ATI Med-Surg Exit Oncology Exam

A nurse is caring for a client who is receiving chemotherapy to treat cancer. Which of the following adverse effects should the nurse anticipate from the chemotherapy? - pancytopenia - bone marrow suppression, a deficiency of WBCs, RBCs, and platelet counts, is an expected adverse effect of chemotherapy - gingival hyperplasia, or overgrowth of gingival tissue in the mouth, is caused by poor oral hygiene, leading to bacterial plaque and tartar accumulation. It is not an adverse effect of chemotherapy - hirsutism, or excessive body or facial hair, is generally caused by Cushing syndrome, especially in women. The nurse should expect to see alopecia, or hair loss, when the client receives chemotherapy - the client might have an inability or lack of desire to eat, causing weight loss due to the adverse effects of chemotherapy, such as a metallic taste in the mouth, nausea and vomiting A nurse on an onclology unit is reinforcing discharge teaching for an adolescent client who received a bone marrow transplant for leukemia. Which of the following information should the nurse include? (SATA) - "You should take your temperature at least once a day." - Clients who are postoperative following bone marrow transplants are immunosuppressed and should continually monitor for manifestations of infection. A temperature that is greater than 38C (100F) should be reported immediately to the provider "Examine your feet daily." - a client who had a bone marrow transplant is immunosuppressed. The client should examine his feet daily to identify injuries that might increase the risk for infection - because of immunosuppression, the client should avoid crowds, such as those encountered at school, a mall, or a movie theater. They will also require time at home to recover and should limit their visitors to individuals who are healthy - client should not clean their toothbrush weekly with alcohol. Alcohol can cause trauma and irritation to the gums and tissues. Rinsing the toothbrush in a weak bleach solution or placing it in the dishwasher weekly are safer alternatives - fresh fruits and vegetables and as well as any other raw good can carry bacteria that may lead to an increased risk of infection A nurse is assisting in planning care for a client who is postoperative following a urinary diversion to treat bladder cancer. Which of the following interventions should the nurse include in the plan of care? - change the collection pouch in the early morning. - the nurse should plan to change the urinary collection pouch in the early morning when urine output is reduced - the nurse should empty the collection pouch when it is 1/3 full to half full to prevent the excess weight of the urine causing the pouch to separate from the skin - the nurse should expect no delay in urinary output following surgery. The nurse should monitor hourly urine output in the immediate postoperative period. Monitoring is then every 4 to 8 hr - the nurse should not use hydrogen peroxide to cleanse the skin around the stoma and under the collection pouch. The nurse should use soap and water for cleansing to decrease the risk of irritating the area A nurse is collecting data from a client who has cancer of the cervix. Which of the following manifestations should the nurse expect? - vaginal bleeding - the most common manifestation of cancer of the cervix is painless vaginal bleeding - unexplained weight loss is a manifestation of cervical cancer - dysuria is a manifestation of cervical cancer - pelvic and chest pain are manifestations of cervical cancer A nurse is collecting data from a client who has cancer and is receiving chemotherapy by peripheral IV infusion. The client reports pain at the insertion site and the nurse notes fluid leaking around the catheter. Which of the following actions should the nurse take first? - stop the infusion - urgent vs. nonurgent priority-setting framework. Many chemotherapy medications are vesicants that can cause extensive tissue damage if extravasation occurs, therefore, the nurse's first action should be to stop the infusion immediately - the nurse should take a photograph of the IV site for documentation of potential harm from extravasation; however, there is another action that is priority - the nurse should take and record the client's vital signs following extravasation of a chemotherapy agent, however, there is another action that is priority - the nurse should identify all medications administered through the IV site for the past 24 hr, however, there is another action that is the priority A nurse is caring for a client who has testicular cancer and is experiencing peripheral neuropathy as an adverse effect of chemotherapy. Which of the following client manifestations is an expected finding of peripheral neuropathy? - tingling of the hands and feet - several chemotherapeutic agents might cause peripheral neuropathy. One of the major