Exam 4 NCLEX Questions

A client is receiving zalcitabine. The nurse should monitor the results of which study to determine the effectiveness of this medication?

CD4+ cell count

The nurse is assigned to care for a client with acquired immunodeficiency syndrome (AIDS) suspected of having Kaposi's sarcoma. The nurse should prepare the client for which test to confirm this diagnosis?

Biopsy

Which explanation should the nurse provide to a patient who has a positive HIV rapid antibody test? Select all that apply.

"Antibodies to the HIV may be present in your blood." "Additional testing is necessary before a final diagnosis is made."

The nurse in the ambulatory care unit is providing home care instructions to a client after cryotherapy for the treatment of malignant skin lesions. Which statement would be most appropriate for the nurse to include in the home care instructions for this client?

"Apply a warm, damp washcloth if discomfort occurs."

When assessing a patient's needs for psychologic support after the patient has been diagnosed with stage I cancer of the colon, which question by the nurse will provide the most information?

"Can you tell me what has been helpful to you in the past when coping with stressful events?"

The nurse instructs a patient with cancer about chemotherapy. Which patient statement indicates that teaching has been effective?

"Chemotherapy stops cancer cells from using body enzymes and chemicals."

For a female client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client?

"Client verbalizes feelings of anxiety."

A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. The nurse knows that teaching about management of the skin reaction has been effective when the patient says

"I can buy a steroid cream to use on the itching area."

The nurse is teaching the client about risk factors for skin cancer. Which statements by the client indicate that teaching was successful? Select all that apply.

"I have to avoid excessive exposure to sunlight." "I am at higher risk for skin cancer because my mother had one."

The nurse has provided discharge instructions to a client who has had cryosurgery to remove a malignant skin lesion. The nurse determines that the client understands the instructions if the client makes which statements? Select all that apply.

"I need to clean the site as prescribed to prevent infection." "I need to expect some swelling and tenderness in the affected area."

The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient may indicate a need for a change in treatment?

"I rarely have the energy to get out of bed."

A client taking a chemotherapeutic agent understands the effects of therapy by stating:

"I will avoid eating hot and spicy foods."

The nurse is reviewing the discharge instructions for the client who had a skin biopsy. Which statement, if made by the client, would indicate a need for further instruction?

"I will return tomorrow to have the sutures removed."

A CD4+ lymphocyte count is performed in a client with human immunodeficiency virus (HIV) infection. When providing education about the testing, what should the nurse tell the client?

"It establishes the stage of HIV infection."

The nurse conducted discharge teaching for the client diagnosed with melanoma. Which statement by a client indicates that education was effective?

"It is highly metastatic."

A 32-year-old male patient is to undergo radiation therapy to the pelvic area for Hodgkin's lymphoma. He expresses concern to the nurse about the effect of chemotherapy on his sexual function. The best response by the nurse to the patient's concerns is

"It is possible you may have some changes in your sexual function, and you may want to consider pretreatment harvesting of sperm if you want children."

A patient with non-Hodgkin lymphoma tells the nurse, "I might as well give up on dating. No woman will want me now." What is the most appropriate response for the nurse to make?

"It sounds like you are concerned about the effects of this disease and the proposed treatment plan."

A client with acquired immunodeficiency syndrome (AIDS) experiences nausea, vomiting, and abdominal pain radiating to the back after taking didanosine. The ambulatory care nurse should provide which response as telephone advice to this client?

"Report to the health care clinic to be seen by the primary health care provider."

On a clinic visit a client who has a relative with cancer, is asking about the warning signs that may relate to cancer. The nurse correctly identifies the warning signs of cancer by responding:

"Sudden weight loss of unexplained etiology can be a warning sign of cancer."

A client scheduled for a skin biopsy is concerned and asks the nurse how painful the procedure is. Which statement is the appropriate response by the nurse?

"The local anesthetic may cause a burning or stinging sensation."

The nurse is providing information to a client scheduled for a skin biopsy. The client asks the nurse how painful the procedure is. The nurse should make which response to the client?

"The local anesthetic may cause a stinging sensation."

A 40-year-old male diagnosed with acute lymphocytic leukemia finished his first cycle of chemotherapy. Which of the following statements by the nurse is wrong?

"Try eating sashimi in one of the famous Japanese restaurants around the city"

A 40-year-old divorced mother of four school-age children is hospitalized with metastatic cancer of the ovary. The nurse finds the patient crying, and she tells the nurse that she does not know what will happen to her children when she dies. The most appropriate response by the nurse is

"Why don't we talk about the options you have for the care of your children?"

A patient who has been told by the health care provider that the cells in a bowel tumor are poorly differentiated asks the nurse what is meant by "poorly differentiated." Which response should the nurse make?

"Your tumor cells look more like immature fetal cells than normal bowel cells."

A 36-year-old man with lymphoma presents with signs of impending septic shock 9 days after chemotherapy. The nurse would expect which of the following to be present?

Low-grade fever, chills, tachycardia

A client with squamous cell carcinoma is receiving bleomycin. What is the priority assessment of the nurse when monitoring for side and adverse effects of bleomycin?

