Oncology NCLEX style questions

Oncology NCLEX style questions

• A nurse is caring for a child who has myelosuppression after receiving chemotherapy. The

nurse should monitor the child for which of the following adverse effects?A.Anorexia and malnutrition B.Bleeding from the gums C.Diarrhea and dehydration D.Full body alopecia

Correct Answer: B- Bleeding from the gums

Rationale: Bleeding from the gums is directly related to myelosuppression due to inhibited bone marrow production of blood cells and platelets. Anorexia, malnutrition, alopecia, diarrhea and dehydration are all a side effect of chemotherapy and are not directly related to myelosuppression.

• A nurse is providing discharge teaching for the parent of a child with brain tumor who is

postoperative tumor resection. The child is to begin outpatient radiation therapy the next day.Which of the following instructions about maintaining skin integrity should the nurse include?A.Do not apply heat to the area of irradiation.B.Do not wash the area of irradiation C.Use an antibiotic ointment to treat skin breakdown.D.Lubricate the skin with hypoallergenic lotion

Correct Answer: A-Do not apply heat to the area of radiation.

Rationale: This instruction will help the client avoid tissue damage. Radiated tissue becomes thinner and might lack tissue receptors that would otherwise alert the child to a potential burn injury. When outdoors in sunlight, the client should wear protective clothing over the area of irradiation.B is incorrect: The child / parent may wash the treatment area gently with warm, not hot, water and a mild soap. They should not scrub the treatment area or remove the radiation area markings. They should then pat the skin dry with a soft, clean towel without rubbing.C and D are incorrect because ointments or lotions should not be used on skin that has been exposed to radiation, unless ordered by a provider This study source was downloaded by 100000869267694 from CourseHero.com on 09-21-2023 04:48:03 GMT -05:00 https://www.coursehero.com/file/179620157/Oncology-NCLEX-style-questions-with-answersdocx/

• A nurse is reviewing the laboratory results of a child who has acute leukemia and received an

aggressive chemotherapy treatment 10 days ago. Which of the following hematologic laboratory values should the nurse expect? (Select all that apply.) A.Decreased platelet count B.Increased hemoglobin count C.Decreased leukocyte count D.Increased platelet count E.Decreased erythrocyte count Correct Answer: A -Decreased platelet count, C- Decreased leukocyte count and E- Decreased erythrocyte count Rationale: nurse should expect to see a decreased platelet, decreased leukocyte and decreased erythrocyte counts due to bone marrow suppression from the chemotherapy treatment.Increased hemoglobin count is incorrect. The nurse should expect to see a decreased hemoglobin count due to bone marrow suppression from the chemotherapy treatment.Increased platelet count is incorrect. The nurse should expect to see a decrease not increased platelet count due to bone marrow suppression from the chemotherapy treatment.

• A nurse is caring for a 17-year-old client who is experiencing a relapse of leukemia and is

refusing treatment. The client's mother insists that the client receive treatment. Which of the following actions should the nurse take?A.Initiate the IV per the parent's request.B.Notify the provider of the situation.C.Administer a sedative to calm the client.D.Offer the client an antiemetic.

Correct Answer: B- Notify the provider of the situation

Rationale: Initiating IV without the child’s assent (permission) might be considered as non- consensual touching of the child and can result in battery charges. The nurse should not insert the IV without the child’s permission. Notifying with the provider of the situation before proceeding allows the chance to further explore the child’s concern, address those concerns This study source was downloaded by 100000869267694 from CourseHero.com on 09-21-2023 04:48:03 GMT -05:00 https://www.coursehero.com/file/179620157/Oncology-NCLEX-style-questions-with-answersdocx/

and obtain assent before proceeding. Administering a sedative violates the child’s right to participate in their care and take away their ability to verbalize their concerns. An antiemetic is not relevant to the situation.

• A nurse is caring for a child following surgical treatment for a brain tumor. Which of the

following interventions should the nurse take?A.Elevate the head of the bed to 30°.B.Place the child in a flat, lateral position C.Provide passive range-of-motion exercises to the neck D.Distract the child with videogames

Correct Answer: A- Elevate the head of the bed to 30°.

Rationale: elevating the head of the bed decreases the risk of increased intracranial pressure (ICP) by promoting venous and CSSF fluid drainage. Placing the child flat increased the risk on increased ICP, it also increased pressure on the incision site. Passive range of motion exercises increased ICP. Videogames might be stimulating to the child and increase ICP. The child should rest in a quite environment instead.

• A nurse is reviewing the CBC findings for 7 years old with who is receiving combination

chemotherapy for Leukemia. Which of the following findings should the nurse report to the provider?A.Hemoglobin 12 B.Potassium 3.5

C.ANC 800

D.Platelets 150 000

Correct Answer:

Rationale: Hemoglobin of 12, platelets of 150,000 and potassium of 3.5 are in the normal range. ANC of 800 is below normal range (normal ANC = 3000-5000), means the child is neutropenic and is at risk for infection.

• A nurse is planning care for a child who has immunosuppression following chemotherapy.

Which of the following interventions should the nurse include in the plan of care?

• Insert an indwelling catheter to monitor urine output This study source was downloaded by 100000869267694 from CourseHero.com on 09-21-2023 04:48:03 GMT -05:00

https://www.coursehero.com/file/179620157/Oncology-NCLEX-style-questions-with-answersdocx/

B.Take the child’s temperature once per shift C.Provide the child with fresh fruit to avoid constipation D.Limit the number of health care workers entering the room

Correct Answer: D- Limit the number of health care workers entering the room

Rationale: Limiting the number of people entering the child’s room to prevent possible overexposure to microorganisms that can lead to an infection. The nurse should avoid inserting an indwelling catheter to help prevent contamination with microorganisms that may cause an infection. The nurse should take the child’s temperature at least every 4 hr to monitor for an increase that might indicate an infection. The nurse should provide the child with fruit that is cooked to help prevent constipation because fresh fruit and vegetable can harbor microorganisms that can cause an infection. This study source was downloaded by 100000869267694 from CourseHero.com on 09-21-2023 04:48:03 GMT -05:00 https://www.coursehero.com/file/179620157/Oncology-NCLEX-style-questions-with-answersdocx/