manifestations of peripheral neuropathy is numbness and tingling of an extremity - thinning of the scalp is alopecia, a known adverse effect of chemotherapy. This manifestation is not related to peripheral neuropathy - reduced ability to concentrate reflects cognitive changes, a known adverse effect of chemotherapy. This manifestation is not related to peripheral neuropathy - sores in the mucous membranes is mucositis, a known adverse effect of chemotherapy. This manifestation is not related to peripheral neuropathy A nurse is caring for a client who has lung cancer that has metastasized. Which of the following findings indicates the client is developing superior vena cava syndrome? - facial edema - superior vena cava syndrome is a medical emergency resulting from a partial occlusion of the superior vena cava, leading to a decreased blood flow through the vein. Most cases of superior vena cava syndrome are associated with cancers involving the client's upper chest, such as advanced lung and breast cancers and lymphoma. The earliest manifestations of superior vena cava syndrome are facial and upper extremity edema. Death can result if the compression is not corrected - superior vena cava syndrome is a partial occlusion of the superior vena cava. It leads to alterations in client's vascular flow, not cardiac arrhythmias - superior vena cava syndrome is a partial occlusion of the superior vena cava. Muscle cramps might inidcate the client has SIADH, and might occur with cancer metastasis to the brain - numbness of the client's hands is a manifestation of spinal cord compression that can result if cancer spreads to the spinal cord A nurse is reinforcing postoperative teaching for a client following a panhysterectomy for uterine cancer. Which of the following information should the nurse provide? - "You might experience manifestations of menopause." - the nurse should inform the client that a panhysterectomy includes the removal of the uterus and ovaries, which might cause manifestations of menopause to occur. Manifestations of menopause include hot flashes, night sweats, and vaginal dryness - the nurse should inform the client that, following a panhysterectomy, pregnancy is not possible and birth control is no longer required - the nurse should inform the client to not lift anything heavier than 2.3 to 4.5 kg (5 to 10 lb) - the nurse should inform the client that pain or burning on urination is not an expected outcome of a panhysterectomy and to report these to the provider. Such manifestations can indicate a UTI A nurse is reinforcing preoperative teaching for a client who has colorectal cancer and is to undergo placement of a colostomy with a perineal wound. Which of the following statements by the client indicates an understanding of the teaching? - "I can have only liquids for 2 days before the surgery." - the client should consume a full or clear liquid diet for 24 to 48 hr before the surgery to decrease bulk. The client should consume a low-residue diet for several days prior to surgery to decrease peristalsis - following placement of a colostomy with a perineal wound, a rectal sensations such as pain and itching might occur even after healing of the client's surgical wound - the client should sit on foam pads or soft pillows and avoid the use of rubber donut devices because of the increased pressure to the incisional site - following surgery, the client's colostomy should begin to function withing 2 to 4 days A nurse is collecting data from a client. Which of the following findings is the highest risk factor for the client developing bladder cancer? - the client who uses tobacco - the nurse should identify the client's tobacco use as being the greatest risk for developing bladder cancer - the nurse should recognize that exposure to chemicals, such as those used in hairdressing, is a risk factor for developing bladder cancer, however, there is a greater risk to the client than chemical exposure - the nurse should recognize that being over the age of 60 is a risk factor for developing bladder cancer, however, there is a greater risk to the client than age - the nurse should recognize that a history of UTIs is a risk factor for developing bladder cancer, however, this is not the greatest risk factor A nurse is reinforcing discharge teaching to a client following open radical prostatectomy. The client is going home with an indwelling urinary catheter. Which of the following statements by the client indicates an understanding of the teaching? - "I will take acetaminophen if I have any pain." - the nurse should teach the client to avoid aspirin and NSAIDs for at least 2 weeks following a surgery to prevent risk of bleeding - the nurse should instruct the clients to shower rather than take a tub bath for 2 to 3 weeks following an open radical prostatectomy - the nurse should instruct the client to use stool softeners, rather than suppositories, to control constipation