Cancer and hematology evolve
When monitoring a client with suspected syndrome of inappropriate antidiuretic hormone (SIADH), the nurse reviews the client's medical record, which contains the following information. The nurse notifies the health care provider for which signs and symptoms consistent with this syndrome? Physical Assessment FindingsDiagnostic FindingsMedicationsNeuro: Episodes of confusionCardiac: Pulse 88 and regularMusculoskeletal: Weakness, tremorsNa: 115 mEq/L (115 mmol/L)K: 4.2 mEq/L (4.2 mmol/L)Creatinine: 0.8 mg/dL (70.8 mcmol/L)Ondansetron (Zofran)Cyclophosphamide (Cytoxan) Select all that apply. a. Hyponatremia b. Mental status changes c. Azotemia d. Bradycardia e. Weakness
a, b, e
When caring for the client receiving cancer chemotherapy, which signs or symptoms related to thrombocytopenia should the nurse report to the health care provider? Select all that apply. a. Bruises b. Fever c. Petechiae d. Epistaxis e. Pallor
a, c, d
The nurse is teaching a client with newly diagnosed anemia about conserving energy. Which instructions would the nurse give to the client? Select all that apply. a. "Provide yourself with four to six small, easy-to-eat meals daily." b. "Perform your care activities in groups to conserve your energy." c. "Stop activity when shortness of breath or palpitations is present." d. "Allow others to perform your care during periods of extreme fatigue." e. "Drink small quantities of protein shakes and nutritional supplements daily." f. "Perform a complete bath daily to reduce your chance of getting an infection."
a, c, d, e
Which potential side effects does the nurse include in the teaching plan for a client undergoing radiation therapy for laryngeal cancer? Select all that apply. a. Fatigue b. Changes in color of hair c. Change in taste d. Changes in skin of the neck e. Difficulty swallowing
a, c, d, e
The nurse is educating a group of young women who have sickle cell disease (SCD). Which statement from a class member indicates further teaching is necessary? a. "The pneumonia vaccine is protection that I need." b. "Getting an annual 'flu shot' would be dangerous for me." c. "I must take my penicillin pills as prescribed, all the time." d. "Frequent handwashing is an important habit for me to develop."
b
The nurse is reinforcing information about genetic counseling to a client with sickle cell disease who has a healthy spouse. What information would the nurse explain to the parents about the risk of a child having sickle cell disease? a. "Sickle cell disease will be inherited by your children." b. "The sickle cell trait will be inherited by your children." c. "Your children will have the disease, but your grandchildren will not." d. "Your children will not have the disease, but your grandchildren could."
b
The nurse is teaching a client with vitamin B12 deficiency anemia about dietary intake. Which type of food does the nurse encourage the client to eat? a. Grains b. Dairy products c. Leafy vegetables d. Starchy vegetables
b
The nurse is transfusing 2 units of packed red blood cells to a postoperative client. What electrolyte imbalance would the nurse monitor for after the blood transfusion? a. Hyponatremia b. Hyperkalemia c. Hypercalcemia d. Hypomagnesemia
b
A client who is receiving a blood transfusion suddenly tells the nurse, "I don't feel right!" What is the nurse's first action? a. Stop the transfusion. b. Call the Rapid Response Team. c. Slow the infusion rate of the transfusion. d. Obtain vital signs and continue to monitor.
