ATI RN
Oncology Test Bank
1. The nurse is caring for a client following radical neck dissection and creation of a tracheostomy. Which assessment finding would indicate an immediate need for intervention?
- A. Frequent swallowing
- B. Presence of mucous membranes
- C. Bubbling in the water-seal chamber
- D. Inspiratory stridor
Correct answer: D
Rationale: Inspiratory stridor is the correct answer as it suggests airway obstruction, a critical issue requiring immediate intervention. Frequent swallowing (choice A) is a common postoperative finding and does not indicate an immediate need for intervention. The presence of mucous membranes (choice B) is a normal finding and does not require immediate intervention. Bubbling in the water-seal chamber (choice C) of a chest tube drainage system is an expected finding and indicates proper functioning of the system, not an immediate need for intervention.
2. The nurse is caring for a patient who has just been given a 6-month prognosis following a diagnosis of extensive-stage small-cell lung cancer. The patient states that he would like to die at home, but the team believes that the patient's care needs are unable to be met in a home environment. What might you suggest as an alternative?
- A. Discuss a referral for rehabilitation hospital.
- B. Panel the patient for a personal care home.
- C. Discuss a referral for acute care.
- D. Discuss a referral for hospice care.
Correct answer: D
Rationale: In this scenario, the most appropriate alternative to address the patient's desire to die at home while ensuring proper care is hospice care. Hospice care is specifically designed to provide support to patients and families in situations where the patient's needs cannot be met at home. Rehabilitation hospital (Choice A), personal care home (Choice B), and acute care (Choice C) are not the most suitable options in this case as they do not focus on end-of-life care and support like hospice care does.
3. A patient with myelofibrosis is being treated with ruxolitinib. What should the nurse monitor to assess the effectiveness of this treatment?
- A. Blood pressure
- B. White blood cell count
- C. Hemoglobin and hematocrit
- D. Spleen size
Correct answer: C
Rationale: Monitoring hemoglobin and hematocrit is essential to assess the effectiveness of ruxolitinib in treating myelofibrosis. Ruxolitinib works by inhibiting JAK1 and JAK2, which are involved in the signaling pathways that regulate blood cell production. Therefore, monitoring hemoglobin and hematocrit levels can provide valuable information on how well the drug is managing the disease. Blood pressure, white blood cell count, and spleen size are not direct indicators of the treatment's effectiveness in myelofibrosis.
4. A nurse provides care on a bone marrow transplant unit and is preparing a female patient for a hematopoietic stem cell transplantation (HSCT) the following day. What information should the nurse emphasize to the patient’s family and friends?
- A. Your family should gather at the bedside in case there is a negative outcome.
- B. Ensure she abstains from eating any food 24 hours before the procedure.
- C. Wear a hospital gown when entering the patient's room.
- D. Avoid visiting if you've had a recent infection.
Correct answer: D
Rationale: The correct answer is D: 'Avoid visiting if you've had a recent infection.' Before a hematopoietic stem cell transplantation, it is essential for visitors to refrain from visiting if they have had a recent illness or vaccination to minimize the risk of infection to the patient. Choice A is incorrect because emphasizing a negative outcome is not beneficial to the patient or their family. Choice B is incorrect as it is not necessary to abstain from food for a hematopoietic stem cell transplantation. Choice C is irrelevant to the situation as wearing a hospital gown is not the key information for family and friends to be aware of.
5. A clinic nurse is working with a patient who has a long-standing diagnosis of polycythemia vera. How can the nurse best gauge the course of the patient's disease?
- A. Document the color of the patient's palms and face during each visit.
- B. Follow the patient's erythrocyte sedimentation rate over time.
- C. Document the patient's response to erythropoietin injections.
- D. Follow the trends of the patient's hematocrit.
Correct answer: D
Rationale: The course of polycythemia vera can be best ascertained by monitoring the patient's hematocrit, which should remain below 45%. Hematocrit levels are a key indicator in assessing the progression of the disease. Choices A, B, and C are not the most appropriate methods for gauging the course of polycythemia vera. Monitoring the color of the patient's palms and face, or their response to erythropoietin injections, may not provide an accurate reflection of the disease's progression. Similarly, while erythrocyte sedimentation rate can be affected in polycythemia vera, it is not the primary marker for monitoring the disease's course.
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