Lung sounds

A client with acquired immunodeficiency syndrome has been started on therapy with zidovudine. The nurse assesses the complete blood cell (CBC) count, knowing that which is an adverse effect of this medication?

Agranulocytopenia

The nurse teaches a patient with cancer of the liver about high-protein, high-calorie diet choices. Which snack choice by the patient indicates that the teaching has been effective?

Strawberry yogurt

A pregnant client who has human immunodeficiency virus (HIV) infection is being seen in the antenatal clinic. The nurse expects the primary health care provider (PHCP) to initiate zidovudine at how many weeks of gestation?

14 weeks

Rhea has malignant lymphoma. As part of her chemotherapy, the physician prescribes chlorambucil (Leukeran), 10 mg by mouth daily. When caring for the client, the nurse teaches her about adverse reactions to chlorambucil, such as alopecia. How soon after the first administration of chlorambucil might this reaction occur?

2 to 3 weeks

Radiation protection is very important to implement when performing nursing procedures. When the nurse is not performing any nursing procedures what distance should be maintained from the client?

3 feet

Nausea and vomiting are common adverse effects of radiation and chemotherapy. When should a nurse administer antiemetics?

30 minutes before the initiation of therapy

Contact of client on radiation therapy should be limited only to how many minutes to promote safety of the therapy personnel?

5 minutes

Which of the following clients is most at risk for developing multiple myeloma?

60-year-old African-American man

A client has requested and undergone testing for human immunodeficiency virus (HIV) infection. The client asks what will be done next because the result of the enzyme-linked immunosorbent assay (ELISA) has been positive. Which diagnostic study should the nurse be aware of before responding to the client?

A Western blot will be done to confirm these findings.

A client reports to the health care clinic for testing for human immunodeficiency virus (HIV) immediately after being exposed to HIV. The test results are negative, and the client expresses relief about not contracting HIV. What should the nurse emphasize when explaining the test results to the client?

A negative HIV test result is not considered accurate immediately after exposure.

When assessing a lesion diagnosed as basal cell carcinoma, the nurse most likely expects to note which findings? Select all that apply.

A pearly papule with a central cater and a waxy border Locationin the bald spot atop the head that is exposed to outdoor sunlight

Which of the following types of leukemia carries the best prognosis?

Acute lymphoblastic leukemia

In which of the following diseases would bone marrow transplantation not be indicated in a newly diagnosed client?

Acute lymphocytic leukemia

Chemotherapeutic agents have different specific classifications. The following medications are antineoplastic antibiotics except:

Adrucil (fluorouracil)

Chemotherapy is one of the therapeutic modalities for cancer. This treatment is contraindicated to which of the following conditions?

All of the above

A male client has an abnormal result on a Papanicolaou test. After admitting, he read his chart while the nurse was out of the room, the client asked what dysplasia means. Which definition should the nurse provide?

Alteration in the size, shape, and organization of differentiated cells

A client with acquired immunodeficiency syndrome (AIDS) is receiving didanosine. When the nurse reviews the client's laboratory test results, which result should be most closely monitored?

Amylase

The nurse is performing a skin assessment on a client diagnosed with malignant melanoma. The nurse should expect to note which characteristic of this type of skin lesion?

An irregularly shaped lesion

The nurse has identified the nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste sensation in a patient with lung cancer who has had a 10% loss in weight. An appropriate nursing intervention that addresses the etiology of this problem is to

Avoid presenting foods for which the patient has a strong dislike

Which of the following complications are three main consequences of leukemia?

Anemia, infection, and bleeding tendencies

A 25-year-old patient is inquiring about the methods or ways to detect cancer earlier. The nurse least likely identifies this method by stating:

Annual Pap smear for sexually active women only

A nurse is providing education in a community setting about general measures to avoid excessive sun exposure. Which of the following recommendations is appropriate?

Apply sunscreen with a sun protection factor (SPF) of 30 or more before sun exposure

Nurse Janet is assigned in the oncology section of the hospital. Which of the following orders should the nurse question if a client is on radiation therapy?

Aspirin every 4 hours

The nurse is reviewing the laboratory results of a client receiving chemotherapy. The platelet count is 10,000 cells/mm. Based on this laboratory value, the priority nursing assessment is which of the following?

Assess level of consciousness

The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for?

Asymmetry

A diagnosis of Hodgkin's disease was made to a 58- year old man and is admitted for the initial cycle of chemotherapy. During the hospitalization, the nurse should watch out for the following complication, except?

Benign prostatic hyperplasia

A cervical radiation implant is placed in the client for treatment of cervical cancer. The nurse initiates what most appropriate activity order for this client?

Bed rest

A female client is undergoing tests for multiple myeloma. Diagnostic study findings in multiple myeloma include:

Bence Jones protein in the urine

At the completion of an assessment the nurse determines that education on methods to reduce the patient's increased risk for developing nonmelanoma skin cancer is required. What did the nurse assess in this patient? 13.7

Blond hair, freckles, fair skin

The nurse is preparing to care for a client with acquired immunodeficiency syndrome (AIDS). In planning infection control for this client, the nurse should implement which form of isolation to prevent the spread of the AIDS virus to others?

