Chapter 22 Care of Patients with Infection (Cancer Therapies Quiz)

A patient with advanced breast cancer tells the nurse she has pain in the back. Which assessment will the nurse perform to detect the complication of spinal cord compression? A. Assess for muscle weakness and/or decreased sensation in the lower extremities B. Auscultate bowel sounds and gently palpate for abdominal pain and distention C. Auscultate breath sounds, observe for dyspnea, and check for edema in the arms and hands D. Assess for dehydration and monitor for signs of hyperkalemia or hyperuricemia

A. Assess for muscle weakness and/or decreased sensation in the lower extremities

For a patient undergoing external radiation therapy, what do the nurse's instructions include? SATA A. Do not remove the markings B. Use lotions liberally to keep skin soft and moist C. Avoid direct skin exposure to sunlight for up to a year D. Use mild soap and water on the affected skin E. Gently rub treated areas to stimulate circulation F. Avoid wearing belts or clothing that binds the irradiated area

A. Do not remove the markings C. Avoid direct skin exposure to sunlight for up to a year D. Use mild soap and water on the affected skin F. Avoid wearing belts or clothing that binds the irradiated area

Which factors are used to determine a cancer patient's absorbed radiation dose? SATA A. Intensity of radiation exposure B. Proximity of radiation source to body C. Type of radiation particle D. Age of the patient during radiation therapy E. Overall health at time of radiation therapy F. Duration of radiation exposure

A. Intensity of radiation exposure B. Proximity of radiation source to body F. Duration of radiation exposure

Because chemotherapy drug dosage is based on total body surface area, the nurse should perform what assessment? A. Measure the patient's height and weight B. Compare the patient's weight to a nomogram C. Calculate body mass index D. Measure abdominal girth

A. Measure the patient's height and weight

Which outcome statement supports the priority goal in the care of a patient who has chemotherapy-induced peripheral neuropathy? A. Patient did not sustain falls or injury during the shift B. Patient's electrolyte values are within normal limits C. Patient verbalized understanding of when to take medication D. Patient and family demonstrate good hand hygiene

A. Patient did not sustain falls or injury during the shift

The nurse is caring for several patients who are receiving chemotherapy. Which patient is most likely to need transfer to the intensive care unit? A. Patient receiving interleukin therapy for renal cell carcinoma develops widespread edema B. Patient receiving estrogen therapy develops calf pain with redness and swelling C. Patient receiving vascular endothelial growth factor/receptor inhibitor has high blood pressure D. Patient receiving an antiandrogen receptor develops gynecomastia

A. Patient receiving interleukin therapy for renal cell carcinoma develops widespread edema

The nurse hears in report that the patient has xerostomia. Which teaching point does the nurse plan to review with the patient? A. Regular dental visits are essential because of increased risk for dental caries B. Use mild soap and apply unscented moisturizers to reduce itching sensation C. Avoid rigorous sports because bones are more prone to pathologic fractures D. Avoid direct sun exposure for at least 1 year because skin will be sensitive

A. Regular dental visits are essential because of increased risk for dental caries

Which example best illustrates appropriate prophylactic cancer surgery? A. Removal of polyp from the colon to prevent colon cancer B. Biopsy of lymph node at a site distal to the primary tumor C. Breast reconstruction after a mastectomy D. Partial removal of a tumor to provide pain relief

A. Removal of polyp from the colon to prevent colon cancer

The patient has breast cancer with bone metastasis. Based on this information, which laboratory result would the nurse carefully monitor? A. Serum calcium level B. Serum blood glucose C. Serum potassium level D. Serum sodium level

A. Serum calcium level

What is the most typical schedule for radiation therapy? A. Small dose of radiation given on a daily basis for a set time period B. Large one-time dose of radiation given after completing chemotherapy C. Small doses of radiation given several days apart to minimize side effects D. Large doses administered monthly for a set periods of months

A. Small dose of radiation given on a daily basis for a set time period

The nurse is caring for an older patient who is getting chemotherapy and filgrastim. Which intervention is the nurse most likely to use to facilitate the purpose of the filgrastim? A. Teach patient, family, and all visitors about meticulous hand hygiene B. Administer filgrastim prior to chemotherapy to prevent nausea C. Teach and assess for bleeding signs such as bruising or bleeding gums D. Assess the patient for fatigue and plan for periods of uninterrupted rest

