frequently.
B) Encourage the client to eat room-temperature foods.
C) Give the client hot liquids to hold in the mouth.
D) Provide local anesthetic medications to swish and spit.
E) Remind the client to brush teeth gently after each meal.

Question 22

A client is having a catheter placed in the femoral artery to deliver yttrium-90 beads into a liver tumor.What action by the nurse is most important?

A) Assessing the client's abdomen beforehand
B) Ensuring that informed consent is on the chart
C) Marking the client's bilateral pedal pulses
D) Reviewing client teaching done previously

Question 23

A client receiving chemotherapy has a white blood cell count of 1000/mm³.What actions by the nurse are most appropriate? (Select all that apply.)

A) Assess all mucous membranes every 4 to 8 hours.
B) Do not allow the client to eat meat or poultry.
C) Listen to lung sounds and monitor for cough.
D) Monitor the venous access device appearance with vital signs.
E) Take and record vital signs every 4 to 8 hours.

Question 24

A client with cancer has anorexia and mucositis,and is losing weight.The client's family members continually bring favorite foods to the client and are distressed when the client won't eat them.What action by the nurse is best?

A) Explain the pathophysiologic reasons behind the client not eating.
B) Help the family show other ways to demonstrate love and caring.
C) Suggest foods and liquids the client might be willing to try to eat.
D) Tell the family the client isn't able to eat now no matter what they bring.

Question 25

A nurse is preparing to administer IV chemotherapy.What supplies does this nurse need? (Select all that apply.)

A) "Chemo" gloves
B) Facemask
C) Isolation gown
D) N95 respirator
E) Shoe covers

Question 26

A client is admitted with superior vena cava syndrome.What action by the nurse is most appropriate?

A) Administer a dose of allopurinol (Aloprim).
B) Assess the client's serum potassium level.
C) Gently inquire about advance directives.
D) Prepare the client for emergency surgery.

Question 27

The student nurse caring for clients who have cancer understands that the general consequences of cancer include which client problems? (Select all that apply.)

A) Clotting abnormalities from thrombocythemia
B) Increased risk of infection from white blood cell deficits
C) Nutritional deficits such as early satiety and cachexia
D) Potential for reduced gas exchange
E) Various motor and sensory deficits

Question 28

A nurse works on an oncology unit and delegates personal hygiene to an unlicensed assistive personnel (UAP).What action by the UAP requires intervention from the nurse?

A) Allowing a very tired client to skip oral hygiene and sleep
B) Assisting clients with washing the perianal area every 12 hours
C) Helping the client use a soft-bristled toothbrush for oral care
D) Reminding the client to rinse the mouth with water or saline

Question 29

A client in the emergency department reports difficulty breathing.The nurse assesses the client's appearance as depicted below:

What action by the nurse is the priority?

A) Assess blood pressure and pulse.
B) Attach the client to a pulse oximeter.
C) Have the client rate his or her pain.
D) Start high-dose steroid therapy.

Question 30

A client's family members are concerned that telling the client about a new finding of cancer will cause extreme emotional distress.They approach the nurse and ask if this can be kept from the client.What actions by the nurse are most appropriate? (Select all that apply.)

A) Ask the family to describe their concerns more fully.
B) Consult with a social worker, chaplain, or ethics committee.
C) Explain the client's right to know and ask for their assistance.
D) Have the unit manager take over the care of this client and family.
E) Tell the family that this secret will not be kept from the client.

Question 31

A client on interferon therapy is reporting severe skin itching and irritation.What actions does the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.)

A) Apply moisturizers to dry skin.
B) Apply steroid creams to the skin.
C) Bathe the client using mild soap.
D) Help the client with a hot water bath.
E) Teach the client to avoid sunlight.

Question 32

A client has thrombocytopenia.What actions does the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.)

A) Apply the client's shoes before getting the client out of bed.
B) Assist the client with ambulation.
C) Shave the client with a safety razor only.
D) Use a lift sheet to move the client up in bed.
E) Use the Waterpik on a low setting for oral care.