Blood and body fluid precautions

The nurse is caring for a client with leukemia. In assessing the client for signs of leukemia, the nurse determines that what should be monitored?

Bone marrow biopsy

The primary health care provider (PHCP) writes a prescription for zidovudine for a client who was admitted to the hospital. The nurse should contact the PHCP to verify the prescription if which finding is noted in the assessment data?

Bone marrow depression

A client with leukemia has neutropenia. Which of the following functions must be frequently assessed?

Breath sounds

The nurse is caring for a client with acquired immunodeficiency syndrome (AIDS) who has begun to experience multiple opportunistic infections. Which laboratory test would be most helpful in assessing the client's need for reassessment of treatment?

CD4+ cell or T lymphocyte count

A patient is being assessed for a melanoma skin lesion. Which assessment finding suggests that further investigation for a melanoma is necessary?

Change in the color or size of a nevus

A patient is receiving external radiation for treatment of lung cancer. What should the nurse teach the patient to care for the skin in the marked area?

Cleanse the skin with soapy water. Avoid rubbing or scratching treated skin areas.

The nurse is beginning an assessment of a patient with moderate anemia. Which manifestation should the nurse expect to assess in this patient?

Complaints of shortness of breath with exercise

A client with acquired immunodeficiency syndrome (AIDS) has been started on therapy with zidovudine. The nurse should monitor the results of which laboratory blood study for adverse effects of therapy?

Complete blood cell (CBC) count

A client had undergone radiation therapy (external). The expected side effects include the following apart from:

Constipation

Dapsone is prescribed to treat toxoplasmosis in a client with acquired immunodeficiency syndrome. The nurse reinforces medication instructions and tells the client to perform which action?

Contact the primary health care provider (PHCP) if fever or a sore throat occurs.

The nurse is caring for a client with acquired immunodeficiency syndrome and detects early infection with Pneumocystis jiroveci by monitoring the client for which clinical manifestation?

Cough

A client has been receiving foscarnet as part of therapy for the treatment of cytomegalovirus (CMV) retinitis and acquired immunodeficiency syndrome (AIDS). The home care nurse should periodically review results of which laboratory blood test to assess for adverse effects to this medication?

Creatinine concentration

The nurse is caring for a client with newly diagnosed human immunodeficiency virus (HIV). Besides preventing the transmission of the disease, what are the goals of medication therapy? Select all that apply.

Decreasing the viral load Delaying disease progression Maintaining or increasing CD4+ T cell counts Preventing HIV-related symptoms and opportunistic diseases

To provide relief from the cytarabine syndrome, which drug is given?

Dexamethasone

A patient diagnosed as being HIV positive is prescribed a protease inhibitor and nucleoside analog. For which metabolic abnormality should the nurse monitor in the patient?

Diabetes mellitus

The nurse is caring for a client with acquired immunodeficiency syndrome (AIDS) who is receiving didanosine. The nurse understands that side and adverse effects associated with this medication include which findings? Select all that apply.

Diarrhea Pancreatitis Lactic acidosis Peripheral neuropathy

In teaching about cancer prevention to a community group, the nurse stresses the promotion of exercise, normal body weight, and a low-fat diet because

Dietary fat and obesity promote growth of many types of cancer

The oncology nurse specialist provides an educational session to nursing staff regarding the characteristics of Hodgkin's disease. The nurse determines that further education is needed if a nursing staff member states which of the following is characteristic of the disease?

Occurs most often in the older client

Nurse Joy is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which of the following principles?

Do not allow pregnant women into the client's room

A patient who is receiving interleukin-2 (IL-2) therapy (Proleukin) complains to the nurse about all of these symptoms. Which one is most important to report to the health care provider?

Dyspnea

Neoplasm can be classified as either benign or malignant. The following are characteristics of malignant tumor apart from:

Encapsulated

A 4-year-old child diagnosed with leukemia is hospitalized for chemotherapy. The child is fearful of the hospitalization. Which nursing intervention should be implemented to alleviate the child's fears?

Encourage the child's parents to stay with the child.

A patient diagnosed with lung cancer reports having difficulty sleeping and often feels tense. What would be the most appropriate initial nursing intervention?

Encourage the patient to express feelings about the cancer diagnosis.

A chemotherapeutic agent known to cause alopecia is prescribed for a patient. To maintain the patient's self-esteem, the nurse plans to

Encourage the patient to purchase a wig or hat and wear it once hair loss begins

The nurse is creating a plan of care for the client with multiple myeloma and includes which priority intervention in the plan?

Encouraging fluids

Interleukin-2 (IL-2) is used as adjuvant therapy for a patient with metastatic renal cell carcinoma. The nurse teaches the patient that the purpose of therapy with this agent is to

Enhance the patient's immunologic response to tumor cells

A client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment finding would the nurse expect to note specifically in the client?