a
A nurse is counseling a 60-year-old African-American male client about risk factors for lung cancer. Teaching should focus most on what risk factor? a. Tobacco use b. Ethnicity c. Gender d. Increased age
a
The RN working on an oncology unit has just received report on these clients. Which client should be assessed first? a. Client with chemotherapy-induced neutropenia who has just been admitted with an elevated temperature b. Client with lymphoma who will need administration of an antiemetic before receiving chemotherapy c. Client with metastatic breast cancer who is scheduled for external beam radiation in 1 hour d. Client with xerostomia associated with laryngeal cancer who needs oral care before breakfast
a
The nurse explains to a client that which risk factor of those listed most likely contributed to the client's primary liver carcinoma? a. Infection with hepatitis B virus b. Consuming a diet high in animal fat c. Exposure to radon d. Familial polyposis
a
The nurse is assessing several clients who are receiving transfusions of blood components. Which assessment finding requires immediate action by the nurse? a. Respiratory rate of 36 breaths/min in a client receiving red blood cells b. Temperature of 99.1°F (37.3°C) for a client with a platelet transfusion c. Sleepiness in a client who received diphenhydramine (Benadryl) as a premedication d. A partial thromboplastin time (PTT) that is 1.2 times normal in a client who received a transfusion of fresh-frozen plasma (FFP)
a
The nurse is caring for a client receiving chemotherapy who reports anorexia. Which measure does the nurse use to best monitor for cachexia? a. Monitor weight. b. Trend red blood cells and hemoglobin and hematocrit. c. Monitor platelets. d. Observe for motor deficits.
a
The nurse is caring for a client who is in sickle cell crisis. What action would the nurse perform first? a. Provide pain medications as needed. b. Apply cool compresses to the client's forehead. c. Increase food sources of iron in the client's diet. d. Encourage the client's use of two methods of birth control.
a
The nurse is caring for a client with neutropenia who has a suspected infection. Which intervention would the nurse implement first? a. Obtain prescribed blood cultures. b. Place the client on Bleeding Precautions. c. Initiate the administration of prescribed antibiotics. d. Give 1000 mL of IV normal saline to hydrate the client.
a
The nurse is infusing platelets to a client who is scheduled for a hematopoietic stem cell transplant. What procedure does the nurse follow for administering this blood product? a. Infuse the transfusion over a 15- to 30-minute period. b. Set up the infusion with the standard transfusion Y tubing. c. Give intravenous corticosteroids before starting the transfusion. d. Allow the platelets to stabilize at the client's bedside for 30 minutes.
a
The nurse is mentoring a recent graduate registered nurse (RN) about administering blood and blood products. What action does the nurse perform before starting the transfusion? a. Verify with another RN all of the data on blood products. b. Use a 22-gauge needle to obtain venous access when starting the infusion. c. Remain with the client who is receiving the blood for the first 5 minutes of the infusion. d. Obtain the client's initial set of vital signs (VS) within the first 10 minutes of the infusion.
a
The nurse is teaching a 47-year-old woman about recommended screening practices for breast cancer. Which statement by the client indicates understanding of the nurse's instructions? a. "My mother and grandmother had breast cancer, so I am at risk." b. "I get a mammogram every 2 years since I turned 30." c. "A clinical breast examination is performed every month since I turned 40." d. "A computed tomography (CT) scan will be done every year after I turn 50."
a
The nurse manager in a long-term care facility is developing a plan for primary and secondary prevention of colorectal cancer. Which tasks associated with the screening plan will be delegated to nursing assistants within the facility? a. Testing of stool specimens for occult blood b. Teaching about the importance of dietary fiber c. Referring clients for colonoscopy procedures d. Giving vitamin and mineral supplements
a
The oncology nurse is caring for a group of clients receiving chemotherapy. The client with which sign/symptom is displaying bone marrow suppression? a. Hemoglobin of 7.4 g/dL (74 mmol/L) and hematocrit of 21.8% b. Potassium level of 2.9 mEq/L (2.9 mmol/L) and diarrhea c. 250,000 platelets/mm3 (250 × 109/L) d. 5000 white blood cells/mm3 (5 × 109/L)
a
Which information must the organ transplant nurse emphasize before a client is discharged? a. "Taking immunosuppressant medications increases your risk for cancer and the need for screenings." b. "You are at increased risk for cancer when you reach 60 years of age." c. "Immunosuppressant medications will decrease your risk for developing cancers." d. "After 6 months, you may stop immunosuppressant medications, and your risk for cancer will be the same as that of the general population."
