ATI Care of Patients with Cancer, Questions and Answers with Explanations, 100% Correct, Download to Score A

Test Bank

MULTIPLE CHOICE

1. What statement indicates that the client understands teaching about neutropenia?

a.            “I need to use a soft toothbrush.”

b.            “I have to wear a mask at all times.”

c.             “My grandchildren may get an infection from me.”

d.            “I will call my doctor if I have an increase in temperature.”

ANS: D

Bone marrow suppression leads to neutropenia and increases the client’s risk for infection. Decreased numbers of neutrophils and other white blood cells can minimize the clinical manifestations of infection. For this reason, the client may not develop a high temperature, even with severe infection, and any elevation of temperature should be reported immediately to the health care provider. The client does not need to wear a mask or use a soft toothbrush (although if the client has low platelets, he or she should use a soft toothbrush to avoid causing trauma). The client is not contagious.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)

MSC: Integrated Process: Nursing Process (Evaluation)

2. A client is undergoing radiation therapy and asks the nurse about skin care for the exposed area. Which statement by the nurse is most accurate?

a.            “No products work well to reduce the skin reactions you get from radiation.”

b.            “No one product works best, so you can choose what you would like to use.”

c.             “The only medication that works well for skin reactions is very expensive.”

d.            “No good studies on skin care with radiation have been conducted to date.”

ANS: B

A recent placebo-controlled study showed that none of three products used to manage radiation-related skin reactions was superior to the others. Researchers concluded that clients should use products that are easy to obtain and use and are within the client’s budget. Simply stating that no one product works well does not give the client enough information to make an informed choice. Prescription medications for skin reactions can be expensive, but again this response does not help the client make a decision.

DIF: Cognitive Level: Comprehension/Understanding REF: p. 414

TOP: Client Needs Category: Health Promotion and Maintenance (Self-Care)

MSC: Integrated Process: Teaching/Learning

3. A client who has just had a mastectomy is crying. When the nurse asks about her crying, the client responds, “I know I shouldn’t cry because this surgery may well save my life.” What is the nurse’s best response?

a.            “It is all right to cry. Mourning this loss will help make you stronger.”

b.            “I know this is hard, but your chances of survival are better now.”

c.             “I can arrange for someone who had a mastectomy to come visit if you like.”

d.            “How have you coped with difficult situations in the past?”

ANS: C

Often, cancer surgery involves the loss of a body part or a decrease in function. Mourning or grieving for a body image alteration is a healthy part of adapting or adjusting to a new image. Visiting with someone who has experienced the same situation as the client is very helpful in showing the client that many aspects of life can be the same afterward. If the opportunity to arrange this type of visit is available, this would be the nurse’s best response. The other options do not provide any assistance to the client in coping with her new body image and grieving for her loss.

DIF: Cognitive Level: Comprehension/Understanding REF: p. 411

TOP: Client Needs Category: Psychosocial Integrity (Therapeutic Communications)

MSC: Integrated Process: Caring

4. In evaluating dietary teaching for a client with chemotherapy-induced neutropenia, the nurse becomes concerned when the client makes which food choice?

a.            Fruit salad

b.            Applesauce

c.             Steamed broccoli

d.            Baked potato

ANS: A

The client who is neutropenic should be taught to eat a low-bacteria diet. This includes avoiding raw fruits or vegetables and undercooked meat, eggs, or fish.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Health Promotion and Maintenance (Self-Care)

MSC: Integrated Process: Nursing Process (Evaluation)

5. What teaching is essential for a client who has received an injection of iodine-131?

a.            “Do not share a toilet with anyone else or let anyone clean your toilet.”

b.            “You need to save all your urine for the next week.”

c.             “No special precautions are needed because this type of radiation is weak.”

d.            “Avoid all contact with other people until the radiation device is removed.”