Enlarged lymph nodes

A male client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment findings would the nurse expect to note specifically in the client?

Enlarged lymph nodes

A client with acquired immunodeficiency syndrome (AIDS) is receiving ganciclovir. The nurse should take which priority action in caring for this client?

Ensure that the client uses an electric razor for shaving.

A patient with Hodgkin's lymphoma is undergoing external radiation therapy on an outpatient basis. After 2 weeks of treatment, the patient tells the nurse, "I am so tired I can hardly get out of bed in the morning." An appropriate intervention for the nurse to plan with the patient is to

Establish a time to take a short walk every day

A patient is going to begin a course of high-energy radiation to kill cancer cells through the use of a machine to focus a beam of radiation on the body. For which type of radiation therapy should the nurse instruct the patient?

External radiation therapy

Angela, a clinical instructor is conducting a lecture about chemotherapy. Which of the following statements is correct about the rate of cell growth in relation to chemotherapy?

Faster growing cells are more susceptible to chemotherapy

A female client with cancer is scheduled for radiation therapy. The nurse knows that radiation at any treatment site may cause a certain adverse effect. Therefore, the nurse should prepare the client to expect:

Fatigue

The nurse is conducting a history and monitoring laboratory values on a client with multiple myeloma. What assessment findings should the nurse expect to note? Select all that apply.

Pathological fracture Urinalysis positive for Bence Jones protein Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

The nurse is teaching a 17-year old client and the client's 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?

Fever

The nurse is reviewing the record of a client admitted to the hospital with a diagnosis of Hodgkin's disease. Which assessment findings noted in the client's record are associated with this diagnosis? Select all that apply.

Fever Weight Loss Night sweats Enlarged, painless lymph nodes

The nurse is providing home care instructions to the client who just had surgery for squamous cell carcinoma. The nurse provides follow-up teaching and explains to the client to watch for which characteristics of this type of skin carcinoma?

Firm, nodular lesion topped with a crust or with a central area of ulceration

What should be the priority when initiating or changing the drug regimen in a patient who is HIV positive?

Patient willingness to adhere to the drug regimen

A client who is human immunodeficiency virus seropositive has been taking stavudine. The nurse should monitor which most closely while the client is taking this medication?

Gait

Nurse Andrei is caring for a client with multiple myeloma. During the review of the laboratory results. The nurse will monitor the client for which of the following conditions?

Hypercalcemia

The nurse is preparing to nasotracheally suction a client with acquired immunodeficiency syndrome (AIDS) who has had blood-tinged sputum with previous suctioning. The nurse plans to use which items as part of standard precautions for this client?

Gloves, gown, mask, and protective eyewear

Which of the following assessment findings in a client with leukemia would indicate that cancer has invaded the brain?

Headache and vomiting

The client with human immunodeficiency virus (HIV) infection has been started on therapy with zidovudine. The nurse reviews the laboratory results and determines that the client is experiencing an adverse effect of the medication if which is noted?

Hemoglobin of 10 g/dL (100 mmol/L)

A client is taking Cyclophosphamide (Cytoxan) for the treatment of lymphoma. The nurse is very cautious in administering the medication because this drug poses the fatal side effect of:

Hemorrhagic cystitis

What are the three most important prognostic factors in determining long-term survival for children with acute leukemia?

Histologic type of disease, initial WBC count, and client's age at diagnosis

A client asks the nurse about obtaining a home test kit to test for human immunodeficiency virus (HIV) status. What should the nurse tell the client?

Home test kits may not be as reliable as laboratory blood tests.

A bone marrow transplant is being considered for treatment of a patient with acute leukemia that has not responded to chemotherapy. In discussing the treatment with the patient, the nurse explains that

Hospitalization will be required for several weeks after the hematopoietic stem cell transplant (HSCT)

The nurse notes that a client is receiving lamivudine. The nurse determines that this medication has been prescribed to treat which condition?

Human immunodeficiency virus (HIV)

The nurse is collecting subjective and objective data from a client and notes that the client is taking abacavir. The nurse determines that this medication has been prescribed to treat which condition?

Human immunodeficiency virus (HIV) infection

The client with leukemia is receiving Myleran (busulfan) and Zyloprim (allopurinol). The nurse tells the client that the purpose if the allopurinol is to prevent:

Hyperuricemia

When caring for a client with a central venous line, which of the following nursing actions should be implemented in the plan of care for chemotherapy administration? Select all that apply.When caring for a client with a central venous line, which of the following nursing actions should be implemented in the plan of care for chemotherapy administration? Select all that apply.

If unable to aspirate blood, reposition the client and encourage the client to cough Contact the health care provider about verifying placement if the status is questionable Inspect the insertion site for swelling, erythema, or drainage Verify patency of the line by the presence of a blood return at regular intervals.

Which of the following substances has abnormal values early in the course of multiple myeloma (MM)?

Immunoglobulins

The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would the nurse expect to note specifically in this disorder?

Increased calcium level

The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which of the following would the nurse expect to note specifically in this disorder?