a
Which task is appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP) working on a medical-surgical unit? a. Obtain vital signs on a client receiving a blood transfusion b. Assist a client with folic acid deficiency in making diet choices c. Administer erythropoietin to a client with myelodysplastic syndrome d. Assess skin integrity on an anemic client who fell during ambulation
a
The nurse is performing an assessment on a client with anemia. What are the typical clinical manifestations of anemia? Select all that apply. a. Pallor b. Fatigue c. Tachycardia d. Dyspnea on exertion e. Elevated temperature f. Decreased breath sounds
a, b, c, d
A client has a diagnosis of lung cancer. To which areas does the nurse anticipate that this client's tumor may metastasize? Select all that apply. a. Brain b. Bone c. Lymph nodes d. Kidneys e. Liver
a, b, c, e
What are the risk factors for the development of leukemia? Select all that apply. a. Down syndrome b. Chemical exposure c. Ionizing radiation d. Prematurity at birth e. Bone marrow hypoplasia f. Multiple blood transfusions
a, b, c, e
The nurse includes which factors in teaching regarding the typical warning signs of cancer? Select all that apply. a. Persistent constipation b. Scab present for 6 months c. Curdlike vaginal discharge d. Axillary swelling e. Headache
a, b, d
An 82-year-old client with anemia is prescribed 2 units of whole blood. Which assessment findings cause the nurse to discontinue the transfusion because it is unsafe for the client? Select all that apply. a. Hypotension b. Hypertension c. Decreased pallor d. Rapid, bounding pulse e. Flattened superficial veins f. Capillary refill less than 3 seconds
a, b, d,
A distant family member arrives to visit a female client recently diagnosed with leukemia. The family member asks the nurse, "What should I say to her?" Which responses does the nurse suggest? Select all that apply. a. "Ask her how she is feeling." b. "Ask her if she needs anything." c. "Tell her to be brave and to not cry." d. "Tell her what you know about leukemia." e. "Talk to her as you normally would when you haven't seen her for a long time."
a, b, e
The nurse reviews the chart of a client admitted with a diagnosis of glioblastoma with a T1NXM0 classification. Which explanation does the nurse offer when the client asks what the terminology means? a. "Two lymph nodes are involved in this tumor of the glial cells, and another tumor is present." b. "The brain tumor measures about 1 to 2 cm and shows no regional lymph nodes and no distant metastasis." c. "This type of tumor in the brain is small with some lymph node involvement; another tumor is present somewhere else in your body." d. "Glioma means this tumor is benign, so I will have to ask your health care provider the reason for the chemotherapy and radiation."
b
The nurse suspects metastasis from left breast cancer to the thoracic spine when the client has which symptom? a. Vomiting b. Back pain c. Frequent urination d. Cyanosis of the toes
b
What is the most important environmental risk for developing leukemia? a. Family history b. Smoking cigarettes c. Living near high-voltage power lines d. Direct contact with others with leukemia
b
Which activity performed by the community health nurse best reflects primary prevention of cancer? a. Assisting women to obtain free mammograms b. Teaching a class on cancer prevention c. Encouraging long-term smokers to get a chest x-ray d. Encouraging sexually active women to get annual Papanicolaou (Pap) smears
b
Which client problem does the nurse set as the priority for the client experiencing chemotherapy-induced peripheral neuropathy? a. Potential for lack of understanding related to side effects of chemotherapy b. Potential for injury related to sensory and motor deficits c. Potential for ineffective coping strategies related to loss of motor control d. Altered sexual function related to erectile dysfunction
b
Which manifestation of an oncologic emergency requires the nurse to contact the health care provider immediately? a. New onset of fatigue b. Edema of arms and hands c. Dry cough d. Weight gain
b
Which medication does the nurse plan to administer to a client before chemotherapy to decrease the incidence of nausea and vomiting? a. Morphine b. Ondansetron (Zofran) c. Naloxone (Narcan) d. Diazepam (Valium)
b
The nurse is conducting a community health education class on diet and cancer risk reduction. What should be included in the discussion? Select all that apply. a. Limit sodium intake. b. Avoid beef and processed meats. c. Increase consumption of whole grains. c. Eat "colorful fruits and vegetables," including greens. d. Avoid gas-producing vegetables such as cabbage.