A. Teach patient, family, and all visitors about meticulous hand hygiene

A patient is receiving radiation treatment by teletherapy. When does exposure to the patient create a risk for harmful radiation? A. The patient is never radioactive B. During the mechanical delivery of gamma rays C. For the first 24 to 48 hours after treatment D. Until the radiation source has decayed by one half-life

A. The patient is never radioactive

The nurse sees that the patient's platelet count is 18,000. What is the nurse's greatest concern related to this laboratory result? A. There is great risk that spontaneous and uncontrollable bleeding may occur B. Patient should be immediately placed in isolation to prevent sepsis or septicemia C. Oxygen-carrying capacity is decreased and patient is likely to experience dyspnea D. Fluid retention increases the risk for heart failure and pulmonary edema

A. There is great risk that spontaneous and uncontrollable bleeding may occur

Which outcome statement indicates that the goal of cytoreductive surgery for cancer has been met? A. Tumor size has been decreased and chemotherapy is pending B. The noninvasive skin cancer was completely removed during surgery C. Subjective back pain has decreased since the removal of the tumor D. Incisional site of breast reconstruction shows no signs of infection

A. Tumor size has been decreased and chemotherapy is pending

Which factors determine the type of therapy for cancer? SATA A. Type and location of cancer B. Overall health of the patient C. Whether the cancer has metastasized D. Previous lymph node biopsy E.Patient's gender F. Family history and genetics

A. Type and location of cancer B. Overall health of the patient C. Whether the cancer has metastasized F. Family history and genetics

The nurse is responsible for teaching the immunosuppressed patient and the family about health promoting activities. Which information is correct? A. Wash hands thoroughly with an antimicrobial soap B. Do not drink water, milk, juice, or other cold liquids C. Boil dishes or use disposables whenever possible D. Don a mask before entering the patient's personal space

A. Wash hands thoroughly with an antimicrobial soap

The nurse reads in the patient's chart that the health care provider is concerned about myelosuppression. Which laboratory results will the nurse closely monitor and report to the provider? SATA A. White blood cell count B. Serum potassium level C. Red blood cell count D. Platelet count E. Serum sodium level F. Serum calcium level

A. White blood cell count C. Red blood cell count D. Platelet count

The nurse hears in report that the patient has cachexia. Which assessment will the nurse plan to perform? A. Ability to ambulate independently B. Appetite and nutritional intake C. Mental status and cognition D. Sensation and pulses in extremities

B. Appetite and nutritional intake

Each chemotherapeutic agent has a specific nadir. What is important for the nurse to do when giving combination therapy? A. Give two agents with similar nadirs B. Avoid giving agents with similar nadirs at the same time C. Watch for first agent's nadir and then give second agent D. Give two agents from different drug classes

B. Avoid giving agents with similar nadirs at the same time

An older patient is receiving epoetin alfa. Based on the knowledge that this medication increases erythrocytes and many other types of blood cells, which abnormal assessment finding suggests the patient is experiencing an adverse effect of the medication? A. Temperature of 100.5 B. Blood pressure is 160/90 mm Hg C. Patient has hemorrhagic cystitis D. Mucous membranes are dry

B. Blood pressure is 160/90 mm Hg

The patient is having nausea and vomiting, so the nurse checks the medication orders for an antiemetic. The orders indicate to give rosiglitazone maleate and metformin hydrochloride as needed for nausea and vomiting. What should the nurse do? A. Give the medication as ordered and observe for symptom relief B. Contact the provider for clarification, because the medication is not an antiemetic C. Check the medication administration record for time of last dose of mediation D. Assess the patient for delayed nausea before giving the medication

B. Contact the provider for clarification, because the medication is not an antiemetic

The healthcare provider informs the nurse that it is likely that the patient's cancer has invaded the bone marrow. Based on this information, the nurse will be vigilant for which signs and symptoms? SATA A. Nausea and vomiting B. Fatigue and weakness C. Decreasing white blood cell count D. Confusion with memory loss E. Bruises or other bleeding signs F. Tachycardia and shortness of breath

