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Myelosuppression
Gastrointestinal
Genitourinary
Integumentary
Respiratory
100
The immune system of a patient with cancer may be depressed because: A. Nutritional status B. Patient controlled-analgesia with basal rate C. Administration of GM-CSF D. Taking iron supplements
What is nutritional status?
100
Which of the following is a complication of xerostomia that would require medical intervention A. Aspiration pneumonia B. Infection in the oral cavity C. Constipation D. Weight gain of 10 pounds
What is infection in the oral cavity?
100
68 year old, stage II prostate cancer, radical prostatectomy 1 month ago, experiencing urinary incontinence several time a day for 1 week Which statement indicates understanding of urinary symptoms? A. "Urinary incontinence commonly occurs after the removal of the prostate, so I will probably always be incontinent." B. "The incontinence should have stopped by now, so I will need an indwelling catheter, just like I did after surgery." C. "Urinary incontinence may continue for several months but should improve with a scheduled voiding program and pelvic muscle exercises." D. "I need to take antibiotics, because my incontinence is probably caused by a bladder infection."
What is C?
100
Which laboratory result is the most important in the client with impaired skin integrity? a. Hemoglobin 9.5 g/dl & hematocrit 30% b. Serum Albumin 2.9 g/dl c. Serum Amylase 70 somogyi unit/gl d. BUN 20 mg/dl
What is albumin? Albumin is important for maintaining adequate protein, which is essential for tissue repair. Low albumin indicates malnutrition.
100
Abnormal accumulation of air in the pleural space is: a. empyema b. pneumothorax c. hemothorax d. pleural effusion
What is pnuemothorax? A - pus in pleural space C - blood in pleural space D - abnormal amounts of fluid in pleural space
200
Drugs that inhibit platelet function should be avoided during nadir. Which of the following inhibit platelet function? A. aspirin & ibuprofen B. iron supplements C. vitamins D. morphine
What is aspirin & ibuprofen?
200
Which of the following is true about the use of corticosteroids in the management of vomiting? A. Beware of classic steroid side effects, even when used for a short time B. Corticosteroids work well in combination with other antiemetics C. Corticosteroid use can cause a decrease in appetite D. Corticosteroid use can lead to dysphagia
What is corticosteroids work well in combination with other antiemetics?
200
Which of these types of medications are prescribed to treat fecal incontinence? a. antispasmodics b. anticholinergics c. calcium antagonists d. bulking agents
What is bulking agents? Antispasmodics are prescribed for urinary incontinence. Anticholinergics can cause urinary retention and overflow incontinence. Calcium antagonists cause urinary retention.
200
Which characteristics of skin make it sensitive to the effects of radiation and chemotherapies? a. presence of mucus-producing glands b. rapidly dividing epithelial cells c. sensitivity to heat, cold & pain d. porous nature of skin
What is rapidly dividing epithelial cells? Both chemotherapy and radiation act best on rapidly dividing cells.
200
Patient states that he is "having his whole left lung taken out." This surgical procedure is called: a. wedge resection b. segmental resection c. lobectomy d. pneumonectomy
What is D? A - removal of wedge-shaped are near lung surface B - removal of one or more segments of a lobe C - removal of a lobe
300
After chemo administration, platelet count usually decreases A. before WBCs decrease B. in 7 to 14 days after the administration of chemo C. after RBCs decrease D. in 28 days after chemo
What is in 7 to 14 days after administration of chemotherapy?
300
Which of the following chemotherapy agents is associated with moderate to high incidence of emesis? a. Topotecan (Hycamtin) b. Busulfan c. Idarubicin (Idamycin) d. paclitaxel
What is idarubicin? The other agents have a minimal to mild emetogenic potential.
300
Which condition commonly occurs in patients with breast cancer with bone metastases that can cause the kidneys to lose the ability to concentrate urine? a. hyperkalemia b. hypocalcemia c. hyponatremia d. hypercalcemia
What is hypercalcemia? Hypercalcemia commonly occurs with metastatic breast cancer, multiple myeloma, squamous cell cancer of lung, head & neck, renal cell cancer, lymphomas & leukemia.