b, c, d
What are the common cancers related to tobacco use? Select all that apply. a. Cardiac cancer b. Lung cancer c. Cancer of the tongue d. Skin cancer e. Cancer of the larynx
b, c, e
When caring for a client who has had a colostomy created during treatment for colon cancer, which nursing actions help support the client in accepting changes in appearance or function? Select all that apply. a. Explain to the client that the colostomy is only temporary. b. Encourage the client to participate in changing the ostomy. c. Obtain a psychiatric consultation. d. Offer to have a person who is coping with a colostomy visit with the client. e. Encourage the client and family members to express their feelings and concerns.
b, d, e
Which finding alarms the nurse when caring for a client receiving chemotherapy who has a platelet count of 17,000/mm3 (17 × 109/L)? a. Increasing shortness of breath b. Diminished bilateral breath sounds c. Change in mental status d. Weight gain of 4 pounds (1.8 kg) in 1 day
c
Which instruction is most appropriate for the nurse to convey to the client with chemotherapy-induced neuropathy? a. Bathe in cold water. b. Wear cotton gloves when cooking. c. Consume a diet high in fiber. d. Make sure shoes are snug.
c
Which statement made by a client allows the nurse to recognize whether the client receiving brachytherapy for ovarian cancer understands the treatment? a. "I may lose my hair during this treatment." b. "I must be positioned in the same way during each treatment." c. "I will have a radioactive device in my body for a short time." d. "I will be placed in a semiprivate room for company."
c
What are serious side effects of antiviral agents prescribed for a client with acute myelogenous leukemia? Select all that apply. a. Stroke b. Diarrhea c. Ototoxicity d. Cardiomyopathy e. Nephrotoxicity
c, e
A client who is undergoing chemotherapy for breast cancer reports problems with concentration and memory. Which nursing intervention is indicated at this time? a. Explain that this occurs in some clients and is usually permanent. b. Inform the client that a small glass of wine may help her relax. c. Protect the client from infection. d. Allow the client an opportunity to express her feelings.
d
A client with leukemia is being discharged from the hospital. The nurse's discharge instructions say to keep regularly scheduled follow-up primary health care provider appointments. The client says, "I don't have transportation." Which is the most appropriate nursing response? a. "You can take the bus." b. "I might be able to take you." c. "A pharmaceutical company might be able to help." d. "The local American Cancer Society may be able to help."
d
A pediatric nurse is floated to a medical-surgical unit. Which client is assigned to the float nurse? a. A 60-year-old with newly diagnosed polycythemia vera who needs teaching about the disease b. A 50-year-old with pancytopenia needing assessment of risk factors for aplastic anemia c. A 55-year-old with folic acid deficiency anemia caused by alcohol abuse who needs counseling d. A 42-year-old with sickle cell disease receiving a transfusion of packed red blood cells
d
A recently admitted client who is in sickle cell crisis requests "something for pain." What medication would the nurse be prepared to administer? a. Oral ibuprofen (Motrin) b. Oral morphine sulfate (MS-Contin) c. Intramuscular (IM) morphine sulfate d. Intravenous (IV) hydromorphone (Dilaudid)
d
An outpatient client is receiving photodynamic therapy. Which environmental factor is a priority for the client to adjust for protection? a. Storing drugs in dark locations at room temperature b. Wearing soft clothing c. Wearing a hat and sunglasses when going outside d. Reducing all direct and indirect sources of light
d
The home health nurse is caring for a client who has a history of a kidney transplant and takes cyclosporine (Sandimmune) and prednisone (Deltasone) to prevent rejection. Which assessment finding is most important to communicate to the transplant team? a. Temperature of 96.6°F (35.9°C) b. Reports of joint pain c. Pink and dry oral mucosa d. Palpable lump in the client's axilla
d
The nurse is assessing the endurance level of a client in a long-term care facility. What question does the nurse ask to get this information? a. "How much exercise do you get?" b. "What is your endurance level?" c. "Are your feet or hands cold, even when you are in bed?" d. "Do you feel more tired after you get up and go to the bathroom?"
