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Oncolocy Immune Chapters Med Surgical

Total questions: 20

Worksheet time: 10mins

Name
Class
Date
1.

The hospice nurse is caring for a client with cancer who is living at home. The nurse has explained to the client and the family that the client is at risk for hypercalcemia and has educated them on that signs and symptoms of this health problem. What else should the nurse teach this client and family to do to reduce the client’s risk of hypercalcemia?

a)

Avoid the use of stool softeners.

b)

Laxatives should be taken daily.

c)

Consume 2 to 4 L of fluid daily.

d)

Restrict calcium intake.

2.

A nurse is teaching a client who is receiving radiation treatment for left lower lobe lung cancer. Which client statement indicates a need for further teaching?

a)

"I'll use hats to protect my head from the sun when my hair falls out."

b)

"If I get nauseous, I'll try to eat several small, bland meals each day."

c)

"I'll allow myself plenty of time to rest between activities."

d)

"Most of the adverse effects should go away shortly after my last radiation treatment."

3.

A client diagnosed with acute myelocytic leukemia has been receiving chemotherapy. During the last 2 cycles of chemotherapy, the client developed severe thrombocytopenia requiring multiple platelet transfusions. The client is now scheduled to receive a third cycle. How can the nurse best detect early signs and symptoms of thrombocytopenia?

a)

Perform a cardiovascular assessment every 4 hours.

b)

Check the client's history for a congenital link to thrombocytopenia.

c)

Closely observe the client's skin for petechiae and bruising.

d)

Monitor daily platelet counts.

4.

The nurse is caring for a client who is to begin receiving external radiation for a malignant tumor of the neck. While providing client education, what potential adverse effects should the nurse discuss with the client?

a)

Cognitive changes

b)

Impaired nutritional status

c)

Diarrhea

d)

Alopecia

5.

The nurse manager is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, what action should the nurse manager emphasize?

a)

Adjust the dose to the client's present symptoms

b)

Wash hands with an alcohol-based cleanser following administration.

c)

Use gloves and a lab coat when preparing the medication.

d)

Dispose of the antineoplastic wastes in the hazardous waste receptacle.

6.

A client was diagnosed with cancer several weeks ago and family members describe him as “utterly distraught.” The client has fully withdrawn from social and family contact. What is the nurse’s best action?

a)

Reassure the client and the family that these types of responses to cancer are common

b)

Refer the client to the appropriate mental health provider.

c)

Educate the client about the mental health benefits of exercise.

d)

Reassure the family that the client is grieving and will eventually come to terms with the diagnosis.

7.

An oncology nurse is caring for a client who has developed erythema following radiation therapy. What should the nurse instruct the client to do?

a)

Periodically apply ice to the area.

b)

Keep the area cleanly shaven.

c)

Avoid using soap on the treatment area.

d)

Apply petroleum jelly to the affected area.

8.

The nurse is completing a focused assessment addressing a client's immune function. What should the nurse prioritize in the physical assessment?

a)

Percussion of the client's abdomen

b)

Palpation of the client's liver

c)

Auscultation of the client's apical heart rate

d)

Palpation of the client's lymph nodes

9.

A client is admitted to the hospital with a diagnosis of pneumonia. The client informs the nurse that he has several drug allergies. The physician has ordered an antibiotic as well as several other medications for cough and fever. What should the nurse do prior to administering the medications?

a)

Administer the medications that the physician ordered.

b)

Call the pharmacy and let them know the client has several drug allergies.

c)

Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive.

d)

Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive.

10.

In which process is the antigen-antibody molecule coated with a sticky substance that facilitates phagocytosis?

a)

Apoptosis

b)

Opsonization

c)

Agglutination

d)

Immunoregulation

11.

A nurse is reviewing a client's medication administration record in an effort to identify drugs that may contribute to the client's recent immunosuppression. What drug is most likely to have this effect?

a)

An antibiotic

b)

A nonsteroidal anti-inflammatory drug (NSAID)

c)

An antineoplastic

d)

An antiretroviral

12.

Thirty minutes after the nurse begins an intravenous immunoglobulin (IVIG) infusion, the client reports itching at the site and a lump in the throat. Which action should the nurse take first?

a)

Apply a tourniquet above the infusion site.

b)

Notify the physician.

c)

Stop the infusion.

d)

Administer subcutaneous epinephrine.

13.

A client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribe

a)

Echocardiography

b)

Electrocardiography

c)

Cervical radiography

d)

Pulmonary function studies

14.

A client with acute myelocytic leukemia is being treated with busulfan. Which laboratory value would the nurse specifically monitor during treatment with this medication?

a)

Clotting time

b)

Uric acid level

c)

Potassium level

d)

Blood glucose level

15.

The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy?

a)

Anemia

b)

Decreased platelet

c)

Increased uric acid level

d)

Decreased leukocyte count

16.

A client calls the nurse in the emergency department and states that he was just stung by a bumblebee while gardening. The client is afraid of a severe reaction because the client's neighbor experienced such a reaction just 1 week ago. Which action should the nurse take?

a)

Advise the client to soak the site in hydrogen peroxide.

b)

Ask the client if he ever sustained a bee sting in the past

c)

Tell the client to call an ambulance for transport to the emergency department.

d)

Tell the client not to worry about the sting unless difficulty with breathing occurs.

17.

The home care nurse is preparing to visit a client who has undergone renal transplantation. The nurse develops a plan of care that includes monitoring the client for signs of acute graft rejection. The nurse documents in the plan to assess the client for which signs of acute graft rejection?

a)

Fever, hypotension, and polyuria

b)

Hypertension, polyuria, and thirst

c)

Fever, hypertension, and graft tenderness

d)

Hypotension, graft tenderness, and hypothermia

18.

A client arrives at the health care clinic and tells the nurse that he was just bitten by a tick and would like to be tested for Lyme disease. The client reports that he removed the tick and flushed it down the toilet. The nurse should take which nursing action?

a)

Refer the client for a blood test immediately.

b)

Ask the client about the size and color of the tick.

c)

Tell the client to return to the clinic in 4 to 6 weeks

d)

Inform the client that the tick is needed to perform a test

19.

The nursing instructor is reviewing the plan of care with a nursing student who is caring for a client with an immune disorder, and they discuss the classes of human antibodies. Which statement by the nursing student indicates a need for further teaching?

a)

"Immunoglobulin G (IgG) is the minor serum antibody."

b)

"Immunoglobulin M (IgM) is the first antibody produced in response to antigen."

c)

"Immunoglobulin E (IgE) accounts for less than 1% of the total antibody level in the blood."

d)

"The major serum antibody is IgG, which constitutes about 70% of the total circulating antibodies."

20.

A home care nurse is assigned to visit a client who has returned home from the emergency department following treatment for a sprained ankle. The nurse notes that the client was sent home with crutches that have rubber axillary pads and needs instruction regarding crutch walking. On admission assessment, the nurse discovered that the client has an allergy to latex. Before providing instructions regarding crutch walking, what action should the nurse take?

a)

Cover the crutch pads with cloth.

b)

Contact the primary health care provider (PHCP)

c)

Call the local medical supply store and ask that a cane be delivered

d)

Tell the client that the crutches must be removed from the house immediately