Pharm Unit 7 (Oncology & Immunocology)
A nurse is caring for a client who has multiple myeloma and has a WBC of 2,200/mm3. Which of the following food items brought by the family should the nurse prohibit from being given to the client?
Fresh fruit basket
A nurse is reviewing the medical record of a client who just returned to the unit following surgery and notes the client has a history of anaphylaxis in response to penicillin. The client's postoperative prescriptions include a dose of cephalexin. Which of the following actions should the nurse take?
Request the surgeon prescribe a different antibiotic
A nurse is caring for a client who is taking oral erythromycin. Which of the following statements by the nurse indicates the client is experiencing a common adverse effect of this medication?
"The client had a small amount of yellow emesis."
A nurse is emptying a client's urinal when she notices the urine is dark amber, cloudy, and has an unpleasant odor. The nurse should identify that these findings are likely to be the result of which of the following?
Urinary tract infection
A nurse is caring for a client who has cancer. The client states that she wants to try nontraditional treatments instead of chemotherapy recommended by her provider. Which of the following responses should the nurse make?
"Tell me more about your concerns about chemotherapy"
A nurse is reinforcing teaching with a client with bacterial conjunctivitis of the right eye, and a prescription for an antibiotic ophthalmic ointment. Which of the following statements should the nurse make?
"Apply the ointment in a thin line into the conjunctival sac."
A client who is taking nitrofurantoin for a urinary tract infection voices a concern to the clinic nurse about voiding brown-colored urine. Which of the following is an appropriate response by the nurse?
"Brown-colored urine is a harmless side effect of the medication."
A nurse is reviewing discharge instructions with a client newly prescribed amoxicillin-clavulanate. Which of the following statements indicates an understanding of the teaching?
"I can take this medication with food."
A nurse is reinforcing teaching to a parent about the use of nystatin for an infant who has oral candidiasis. Which of the following statements by the parent indicates an understanding of the administration of nystatin?
"I will swab the medication inside my baby's mouth and on her tongue."
A nurse is reinforcing home instructions for a client who as an immunodeficiency. Which of the following client statements indicates a need for further teaching?
"I will take my temperature once a week."
A nurse is reinforcing teaching a client who has a new prescription for gentamycin ointment to treat a skin infection. Which of the following statements by the client indicates an understanding of the teaching?
"I'll wash the area with soap and water before I apply the cream."
A nurse is reinforcing teaching with a client who has thrombocytopenic disorder. Which of the following information should the nurse include?
"Notify the dentist of condition prior to invasive procedure."
A nurse is reinforcing teaching about vancomycin with a client who has an infection. Which of the following information should the nurse include in the teaching?
"Notify your provider if you experience any changes in your hearing."
A client who has chronic lymphocytic leukemia is starting chemotherapy treatments and asks if she needs to make any dietary changes. Which of the following statements by the nurse is appropriate?
"Use sugar-free gum if you experience a metallic taste in your mouth."
A nurse is collecting data from a client who has a urinary tract infection. Which of the following findings should the nurse expect? *Select all that apply*
- Dysuria - Urinary frequency - Hematuria
A nurse is assisting with discharge teaching for a client who is postoperative from a mastectomy including the removal of axillary lymph nodes. Which of the following instructions should the nurse include? *Select all that apply*
- Perform range-of-motion exercises of the affected arm - Elevated the affected arm on a pillow when resting in bed
A nurse is caring for a client who is receiving IV tobramycin and has a prescription for peak and trough blood levels with the next dose scheduled for 1800. The nurse should expect the lab to draw blood samples at which of the following times?
1745 and 1830
A nurse is reviewing a client's admission laboratory values. The client has thrombocytopenia with a platelet count of 34,000/mm3. Which of the following actions should the nurse take?
Apply pressure for 3 to 10 min following venipunctures.
A nurse is assisting with the plan of care for a client who has leukemia and whose platelet count is 50,000 mm3. Which of the following interventions should the nurse include in the plan of care?
Administer a stool softener
A nurse is caring for a client who received an injection of penicillin G procaine and beings to experience an anaphylactic reaction. Which of the following actions should the nurse take first?
Administer epinephrine subcutaneously
A nurse is caring for a child who is allergic to penicillin. Which of the following medications should the nurse identify as contraindicated for the child?