300
What is the most appropriate nursing action in the client with cancer who is at risk for fungal infection? a. apply Betadine to moist areas b. dry the skin folds of the client c. bathe the client daily d. keep the patient's room cool
What is dry skin folds? Betadine will cause drying which may increase risk of breaks in skin. Bathing is necessary, but not without careful drying of skin folds. Cool room will reduce perspiration, but skin folds will still be a moist environment conducive to fungi growth.
300
A "whistling sound" on ausculatation would be documented as: a. dyspnea b. tachypnea c. egohony d. wheezing
What is wheezing? A - shortness of breath B - abnormal rapid respirations C - abnormal change in tone heard during lung auscultation
400
Thrombocytopenia describes A. decrease in circulating platelets < 100,000/mm3 B. decrease in circulating WBCs < 1500/mm3 C. decrease in circulating neutrophils < 1000/mm3 D. decrease in cirulating RBCs < 1000/mm3
What is decrease in circulating platelets < 100,000/mm3?
400
Which of the following chemotherapy agents is likely to potentiate the problem of esophagitis in patients also receiving radiation therapy to the esophagus? a. cyclophosphamide (Cytoxan) b. 5-fluorouracil (5-Fu) c. Paclitaxel (Taxol) d. Busulfan (Myleran)
What is 5-Fu? 5-Fu produces an additive toxic effect with radiation.
400
Which chemotherapy agent requires aggressive hydration before, during and after therapy to prevent renal toxicity? a. Daunorubicin b. 5-Fu c. Cisplatin d. flutamide
What is Cisplatin? Daunorubicin - red urine 5-Fu - diarrhea & stomatitis flutamide - hepatotoxicity & gynecomastia
400
What is the most appropriate nursing action to prevent skin breakdown in a cognitively impaired patient who has lost bowel and bladder control? a. Inspect & wash the perineal area at frequent intervals b. Remind the patient to use the call light for assistance c. Apply an adult diaper d. Turn and position patient every 4 hours
What is A? Urine or stool on skin can irritate skin and increase risk of skin breakdown
400
A patient receiving radiation therapy and bleomycin is at risk for which pulmonary toxicity? a. superior vena cava syndrome b. pulmonary empyema c. pneumonitis d. pleural effusion
What is C? A - not a pulmonary toxicity B - not associated with radiation & chemo D - not associated with bleomycin
500
Bleeding precautions have been written for patient with platelet < 10,000/mm3. Which should be questioned? A. Avoid using a blood pressure cuff or tourniquet B. Administer rectal acetaminophen for fever > 101F C. Apply firm pressure to venipuncture sites for 5 minutes D. Administer stool softener twice a day
What is administer rectal acetaminophen for fever > 101 F?
500
Choose the best appetite stimulant for a diabetic patient on an extensive chemotherapy regimen who has not experienced nausea or vomiting. A. Cannabinoids B. Corticosteroids C. Metoclopramide (Reglan) D. Megestrol acetate (Megace)
What is Megace? Corticosteroids are not indicated because of the diabetes. Both Reglan and corticosteroids are indicated for patients experiencing nausea & vomiting. Megace increases appetite, causes weight gain & improves quality of life.
500
Which type of cancer produces Bence Jones proteins and damaging casts that result in renal dysfunction, often requiring hemodialysis? a. testicular cancer b. cervical cancer c. small cell lung cancer d. multiple myeloma
What is multiple myeloma? Bence Jones proteins are found almost exclusively in the urine of patients with multiple myeloma.
500
The skin around a hip pinning site is swollen, red and crusty with dried drainage. What is the most appropriate course of action? a. decrease traction weight b. apply new dressing c. observe site for 24 hours d. notify physician
What is D? A - not a nursing action B - may be done after site inspected by physician C - too long to wait in immunocompromise patient
500
On pre- chemo assessment of a patient 3 months post-op for breast cancer, you note tachypnea, dullness to percussion in right lower lobe of the lung, absent breath sounds (RLL), egophony in right chest and slight fever. The patient most likely has: a. hypercalcemia b. severe anemia c. pulmonary fibrosis d. pleural effusion
What is D? Tachypnea, dullness to percussion, absent breath sounds, egophony and slight fever are classic signs of pleural effusion.