B. Fatigue and weakness C. Decreasing white blood cell count E. Bruises or other bleeding signs F. Tachycardia and shortness of breath

The nurse is caring for a patient who must receive a chemotherapy infusion. What is the most important intervention related to extravasation? A. Identify the specific antidote and make sure it is readily available B. Frequently monitor the access site to prevent leakage of large volumes C. Advocate that an implanted port be established prior to administration D. Avoid administering any drugs or fluids that are vesicants to tissues

B. Frequently monitor the access site to prevent leakage of large volumes

Which cancer patient is the most likely candidate for palliative surgery? A. Needs extensive cosmetic repair after treatment of neck cancer B. Has continuous vomiting because tumor is obstructing the intestines C. Has a suspicious skin lesion that requires further investigation D. Has been treated for cancer and is currently asymptomatic

B. Has continuous vomiting because tumor is obstructing the intestines

Which cancer patient is the most likely candidate for reconstructive surgery? A. Has severe back pain and decreased sensation in the lower extremities B. Has significant scarring of the face and neck after completing treatments C. Requires lymph node removal for possible metastasis of primary tumor D. Has leukemia that is not responding to transfusion therapy

B. Has significant scarring of the face and neck after completing treatments

What instructions will the nurse given to unlicensed assistive personnel regarding the hygienic care of a patient with neutropenia? A. Do not enter the room unless absolutely necessary and then minimize time spent in the room B. Mouth care and washing of the axillary and perineal regions must be done during the shift C. If the patient seems very tired, assist with toileting but defer all other aspects of hygienic care D. Assist the patient to perform hygienic care according to the standard routine for all patients

B. Mouth care and washing of the axillary and perineal regions must be done during the shift

Which patient has a condition that is a significant contraindication for photodynamic therapy? A. Patient has a history of frequent sunburn and is at risk for skin cancer B. Patient has known tumor involvement of a major blood vessel C. Patient needs treatments that would involve the upper airways D. Patient had surgery for breast cancer several years ago

B. Patient has known tumor involvement of a major blood vessel

What is the most common side effect of radiation? A. Altered taste sensation B. Radiodermatitis C. Nausea D. Fatigue

B. Radiodermatitis

Which laboratory result is the most important in relation to the nadir for a chemotherapeutic agent? A. Red blood cell count B. White blood cell count C. Platelet count D. Serum calcium level

B. White blood cell count

Which patient with cancer has the greatest risk for infection? A. Recently diagnosed with breast cancer B. With neutropenia from leukemia C. With lung cancer who has a persistent cough D. Diagnosed with prostate cancer 3 years ago

B. With neutropenia from leukemia

A patient with colon cancer asks, "Why does everyone keep insisting that I eat so much? I'm not hungry and I have been overweight my whole life." Which response is the most appropriate? A. "What would you like to eat? I can get you something that you will really enjoy." B. "The cancer may spread to your stomach; you should eat while you still can." C. "Cancer in the intestinal tract may increase metabolic rate and needs for nutrients." D. "Well, you don't have to eat if you don't want to, but eating will help your body to heal."

C. "Cancer in the intestinal tract may increase metabolic rate and needs for nutrients."

The nurse hears in report that the patient is distressed by the prospect of developing alopecia. Which question is the nurse most likely to ask to assess the patient's concerns? A. "Would you like additional information about side effects of chemotherapy?" B. "What questions do you have about hair and skin care products?" C. "How would losing your hair affect your life and activities?" D. "How would you feel about talking to someone who experienced hair loss?"

C. "How would losing your hair affect your life and activities?"

What technique is used in oral care for a patient with mucositis? A. Apply petroleum jelly to lips after each mouth care B. Brush teeth and tongue rigorously with a toothbrush every 8 hours C. "Swish and spit" room-temperature tap water every 1-2 horus for comfort D. Use commercial mouthwashes and glycerin swabs to refresh mouth

C. "Swish and spit" room-temperature tap water every 1-2 horus for comfort

A patient has a diagnosis of cancer with a gram-negative infection. Which assessment finding alerts the nurse that the patient may have developed the life-threatening complication of disseminated intravascular coagulation? A. Altered cognition and reports of skeletal pain B. Irregular heart rate with elevated potassium level C. Bleeding from multiple sites throughout the body D. 2+ pitting edema and weight gain

