Deck 24: Care of Patients With Cancer

Question 1

A client has bone cancer.What intervention does the nurse implement as a priority for this client?

A) Using a lift sheet when repositioning the client
B) Positioning the client's heels to keep them from touching the mattress
C) Providing small, frequent meals rich in calcium and phosphorus
D) Applying pressure for 5 minutes after intramuscular injections

Answer 1

Using a lift sheet when repositioning the client

Question 2

A client receiving intravenous chemotherapy asks the nurse the reason for wearing a mask,gloves,and gown while administering drugs to the client.What is the nurse's best response?

A) "These coverings protect you from getting an infection from me."
B) "I am preventing the spread of infection from you to me or any other client here."
C) "The policy is for any nurse giving these drugs to wear a gown, gloves, and mask."
D) "The clothing protects me from accidentally absorbing these drugs."

Answer 2

"The clothing protects me from accidentally absorbing these drugs."

Question 3

A client is receiving a chemotherapeutic agent intravenously through a peripheral line.What is the nurse's first action when the client reports burning at the site?

A) Check for a blood return.
B) Slow the rate of infusion.
C) Discontinue the infusion.
D) Apply a cold compress.

Answer 3

Discontinue the infusion.

Question 4

A client who has just had a mastectomy is crying.When the nurse asks about her crying,the client responds,"I know I shouldn't cry because this surgery may well save my life." What is the nurse's best response?

A) "It is all right to cry. Mourning this loss will help make you stronger."
B) "I know this is hard, but your chances of survival are better now."
C) "I can arrange for someone who had a mastectomy to come visit if you like."
D) "How have you coped with difficult situations in the past?"

Question 5

A client is on chemotherapy and has a platelet count of 25,000.Which intervention is most important to teach this client?

A) "Eat a low-bacteria diet."
B) "Take your temperature daily."
C) "Use a soft-bristled toothbrush."
D) "Avoid alcohol-based mouthwashes."

Question 6

A client with prostate cancer is taking estrogen daily to control tumor growth.He reports that his left calf is swollen and painful.Which is the nurse's best action?

A) Instruct the client to keep the leg elevated.
B) Measure and compare calf circumferences.
C) Apply ice to the calf after massaging it.
D) Document this expected response.

Question 7

A client with chemotherapy-induced bone marrow suppression has received filgrastim (Neupogen).Which laboratory finding indicates that this therapy is effective for the client?

A) Hematocrit is 28%.
B) Hematocrit is 38%.
C) Segmented neutrophil count is 2500/mm³.
D) Segmented neutrophil count is 3500/mm³.

Question 8

A client is receiving interleukin-2 (IL-2)for cancer.Which drug is the nurse prepared to administer if needed?

A) Lorazepam (Ativan)
B) Meperidine (Demerol)
C) Furosemide (Lasix)
D) Epoetin alfa (Epogen)

Question 9

A client's radiation implant has become dislodged overnight,and the nurse finds it in the client's bed.What does the nurse do first?

A) Assess the client's skin for radiation burns.
B) Use tongs to put the implant into the radiation container.
C) Notify the safety officer and move the client to a different room.
D) Don gloves and attempt to replace the implant.

Question 10

In evaluating dietary teaching for a client with chemotherapy-induced neutropenia,the nurse becomes concerned when the client makes which food choice?

A) Fruit salad
B) Applesauce
C) Steamed broccoli
D) Baked potato

Question 11

A client is undergoing radiation therapy and says,"I will be so glad when this is over and I don't have to worry about my skin." What response by the nurse is most appropriate?

A) "Unfortunately, your skin will be permanently damaged from the radiation."
B) "You need to protect your skin from the sun for at least a year afterward."
C) "You can get a prescription for special lotions that reduce the effects of radiation."
D) "You're having skin problems? That is unusual; let me take a look at your skin."

Question 12

A client's spouse reports that the last time the client received lorazepam (Ativan)before receiving chemotherapy,the client was extremely drowsy and didn't remember the trip home.Which is the nurse's best action?

A) Hold the dose of lorazepam for this round of chemotherapy.
B) Explain that this is a normal response to the drug.
C) Perform a Mini-Mental State Examination.
D) Document the response in the client's chart.

Question 13

What is the priority problem for a client experiencing chemotherapy-induced anemia?

A) Risk for injury related to fatigue
B) Fatigue related to decreased oxygenation
C) Body image problems related to skin color changes
D) Inadequate nutrition related to anorexia

Question 14

A client is hospitalized for chemotherapy.The registered nurse intervenes when observing which action by the nursing assistant?

A) Allowing the client to rest instead of making him or her perform oral hygiene
B) Helping the client wash the groin and axillary areas every 12 hours
C) Cutting food and opening food packages when the client's meal tray arrives
D) Reminding the client to use the incentive spirometer every hour while awake

Question 15

What statement indicates that the client understands teaching about neutropenia?

A) "I need to use a soft toothbrush."
B) "I have to wear a mask at all times."
C) "My grandchildren may get an infection from me."
D) "I will call my doctor if I have an increase in temperature."

Question 16

A client is undergoing radiation therapy and asks the nurse about skin care for the exposed area.Which statement by the nurse is most accurate?

A) "No products work well to reduce the skin reactions you get from radiation."
B) "No one product works best, so you can choose what you would like to use."
C) "The only medication that works well for skin reactions is very expensive."
D) "No good studies on skin care with radiation have been conducted to date."

Question 17

A client scheduled to undergo radiation therapy for breast cancer asks why 6 weeks of daily treatment is necessary.What is the nurse's best response?