d
The nurse is caring for a client with sickle cell disease. Which nursing action is most effective in reducing the potential for sepsis in this client? a. Check vital signs every 4 hours b. Administer prophylactic drug therapy c. Monitor for abnormal laboratory values d. Perform frequent and thorough handwashing
d
The nurse is giving a group presentation on cancer prevention and recognition. Which statement by an older adult male client indicates understanding of the nurse's instructions? a. "Cigarette smoking always causes lung cancer." b. "Taking multivitamins will prevent me from developing cancer." c. "If I have only one shot of whiskey a day, I probably will not develop cancer." d. "I need to report the pain going down my legs to my health care provider."
d
The nurse is teaching a client about induction therapy for acute leukemia. Which client statement indicates a need for additional education? a. "I will need to avoid people with a cold or flu." b. "I will probably lose my hair during this therapy." c. "The goal of this therapy is to put me in remission." d. "After this therapy, I will not need to have any more."
d
The nurse is to administer packed red blood cells to a client. How does the nurse ensure proper client identification? a. Ask the client's name b. Check the client's armband c. Verify the client's room number d. Review all information with another registered nurse (RN)
d
The nurse presents a cancer prevention program to teens. Which instruction will have the greatest impact in cancer prevention? a. Avoid asbestos. b. Wear sunscreen. c. Get the human papilloma virus (HPV) vaccine. d. Do not smoke cigarettes.
d
Which client does the nurse assign as a roommate for a client with aplastic anemia? a. A 34-year-old with idiopathic thrombocytopenia who is taking steroids b. A 23-year-old with sickle cell disease who has two draining leg ulcers c. A 30-year-old with leukemia who is receiving induction chemotherapy d. A 28-year-old with glucose-6-phosphate dehydrogenase (G6PD) deficiency anemia who is receiving mannitol (Osmitrol)
d
Which client is at greatest risk for experiencing a hemolytic transfusion reaction? a. A 42-year-old client with allergies b. A 78-year-old client with arthritis c. A 58-year-old immune-suppressed client d. A 34-year-old client with type O blood
d
Which nursing intervention most effectively protects a client with thrombocytopenia? a. Take rectal temperatures b. Avoid the use of dentures c. Apply warm compresses on trauma sites d. Encourage the use of an electric shaver
d
Which statement about the process of malignant transformation is correct? a. Mutation of genes is an irreversible event that always leads to cancer development in the initiation phase. b. Insulin and estrogen enhance the division of an initiated cell during the promotion phase. c. Tumors form when carcinogens invade the gene structure of the cell in the latency phase. d. Nutrition of cancer cells is provided by tumor angiogenesis factor (TAF) in the promotion stage.
d
The nurse is teaching a client who is receiving an antiestrogen drug about the side effects she may encounter. Which side effects does the nurse include in the discussion? Select all that apply. a. Heavy menses b. Smooth facial skin c. Hyperkalemia d. Breast tenderness e. Weight loss f. Deep vein thrombosis
d, f
The nurse has received in report that a client receiving chemotherapy has severe neutropenia. Which interventions does the nurse plan to implement? Select all that apply. a. Assess for fever. b. Observe for bleeding. c. Administer pegfilgrastim (Neulasta). d. Do not permit fresh flowers or plants in the room. e. Do not allow the client's 16-year-old son to visit. f. Teach the client to omit raw fruits and vegetables from the diet.
a, c, d, f
A client who has been newly diagnosed with leukemia is admitted to the hospital. Avoiding which potential problem takes priority in the client's nursing care plan? a. Hypoxia b. Infection c. Hemorrhage d. Fluid overload (overhydration)
b
A client with multiple myeloma reports bone pain that is unrelieved by analgesics. What is the most appropriate response by the nurse? a. "Ask your doctor to prescribe more medication." b. "Would you like to try some relaxation techniques?" c. "I'll turn on some soothing classical music for you." d. "It is too soon for additional medication to be given."