C. Bleeding from multiple sites throughout the body

What is the major side effect that limits the dose of chemotherapy? A. Nausea and vomiting B. Peripheral neuropathy C. Bone marrow suppression D. "Chemo brain"

C. Bone marrow suppression

Why does the nurse wear a dosimeter when providing care to a patient receiving brachytherapy? A. Indicates special expertise in radiation therapy B. Protects the nurse from absorbing radiation C. Measures the nurse's exposure to radiation D. Ensures that the radiation dosage is accurate

C. Measures the nurse's exposure to radiation

Which patient circumstance would prompt the health care team to use the National Comprehensive Cancer Network Distress Thermometer? A. Patient was recently diagnosed with breast cancer and is refusing to discuss treatment options B. Family member of dying cancer patient is overwhelmed by anticipatory grief and loss C. Patient is having multiple physical symptoms and emotional problems related to cancer therapy D. Patient and family are distressed because cancer therapy has not induced remission

C. Patient is having multiple physical symptoms and emotional problems related to cancer therapy

A patient is taking oprelvekin. Which assessment data finding indicates that the therapy is working? A. Weight has increased by 2 lbs B. Nausea and vomiting are relieved C. Platelet count is increasing D. Hemoglobin level is normalizing

C. Platelet count is increasing

The charge nurse sees an order for intravenous (IV) chemotherapy. According to the Oncology Nursing Society, who should the charge nurse assign to administer the medication? A. Any nurse who has studied pharmacology and has IV therapy training B. Advanced-practice nurse who specializes in oncology education C. Registered nurse who completed an approved chemotherapy course D. Licensed practical nurse with years of experience in giving medications

C. Registered nurse who completed an approved chemotherapy course

A patient is on a newer protocol, dose-dense chemotherapy. Which factor is most likely to contribute to patient noncompliance if the nurse fails to educate the patient and the family? A. Treatment is expensive and less likely to be covered by insurance B. Length of therapy is prolonged and progress is slow to manifest C. Side effects are likely to be more intense and unpleasant D. Medication administration is painful and pain does not respond to medications

C. Side effects are likely to be more intense and unpleasant

An older adult is having frequent and severe chemotherapy-induced nausea and vomiting that seems to be anticipatory and acute. Which assessment is the most important to make? A. Fears and feelings associated with chemotherapy B. Patient's self-management of distressing symptoms C. Signs of dehydration or electrolyte imbalance D. Willingness to try complementary or alternative therapies

C. Signs of dehydration or electrolyte imbalance

How does the nurse apply the "inverse square law" in caring for a patient with cancer who is treated with a radiation implant? A. Assists the healthcare provider to calculate the radiation dose B. Reminds all care staff to wear a dosimeter film badge for protection C. Stands at a distance from the patient as much as possible D. Monitors condition of skin after therapy with gamma rays

C. Stands at a distance from the patient as much as possible

A patient with lymphoma wakes up from a night's sleep with severe facial swelling and tightness of the gown collar. Which emergency complication does the nurse suspect? A. Tumor lysis syndrome B. Cancer-induced hypercalcemia C. Superior vena cava syndrome D. Left-sided heart failure

C. Superior vena cava syndrome

The nurse in the radiation department is caring for a patient who will receive stereotactic body radiotherapy. Which intervention is the nurse most likely to use in the care of this patient? A. Remind the patient that no pregnant visitors should come for several days B. Dispose of radioactive urine and stool so that self and others are not exposed C. Teach the patient about the need for exact positioning during the treatment D. Assess the patient for history of allergies to iodine or contrast media

C. Teach the patient about the need for exact positioning during the treatment

The nurse is supervising a nursing student who is giving care to a patient with a sealed iplant. The nurse would intervene if the student performed which action? A. Places a "Caution: Radioactive Material" sign on the door of the patient's room B. Wears a dosimeter film badge at all times while caring for the patient C. Wears a lead apron while providing care and turns away from the patient D. Saves all dressings and bed linens in the patient's room

