ATI RN
ATI Oncology Questions
1. 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.
2. A patient admitted with cancer asks the nurse about the difference between chemotherapy and radiation therapy. Which of the following responses by the nurse indicates a need for further teaching?
- A. Chemotherapy kills cancer cells
- B. Radiation therapy can be internal or external
- C. Radiation therapy is often external
- D. Chemotherapy is more likely to kill normal cells
Correct answer: D
Rationale: While chemotherapy does affect normal, healthy cells—particularly those that divide rapidly—it is not "more likely" to kill normal cells compared to cancer cells. Chemotherapy targets rapidly dividing cells, which includes both cancer cells and some normal cells (like those in hair follicles, the gastrointestinal tract, and bone marrow). However, its primary goal is to kill cancer cells, and its effects on normal cells are a side effect, not the main function. Therefore, the statement that chemotherapy is "more likely" to kill normal cells is inaccurate and indicates a need for further teaching.
3. A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection-related death in oncology patients?
- A. Encourage several small meals daily.
- B. Provide skin care to maintain skin integrity.
- C. Assist the patient with hygiene, as needed.
- D. Assess the integrity of the patient’s oral mucosa regularly.
Correct answer: B
Rationale: In oncology patients, particularly those undergoing chemotherapy or radiation therapy, myelosuppression (the decrease in bone marrow activity that leads to reduced white blood cells, red blood cells, and platelets) increases the risk of infection. Maintaining skin integrity is crucial because the skin acts as the body's first line of defense against infections. If the skin becomes compromised, such as through radiation burns, rashes, or breakdowns, it provides a potential entry point for pathogens, increasing the risk of infection. Since infections in oncology patients can quickly become severe due to their weakened immune systems, maintaining skin integrity is a critical intervention to reduce infection risk, especially for patients who are immunosuppressed.
4. The nurse has taught a client with cancer ways to prevent infection. What statement by the client indicates that more teaching is needed?
- A. I should take my temperature daily and when I don’t feel well.
- B. I will discard perishable liquids after sitting out for over an hour.
- C. I won’t let anyone share any of my personal toiletries.
- D. It’s alright for me to keep my pets and change the litter box.
Correct answer: D
Rationale: Clients with cancer, especially those undergoing chemotherapy or other immunosuppressive treatments, are at increased risk for infections due to a weakened immune system. Changing a litter box exposes the client to pathogens such as Toxoplasma gondii and other harmful bacteria or parasites found in cat feces, which could lead to serious infections. It is recommended that immunocompromised individuals avoid activities like changing litter boxes to reduce their risk of exposure to infectious agents. A family member or caregiver should handle this task to protect the client.
5. The clinic nurse is caring for a patient whose grandmother and sister have both had breast cancer. She requested a screening test to determine her risk of developing breast cancer and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response?
- A. Research has shown that eating a healthy diet can provide all the protection you need against breast cancer.
- B. Research has shown that taking the drug tamoxifen can reduce your chance of breast cancer.
- C. Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer.
- D. Research has shown that there is little you can do to reduce your risk of breast cancer if you have a genetic predisposition.
Correct answer: B
Rationale: Tamoxifen is a selective estrogen receptor modulator (SERM) that has been shown to significantly reduce the risk of developing breast cancer in women who are at high risk, particularly those with a family history of the disease or a positive genetic test for BRCA mutations. Large-scale studies have demonstrated that tamoxifen can reduce the incidence of breast cancer by up to 50% in high-risk women. It works by blocking estrogen receptors in breast tissue, which helps prevent the development of estrogen receptor-positive breast cancers.
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