Chemotherapy NCLEX Questions
The charge nurse is making assignments for the next shift. Which of the following clients can be assigned to the same nurse as the client with a neutrophil count of 490? Select all that apply. a. A client with a broken hip b. A client with glaucoma c. A client with MRSA d. A client with HIV e. a client with pneumonia
a, b A client with a broken hip A client with a neutrophil count of 490 is immunocompromised, and should be placed on neutropenic precautions. The nurse caring for this client cannot care for clients with transmittable diseases at the same time. A client with glaucoma This client is appropriate because glaucoma is not a transmittable disease.
The nurse is caring for a client who has been placed on neutropenic precautions. The nurse knows that this includes which of the following? Select all that apply. a. No suppositories b. No flowers c. No cooked meat d. No fresh vegetables e. No salt
a, b, d No suppositories Neutropenic precautions include thorough hand washing, a low microbial diet (no fresh salads, fruits, vegetables, uncooked meats), a daily room cleaning, nothing per rectum, dedicated equipment for the client, and a private room. No flowers This is not allowed for a client on neutropenic precautions. No cooked meat Uncooked meat is not allowed, but cooked meat is allowed. No fresh vegetables This is not allowed for a client on neutropenic precautions. No salt Salt is allowed with neutropenic precautions.
Which is the most common reason a client cannot receive chemotherapy? a. Absolute neutrophil count b. Nausea and vomiting c. Fatigue d. Mucositis
a. Absolute neutrophil count This is the most common reason a client is not cleared for chemotherapy. The absolute neutrophil count (ANC) must be above 1,000 in order for the provider to allow the client to go ahead with chemotherapy. Nausea and vomiting Nausea and vomiting are a side-effect of chemotherapy, but are not typically a reason that chemotherapy is delayed. The neutrophil count is the most common reason for a client to have to wait for a dose of chemotherapy. Fatigue Excessive fatigue is an expected outcome of chemotherapy treatments. While it is not a reason to forego chemotherapy, it will prompt the nurse to talk to the client about getting enough rest and nutrition. Mucositis Mucositis, or inflammation of the mucous membranes, is a side effect of chemotherapy. This does not lead to a delay in chemotherapy administration, but may require frequent medicated rinses of the oral cavity, increased brushing with a soft toothbrush, and actions to keep the mouth from becoming too dry.
A nurse is teaching a client with cancer about safety when receiving chemotherapy drugs. The nurse wants the client to understand about how chemotherapy can be harmful to healthy people who live with the client. Which action should the nurse counsel the client to perform after receiving chemotherapy that would most likely protect those who live with the client? a. Flush the toilet twice with the lid down after using b. If the client vomits, close the door to the area and allow it to dry before cleaning c. Wash all clothes that have body fluids on them by hand d. Use a separate set of flatware and dishes that are not used by others in the family
a. Flush the toilet twice with the lid down after using Chemotherapy, which is a treatment for clients with cancer, can be harmful for others who live with the client. Chemotherapy can cause abnormalities in the DNA of healthy people when they are exposed to the substance. The nurse should teach the client to take measures to protect others living in the home from being exposed. An example is to close the lid of the toilet and flush it twice after using it to reduce the risk of contamination when chemotherapy agents are eliminated from the body.
The infusion nurse is reviewing the schedule of chemotherapy clients for the day. The nurse knows that chemotherapy is given for which of the following scenarios? Select all that apply. a. To prevent cancer b. To cure the client of cancer c. To delay the progression of cancer d. To make a client with cancer more comfortable e. To eliminate BRCA-1 and BRCA-2
b, c, d To cure the client of cancer If a client has cancer, chemotherapy is a treatment modality, usually used in combination with other treatments, to cure cancer. To delay the progression of cancer In a client with advanced age or illness, chemotherapy may be used to delay the progression of cancer rather than cure it. To make a client with cancer more comfortable In some clients, chemotherapy is used as a palliative treatment to reduce the size of a tumor rather than cure it.
A client who has to start chemotherapy for a new diagnosis of cancer becomes very anxious and upset about the thought of the new treatment. Which type of referral could the nurse make in this situation? Select all that apply. a. A referral for a new oncologist b. a referral to a doctor of homeopathy c. A referral to an integrative health care provider d. A referral to a cancer support group e. A referral to have a diagnostic test done
c, d Referrals that would be helpful for the client with anxiety are focused on relaxation, support, and stress reduction. Natural homeopathic remedies do not address the client's anxiety, nor does switching oncologists or more diagnostic tests. A nurse has the capability of making some types of referrals, particularly those that are for supportive care for the client. The nurse cannot write orders or prescribe but can make a referral for such services as complementary therapies, use of assistive devices, or information about support groups and community resources.
