STATES - 5

b) Health status before neutropenia

1. John is admitted with neutropenia, what does the nurse assess in determining his risk for infection a) Length of time neutropenia has existed b) Health status before neutropenia c) Body build and weight d) Resistance to infection in childhood

a) Administer prescribed aspirin and antihistamines

10. A client has received 25ml of packed red blood cells when she began to experience low back pain and mild itching. After stopping the transfusion the nurse should a) Administer prescribed aspirin and antihistamines b) Collect blood and urine samples to be sent to the laboratory c) Administer prescribed diuretics, oxygen and morphine d) Administer prescribed vasopressors

a) Its okay to be scared. What is it about cancer that yourre afraid of

11. The nurse in the preoperative period is preparing a female client for surgery and notices that the client looks sad. The client says, 'im scared of having cancer. Its so horrible and I brought it on myself. I should have quit smoking years ago'. What would be the nurses best response to the client a) Its okay to be scared. What is it about cancer that yourre afraid of b) Its normal to be scared. I would be too. Well help you through it c) Don't be hard on yourself. You don't know if your smoking caused the cancer d) Do you feel guilty because you smoked

a) Washing the area with water

12. Following mastectomy the client is now due to have radiation therapy. She should be taught to care for the skin at the therapy site by a) Washing the area with water b) Exposing the area to dry heat c) Applying an ointment to the area d) Using talcum powder on the area

b) Bran muffin, skim milk, sir fried broccoli

13. A 42 year old woman is interested in making dietary changes to reduce her risk of colon cancer. What dietary selections would the nurse suggest a) Croissant, peanut butter, sandwiches, whole milk b) Bran muffin, skim milk, sir fried broccoli c) Bagel with cream cheese, cauliflower salad d) Oatmeal, baked potato, turkey sandwich

a) Fever

14. The nurse is teaching a 19 year old client and the clients family about what to expect with high dose chemotherapy and the effects of neutropenia. What should the nurse teach as the most reliable early indicator of infection in a neutropenic client a) Fever b) Chills c) Tachycardia d) Dyspnoea

a) Eating frequent, small meals throughout the day

15. The client is being discharged with oral chemotherapy, in teaching the client and family how to manage nausea and vomiting at home, which of the following should be discussed a) Eating frequent, small meals throughout the day b) Eating three normal meals a day c) Eating only cold food but no salads d) Limiting the amount of fluid intake

d) Amount of subcutaneous tissue

16. In setting up a syringe driver to administer analgesia which of the following factors would be most important for the nurse to consider when determining the angle at which to insert the needle a) Size of the syringe b) Tissue turgor c) Length of the needle d) Amount of subcutaneous tissue

b) Elevated serum alkaline phosphatase

17. A client is diagnosed with metastatic bone cancer. Which of the following abnormal laboratory values would the nurse expect to see a) Hypocalcemia b) Elevated serum alkaline phosphatase c) Hypokalemia d) Hypoglycaemia

d) Skin and pressure sore risk

18. Mrs Johnson has had a recurrence of breast cancer and has been managed at home with support from the palliative care nurse specialist. This morning when visiting her, the nurse noted she was experiencing severe low back pain especially when lying down. Which of the following assessments would be the priority a) Bowel and bladder b) Respiratory c) Neurological d) Skin and pressure sore risk

c) Redness of the surface tissue

19. The nurse would teach the client that a normal local tissue response to radiation is a) Atrophy of the skin b) Scattered pustule formation c) Redness of the surface tissue d) Sloughing of two layers of skin

a) Change gloves immediately after use

2. What nursing action would be important in preventing cross contamination a) Change gloves immediately after use b) Stand two feet from the patient c) Speak minimally when in the room d) Wear long sleeved shirts

a) When cervical cancer is detected early and treated aggressively, the cure rate is almost 100%