Amoxicillin-clavulanate (Augmentin)
A nurse is reinforcing teaching with a client who has neutropenia. Which of the following instructions should the nurse include in the teaching?
Avoid crowded places
A nurse is caring for a client receiving chemotherapy. The nurse should identify that a client who has myelosuppression is at risk for which of the following conditions?
Bleeding from the gums
A nurse suspects anaphylaxis when caring for a client following the initial administration of an oral antibiotic. Which of the following is the priority intervention by the nurse?
Check the client's respiratory rate
A nurse is assessing an older adult client who has a urinary tract infection (UTI). Which of the following findings should the nurse identify as unique for this age group?
Confusion
A nurse is reinforcing teaching with a client who has frequent urinary tract infections (UTIs). The nurse should identify that the client can use which of the following herbal supplements to help prevent UTIs?
Cranberry juice
A nurse is reinforcing teaching with a client who has a urinary tract infection (UTI). Which of the following risk factors should the nurse include in the teaching?
Diabetes mellitus
A nurse is reinforcing teaching with a female client about preventing urinary tract infections (UTIs). Which of the following instructions should the nurse include?
Drink 16 oz cranberry juice each day
A nurse is discussing alopecia with a client who is scheduled to begin chemotherapy. Which of the following statements should the nurse include?
Hair loss is common and includes eyebrows and eyelashes
A nurse is preparing to administer prednisone to a client for treatment of rheumatoid arthritis. Which of the following findings indicates to the nurse the treatment is effective?
Improved range of motion
A nurse is reinforcing teaching with a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching?
Increase fluid intake by drinking bottled water.
A nurse is preparing to administer IV vancomycin to a client who has methicillin-resistant Staphylococcus aureus (MRSA). Which of the following actions should the nurse plan to take?
Infuse the medication over at least 60 min
A nurse is preparing to administer the first dose of etanercept to a client who had rheumatoid arthritis. Which of the following actions should the nurse take?
Inject the medication subcutaneously into the client's upper arm.
A nurse is reinforcing teaching with a female client who has thrombocytopenia. Which of the following instructions should the nurse include? *Select all that apply*
Lubricate lips with water-soluble ointment Brush teeth with a soft toothbrush Blow nose gently
A nurse is collecting data from client who has received chemotherapy to treat lung cancer. Which of the following adverse effects should the nurse report to the provider?
Manifestations of infection
A nurse is caring for a client who has chlamydia and a new prescription for azithromycin. Which of the following information should the nurse include when reinforcing teaching about this medication?
Notify provider if you experience a sore throat or fever while taking this medication.
A nurse is reinforcing teaching with an adolescent who has a new prescription for sulfamethoxazole-trimethoprim. Which of the following adverse effects should the nurse include in the teaching?
Photosensitivity
A nurse is reinforcing discharge teaching with a client who is immunocompromised. Which of the following instructions should the nurse include in the teaching? *Select all that apply*
Restrict visitor with active infections Instruct the client to eat cooked foods only
A nurse is contributing to the plan of care for an older adult who has WBC of 2000/mm3 after three rounds of chemotherapy. Which of the following interventions should the nurse include in the plan?
Serve cooked fruit with meals
A nurse is reinforcing teaching with a client who has HIV and is being discharged home. Which of the following instructions should the nurse include in the teaching?
Take temperature once a day
A nurse is reviewing a client's peak and trough levels of gentamicin. The peak should be 6 to 8 mcg/mL and the trough should be 0.5 to 1 mcg/mL. The client's peak is 10 mcg/mL and his trough is 2.3 mcg/mL. Which of the following clinical manifestations should the nurse expect with these findings? *Select all that apply*
Tinnitus Persistent headache
A nurse is caring for a client who comes to the clinic to be tested for tuberculosis (TB) after a close family contacts positive. Which of the following measures should the nurse anticipate preparing for this client?
Tuberculin skin test
A nurse is collecting data from an infant who has otitis media. The nurse should expect which of the following findings?
Tugging on the affected ear lobe.
A nurse is reviewing the medication record of a client who has chronic renal disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?
Vancomycin
A nurse is collecting data from a client who has a prescription for oral clindamycin hydrochloride. Which of the following findings should the nurse immediately report to the provider?
Watery diarrhea
A nurse is caring for a client who just received a dose of IV ampicillin. Which of the following client reactions requires priority intervention by the nurse?
Wheezing