ATI RN
Oncology Questions
1. A patient with non-Hodgkin lymphoma (NHL) is receiving monoclonal antibody therapy. What is the priority assessment during the infusion of this medication?
- A. Vital signs
- B. Skin reactions
- C. Respiratory status
- D. Renal function
Correct answer: A
Rationale: The correct answer is A: Vital signs. Monitoring vital signs is crucial during the infusion of monoclonal antibody therapy as there is a risk of infusion reactions such as fevers, chills, hypotension, and tachycardia. Assessing vital signs allows for early detection of any adverse reactions, enabling prompt intervention. Skin reactions (choice B), respiratory status (choice C), and renal function (choice D) are important assessments in general patient care but are not the priority during the infusion of monoclonal antibody therapy.
2. A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?
- A. Administer an antiemetic.
- B. Administer an antimetabolite.
- C. Administer a tumor antibiotic.
- D. Administer an anticoagulant.
Correct answer: A
Rationale: The correct answer is A: Administer an antiemetic. Chemotherapy commonly causes nausea and vomiting as adverse effects. Antiemetics are medications specifically used to prevent or treat these symptoms. Choices B, C, and D are incorrect because administering an antimetabolite, a tumor antibiotic, or an anticoagulant would not directly address the most common adverse effects of chemotherapy, which are nausea and vomiting.
3. The client is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care?
- A. I change my pouch every week.
- B. I change the appliance in the morning.
- C. I empty the urinary collection bag when it is two-thirds full.
- D. When I'm in the shower, I direct the flow of water away from my stoma.
Correct answer: D
Rationale: The correct answer is D because directing water away from the stoma while showering is incorrect. The stoma can and should be cleaned with water. Choices A, B, and C demonstrate proper stoma care practices, such as changing the pouch regularly, changing the appliance in the morning, and emptying the collection bag when it is two-thirds full, which are all appropriate actions for caring for a urinary stoma.
4. A nurse is caring for a client admitted for Non-Hodgkin’s lymphoma and chemotherapy. The client reports nausea, flank pain, and muscle cramps. What action by the nurse is most important?
- A. Request an order for serum electrolytes and uric acid.
- B. Increase the client’s IV infusion rate.
- C. Instruct assistive personnel to strain all urine.
- D. Administer an IV antiemetic.
Correct answer: A
Rationale: The client's symptoms of nausea, flank pain, and muscle cramps are suggestive of tumor lysis syndrome (TLS), a potentially life-threatening complication of chemotherapy in which cancer cells break down rapidly, releasing large amounts of intracellular components into the bloodstream. This leads to imbalances in electrolytes (elevated potassium, phosphate, and uric acid levels, with low calcium levels), which can cause severe metabolic disturbances, including kidney damage, arrhythmias, and muscle cramps. Checking serum electrolytes and uric acid levels is crucial for diagnosing and managing TLS early, preventing further complications.
5. An oncology nurse educator is providing health education to a patient who has been diagnosed with skin cancer. The patient’s wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?
- A. Malignant cells contain more fibronectin than normal body cells.
- B. Malignant cells contain proteins called tumor-specific antigens.
- C. Chromosomes contained in cancer cells are more durable and stable than those of normal cells.
- D. The nuclei of cancer cells are unusually large, but regularly shaped.
Correct answer: B
Rationale: Malignant (cancer) cells often express tumor-specific antigens (TSAs), which are proteins or markers on the surface of cancer cells that are not found on normal cells. These antigens are produced due to genetic mutations in cancer cells and can sometimes be used to help the immune system recognize and attack cancerous cells. Tumor-specific antigens play a key role in cancer diagnosis, monitoring, and targeted therapies.
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