ATI RN
Oncology Questions
1. A client with neutropenia is admitted to the hospital. What precaution is most important for the nurse to implement?
- A. Strict hand hygiene.
- B. Limit visitor contact with the client.
- C. Administer prophylactic antibiotics as ordered.
- D. Administer blood products as ordered.
Correct answer: A
Rationale: The correct answer is A: Strict hand hygiene. Neutropenic clients have a low level of neutrophils, which are important in fighting infections. Therefore, maintaining strict hand hygiene is crucial in preventing the introduction of pathogens that could lead to infections. Limiting visitor contact (choice B) is important but not as critical as preventing the introduction of pathogens through proper hand hygiene. Administering prophylactic antibiotics (choice C) and blood products (choice D) are treatment measures and do not address the preventive aspect that hand hygiene provides.
2. The home health care nurse is caring for a client with cancer who is complaining of acute pain. The most appropriate determination of the client's pain should include which assessment?
- A. The client's pain rating
- B. Nonverbal cues from the client
- C. The nurse's impression of the client's pain
- D. Pain relief after appropriate nursing intervention
Correct answer: A
Rationale: The correct answer is A: The client's pain rating. Pain assessment should primarily rely on the client's self-report for the most accurate determination of pain intensity. Nonverbal cues from the client (choice B) can provide additional information but should not replace the client's self-report. The nurse's impression of the client's pain (choice C) may be subjective and less reliable than the client's self-assessment. Pain relief after appropriate nursing intervention (choice D) is an important outcome but does not replace the initial assessment of the client's pain.
3. A client receiving chemotherapy is experiencing severe nausea and vomiting. Which intervention should the nurse implement first?
- A. Administer antiemetics 30 minutes before chemotherapy.
- B. Offer small, frequent meals that are bland and easy to digest.
- C. Encourage the client to rest after meals to reduce nausea.
- D. Instruct the client to use relaxation techniques.
Correct answer: A
Rationale: The correct answer is A: Administer antiemetics 30 minutes before chemotherapy. Administering antiemetics before chemotherapy is crucial to prevent nausea rather than treating it after it occurs. This proactive approach helps in minimizing the side effects. Choice B, offering small, frequent meals, can be beneficial but is not the first intervention for severe nausea and vomiting. Choice C, encouraging rest after meals, may help but is not the priority when the client is experiencing severe symptoms. Choice D, instructing the client to use relaxation techniques, is not the first-line intervention for severe nausea and vomiting in a client receiving chemotherapy.
4. When preparing for the patient's subsequent care after completing the full course of treatment for acute lymphocytic leukemia without a significant response, what action should the nurse take?
- A. Arrange a meeting between the patient's family and the hospital chaplain.
- B. Assess the factors underlying the patient's failure to adhere to the treatment regimen.
- C. Encourage the patient to vigorously pursue complementary and alternative medicine (CAM).
- D. Identify the patient's specific wishes around end-of-life care.
Correct answer: D
Rationale: In cases where a patient does not respond appreciably to therapy, it is crucial to identify and respect the patient's choices regarding treatment, including preferences for end-of-life care. Option A is incorrect because it focuses on spiritual support rather than the patient's care preferences. Option B is incorrect as it assumes non-adherence to treatment without evidence. Option C is incorrect as it suggests an alternative treatment approach without considering the patient's wishes for end-of-life care.
5. The client is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care?
- A. I change my pouch every week.
- B. I change the appliance in the morning.
- C. I empty the urinary collection bag when it is two-thirds full.
- D. When I'm in the shower, I direct the flow of water away from my stoma.
Correct answer: D
Rationale: The correct answer is D because directing water away from the stoma while showering is incorrect. The stoma can and should be cleaned with water. Choices A, B, and C demonstrate proper stoma care practices, such as changing the pouch regularly, changing the appliance in the morning, and emptying the collection bag when it is two-thirds full, which are all appropriate actions for caring for a urinary stoma.
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