Increased calcium levels

The nurse is identifying potential patient problems for a patient receiving a bone marrow transplant for treatment of acute myelocytic leukemia. Which potential problems would be the immediate priority for this patient? Select all that apply.

Increased risk for developing an infection Increased risk of bleeding

The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy?

Increased uric acid level

A male client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer?

Indigestion

The client with acquired immunodeficiency syndrome (AIDS) and Pneumocystis jiroveci infection has been receiving pentamidine. The nurse caring for the client should monitor the client most closely for signs of which adverse effect of the medication?

Infection

The nurse is reviewing the laboratory results for a client with a diagnosis of leukemia and notes that the absolute neutrophil count is decreased. The nurse interprets this to mean that the client is at risk for which problem?

Infection

The nurse is reviewing the laboratory test results for a client with a diagnosis of leukemia. The nurse notes that the granulocyte count is decreased. The nurse interprets that the client is at risk for which condition?

Infection

A client who has been receiving pentamidine intravenously now has a fever with a temperature of 102º F (38.9º C). Keeping in mind that the client has a diagnosis of acquired immunodeficiency syndrome (AIDS) and Pneumocystis jiroveci pneumonia, the nurse should interpret that this fever is most associated with which condition?

Infection caused by leukopenic effects of the medication

The nurse works with high-risk clients in an urban outpatient setting. Which groups should be tested for human immunodeficiency virus (HIV)? Select all that apply.

Injection drug abusers Prostitutes and their clients People with sexually transmitted infections (STIs)

For a female client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the plan of care?

Inspecting the skin for petechiae once every shift

According to a standard staging classification of Hodgkin's disease, which of the following criteria reflects stage III?

Involvement of lymph node regions or structures on both sides of the diaphragm

A CD4 T-cell count is measured in a client newly diagnosed with human immunodeficiency virus (HIV). In planning care, the nurse understands that which is accurate regarding the CD4 T-cell count? Select all that apply.

Is a primary marker of immunocompetence Plays a role in the cell-mediated immune response Guides decision making regarding timing of initiation of treatment

A male client is receiving the cell cycle-nonspecific alkylating agent Thioplex (thiotepa), 60 mg weekly for 4 weeks by bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. The client asks the nurse how the drug works. How does thiotepa exert its therapeutic effects?

It interferes with DNA replication and RNA transcription

The nurse is caring for a client with acquired immunodeficiency syndrome (AIDS) who is experiencing night fever and night sweats. Which nursing interventions would be helpful in managing this symptom? Select all that apply.

Keep liquids at the bedside. Place a towel over the pillowcase. Make sure the pillow has a plastic cover. Keep a change of bed linens nearby in case they are needed.

A client returns to the clinic for follow-up treatment after a skin biopsy of a suspicious lesion performed 1 week ago. The biopsy report indicates that the lesion is a melanoma. The nurse understands that melanoma has which characteristics? Select all that apply.

Lesion is highly metastatic. Lesion is a nevus that has changes in color.

The community nurse is conducting a health promotion program at a local school and is discussing the risk factors associated with cancer. Which of the following, if identified by the client as a risk factor, indicates a need for further instructions?

Low-fat and high-fiber diet

A female client with cancer is being evaluated for possible metastasis. Which of the following is one of the most common metastasis sites for cancer cells?

Liver

The nurse is monitoring a client with chronic lymphocytic leukemia (CLL). Which sign should the nurse specifically monitor for and report to the primary health care provider?

Lymphadenopathy

A client is diagnosed with multiple myeloma. The client asks the nurse about the diagnosis. The nurse bases the response on which of the following descriptions of this disorder?

Malignant proliferation of plasma cells and tumors within the bone

Which of the following represents the most appropriate nursing intervention for a client with pruritus caused by cancer or the treatments?

Medicated cool baths

The nurse is assigned to care for a client with human immunodeficiency virus (HIV) infection. The nurse reviews the client's health care record and notes documentation of toxoplasmosis encephalitis. On the basis of this information, the nurse would assess for which manifestation?

Mental status changes

A patient with a history of colon cancer is informed that cells from the colon tumor have traveled to the liver. Which process should the nurse plan to explain to the patient?

Metastasis

Nausea and vomiting is an expected side effect of chemotherapeutic drug use. Which of the following drugs should be administered to a client on chemotherapy to prevent nausea and vomiting?

Metozol (metoclopramide)

The nurse in the surgical care center will be assisting the primary health care provider to perform a punch biopsy of a client's skin lesion. Which interventions should be included in the preprocedure plan of care? Select all that apply.

Obtain an informed consent. Prepare to apply direct pressure to the biopsy site after the procedure. Tell the client that a small piece of tissue will be removed for examination.

The client with cancer is receiving chemotherapy and develops thrombocytopenia. The nurse identifies which intervention is the highest priority in the nursing plan of care?

Monitoring the platelet count

Maria was recently diagnosed with Hodgkin's lymphoma. Upon the early diagnosis, the nurse will expect which of the following areas is often involved?