20. The husband of a client with cervical cancer says to the nurse, 'the doctor told my wife that her cancer is curable. Is he just trying to make us feel better.' Which would be the nurses most accurate response a) When cervical cancer is detected early and treated aggressively, the cure rate is almost 100% b) The 5 year survival rate is about 75%, which makes the odds pretty good c) Saying a cancer is curable means that 50% of all women with cancer survive at least 5 years d) Cancers of the female reproductive tract tend to be slow growing and respond well to treatment

b) Anxiety related to self care deficit from imposed immobility during radiation

21. A priority nursing diagnosis for a client with cervical cancer who has an internal radium implant would be a) Pain related to cervical tumour b) Anxiety related to self care deficit from imposed immobility during radiation c) Impaired health maintenance related to surgery d) Disturbed sleep pattern related to interruptions by health care personnel

d) Nausea and a foul vaginal discharge

22. The nurse should carefully observe a client with internal radium implants for typical side effects associated with radiation therapy to the cervix. These effects include a) Severe vaginal itching b) Confusion c) High fever in the afternoon or evening d) Nausea and a foul vaginal discharge

a) Anger

23. A terminally ill clients husband tells the nurse, 'I wish we had taken that trip to europe last year. We just kept putting it off, and now im furious that we didn't go.' The nurse interprets that husbands statement as indicating which of the following stages of adapt ion to dying a) Anger b) Denial c) Bargaining d) Depression

d) Identify available resources

24. A client is newly diagnosed with cancer and is beginning a treatment plan. Which of the following nursing interventions will be most effective in helping the client cope a) Assume decision making for the client b) Encourage strict compliance with all treatment regimens c) Inform the client of all possible adverse treatment effects d) Identify available resources

a) Antiemetics

25. Mr green has been admitted terminally ill and in need of pain management. He has now been commenced on oral morphine. What would you also ensure the doctor prescribe at this time a) Antiemetics b) Subcutaneous fluids c) Aperients d) Sedatives

a) Using suppositories or enemias

3. What would you teach john and his family to avoid a) Using suppositories or enemias b) Using a high efficiency particulate air filter mask c) Performing perineal care after every bowel movement d) Performing oral care after every meal

d) There is no bleeding at aspiration site

4. 24 hours after john has a bone marrow aspiration, the nurse evaluates which of the following as an appropriate client outcome a) The client maintains bed rest b) There is redness and swelling at the aspiration site c) The client requests morphine sulphate 2mg IM every 2 hours d) There is no bleeding at aspiration site

c) A sachet of lavender

5. During the induction stage for treatment of leukaemia, the nurse should remove which items that the family has brought into the room a) A bible b) A picture c) A sachet of lavender d) A hairbrush

d) Haemorrhage

6. The goal of nursing care for a client with acute myeloid leukaemia is to prevent a) Cardiac arrhythmias b) Liver failure c) Renal failure d) Haemorrhage

a) Combination chemotherapy is used to interrupt cell growth cycle at different points

7. The nurse is evaluating the clients learning about combination chemotherapy. Which of the following statements about reasons for using combination chemotherapy indicates the need for further explanation a) Combination chemotherapy is used to interrupt cell growth cycle at different points b) Combination chemo is used to destroy cancer cells and treat side effects simultaneously c) Combination chemo is used to decrease resistance d) Combination chemo is used to minimise the toxicity from using high doses of single agent

a) Biliary system

8. In providing care to the client with leukaemia who has developed thrombocytopenia, the nurse assessed the most common sites for bleeding. Which of the following is not a common site a) Biliary system b) Gastrointestinal tract c) Brain and meninges d) Pulmonary system

a) To the client from sources outside the clients environment

9. The nurses best explanation for why the severely neutropenic client is place in reverse isolation is that reverse isolation helps prevent the spread of organisms a) To the client from sources outside the clients environment b) From the client to health care personnel, visitors and other clients c) By using special techniques to dispose of contaminated material d) By using special techniques to hand the clients linens and personal items