NUR2392/NUR 2392 Exam 4 V1 |
Multidimensional Care II (MDC 2) Q&A
with Rationale | Rasmussen University
1. A nurse is caring for a client with a T3N1M0 tumor. How should the nurse interpret this
finding using the TNM staging system?
A. The tumor is small, with no lymph node involvement and distant metastasis.
B. The tumor is large, involves regional lymph nodes, but has no distant metastasis.
C. The tumor is in situ, with extensive node involvement and local metastasis.
D. The tumor is moderate in size, with no node involvement and suspected metastasis.
Correct Answer: B
Rationale: The TNM system identifies the size and extent of the primary tumor (T),
involvement of regional lymph nodes (N), and the presence of distant metastasis (M). A T3
indicates a large tumor size, N1 indicates involvement of regional nodes, and M0 indicates
no distant metastasis is present. Understanding this staging is critical for determining
prognosis and treatment plans for oncology patients.
2. A client receiving chemotherapy is diagnosed with neutropenia. Which nursing
intervention is the highest priority?
A. Monitor for signs of hemorrhage and bruising.
B. Encourage the client to eat fresh fruits and vegetables.
,C. Provide the client with a soft-bristled toothbrush.
D. Strictly adhere to hand hygiene and limit visitors with respiratory infections.
Correct Answer: D
Rationale: Neutropenia significantly increases the risk of life-threatening infections due to
a low white blood cell count. Hand hygiene is the single most effective way to prevent the
transmission of pathogens to an immunocompromised patient. The nurse must also
monitor for subtle signs of infection as the inflammatory response may be diminished.
3. When providing discharge instructions to a client who received external beam radiation
therapy, which statement by the client indicates a need for further teaching?
A. ‘I will use a mild, unscented soap to wash the area.’
B. ‘I should protect the area from direct sunlight.’
C. ‘I will wear loose-fitting cotton clothing over the treated site.’
D. ‘I will scrub the radiation markings off my skin with a washcloth.’
Correct Answer: D
Rationale: Radiation markings must not be removed until the entire course of therapy is
completed as they guide the treatment beam. Scrubbing the skin can cause irritation or
breakdown of the skin, which is already sensitized by radiation. Skin care in the radiation
zone should focus on gentleness and avoiding friction or chemicals.
, 4. A client with end-stage lung cancer is being transitioned to hospice care. The family asks
what the difference is between palliative care and hospice. Which response by the nurse is
accurate?
A. ‘Palliative care is only for patients who have less than six months to live.’
B. ‘Hospice care focuses on curative treatments, while palliative care is for comfort.’
C. ‘Hospice is a form of palliative care provided when a client is near the end of life.’
D. ‘There is no difference; the terms are used interchangeably in the hospital.’
Correct Answer: C
Rationale: Hospice is a specific type of palliative care that is initiated when curative
treatment is no longer pursued and life expectancy is generally six months or less.
Palliative care can be started at any stage of a serious illness and can occur simultaneously
with curative treatments. Both focus on symptom management and quality of life for the
client and family.
5. A client is diagnosed with Acute Myeloid Leukemia (AML). Which laboratory result should
the nurse anticipate?
A. Presence of blast cells in the peripheral blood.
B. Increased hemoglobin and hematocrit.
C. Elevated platelet count above 450,000/mm3.
D. Decreased blood urea nitrogen (BUN).
Multidimensional Care II (MDC 2) Q&A
with Rationale | Rasmussen University
1. A nurse is caring for a client with a T3N1M0 tumor. How should the nurse interpret this
finding using the TNM staging system?
A. The tumor is small, with no lymph node involvement and distant metastasis.
B. The tumor is large, involves regional lymph nodes, but has no distant metastasis.
C. The tumor is in situ, with extensive node involvement and local metastasis.
D. The tumor is moderate in size, with no node involvement and suspected metastasis.
Correct Answer: B
Rationale: The TNM system identifies the size and extent of the primary tumor (T),
involvement of regional lymph nodes (N), and the presence of distant metastasis (M). A T3
indicates a large tumor size, N1 indicates involvement of regional nodes, and M0 indicates
no distant metastasis is present. Understanding this staging is critical for determining
prognosis and treatment plans for oncology patients.
2. A client receiving chemotherapy is diagnosed with neutropenia. Which nursing
intervention is the highest priority?
A. Monitor for signs of hemorrhage and bruising.
B. Encourage the client to eat fresh fruits and vegetables.
,C. Provide the client with a soft-bristled toothbrush.
D. Strictly adhere to hand hygiene and limit visitors with respiratory infections.
Correct Answer: D
Rationale: Neutropenia significantly increases the risk of life-threatening infections due to
a low white blood cell count. Hand hygiene is the single most effective way to prevent the
transmission of pathogens to an immunocompromised patient. The nurse must also
monitor for subtle signs of infection as the inflammatory response may be diminished.
3. When providing discharge instructions to a client who received external beam radiation
therapy, which statement by the client indicates a need for further teaching?
A. ‘I will use a mild, unscented soap to wash the area.’
B. ‘I should protect the area from direct sunlight.’
C. ‘I will wear loose-fitting cotton clothing over the treated site.’
D. ‘I will scrub the radiation markings off my skin with a washcloth.’
Correct Answer: D
Rationale: Radiation markings must not be removed until the entire course of therapy is
completed as they guide the treatment beam. Scrubbing the skin can cause irritation or
breakdown of the skin, which is already sensitized by radiation. Skin care in the radiation
zone should focus on gentleness and avoiding friction or chemicals.
, 4. A client with end-stage lung cancer is being transitioned to hospice care. The family asks
what the difference is between palliative care and hospice. Which response by the nurse is
accurate?
A. ‘Palliative care is only for patients who have less than six months to live.’
B. ‘Hospice care focuses on curative treatments, while palliative care is for comfort.’
C. ‘Hospice is a form of palliative care provided when a client is near the end of life.’
D. ‘There is no difference; the terms are used interchangeably in the hospital.’
Correct Answer: C
Rationale: Hospice is a specific type of palliative care that is initiated when curative
treatment is no longer pursued and life expectancy is generally six months or less.
Palliative care can be started at any stage of a serious illness and can occur simultaneously
with curative treatments. Both focus on symptom management and quality of life for the
client and family.
5. A client is diagnosed with Acute Myeloid Leukemia (AML). Which laboratory result should
the nurse anticipate?
A. Presence of blast cells in the peripheral blood.
B. Increased hemoglobin and hematocrit.
C. Elevated platelet count above 450,000/mm3.
D. Decreased blood urea nitrogen (BUN).