Neck

A patient is taking the nucleoside reverse transcriptase inhibitor zidovudine (Retrovir) for HIV. What should the nurse identify as an adverse reaction to this medication? Select all that apply

Neutropenia Anemia

The nurse is concerned that a patient's skin lesion with an irregular border could become malignant. Which lesion did the nurse assess in the patient?

Nevi

A patient with multiple myeloma calls the home health nurse complaining of a new onset of severe back pain. What should the nurse respond to this patient?

Notify the healthcare provider of the onset of new pain.

The community health nurse is conducting an education session for community members regarding measures to prevent skin cancer and is providing instructions for use of sunscreen protection. The nurse determines that teaching was effective if a community member states that chemical sunscreens are most effective when applied at what time?

One hour before exposure to the sun

External-beam radiation is planned for a patient with endometrial cancer. The nurse teaches the patient that an important measure to prevent complications from the effects of the radiation is to

Perform perianal care with sitz baths and meticulous cleaning

A child is seen in the pediatrician's office for complaints of bone and joint pain. Which of the following other assessment findings may suggest leukemia?

Petechiae

A male client is in isolation after receiving an internal radioactive implant to treat cancer. Two hours later, the nurse discovers the implant in the bed linens. What should the nurse do first?

Pick up the implant with long-handled forceps and place it in a lead-lined container

The nurse is caring for a client with leukemia who is receiving intravenous chemotherapy. The nurse reviews the laboratory results and notes that the white blood cell count is 2000 mm3 (2 × 109/L), the platelet count is 150,000 mm3 (150 × 109/L), the clotting time is 10 minutes, and the ammonia level is 20 mcg/dL (12 mcmol/L). Which nursing action would be appropriate?

Place the client on neutropenic precautions.

The nurse has a prescription to administer foscarnet intravenously to a client with acquired immunodeficiency syndrome (AIDS). What should the nurse plan to do before administering this medication?

Place the solution on a controlled infusion pump.

A patient is experiencing bone marrow depression as a result of chemotherapy. Which assessment should the nurse expect because of this health problem?

Platelet count of 50,000

During an assessment, the nurse observes reddish-purple spots and areas of purple bruising on a patient's arms and legs. Which laboratory result would be consistent with this assessment finding?

Platelets 60 × 103/mm3

The nurse notes a cough, shortness of breath, and tachypnea in a patient with AIDS. Which opportunistic infection is probably causing these manifestations?

Pneumocystis jiroveci

A client who is human immunodeficiency virus (HIV)-positive has had a tuberculin skin test (TST). The nurse notes a 7-mm area of induration at the site of the skin test and interprets the result as which finding?

Positive

The client with acquired immunodeficiency syndrome is diagnosed with cutaneous Kaposi's sarcoma. Based on this diagnosis, the nurse understands that this has been confirmed by which finding?

Positive punch biopsy of the cutaneous lesions

The nurse is reviewing the medical record for a client who has been diagnosed with Hodgkin's disease. The nurse should check which diagnostic test noted in the client's record to determine the stage of the disease?

Positron emission topography (PET) scan

A client who is seropositive for human immunodeficiency virus (HIV) has been taking stavudine. The nurse assesses which most closely while the client is taking this medication?

Presence of paresthesia

Which nursing interventions are priorities for a patient with acute myeloid leukemia? Select all that apply.

Private room Soft, bland diet Oral hygiene after meals

The nurse is monitoring a client with acute lymphocytic leukemia for toxic effects of asparaginase. The nurse should notify the primary health care provider if monitoring reveals which finding?

Prolonged blood clotting times

The nurse is assisting in planning care for a client with a diagnosis of immunodeficiency and should incorporate which action as a priority in the plan?

Protecting the client from infection

A patient is experiencing nausea and vomiting after daily chemotherapy treatments. What should the nurse do to help this patient?

Provide antiemetic medication 30 to 40 minutes prior to each treatment.

During chemotherapy, an oncology client has a nursing diagnosis of impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis?

Providing a solution of hydrogen peroxide and water for use as a mouth rinse

A client with acquired immunodeficiency syndrome is suspected of having cutaneous Kaposi's sarcoma. The nurse should prepare the client for which test to confirm the presence of this type of sarcoma?

Punch biopsy of the cutaneous lesions

The nurse is teaching a client with acquired immunodeficiency syndrome (AIDS) how to avoid food-borne illnesses. The nurse should instruct the client that which food can cause a food-borne illness?

Raw oysters

A 35-year-old client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis (inflammation of the mouth)?

Red, open sores on the oral mucosa

Cytarabine (Ara-C) is an antimetabolite that can cause a common cytarabine syndrome which includes the following, except:

Red-orange urine

A client with acquired immunodeficiency syndrome (AIDS) is experiencing nausea and vomiting. The nurse should include which measure in the dietary plan?

Remove dairy products and red meat from the meal.

The nurse is reviewing the laboratory test results for a client with a diagnosis of leukemia who is receiving chemotherapy. The nurse notes that the client's platelet count is 20,000 mm3 (200 × 109/L). The nurse should prepare to implement which action based on this finding?

