ATI RN
Oncology Test Bank
1. A client who is at risk for disseminated intravascular coagulation (DIC) has a serum fibrinogen level of 110 mg/dL. The nurse should take which of the following actions first?
- A. Recheck the fibrinogen level in 4 hours
- B. Notify the health care provider
- C. Continue to monitor the client
- D. Administer cryoprecipitate as prescribed
Correct answer: B
Rationale: A serum fibrinogen level of 110 mg/dL indicates a low level, which puts the client at risk for bleeding in DIC. The priority action for the nurse is to notify the health care provider. Rechecking the fibrinogen level may delay necessary interventions, administering cryoprecipitate should be done based on the provider's prescription, and while monitoring is important, immediate notification of the provider is crucial to address the low fibrinogen level promptly.
2. The nurse is assessing a client with leukemia who is receiving chemotherapy. Which of the following findings would be of most concern?
- A. Alopecia
- B. Fatigue
- C. Nausea and vomiting
- D. Mouth sores
Correct answer: D
Rationale: The correct answer is D, 'Mouth sores.' Mouth sores (stomatitis) are a common and potentially serious side effect of chemotherapy. They can lead to difficulty eating, increased risk of infection, and overall decreased quality of life for the client. While alopecia, fatigue, and nausea/vomiting are also common side effects of chemotherapy, they are generally manageable and do not pose the same level of immediate concern as the development of mouth sores in a client undergoing chemotherapy.
3. A patient with myelofibrosis is being treated with ruxolitinib. What should the nurse monitor to assess the effectiveness of this treatment?
- A. Blood pressure
- B. White blood cell count
- C. Hemoglobin and hematocrit
- D. Spleen size
Correct answer: C
Rationale: Monitoring hemoglobin and hematocrit is essential to assess the effectiveness of ruxolitinib in treating myelofibrosis. Ruxolitinib works by inhibiting JAK1 and JAK2, which are involved in the signaling pathways that regulate blood cell production. Therefore, monitoring hemoglobin and hematocrit levels can provide valuable information on how well the drug is managing the disease. Blood pressure, white blood cell count, and spleen size are not direct indicators of the treatment's effectiveness in myelofibrosis.
4. What is a characteristic of normal cells?
- A. They have no functions
- B. They have a larger nucleus
- C. They undergo apoptosis
- D. They have a dark-colored nucleus
Correct answer: C
Rationale: The correct answer is that normal cells undergo apoptosis, which is a programmed cell death process essential for maintaining tissue homeostasis. Choice A is incorrect as normal cells do have specific functions. Choice B is incorrect as the size of the nucleus may vary but is not a defining characteristic of normal cells. Choice D is incorrect as the color of the nucleus is not a standard characteristic of normal cells.
5. An oncology nurse is caring for a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patient's most recent blood tests, the nurse should anticipate what imbalance?
- A. Hypercalcemia
- B. Hyperproteinemia
- C. Elevated serum viscosity
- D. Elevated RBC count
Correct answer: A
Rationale: The correct answer is A, Hypercalcemia. In multiple myeloma, bone destruction can lead to the release of calcium from the bones into the bloodstream, causing hypercalcemia. This imbalance is commonly seen in patients with multiple myeloma. Choice B, Hyperproteinemia, is not typically associated with bone destruction in multiple myeloma. Choice C, Elevated serum viscosity, and Choice D, Elevated RBC count, are not directly related to the bone destruction seen in multiple myeloma.
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