ATI RN
ATI Oncology Questions
1. A nurse is caring for a client admitted for Non-Hodgkin’s lymphoma and chemotherapy. The client reports nausea, flank pain, and muscle cramps. What action by the nurse is most important?
- A. Request an order for serum electrolytes and uric acid.
- B. Increase the client’s IV infusion rate.
- C. Instruct assistive personnel to strain all urine.
- D. Administer an IV antiemetic.
Correct answer: A
Rationale: The client's symptoms of nausea, flank pain, and muscle cramps are suggestive of tumor lysis syndrome (TLS), a potentially life-threatening complication of chemotherapy in which cancer cells break down rapidly, releasing large amounts of intracellular components into the bloodstream. This leads to imbalances in electrolytes (elevated potassium, phosphate, and uric acid levels, with low calcium levels), which can cause severe metabolic disturbances, including kidney damage, arrhythmias, and muscle cramps. Checking serum electrolytes and uric acid levels is crucial for diagnosing and managing TLS early, preventing further complications.
2. While giving care to a client with an internal cervical radiation implant, the nurse finds the implant in the bed. The nurse should take which initial action?
- A. Call the health care provider (HCP).
- B. Reinsert the implant into the vagina.
- C. Pick up the implant with gloved hands and flush it down the toilet.
- D. Pick up the implant with long-handled forceps and place it in a lead container.
Correct answer: D
Rationale: When caring for a client with an internal cervical radiation implant, safety measures must be followed to protect both the client and healthcare personnel from radiation exposure. If the implant becomes dislodged and is found in the bed, the nurse’s priority is to handle it safely using long-handled forceps, as direct contact with the implant could result in radiation exposure. The implant should be placed in a lead-lined container, which is specifically designed to shield against radiation, to prevent further contamination or exposure. After securing the implant, the nurse should notify the radiation safety officer or healthcare provider for further guidance.
3. A client is receiving chemotherapy through a peripheral IV line. What action by the nurse is most important?
- A. Assessing the IV site and blood return every hour.
- B. Educating the client on side effects.
- C. Monitoring the client for nausea.
- D. Providing warm packs for comfort.
Correct answer: A
Rationale: Chemotherapy drugs are often vesicants, meaning they can cause severe tissue damage if they leak (extravasate) outside of the vein. When chemotherapy is administered through a peripheral IV line, it is crucial for the nurse to frequently assess the IV site for signs of complications such as redness, swelling, or pain, which could indicate extravasation. Checking for blood return ensures the IV catheter is still in the vein and functioning properly. Preventing tissue damage from chemotherapy extravasation is a top priority, and frequent monitoring helps ensure the infusion is proceeding safely.
4. A patient who is undergoing consolidation therapy for the treatment of leukemia has been experiencing debilitating fatigue. How can the nurse best meet this patients needs for physical activity?
- A. Teach the patient about the risks of immobility and the benefits of exercise.
- B. Assist the patient to a chair during awake times, as tolerated.
- C. Collaborate with the physical therapist to arrange for stair exercises.
- D. Teach the patient to perform deep breathing and coughing exercises.
Correct answer: B
Rationale: For patients undergoing consolidation therapy for leukemia, severe fatigue is a common side effect of treatment due to factors such as anemia, decreased nutritional intake, and the body’s response to chemotherapy. While exercise is beneficial, the patient's fatigue may limit their ability to engage in strenuous activity. Assisting the patient to sit in a chair during awake times is a practical way to encourage some physical activity while respecting their fatigue levels. This intervention helps prevent complications associated with immobility, such as muscle atrophy and venous stasis, without overwhelming the patient. It allows the patient to engage in light activity that is manageable and promotes recovery.
5. A patient with acute myeloid leukemia (AML) is receiving induction therapy. What is the priority nursing intervention during this phase of treatment?
- A. Administering pain management
- B. Monitoring for signs of infection
- C. Providing emotional support
- D. Monitoring fluid balance
Correct answer: B
Rationale: Induction therapy for acute myeloid leukemia (AML) involves intensive chemotherapy aimed at achieving remission by eliminating a large number of cancerous cells. However, this aggressive treatment also severely reduces the production of healthy blood cells, including neutrophils, which leads to neutropenia (a dangerously low number of neutrophils). This makes the patient highly susceptible to infections, which can be life-threatening. Monitoring for signs of infection is critical during this phase, as infections may occur quickly and progress rapidly due to the compromised immune system. Early detection and prompt treatment of infections are vital to improving patient outcomes during induction therapy.
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