Remove the rectal thermometer from the client's room.

Dapsone is prescribed for a client with acquired immunodeficiency syndrome (AIDS) for the treatment of toxoplasmosis. The nurse provides medication instructions and determines that the client understands the instructions if the client states that which action is necessary?

Report a sore throat to the primary health care provider (PHCP).

When the nurse is administering a vesicant chemotherapeutic agent intravenously, an important consideration is to

Stop the infusion if swelling is observed at the site

A patient receiving head and neck radiation and systemic chemotherapy has ulcerations over the oral mucosa and tongue and thick, ropey saliva. An appropriate intervention for the nurse to teach the patient is to

Rinse the mouth before and after each meal and at bedtime with a saline solution

The clinic nurse prepares instructions for a client diagnosed with leukemia who developed stomatitis after the administration of a course of antineoplastic medications. The nurse should provide the client with which instruction?

Rinse the mouth with a diluted solution of baking soda or saline.

After the nurse has explained the purpose of and schedule for chemotherapy to a 23-year-old patient who recently received a diagnosis of acute leukemia, the patient asks the nurse to repeat the information. Based on this assessment, which nursing diagnosis is most likely for the patient?

Risk for ineffective health maintenance related to anxiety about new leukemia diagnosis

A patient is going to receive chemotherapeutic medication that affects DNA replication and chromosome duplication. Which phase of the cell cycle is this medication going to affect?

S phase

The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine. The nurse interprets that the client may have the medication discontinued by the primary health care provider if which elevated result is noted?

Serum amylase level

The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome who is receiving foscarnet, an antiviral medication. The nurse should monitor the results of which laboratory study while the client is taking this medication?

Serum creatinine level

A client with acquired immunodeficiency syndrome (AIDS) is experiencing fatigue. The nurse should plan to teach the client which strategy to conserve energy after discharge from the hospital?

Sit for as many activities as possible.

The male client is receiving external radiation to the neck for cancer of the larynx. The most likely side effect to be expected is:

Sore throat

A client with human immunodeficiency virus (HIV) infection has a fever, and histoplasmosis is suspected. The nurse should prepare the client for which diagnostic test to confirm the presence of histoplasmosis?

Sputum culture

The nurse is caring for a client with human immunodeficiency virus (HIV) infection and notes a diagnosis of cryptococcosis in the client's medical record. The nurse understands that this opportunistic infection most likely was diagnosed by which test?

Sputum culture

A man has been admitted to the surgical unit after hernia repair surgery. The medical record reports that the client is human immunodeficiency virus (HIV) positive. The nurse should implement which precautions for this client?

Standard precautions

A client with human immunodeficiency virus infection has signs and symptoms of cryptosporidiosis. The nurse should prepare the client for which test that will assist in confirming the diagnosis?

Stool culture

Which of the following medications usually is given to a client with leukemia as prophylaxis against P. carinii pneumonia?

Sulfamethoxazole and trimethoprim (Bactrim)

A client with human immunodeficiency virus infection is taking indinavir. The nurse plans to provide the client with which direction when providing instructions about the use of this medication?

Take the medication with water on an empty stomach.

A patient who has terminal cancer of the liver and is cared for by family members at home tells the nurse, "I have intense pain most of the time now." The nurse recognizes that teaching regarding pain management has been effective when the patient

Takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs

A patient with lymphoma is prescribed the CHOP chemotherapy regimen. What should the nurse explain about the purpose of combining these medications as treatment for the disorder? Select all that apply.

Targets different phases of the cell cycle Reduces drug resistance

The nurse is caring for a female client experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. The nurse plans to:

Teach the client and family about the need for hand hygiene

The client with acquired immunodeficiency syndrome (AIDS) has been prescribed raltegravir. The nurse determines that the client may be experiencing an adverse effect related to this medication if which assessment finding is noted?

Temperature of 101.2º F (38.4º C)

The client with acquired immunodeficiency syndrome and Pneumocystis jiroveci infection has been receiving pentamidine. The client develops a temperature of 101º F (38.3º C). The nurse continues to assess the client, knowing that this sign most likely indicates which condition?

That the client has developed another infection caused by leukopenic effects of the medication

Which action by a nursing assistant (NA) when caring for a patient who has pancytopenia indicates a need for the nurse to intervene?

The NA assists the patient to use dental floss after eating

Which action by a nursing assistant (NA) caring for a patient with a temporary radioactive cervical implant indicates that the RN should intervene?

The NA stands by the patient's bed for an hour talking with the patient

A client with acquired immunodeficiency syndrome (AIDS) has a concurrent diagnosis of histoplasmosis. During the assessment, the nurse notes that the client has enlarged lymph nodes. How should the nurse interpret this assessment finding?

The client has disseminated histoplasmosis infection.

A client with acquired immunodeficiency syndrome (AIDS) has a respiratory infection from Pneumocystis jiroveci and has been experiencing difficulty breathing and resultant problems with gas exchange. Which finding indicates that the expected outcome of care has yet to be achieved?

The client limits fluid intake.

