ATI RN
ATI Oncology Questions
1. A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should the nurse prioritize when addressing the patients severe bone pain?
- A. Implementing distraction techniques
- B. Educating the patient about the effective use of hot and cold packs
- C. Teaching the patient to use NSAIDs effectively
- D. Helping the patient manage the opioid analgesic regimen
Correct answer: D
Rationale: Multiple myeloma causes severe bone pain due to the proliferation of malignant plasma cells in the bone marrow, leading to osteolytic lesions and bone destruction. Opioid analgesics are often required to manage this level of pain effectively, especially in cases where the pain is severe and chronic. The nurse's priority should be helping the patient manage their opioid regimen, ensuring they understand proper dosing, side effects, and safe use of the medication. Opioids are generally necessary in such cases because they provide stronger pain relief compared to other types of analgesics, such as NSAIDs or non-opioid medications.
2. A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain. His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of immature cells. The nurse caring for this patient suspects a diagnosis of what?
- A. AML
- B. CML
- C. MDS
- D. ALL
Correct answer: D
Rationale: Acute Lymphocytic Leukemia (ALL) is a type of cancer where immature lymphocytes (a type of white blood cell) proliferate uncontrollably in the bone marrow. This leads to a reduction in the production of platelets, leukocytes, and erythrocytes, causing symptoms such as fatigue, anemia, bleeding tendencies, and increased susceptibility to infection. In ALL, leukemic cell infiltration into other organs is common, which can manifest as severe headaches (due to central nervous system involvement), vomiting, and testicular pain (due to infiltration of leukemic cells into the testes). These are hallmark signs of ALL, especially in younger patients.
3. Traditionally, nurses have been involved with tertiary cancer prevention. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention?
- A. Yearly Pap tests
- B. Testicular self-examination
- C. Teaching patients to wear sunscreen
- D. Screening mammograms
Correct answer: C
Rationale: Primary prevention involves actions taken to reduce the risk of developing cancer by preventing exposure to known risk factors or promoting healthy behaviors. Teaching patients to wear sunscreen is an example of primary prevention because it aims to reduce the risk of skin cancer by minimizing exposure to harmful ultraviolet (UV) radiation from the sun. Encouraging protective measures such as wearing sunscreen, avoiding tanning beds, and wearing protective clothing are all steps to prevent skin cancer before it develops.
4. A patient with a myelodysplastic syndrome is being treated on the medical unit. What assessment finding should prompt the nurse to contact the patients primary care provider?
- A. The patient is experiencing a frontal lobe headache.
- B. The patient has an episode of urinary incontinence.
- C. The patient has an oral temperature of 37.5C (99.5F).
- D. The patients SpO2 is 91% on room air.
Correct answer: C
Rationale: Patients with myelodysplastic syndrome (MDS) have a dysfunctional bone marrow that leads to ineffective blood cell production, including white blood cells, which are crucial for fighting infections. As a result, they are at high risk for infections. Even a slight elevation in temperature, such as 37.5°C (99.5°F), could be an early sign of infection in an immunocompromised patient. Early detection and treatment of infections are critical in MDS patients, as infections can quickly become severe or life-threatening due to their compromised immune system.
5. A nurse practitioner is assessing a patient who has a fever, malaise, and a white blood cell count that is elevated. Which of the following principles should guide the nurses management of the patients care?
- A. There is a need for the patient to be assessed for lymphoma.
- B. Infection is the most likely cause of the patients change in health status.
- C. The patient is exhibiting signs and symptoms of leukemia.
- D. The patient should undergo diagnostic testing for multiple myeloma.
Correct answer: B
Rationale: An elevated white blood cell (WBC) count, also known as leukocytosis, is most commonly a response to infection. When the body detects an infection, the immune system responds by increasing the production of white blood cells to fight off the invading pathogens. The accompanying symptoms of fever and malaise are typical signs of infection, supporting the likelihood that this patient’s health status is related to an infectious process rather than a more serious hematologic condition like lymphoma or leukemia.
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