A) "Your cancer is widespread and requires more than the usual amount of radiation treatment."
B) "Giving larger doses of radiation for a shorter period of time does not produce better effects and has worse side effects."
C) "Research has shown that more cancer cells are killed if radiation is given in smaller doses over a longer time period."
D) "It is less likely that your hair will fall out or that you will become anemic if radiation is given in this manner."

Question 18

What teaching is essential for a client who has received an injection of iodine-131?

A) "Do not share a toilet with anyone else or let anyone clean your toilet."
B) "You need to save all your urine for the next week."
C) "No special precautions are needed because this type of radiation is weak."
D) "Avoid all contact with other people until the radiation device is removed."

Question 19

The student nurse overhears several staff members referring to a client who is receiving chemotherapy as having "chemo brain." The student asks the instructor what that means.Which response by the instructor is best?

A) "That is an awful thing to say and the staff should not call a client by that name."
B) "It refers to the client's brain as being irreversibly damaged by the chemotherapy."
C) "The client has reduced cognitive function that may last for several years."
D) "The client has delirium related to the toxic effects of the chemotherapy."

Question 20

A nurse manager on an oncology nursing unit notes an increased incidence of infection and serious consequences for clients on the unit.Which action by the nursing manager is most beneficial in this situation?

A) Review asepsis policies at a mandatory in-service for staff.
B) Spot-check all staff for good handwashing practices.
C) Develop standard protocols to identify and treat clients with infection.
D) Institute protective precautions for all clients receiving chemotherapy.

Question 21

The nurse questions which activity for the client with thrombocytopenia?

A) Application of warm compresses to bruises
B) Cleaning teeth with a soft-bristled brush
C) Taking acetaminophen (Tylenol) for pain
D) Using stool softeners daily for constipation

Question 22

The nurse is caring for a client who has a sealed radiation implant for cervical cancer.Which activities by the nurse are appropriate?

A) Inform the supervisor of the nurse's positive pregnancy test.
B) Obtain the dosimeter badge from the nurse going off shift.
C) Keep the client's door open for frequent observation.
D) Dispose of dirty linen in a red "biohazard" bag.
E) Wear a lead apron while providing client care.

Question 23

A client has small cell lung cancer.Which laboratory result requires immediate intervention by the nurse?

A) Serum potassium of 5.1 mEq/L
B) Serum sodium of 118 mEq/L
C) Hematocrit of 45%
D) Blood urea nitrogen (BUN) of 10 mg/dL

Question 24

The nurse is planning care for a client with hypercalcemia secondary to bone metastasis.Which interventions are included in the plan?

A) Increase oral fluids.
B) Place an oral airway at the bedside.
C) Monitor for Chvostek's sign.
D) Implement seizure precautions.
E) Assess for hyperactive reflexes.
F) Observe for muscle weakness.

Question 25

A client is receiving high-dose chemotherapy for multiple myeloma.Which intervention is most important for the nurse to implement to prevent complications during chemotherapy?

A) Ensure that the client's fluid intake is 3000 to 5000 mL/day.
B) Monitor telemetry every hour during therapy.
C) Apply pressure to all injection sites for 5 minutes.
D) Assist the client in all ambulatory activities.

Question 26

After receiving change-of-shift report,which client does the nurse assess first?

A) Client with leukemia who needs an antiemetic before chemotherapy
B) Client with breast cancer scheduled for external beam radiation
C) Client with xerostomia associated with laryngeal cancer
D) Client with neutropenia who has just been admitted with a possible infection

Question 27

The nurse prioritizes which intervention in a client with xerostomia secondary to radiation therapy to the neck area?

A) Applying lotions and oils to affected areas
B) Wearing a hat to decrease heat loss
C) Providing oral care after meals and at bedtime
D) Monitoring vital signs every 4 hours

Question 28

In planning a teaching session for a client undergoing photodynamic therapy for lung cancer,the nurse includes which statements?

A) "This is a palliative treatment that should decrease your pain."
B) "Avoid exposure to the sun for 1 to 3 months after the treatment."
C) "Do not eat or drink anything before your treatments."
D) "Do not remove skin markings between treatments."
E) "You need to wear sunglasses to protect your eyes after treatments."
F) "Make sure you keep your curtains closed at home afterward."

Question 29

Which statement indicates that the client needs more teaching about mucositis?

A) "I will rinse my mouth with water after every meal."
B) "I will use a soft-bristled toothbrush to prevent trauma."
C) "I should use an alcohol-based mouth rinse to kill bacteria."
D) "I cannot use floss because it may irritate my gums."

Question 30

A nurse is reviewing the white blood cell count with differential for a client receiving chemotherapy for cancer.Which finding alerts the nurse to the possibility of sepsis?

A) Total white blood cell count is 9000/mm³.
B) Lymphocytes outnumber basophils.
C) "Bands" outnumber "segs."
D) Monocyte count is 1800/mm³.

Question 31

The nurse teaches a client with superior vena cava syndrome that improvement is characterized by which clinical manifestation?

A) The client's hands are less swollen.
B) Breath sounds are clear bilaterally.
C) The client's back pain is relieved.
D) Pedal edema is present.

Question 32

A client with advanced cancer is being treated with intravenous mithramycin (Mithracin).Which clinical manifestation indicates that the treatment is effective?

A) Bowel sounds are active in all four quadrants.
B) The client's serum sodium level is 138 mEq/L.
C) The pulse rate is 68 beats/min and bounding.
D) Urine output has increased to 30 mL/hr.

Question 33

A client has late-stage colon cancer with metastasis to the spine and bones.Which nursing intervention does the nurse add to the care plan to address a priority problem?

A) Provide six small meals and snacks daily.
B) Offer the client prune juice twice a day.
C) Ensure that the client gets adequate rest.
D) Give the client pain medications around the clock.