ATI RN
ATI Oncology Questions
1. 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.
2. A client has a platelet count of 9800/mm3. What action by the nurse is most appropriate?
- A. Assess the client for calf pain, warmth, and redness.
- B. Instruct the client to call for help to get out of bed.
- C. Obtain cultures as per the facility’s standing policy.
- D. Place the client on protective Isolation Precautions.
Correct answer: B
Rationale: A platelet count of 9800/mm³ indicates severe thrombocytopenia, placing the client at high risk for bleeding, even with minor trauma or injury. Instructing the client to call for help before getting out of bed ensures they receive assistance with mobility, which reduces the risk of falls or injuries that could lead to serious bleeding. Preventing any activity that could result in trauma is crucial when managing clients with very low platelet counts.
3. A nurse is planning care for a patient with leukemia who has been experiencing severe fatigue. What is the most appropriate intervention to include in the care plan?
- A. Encouraging the patient to remain in bed
- B. Scheduling frequent rest periods
- C. Providing a high-calorie diet
- D. Administering blood transfusions
Correct answer: B
Rationale: In patients with leukemia, severe fatigue is a common symptom due to factors such as anemia, the disease process itself, and the effects of treatments like chemotherapy. The most appropriate intervention is to schedule frequent rest periods to help manage fatigue while encouraging a balance between rest and activity. This approach allows the patient to conserve energy for essential tasks and prevent exhaustion, without promoting complete inactivity, which can lead to deconditioning.
4. The nurse is caring for a client who is at risk for tumor lysis syndrome. Which laboratory value requires the nurse to intervene?
- A. Decreased blood urea nitrogen (BUN)
- B. Increased serum calcium
- C. Increased creatinine level
- D. Increased blood glucose level
Correct answer: C
Rationale: Tumor lysis syndrome (TLS) is a potentially life-threatening condition that occurs when large numbers of cancer cells die rapidly, releasing their contents into the bloodstream. This can overwhelm the kidneys and lead to acute kidney injury. Creatinine is a waste product filtered out of the blood by the kidneys, and an elevated creatinine level is a sign of kidney dysfunction or damage. In TLS, increased creatinine levels indicate that the kidneys are struggling to filter out the excess waste products from cell breakdown, requiring immediate intervention to prevent further complications, such as acute renal failure.
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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