A
Which of the following a nursing priority when caring for a patient receiving chemotherapy? Select all that apply.
A. Symptom management
B. Preventing infection
C. Connecting the patient to support groups
D. Avoiding the patient when possible for 24 hours after each treatment
E. Bleeding precautions
F. Keeping fresh flowers in the patient's room to brighten their day and improve mental health
A. Symptom management
B. Preventing infection
C. Connecting the patient to support groups
E. Bleeding precautions
A nurse observes a colleague preparing a patient's medications. The colleague quickly opens the patient's tamoxifen and puts it in a med cup. The colleague then enters the patient's room, hands the patient the med cup, washes their hands, and exits their room. What recommendation would the nurse make to their colleague?
A. There's no need to wash your hands before leaving the patient's room since you didn't touch the patient.
B. Putting the medication into a cup is an extra step and a waste of time - next time you should pop the drug out of the package directly into the patient's hand.
C. Tamoxifen is a chemotherapy drug and should be treated the same as IV chemo treatments. Next time you should wear gloves before handling the medication for your own safety.
D. The colleague did everything exactly as you would do it, and you have no recommendations.
C. Tamoxifen is a chemotherapy drug and should be treated the same as IV chemo treatments. Next time you should wear gloves before handling the medication for your own safety.
The nurse is assigned a patient due to receive radiation therapy later that day. The nurse knows that which of the following are priority safety factors for protecting themselves? Select all that apply.
A. Avoidance
B. Time
C. Distance
D. Shielding
B. Time
C. Distance
D. Shielding
This nurse recognizes that which drug class binds to receptors on progenitor cells in the bone marrow to stimulate production of WBCs, RBC, and platelets?
A. Immunomodulating drugs
B. Hematopoietic drugs
C. Monoclonal antibodies
D. Radiation therapy
B. Hematopoietic drugs
The nurse is caring for a new cancer patient taking Humera for RA. The nurse recognizes Humera as what type of medication?
A. Interferon
B. Monoclonal Antibody
C. Interleukins
D. Colony stimulating factor
B. Monoclonal Antibody
Which of the following statements are true regarding side effects of radiation? Select all that apply.
A. The patient will not experience any long-term effects from radiation therapy.
B. The side effects the patient experiences will vary according to the treatment site.
C. The patient is at risk for secondary malignancies.
D. The patient may experience altered taste sensations.
E. The patient should purchase a wig in preparation for alopecia.
B. The side effects the patient experiences will vary according to the treatment site.
C. The patient is at risk for secondary malignancies.
D. The patient may experience altered taste sensations.
The nurse is prepping a patient to receive their first chemotherapy treatment. The patient is nervous and asking the nurse a lot of questions. The patient asks, "How do you know how much I'm supposed to get? I don't want to get too much.." The nurse would answer with which of the following statements?
A. The amount of chemo you receive is based solely on the staging of your cancer.
B. The amount of chemo you receive is standard - everyone receives the same amount.
C. The amount of chemo you get is calculated based on body surface area calculations.
D. The chemo dosage is calculated based on your age.
C. The amount of chemo you get is calculated based on body surface area calculations.
A nurse is caring for a patient that is taking a hemopoietic drug. Which of the follow labs would the nurse anticipate monitoring? Select all that apply.
A. RBCs
B. WBCs
C. ANC
D. Ketones
E. Potassium
A. RBCs
B. WBCs
C. ANC
The nurse knows that type of drug prevents cancer cells from dividing and replicating & increases activity of macrophages, neutrophils, and natural killer cells?
A. Monoclonal antibodies
B. Colony stimulating factors
C. Interferons
D. Platelet promoting drugs
C. Interferons
The nurse recognizes that which of the following are the 3 stages of development of a malignant neoplasm?
A. Metastasis
B. Initiation
C. Multiplication
D. Promotion
E. Progression
B. Initiation
D. Promotion
E. Progression
The nurse recognizes which of the following as the most feared cancer symptom?
A. Fatigue
B. Pain
C. Nausea and vomiting
D. Alopecia
B. Pain
A patient with end-stage breast cancer has accepted her diagnosis and wishes to "stop treatment and enjoy the life she has left." Which of the following would be the goal for this patient's treatment?
A. Cure
B. Control
C. Palliation
D. All of the above
C. Palliation
Which of the following diagnostic tests allow direct visualization and/or sampling of suspicious tissues? Select all that apply.
A. Colonoscopy
B. Mammography
C. Biopsy
D. Endoscopy
E. Ultrasound
A. Colonoscopy
C. Biopsy
D. Endoscopy
What type of support might the nurse offer for a patient receiving radiation therapy?
A. Grief support
B. Financial support
C. Friendship
D. Nutritional guidelines
A. Grief support
Which of the following would be collaborative interventions between the nurse and other members of the health care team? Select all that apply.
