ONCOLOGY NCLEX ACTUAL EXAM

ONCOLOGY NCLEX ACTUAL EXAM

LATEST WITH COMPLETE QUESTIONS

AND CORRECT ANSWERS GRADED A+

A 64-year-old male patient who is receiving radiation to the head and neck as treatment for an invasive malignant tumor complains of mouth sores and pain. Which intervention should the nurse add to this patient's plan of care?

• Weigh the patient every month to monitor for weight loss.
• Cleanse the mouth every 2 to 4 hours with hydrogen peroxide.
• Provide high-protein and high-calorie, soft foods every 2 hours.
• Apply palifermin (Kepivance) liberally to the affected oral

mucosa. Correct Answer C. Provide high-protein and high-calorie, soft foods every 2 hours.

A patient with stomatitis should have soft, nonirritating foods offered frequently. The diet should be high in protein and high in calories. Saline or water should be used to cleanse the mouth (not hydrogen peroxide). Palifermin is administered intravenously as a growth factor to stimulate cells on the surface layer of the mouth to grow. Patients should be weighed at least twice each week to monitor for weight loss.

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A 70-year-old man who has end-stage lung cancer is admitted to the hospital with confusion and oliguria for 2 days. Which finding would the nurse report immediately to the health care provider?

• Weight gain of 2 lb
• Urine specific gravity of 1.015
• Blood urea nitrogen of 20 mg/dL
• Serum sodium level of 118 mEq/L Correct Answer D. Serum

sodium level of 118 mEq/L

Lung cancer cells are able to manufacture and release antidiuretic hormone (ADH) with resultant water retention and hyponatremia.Hyponatremia (serum sodium levels less than 135 mEq/L) may lead to central nervous system symptoms such as confusion, seizures, coma, and death. A weight gain may be due to fluid retention. The urine specific gravity and blood urea nitrogen are normal.

The nurse is caring for a patient receiving an initial dose of chemotherapy to treat a rapidly growing metastatic colon cancer.The nurse is aware that this patient is at risk for tumor lysis syndrome (TLS) and will monitor the patient closely for which abnormality associated with this oncologic emergency?

• Hypokalemia
• Hypouricemia
• Hypocalcemia
• Hypophosphatemia Correct Answer C. Hypocalcemia 2 / 4

TLS is a metabolic complication characterized by rapid release of intracellular components in response to chemotherapy. This can rapidly lead to acute renal injury. The hallmark signs of TLS are hyperuricemia, hyperphosphatemia, hyperkalemia, and hypocalcemia.

The nurse is caring for a patient suffering from anorexia secondary to chemotherapy. Which strategy would be most appropriate for the nurse to use to increase the patient's nutritional intake?

• Increase intake of liquids at mealtime to stimulate the appetite.
• Serve three large meals per day plus snacks between each

meal.

• Avoid the use of liquid protein supplements to encourage

eating at mealtime.

• Add items such as skim milk powder, cheese, honey, or peanut

butter to selected foods Correct Answer D. Add items such as skim milk powder, cheese, honey, or peanut butter to selected foodS

The nurse can increase the nutritional density of foods by adding items high in protein and/or calories (such as peanut butter, skim milk powder, cheese, honey, or brown sugar) to foods the patient will eat. Increasing fluid intake at mealtime fills the stomach with fluid and decreases the desire to eat. Small frequent meals are best tolerated. Supplements can be helpful. 3 / 4

Which item would be most beneficial when providing oral care to a patient with metastatic cancer who is at risk for oral tissue injury secondary to chemotherapy?

• Firm-bristle toothbrush
• Hydrogen peroxide rinse
• Alcohol-based mouthwash
• 1 tsp salt in 1 L water mouth rinse Correct Answer D. 1 tsp salt

in 1 L water mouth rinse

A salt-water mouth rinse will not cause further irritation to oral tissue that is fragile because of mucositis, which is a side effect of chemotherapy. A soft-bristle toothbrush will be used. One teaspoon of sodium bicarbonate may be added to the salt-water solution to decrease odor, alleviate pain, and dissolve mucin.Hydrogen peroxide and alcohol-based mouthwash are not used because they would damage the oral tissue.

Which nursing diagnosis is most appropriate for a patient experiencing myelosuppression secondary to chemotherapy for cancer treatment?

• Acute pain
• Hypothermia
• Powerlessness
• Risk for infection Correct Answer D. Risk for infection
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