ATI RN
Oncology Questions
1. Nurse Rose is caring for a client with cancer who has developed spinal cord compression. Which of the following symptoms would the nurse expect to find?
- A. Decreased deep tendon reflexes
- B. Severe headache
- C. Back pain
- D. Loss of bladder control
Correct answer: C
Rationale: The correct answer is C: 'Back pain.' Back pain is a common symptom of spinal cord compression in cancer patients. This condition can cause localized or radiating back pain due to the compression of the spinal cord or nerves. While symptoms such as decreased deep tendon reflexes, severe headache, and loss of bladder control can occur in other conditions, back pain is specifically associated with spinal cord compression in cancer patients.
2. The home health nurse is performing a home visit for an oncology patient discharged 3 days ago after completing treatment for non-Hodgkin lymphoma. The nurse's assessment should include examination for the signs and symptoms of what complication?
- A. Tumor lysis syndrome (TLS)
- B. Syndrome of inappropriate antidiuretic hormone (SIADH)
- C. Disseminated intravascular coagulation (DIC)
- D. Hypercalcemia
Correct answer: A
Rationale: The correct answer is A: Tumor lysis syndrome (TLS). Tumor lysis syndrome is a potential complication after treatment for certain cancers, including non-Hodgkin lymphoma. The rapid breakdown of cancer cells in response to treatment can lead to metabolic abnormalities, such as hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia, which can be life-threatening. Choice B, Syndrome of inappropriate antidiuretic hormone (SIADH), is not typically associated with non-Hodgkin lymphoma treatment. Choice C, Disseminated intravascular coagulation (DIC), is more commonly seen in conditions such as sepsis or trauma, not directly related to non-Hodgkin lymphoma treatment. Choice D, Hypercalcemia, is not a common complication following treatment for non-Hodgkin lymphoma.
3. When preparing for the patient's subsequent care after completing the full course of treatment for acute lymphocytic leukemia without a significant response, what action should the nurse take?
- A. Arrange a meeting between the patient's family and the hospital chaplain.
- B. Assess the factors underlying the patient's failure to adhere to the treatment regimen.
- C. Encourage the patient to vigorously pursue complementary and alternative medicine (CAM).
- D. Identify the patient's specific wishes around end-of-life care.
Correct answer: D
Rationale: In cases where a patient does not respond appreciably to therapy, it is crucial to identify and respect the patient's choices regarding treatment, including preferences for end-of-life care. Option A is incorrect because it focuses on spiritual support rather than the patient's care preferences. Option B is incorrect as it assumes non-adherence to treatment without evidence. Option C is incorrect as it suggests an alternative treatment approach without considering the patient's wishes for end-of-life care.
4. A client is diagnosed as having a positive reaction to the Mantoux test. Which of the following is the most appropriate nursing action?
- A. Isolate the client in a private room.
- B. Administer isoniazid (INH) as prescribed.
- C. Schedule the client for a chest x-ray.
- D. Begin a 9-month course of medication therapy.
Correct answer: C
Rationale: The correct answer is to schedule the client for a chest x-ray. A positive Mantoux test indicates exposure to TB, but it does not confirm active disease. A chest x-ray is necessary to assess the presence of active TB disease. Isolating the client in a private room (Choice A) is not necessary based solely on a positive Mantoux test result. Administering isoniazid (INH) (Choice B) or beginning a 9-month course of medication therapy (Choice D) is premature without confirming active TB through a chest x-ray.
5. A nurse is providing education to a patient with polycythemia vera about self-care strategies. What advice should the nurse include?
- A. Avoid hot showers
- B. Drink plenty of fluids
- C. Avoid tight and restrictive clothing
- D. Avoid prolonged sitting
Correct answer: B
Rationale: The correct advice for a patient with polycythemia vera is to drink plenty of fluids. This helps in reducing the risk of thrombosis by keeping the blood less viscous. Avoiding hot showers (Choice A) is not directly related to managing polycythemia vera. While avoiding tight and restrictive clothing (Choice C) can help improve circulation, it is not the most crucial advice for these patients. Avoiding prolonged sitting (Choice D) is important to prevent blood clots but is not as critical as staying well-hydrated.
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