ANS: A

The radiation source is an unsealed isotope that is eliminated from the body in waste products, especially urine and feces. This material is radioactive for about 48 hours after instillation of the isotope. Having the client not share a toilet with other people or allowing anyone to clean the client’s toilet for a specific period of time ensures that the isotope has been completely eliminated, and that the client’s wastes are no longer radioactive.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Safe and Effective Care Environment (Safety and Infection Control—Handling Hazardous and Infectious Materials)

MSC: Integrated Process: Nursing Process (Implementation)

6. A client has bone cancer. What intervention does the nurse implement as a priority for this client?

a.            Using a lift sheet when repositioning the client

b.            Positioning the client’s heels to keep them from touching the mattress

c.             Providing small, frequent meals rich in calcium and phosphorus

d.            Applying pressure for 5 minutes after intramuscular injections

ANS: A

Bone metastasis of cancer can cause such bone destruction that grasping or pulling a client can result in a pathologic fracture. Using a lift sheet spreads the client’s weight more evenly, preventing excessive force on any one body area. Preventing pressure on the heels will help prevent pressure ulcers; this is a good intervention for all clients but does not take priority over preventing fractures. Adding calcium and phosphorus to meals will not prevent fractures. Applying pressure after IM injections is not related to this client’s condition.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Safe and Effective Care Environment (Safety and Infection Control—Accident/Injury Prevention)

MSC: Integrated Process: Nursing Process (Implementation)

7. A client is undergoing radiation therapy and says, “I will be so glad when this is over and I don’t have to worry about my skin.” What response by the nurse is most appropriate?

a.            “Unfortunately, your skin will be permanently damaged from the radiation.”

b.            “You need to protect your skin from the sun for at least a year afterward.”

c.             “You can get a prescription for special lotions that reduce the effects of radiation.”

d.            “You’re having skin problems? That is unusual; let me take a look at your skin.”

ANS: B

Skin that has been in the path of external radiation is more susceptible to sun damage and must be protected from the sun for at least a year after completion of radiation therapy. Skin changes due to radiation are common but may not be permanent, depending on the amount of radiation absorbed. No one skin care product has been shown to significantly help radiation-related skin problems.

DIF: Cognitive Level: Comprehension/Understanding REF: p. 413

TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications of Diagnostic Tests/Treatments/Procedures)

MSC: Integrated Process: Teaching/Learning

8. A client scheduled to undergo radiation therapy for breast cancer asks why 6 weeks of daily treatment is necessary. What is the nurse’s best response?

a.            “Your cancer is widespread and requires more than the usual amount of radiation treatment.”

b.            “Giving larger doses of radiation for a shorter period of time does not produce better effects and has worse side effects.”

c.             “Research has shown that more cancer cells are killed if radiation is given in smaller doses over a longer time period.”

d.            “It is less likely that your hair will fall out or that you will become anemic if radiation is given in this manner.”

ANS: C

Because of varying responses of all cancer cells within a given tumor, small doses of radiation are given on a daily basis for a set period of time. This method allows multiple opportunities to destroy cancer cells while minimizing damage to normal tissues.

DIF: Cognitive Level: Comprehension/Understanding REF: p. 411

TOP: Client Needs Category: Health Promotion and Maintenance (Principles of Teaching/Learning)

MSC: Integrated Process: Teaching/Learning

9. A client’s radiation implant has become dislodged overnight, and the nurse finds it in the client’s bed. What does the nurse do first?

a.            Assess the client’s skin for radiation burns.

b.            Use tongs to put the implant into the radiation container.

c.             Notify the safety officer and move the client to a different room.

d.            Don gloves and attempt to replace the implant.

ANS: B

The implant does emit radiation and should be placed into the secure, lead-lined container in the client’s room. The nurse does not directly touch this implant but uses long-handled tongs for this purpose. The nurse does not need to assess the client’s skin, nor should he or she attempt to replace the source. Moving the client is not necessary, although in keeping with facility policy, the radiation safety officer may need to be notified.

DIF: Cognitive Level: Application/Applying or higher REF: N/A

TOP: Client Needs Category: Safe and Effective Care Environment (Safety and Infection Control—Handling Hazardous and Infectious Materials)

MSC: Integrated Process: Nursing Process (Implementation)