A. Nutritional support
B. Exercise and sleep interventions for fatigue
C. Checking temp at regular intervals to watch for infection
D. Educating the patient on increased risk for infection
E. Ordering meds for symptom management
A. Nutritional support
B. Exercise and sleep interventions for fatigue
Which of the following symptoms can result in impaired nutrition for a cancer patient receiving treatment? Select all that apply.
A. Xerostomia
B. Nausea
C. Mucositis
D. Loss of appetite
E. Change in bowel habit
A. Xerostomia
B. Nausea
C. Mucositis
D. Loss of appetite
E. Change in bowel habit
A 59 year old patient arrives at the hospital with the following presentation: nausea and vomiting for 10 days, diarrhea, loss of appetite, and a nagging cough. The patient also complains of a painful sore in his mouth that "just won't heal up." Which of these findings are part of the 7 warning signs of cancer?
A. Extended nausea and vomiting
B. Diarrhea
C. Loss of appetite
D. Nagging cough
E. Painful sore that doesn't heal
B. Diarrhea
D. Nagging cough
E. Painful sore that doesn't heal
A nurse is caring for a paint with triple negative breast cancer. While going over the MAR the nurse notes that the patient receives both chemotherapy and Neupogen. Which of the following a nursing implication the nurse should be aware of when administering this patient's medications?
A. The patient will be at an even higher risk for thrombocytopenia compared to a patient doing only chemotherapy treatment.
B. The nurse must check and chart the patient's vitals before every administration of the Neupogen.
C. The Neupogen enhances the the effectiveness of the chemotherapy and reduces adverse side effects. Therefore, the nurse should administer the medication immediately after beginning chemotherapy treatment.
D. The Neupogen should not be administered within 24 hours of the chemo. Optimal start time is 24-48 hours after chemo is given.
D. The Neupogen should not be administered within 24 hours of the chemo. Optimal start time is 24-48 hours after chemo is given.
A cancer patient that has just received a bone marrow transplant has a new order in the MAR for homapoietic drug. The nurse knows that the drug is being prescribed for what reason?
A. To reduce the risk of transplant rejection
B. To decrease recovery time after bone marrow transplant
C. To decrease pain after transplant procedure
D. To reduce risk of infection following bone marrow transplant
B. To decrease recovery time after bone marrow transplant
The student nurse asks for clarification on why colony stimulating drugs are contraindicated with greater than 10% myeloid blasts. Which answer would the student nurse's instructor provide?
A. It can stimulate malignant growth
B. The drug will not have any effect at this % of myeloid blasts
C. If the myeloid blasts continue to increase, it can lead to an overproduction of RBCs
D. All of the above
A. It can stimulate malignant growth
Which of the following would be priority nursing interventions when caring for a patient with radiation-induced xerostomia? Select all that apply.
A. Mouth care
B. Gargling with an alcohol based mouthwash every 2 hours to stimulate salivary production
C. Preventing infection
D. Sustaining nutrition
E. Self-esteem concerns
A. Mouth care
C. Preventing infection
D. Sustaining nutrition
Which of the following adverse effects might the nurse anticipate for a patient starting a new hemapoietic drug? Select all that apply.
A. Fever
B. Alopecia
C. Bone pain
D. Xerostomia
E. Edema
A. Fever
B. Alopecia
C. Bone pain
E. Edema
A nurse begins her shift by performing an assessment on her first patient that just received their third chemo treatment 3 days ago. Which of the following findings would be most concerning to the nurse and require immediate follow-up with the physician?
A. Hgb level at 12.4
B. Temp of 99.8 F
C. Open, painful ulcers in the mouth
D. BP 134/90
E. Patient reports only sleeping a couple of hours during the night and is "extremely exhausted."
B. Temp of 99.8 F
A nurse is assigned four cancer patients at the start of her shift. Which of the following patients has the most severe diagnosis based on the TNM classification system?
A. Maria, age 56, Breast Cancer: T1, N2, M0
B. Wayne, age 78, Prostate Cancer: T3, N2, M3
C. Dorothy, age 69, Colon Cancer: T1s, N0, M0
D. Jenna, age 42, Breast Cancer: T2, N0, M1
B. Wayne, age 78, Prostate Cancer: T3, N2, M3
The nurse knows that their patient chemotherapy-induced bone marrow suppression is at risk for anemia, thrombocytopenia, and neutropenia. As the nurse, how would you explain the reasons for these risks to the patient?
Anemia - the bone marrow is where rbcs are produced so if it suppressed, there are no new rbcs being produced leading to anemia
Thrombocytopenia - impaired clotting due to diminished platelet count
Neutropenia - chemo may prevent the bone marrow from producing adequate number of neutrophils (wbc that destroys germs) leading to high risk for infection