ATI RN
ATI Oncology Questions
1. A patient diagnosed with polycythemia vera presents to the clinic for routine bloodwork. What should the nurse monitor for in this patient as a priority?
- A. Hemoglobin and hematocrit levels
- B. Platelet count
- C. White blood cell count
- D. Blood pressure
Correct answer: B
Rationale: In polycythemia vera, there is an overproduction of red blood cells, white blood cells, and platelets, which leads to increased blood viscosity and a high risk for thrombosis (blood clot formation). Monitoring the platelet count is a priority because elevated platelet levels contribute significantly to the risk of developing blood clots, which can result in life-threatening complications such as strokes, heart attacks, or deep vein thrombosis (DVT). Therefore, regular monitoring of the platelet count is essential to assess the patient’s risk for thrombosis and to guide treatment decisions, such as phlebotomy or medication adjustments to lower platelet levels.
2. The nurse knows that all of the following are risk factors for breast cancer except:
- A. Family history
- B. Nulliparity
- C. Chest xray
- D. Multiple sex partners
Correct answer: D
Rationale: Multiple sex partners are not a recognized risk factor for breast cancer. Breast cancer is primarily influenced by hormonal, genetic, and environmental factors, not sexual activity or the number of sexual partners. Established risk factors for breast cancer include family history, hormonal factors such as early menarche, late menopause, and nulliparity (having no children), as well as certain environmental exposures.
3. A client is receiving rituximab and asks how it works. What response by the nurse is best?
- A. It causes rapid lysis of the cancer cell membranes.
- B. It destroys the enzymes needed to create cancer cells.
- C. It prevents the start of cell division in the cancer cells.
- D. It sensitizes certain cancer cells to chemotherapy.
Correct answer: C
Rationale: Rituximab is a monoclonal antibody that targets CD20, a protein found on the surface of certain B-cells, including some cancerous B-cells, such as in non-Hodgkin's lymphoma and chronic lymphocytic leukemia (CLL). Rituximab works by binding to the CD20 protein, which leads to the destruction of the cancerous B-cells through various mechanisms, including preventing the initiation of cell division. By blocking the division process, rituximab helps slow the growth and proliferation of cancer cells, allowing the immune system and additional treatments to clear them more effectively.
4. A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe?
- A. Pruritis (itching)
- B. Nausea and vomiting
- C. Altered glucose metabolism
- D. Confusion
Correct answer: B
Rationale: Nausea and vomiting are among the most common and distressing side effects of chemotherapy. Chemotherapy drugs target rapidly dividing cells, including cancer cells, but they also affect healthy cells in the gastrointestinal (GI) tract, triggering the release of chemicals that stimulate the brain’s vomiting center. These side effects can occur immediately (acute), be delayed, or even anticipatory, and often require management with antiemetic (anti-nausea) medications to improve the patient’s comfort and quality of life during treatment.
5. 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.
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