b
A client with thrombocytopenia is being discharged. Which instruction would the nurse include in a teaching plan for this client? a. "Avoid large crowds." b. "Use a soft-bristled toothbrush." c. "Drink at least 2 L of fluid per day." d. "Elevate your lower extremities when sitting."
b
The nurse is assessing a client with lung cancer. Which symptom does the nurse anticipate finding? a. Easy bruising b. Dyspnea c. Night sweats d. Chest wound
b
The nurse is caring for a client who is receiving rituximab (Rituxan) for treatment of lymphoma. During the infusion, it is essential for the nurse to observe for which side effect? a. Alopecia b. Allergy c. Fever d. Chills
b
The nurse is caring for a client with end-stage ovarian cancer who needs clarification on the purpose of palliative surgery. Which outcome should the nurse teach the client is the goal of palliative surgery? a. Cure of the cancer b. Relief of symptoms or improved quality of life c. Allowing other therapies to be more effective d. Prolonging the client's survival time
b
The nurse is caring for a client with hyperuricemia associated with tumor lysis syndrome (TLS). Which medication does the nurse anticipate being ordered? a. Recombinant erythropoietin (Procrit) b. Allopurinol (Zyloprim) c. Potassium chloride d. Radioactive iodine-131 (131I)
b
The nurse is caring for a client with neutropenia. Which clinical manifestation indicates that the client has an infection or an infection needs to be ruled out? a. Evidence of pus b. Wheezes or crackles c. Fever of 102°F (38.9°C) or higher d. Coughing and deep breathing
b
Which client statement indicates in-home stem cell transplantation is not a viable option? a. "We live 5 miles from the hospital." b. "I will have lots of medicine to take." c. "I was a nurse, so I can take care of myself." d. "I don't feel strong enough, but my wife said she would help."
c
A 32-year-old client is recovering from a sickle cell crisis. The client's discomfort is controlled with pain medications and discharge planning has been initiated. What medication will the nurse anticipate to be prescribed before discharge? a. Heparin (Heparin) b. Warfarin (Coumadin) c. Hydroxyurea (Droxia) d. Tissue plasminogen activator (t-PA)
c
A 52-year-old client tells the nurse that she has never had a mammogram because she is terrified that she will have cancer. Which response by the nurse is therapeutic? a. "Don't worry, most lumps are discovered by women during breast self-examination." b. "Does anyone in your family have breast cancer?" c. "Finding a cancer in the early stages increases the chance for cure." d. "Have you noticed a lump or thickening in your breast?"
c
A client who is scheduled to undergo radiation for prostate cancer is admitted to the hospital by the nurse. Which statement by the client is most important to communicate to the health care provider? a. "I am allergic to iodine." b. "My urinary stream is very weak." c. "My legs are numb and weak." d. "I am incontinent when I cough."
c
A hematology unit is staffed by registered nurse's (RNs), licensed practical nurses (LPNs)/licensed vocational nurse (LVNs), and unlicensed assistive personnel (UAP). When the nurse manager is reviewing staff documentation, which entry indicates the need for staff education for his or her appropriate level of responsibility and client care? a. "Abdominal pain relieved by morphine 4 mg IV; client resting comfortably and denies problems. B.C., RN" b. "Ambulated in hallway for 40 feet (12 m) and denies shortness of breath at rest or with ambulation. T.Y., LPN" c. "Client reporting increased shortness of breath; oxygen increased to 4 L by nasal cannula. M.N., UAP" d. "Vital signs 98.6°F (37.0°C), heart rate 60, respiratory rate 20, blood pressure 110/68, and oximetry 98% on room air. L.D., UAP"
c
A newly graduated RN has just finished a 6-week orientation to the oncology unit. Which client is most appropriate to assign to the new graduate? a. A 30-year-old with acute lymphocytic leukemia who will receive combination chemotherapy today b. A 40-year-old with chemotherapy-induced nausea and vomiting who has had no urine output for 16 hours c. A 45-year-old with pancytopenia who will require IV administration of erythropoietin (Procrit) d. A 72-year-old with tumor lysis syndrome who is receiving normal saline IV at a rate of 250 mL/hr
c
The nurse assess the client with which hematologic condition first? a. A 32-year-old with pernicious anemia who needs a vitamin B12 injection b. A 67-year-old with acute myelocytic leukemia with petechiae on both legs c. An 81-year-old with thrombocytopenia and an increase in abdominal girth d. A 40-year-old with iron deficiency anemia who needs a Z-track iron injection
c
The nurse corrects the nursing student when caring for a client with neutropenia secondary to chemotherapy in which circumstance? a. The student demonstrates asepsis by scrubbing the hub of IV tubing before administering an antibiotic. b. The nurse overhears the student explaining to the client the importance of handwashing. c. The student teaches the client that symptoms of neutropenia include fatigue and weakness. d. The nurse observes the student educating the client about hygiene and perineal care.