The home health care nurse is caring for a male client with cancer and the client is complaining of acute pain. The appropriate nursing assessment of the client's pain would include which of the following?

The client's pain rating

The oncology nurse specialist provides an educational session for nursing staff regarding the characteristics of Hodgkin's disease. The nurse determines that further teaching is needed if a nursing staff member states that which is a characteristic of the disease?

The disease occurs most often in those older than 75 years of age.

A client with acquired immunodeficiency syndrome who is taking zidovudine 200 mg orally 3 times daily has severe neutropenia noted on follow-up laboratory studies. The nurse interprets that which change is likely to occur at this point?

The medication probably will be discontinued until laboratory results indicate bone marrow recovery.

The nurse is preparing Cytoxan (cyclophosphamide). Safe handling of the drug should be implemented to protect the nurse from injury. Which of the following actions by the nurse should be corrected?

The nurse should wear a mask and gloves

Which information obtained by the nurse about a patient with colon cancer who is scheduled for external radiation therapy to the abdomen indicates a need for patient teaching?

The patient swims a mile 5 days a week

A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the RN caring for the patient indicates that the nurse should take action?

The patient's visitors bring in some fresh peaches from home

A client is tested for human immunodeficiency virus (HIV) infection with an enzyme-linked immunosorbent assay (ELISA), and the test result is positive. What should the nurse tell the client?

The test will need to be confirmed with a Western blot.

The nurse is preparing to instruct a group of patients newly diagnosed with cancer on the role of oncogenes. What should the nurse explain as a characteristic of oncogenes?

They promote cell growth when activated.

The nurse is reviewing the chart of a client who is newly diagnosed with chronic lymphocytic leukemia. Which of the following laboratory values is expected to be seen?

Thrombocytopenia and increased lymphocytes

Which of the following is the reason to perform a spinal tap on a client newly diagnosed with leukemia?

To assess for central nervous system infiltration

The following are teaching guidelines regarding radiation therapy except:

To promote safety, the client is assisted by therapy personnel while the machine is in operation

Pyrimethamine has been added to the medication regimen for a client with acquired immunodeficiency syndrome. On review of the client's record, the nurse notes this new prescription and plans care knowing that it has been prescribed to treat which condition?

Toxoplasmosis

The client who is seropositive for human immunodeficiency virus (HIV) has been taking ritonavir. The nurse tells the client that which follow-up laboratory study will be necessary while taking this medication?

Triglyceride level

The nurse is monitoring the uric acid, potassium, phosphorus, and calcium levels for a patient completing the first cycle of chemotherapy. For which complication is the nurse monitoring the patient?

Tumor lysis syndrome

In staging and grading neoplasm TNM systems is used. TNM stands for:

Tumor, node, metastasis

A client with acute myelocytic leukemia is being treated with busulfan. Which laboratory value would the nurse specifically monitor during treatment with this medication?

Uric acid level

A patient with tumor lysis syndrome (TLS) is taking Zyloprim (allopurinol). Which laboratory value should the nurse monitor to determine the effectiveness of the medication?

Uric acid level

The nurse participating in a health fair is setting up a booth on prevention of human immunodeficiency virus (HIV) transmission. A poster is planned that will list sexual behaviors in 1 of 2 columns, "safe" and "not safe." Which behavior should the nurse place in the "not safe" column?

Use of natural skin condoms

The health education nurse provides instructions to a group of clients regarding measures that will assist in preventing skin cancer. Which instructions should the nurse provide? Select all that apply.

Use sunscreen when participating in outdoor activities. Wear a hat, opaque clothing, and sunglasses when in the sun. Examine your body monthly for any lesions that may be suspicious.

Which of the following treatment measures should be implemented for a child with leukemia who has been exposed to the chickenpox?

VZIG should be given within 72 hours of exposure

The nurse is assigned to care for a client with human immunodeficiency virus (HIV) infection. The nurse notes recent documentation of herpes simplex in the client's medical record. On assessment, the nurse would expect to note which type of lesion?

Vesicular lesions that rupture

A client with human immunodeficiency virus (HIV) infection is diagnosed with herpes simplex virus (HSV). The nurse should prepare the client for which diagnostic test to determine the presence of herpesvirus infection?

Viral culture

Which information noted by the nurse reviewing the laboratory results of a patient who is receiving chemotherapy is most important to report to the health care provider?

WBC count of 1700/µl

Skin reactions are common in radiation therapy. Nursing responsibilities on promoting skin integrity should be promoted apart from:

Washing the area with a bar of scented soap and water and patting it dry not rubbing it

The nurse prepares to give a bath and change the bed linens of a client with cutaneous Kaposi's sarcoma lesions. The lesions are open and draining a scant amount of serous fluid. Which would the nurse incorporate into the plan during the bathing of this client?

Wearing a gown and gloves

The nurse reviews the record of a client with acquired immunodeficiency syndrome (AIDS) and notes that the client has a diagnosis of Candida. When performing history-taking and assessment, which finding should the nurse anticipate?

Yellowish-white, curd-like patches in the oral cavity