ATI RN
Oncology Questions
1. All of the following are warning signs of cancer except:
- A. Patient palpates a bump on the side of the breast
- B. Bruises are found on the body that the client cannot explain
- C. Patient often complains of impaired digestion
- D. Patient has blood-tinged sputum
Correct answer: D
Rationale: The correct answer is D. Blood-tinged sputum is not a typical warning sign of cancer but rather a symptom that can indicate other serious conditions like respiratory issues or infections. Choices A, B, and C are common warning signs of cancer: palpable lumps or bumps, unexplained bruises, and persistent digestive issues are often associated with cancer and should be evaluated by a healthcare professional for further assessment and diagnosis.
2. Nurse Cecilia is caring for a client who has undergone a vaginal hysterectomy. The nurse avoids which of the following in the care of this client?
- A. Elevating the knee gatch on the bed
- B. Assisting with range-of-motion leg exercises
- C. Removal of antiembolism stockings twice daily
- D. Checking placement of pneumatic compression boots
Correct answer: A
Rationale: The correct answer is A. Elevating the knee gatch on the bed should be avoided in the care of a client who has undergone a vaginal hysterectomy. This action can inhibit venous return, increasing the risk of deep vein thrombosis or thrombophlebitis. Choices B, C, and D are appropriate nursing interventions for postoperative care to prevent complications and promote circulation.
3. A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The patient states, 'They tell me my cancer is malignant, while my coworker's breast tumor was benign. I just don't understand at all.' When preparing a response to this patient, the nurse should be cognizant of what characteristic that distinguishes malignant cells from benign cells of the same tissue type?
- A. Slow rate of mitosis of cancer cells
- B. Different proteins in the cell membrane
- C. Differing size of the cells
- D. Different molecular structure in the cells
Correct answer: B
Rationale: The correct answer is B. Malignant cells have different proteins in their membranes, such as tumor-specific antigens, which distinguish them from benign cells. Choice A is incorrect as cancer cells typically have a rapid and uncontrolled rate of mitosis. Choice C is incorrect as the size of cells alone does not distinguish between malignant and benign cells. Choice D is incorrect as the molecular structure is not the primary characteristic that distinguishes between malignant and benign cells.
4. 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.
5. While a patient is receiving IV doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize what action?
- A. Stopping the administration of the drug immediately
- B. Notifying the patient's physician
- C. Continuing the infusion but decreasing the rate
- D. Applying a warm compress to the infusion site
Correct answer: A
Rationale: The correct action for the nurse to take when observing swelling and pain at the IV site during the administration of doxorubicin hydrochloride is to stop the administration of the drug immediately. Doxorubicin hydrochloride can cause severe tissue damage, so discontinuing the infusion is crucial to prevent further harm to the patient. Notifying the physician is important, but it should not take precedence over stopping the drug. Continuing the infusion, even at a decreased rate, can exacerbate tissue damage. Applying a warm compress is not appropriate in this situation and may worsen the tissue injury caused by the drug.
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