C. Wears a lead apron while providing care and turns away from the patient

The nurse is talking to a young athlete who needs lung removal for treatment of lung cancer. Which statement best indicates that the patient is coping with the uncertainty of cancer and long-term impact on his physical activities? A. "If I delay the surgery, I could still compete for a couple of months" B. "My coach says I might be able to compete even with one lung" C. "Competing in sports is important to me, and eventually I will recover' D. "I love to compete in sports, but I like to do a lot of other things too"

D. "I love to compete in sports, but I like to do a lot of other things too"

Which cancer patient has the highest risk to develop sepsis? A. 34-year-old patient who has received high-dose radiation to the upper chest area B. 66-year-old patient with hypercalcemia and dehydration C. 53-year-old with small cell lung cancer and hyponatremia D. 82-year-old patient with neutropenia and a low-grade fever

D. 82-year-old patient with neutropenia and a low-grade fever

A patient diagnosed with bone cancer reports fatigue, loss of appetite, and constipation. Which laboratory result does the nurse report immediately? A. Potassium level of 4.2 mEq/L B. Magnesium level of 2.0 mg/dL C. Sodium level of 140 mEq/L D. Calcium level of 10.5 mEq/dL

D. Calcium level of 10.5 mEq/dL

The patient has thyroid cancer and will be treated with injection of the radionuclide iodine-131 (brachytherapy). Which guideline is the most relevant when instructing the unlicensed assistive personnel on how to assist the patient with hygiene and activities of daily living? A. Oncology Nursing Society practice guidelines B. American Cancer Society treatment guidelines C. Institutional evidence-based policies for infection control D. Institutional policies for handling body fluids and wastes

D. Institutional policies for handling body fluids and wastes

The nurse works at an institution where pharmacogenomics is incorporated into the care of cancer patients. How does this newer approach impact nursing care? A. Nurse is likely to see fewer cancers that are linked to a genetic etiology B. Targeted chemotherapy selection will eliminate side effects C. Prophylactic treatment of first-degree family members is likely to increase D. Patient's risk for more dangerous side effects is decreased

D. Patient's risk for more dangerous side effects is decreased

According to Quality and Safety Education for Nurses (QSEN), what is the priority nursing assessment that the nurse should perform every 8 hours to protect a patient who has neutropenia? A. Assess patient's concerns first and then follow up by addressing each concern and problem B. Monitor for complications that are associated with the type of therapy that patient is receiving C. Perform focused assessment that includes pain and body system most affected by cancer D. Perform total patient assessment and check for common symptoms associated with infection

D. Perform total patient assessment and check for common symptoms associated with infection

Based on the "inverse square law" for radiation exposure, which patient received the smallest radiation dose? A. Received radiation dose at a distance of 0.5 meter B. Received radiation dose at a distance of 1 meter C. Received radiation dose at a distance of 2.5 meters D. Received radiation dose at a distance of 3 meters

D. Received radiation dose at a distance of 3 meters

The nurse is caring for a 56-year-old woman who had a modified mastectomy for breast cancer. The woman jokes, "That breast was too saggy anyway. Good riddance to it." Later, the nurse sees the woman crying. What should the nurse do first? A. Encourage the woman to accept body changes by looking at the surgical site B. Suggest participation in a support group sponsored by the American Cancer Society C. Invite a breast cancer survivor who successfully coped with mastectomy D. Sit with the woman and encourage her to express her feelings and concerns

D. Sit with the woman and encourage her to express her feelings and concerns

A patient is being discharged with a prescription for an oral cancer agent. Which teaching point will the nurse emphasize? A. Oral anticancer medications are less toxic and can be handled like regular medications B. Oral forms are more convenient and portable and cost less than IV medications C. Crushing the medication and mixing it with pudding or juice will mask the unpleasant taste D. Skipping or reducing doses may seem unimportant but can lead to disease progression

D. Skipping or reducing doses may seem unimportant but can lead to disease progression

The patient is prescribed a biologic response modifier, leukine. Which outcome statement about the medication therapy reflect the concept of immunity? A. Electrolyte levels are improving and there is no edema B. Erythrocytes are increased and fatigue is resolving C. Platelet count is normalizing and there is no signs of bleeding D. White cell count is improving and there are no signs of infection

D. White cell count is improving and there are no signs of infection