ATI RN
ATI Oncology Questions
1. 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.
2. Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?
- A. He has fresh, active upper GI bleeding.
- B. He needs immediate saline gastric lavage.
- C. His gastric bleeding occurred 2 hours earlier.
- D. He needs a transfusion of packed RBCs.
Correct answer: C
Rationale: Coffee-ground emesis is a sign of upper gastrointestinal bleeding that occurred approximately 2 hours earlier. It results from the breakdown of blood in the stomach due to digestive enzymes, giving it a coffee-ground appearance. Choice A is incorrect because coffee-ground emesis indicates older, partially digested blood, not fresh active bleeding. Choice B is incorrect as gastric lavage is not indicated for coffee-ground emesis. Choice D is incorrect because a transfusion of packed RBCs is not the immediate management for this presentation.
3. Kyle, a patient with schizophrenia, began taking the first-generation antipsychotic haloperidol (Haldol) last week. One day you find him sitting very stiffly and not moving. He is diaphoretic, and when you ask if he is okay, he seems unable to respond verbally. His vital signs are: BP 170/100, P 110, T 104.2°F. What is the priority nursing intervention? Select one that does not apply.
- A. Hold his medication and contact his prescriber.
- B. Wipe him with a washcloth wet with cold water or alcohol.
- C. Administer a medication such as benztropine IM to correct this dystonic reaction.
- D. Reassure him that although there is no treatment for his tardive dyskinesia, it will pass.
Correct answer: C
Rationale: The patient's symptoms, including stiffness, diaphoresis, inability to respond verbally, and vital sign abnormalities, are indicative of neuroleptic malignant syndrome (NMS), a serious and potentially life-threatening side effect of antipsychotic medications. Administering a medication such as benztropine intramuscularly is the priority to address the dystonic reaction associated with NMS. This intervention can help alleviate symptoms and prevent further complications. Holding the medication and contacting the prescriber may be necessary but addressing the acute symptoms takes precedence. Wiping the patient with a cold washcloth or alcohol would not address the underlying medical emergency. Reassuring the patient about tardive dyskinesia is irrelevant and not the immediate concern in this scenario.
4. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?
- A. Remove the patch each evening.
- B. Do not cut the patch in half even if angina attacks are under control.
- C. Remove the nitroglycerin patch for 30 minutes if a headache occurs.
- D. Apply a new patch every 48 hours.
Correct answer: A
Rationale: The correct instruction for a client using a Nitroglycerin transdermal patch is to remove the patch each evening to prevent tolerance. This allows for a nitrate-free period of 10 to 12 hours during each 24-hour period, reducing the risk of developing tolerance to the medication. Choice B is incorrect because cutting the patch could alter the dose delivery and is not recommended. Choice C is incorrect as removing the patch for 30 minutes when a headache occurs may not be effective in managing symptoms. Choice D is incorrect as Nitroglycerin patches are usually applied once daily, not every 48 hours.
5. Which action would break sterile technique while preparing a sterile field for a dressing change?
- A. Using sterile forceps instead of sterile gloves to handle a sterile item
- B. Touching the outside wrapper of sterilized material without sterile gloves
- C. Placing a sterile object at the edge of the sterile field
- D. Pouring out a small amount of solution (15 to 30 ml) before pouring it into a sterile container
Correct answer: B
Rationale: Touching the outside wrapper of sterilized material without sterile gloves can introduce contaminants and compromise the sterility of the item. It is crucial to maintain strict adherence to sterile technique to prevent infections and ensure patient safety during procedures.
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