Med Surg Final for Windsor 2024TEST
BANK QUESTIONS AND CORRECT DETAILED
ANSWERS
1. After change-of-shift report on the oncology unit, which patient should the nurse assess first
(monitor temp) pg 248 - ANSWER>>ANSWER: c. Patient who is neutropenic and has a
temperature of 100.5 F (38.1 C)
The nurse is planning for a patient who is chronically malnourished. Which action is appropriate
for the nurse to delegate to unlicensed assistive personnel - ANSWER>>ANSWER: offer
supplemental between meals
1. Principles of ALARA (as low as reasonable, achievable and time, distance and shielding it is
important when caring pt w/ source of internal radiation. Pg 248 - ANSWER>>a. Organize care
limit the time spent indirect contact w/ pt.
b. Maximize anxiety and confusion, tell pt the reason for time and distance limitations before
the procedure.
c. The radiation safety officer will say how much time @ specific distance can be spent w/ the
pt.
d. Only care that must be delivered, near the source such as checking placement of the implant
if available
e. Use shielding if available
f. Do not deliver care w/o wearing a film badge (dosimeter) showing cumulative radiation
exposure.
g. Do not share film badge
h. Do not wear it anywhere but at work & return it accordingly to the agency protocol.
Cells that are destroyed by chemotherapy or radiation located in field (head, neck, stomach,
esophagus - ANSWER>>ANSWER: stomatitis, mucositis, esophagitis, dry mouth
Carotid artery rupture-invasion of arterial wall by tumor or erosion surgery or radiation
therapy, occurs often in pts w/ head and neck cancer. - ANSWER>>ANSWER: priority; bleeding
ranges from minor oozing to spurting of blood in the case of "blowout" of artery.
-Management: IV fluids & blood products or surgery ligation of carotid artery above and below
rupture site and reduction of local tumor.
, Tumor lysis syndrome -metabolic complication characterized by rapid release of intracellular
components in response to chemotherapy and radiation therapy - ANSWER>>HALLMARK
SIGNS: hyperuricemia, hyperphosphatemia, hyperkalemia, hypocalcemia
s/s: weakness, muscle cramps, diarrhea, nausea, and vomiting
occurs: w/in 24-48 hours after starting chemotherapy
may last 5-7 days
metabolic abnormalities & concentrated uric acid (crystallizes)
management:
- identify pts at risk
-hydration therapy-to increase urine output
-allopurinol -decreased uric acid concentrations
-use IV sodium bicarbonate-counter effects of acidic properties that are released.
-interpret ABGs
A patient who is being treated for stage IV lung cancer tells the nurse about new- onset back
pain. Which action should the nurse take first? - ANSWER>>b. Assess for sensation and strength
in the legs
The nurse receives change-of-shift report on the oncology unit. Which patient should the nurse
assess first? - ANSWER>>ANSWER:c. 24-year-old patient who received neck radiation and has
blood oozing from the neck
The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which
laboratory result is most important to report to the health care provider? - ANSWER>>ANSWER:
d. White blood cell (WBC) count of 2700/L
A hospitalized patient who has received chemotherapy for leukemia develops neutropenia.
Which observation by the nurse would indicate a need for further teaching? -
ANSWER>>ANSWER: b. The patient's visitors bring in some fresh peaches from home
A patient who has severe pain associated with terminal pancreatic cancer is being cared for at
home by family members. Which finding by the nurse indicates that teaching regarding pain
management has been effective? - ANSWER>>ANSWER: c. The patient takes opioids around the
clock on a regular schedule and uses additional doses when breakthrough pain occurs
BANK QUESTIONS AND CORRECT DETAILED
ANSWERS
1. After change-of-shift report on the oncology unit, which patient should the nurse assess first
(monitor temp) pg 248 - ANSWER>>ANSWER: c. Patient who is neutropenic and has a
temperature of 100.5 F (38.1 C)
The nurse is planning for a patient who is chronically malnourished. Which action is appropriate
for the nurse to delegate to unlicensed assistive personnel - ANSWER>>ANSWER: offer
supplemental between meals
1. Principles of ALARA (as low as reasonable, achievable and time, distance and shielding it is
important when caring pt w/ source of internal radiation. Pg 248 - ANSWER>>a. Organize care
limit the time spent indirect contact w/ pt.
b. Maximize anxiety and confusion, tell pt the reason for time and distance limitations before
the procedure.
c. The radiation safety officer will say how much time @ specific distance can be spent w/ the
pt.
d. Only care that must be delivered, near the source such as checking placement of the implant
if available
e. Use shielding if available
f. Do not deliver care w/o wearing a film badge (dosimeter) showing cumulative radiation
exposure.
g. Do not share film badge
h. Do not wear it anywhere but at work & return it accordingly to the agency protocol.
Cells that are destroyed by chemotherapy or radiation located in field (head, neck, stomach,
esophagus - ANSWER>>ANSWER: stomatitis, mucositis, esophagitis, dry mouth
Carotid artery rupture-invasion of arterial wall by tumor or erosion surgery or radiation
therapy, occurs often in pts w/ head and neck cancer. - ANSWER>>ANSWER: priority; bleeding
ranges from minor oozing to spurting of blood in the case of "blowout" of artery.
-Management: IV fluids & blood products or surgery ligation of carotid artery above and below
rupture site and reduction of local tumor.
, Tumor lysis syndrome -metabolic complication characterized by rapid release of intracellular
components in response to chemotherapy and radiation therapy - ANSWER>>HALLMARK
SIGNS: hyperuricemia, hyperphosphatemia, hyperkalemia, hypocalcemia
s/s: weakness, muscle cramps, diarrhea, nausea, and vomiting
occurs: w/in 24-48 hours after starting chemotherapy
may last 5-7 days
metabolic abnormalities & concentrated uric acid (crystallizes)
management:
- identify pts at risk
-hydration therapy-to increase urine output
-allopurinol -decreased uric acid concentrations
-use IV sodium bicarbonate-counter effects of acidic properties that are released.
-interpret ABGs
A patient who is being treated for stage IV lung cancer tells the nurse about new- onset back
pain. Which action should the nurse take first? - ANSWER>>b. Assess for sensation and strength
in the legs
The nurse receives change-of-shift report on the oncology unit. Which patient should the nurse
assess first? - ANSWER>>ANSWER:c. 24-year-old patient who received neck radiation and has
blood oozing from the neck
The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which
laboratory result is most important to report to the health care provider? - ANSWER>>ANSWER:
d. White blood cell (WBC) count of 2700/L
A hospitalized patient who has received chemotherapy for leukemia develops neutropenia.
Which observation by the nurse would indicate a need for further teaching? -
ANSWER>>ANSWER: b. The patient's visitors bring in some fresh peaches from home
A patient who has severe pain associated with terminal pancreatic cancer is being cared for at
home by family members. Which finding by the nurse indicates that teaching regarding pain
management has been effective? - ANSWER>>ANSWER: c. The patient takes opioids around the
clock on a regular schedule and uses additional doses when breakthrough pain occurs