c
The nurse is transfusing a unit of whole blood to a client when the primary health care provider prescribes "Furosemide (Lasix) 20 mg IV push." Which intervention would the nurse perform? a. Piggyback the furosemide into the infusing blood. b. Give furosemide to the client intramuscularly (IM). c. Administer the furosemide after completion of the transfusion. d. Add furosemide to the normal saline that is infusing with the blood.
c
The nurse performs an assessment on a newly admitted client with thrombocytopenia. Which assessment finding requires immediate intervention by the nurse? a. Reports of pain b. Increased temperature c. Bleeding from the nose d. Decreased urine output
c
The oncology nurse should use which intervention to prevent disseminated intravascular coagulation (DIC)? a. Monitoring platelets b. Administering packed red blood cells c. Using strict aseptic technique to prevent infection d. Administering low-dose heparin therapy for clients on bedrest
c
When caring for a client receiving chemotherapy, the nurse plans care during the nadir of bone marrow activity to prevent which complication? a. Drug toxicity b. Polycythemia c. Infection d. Dose-limiting side effects
c
When caring for the client with chemotherapy-induced mucositis, which intervention will be most helpful? a. Administering a biological response modifier b. Encouraging oral care with commercial mouthwash c. Providing oral care with a disposable mouth swab d. Maintaining NPO until the lesions have resolved
c
A 56-year-oldclient admitted with a diagnosis of acute myelogenous leukemia (AML) has been prescribed intravenous (IV) cytosine arabinoside and an IV infusion of daunorubicin. The client develops an infection. Which action would the nurse take to determine that the appropriate antibiotic has been prescribed to treat this condition? a. Monitor the client's white blood cell (WBC) count level b. Evaluate the client's liver function tests (LFTs) and serum creatinine levels c. Recognize that vancomycin (Vancocin) is the drug of choice used to treat all infections in clients with AML d. Check the culture and sensitivity test results to be certain that the requested antibiotic is effective against the organism causing the infection
d
A 72-year-old client recovering from lung cancer surgery asks the nurse to explain how she developed cancer when she has never smoked. Which factor may explain the possible cause? a. A diagnosis of diabetes treated with insulin and diet b. An exercise regimen of jogging 3 miles four times a week c. A history of cardiac disease d. Advancing age
d
A client admitted with a diagnosis of acute myelogenous leukemia is prescribed intravenous (IV) cytosine arabinoside for 7 days and an infusion of daunorubicin for the first 3 days. What is the major side effect of this drug therapy? a. Nausea b. Stomatitis c. Liver toxicity d. Bone marrow suppression
d
A client has a glioblastoma. The nurse begins to plan care for this client with which type of cancer? a. Liver b. Smooth muscle c. Fatty tissue d. Brain
d
A client recovering from a sickle cell crisis is to be discharged. The nurse says to the client, "You and all clients with sickle cell disease are at risk for infection because of your decreased spleen function. For this reason, you will most likely be prescribed an antibiotic before discharge." Which drug does the nurse anticipate the primary health care provider (PHCP) will prescribe? a. Cefaclor (Ceclor) b. Vancomycin (Vancocin) c. Gentamicin (Garamycin) d. Penicillin V (Pen-V K)
d