All-in-One Nursing Care Planning
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,1) MCQ — Cancer Care: Febrile Neutropenia
Clinical Scenario:
A client receiving cytotoxic chemotherapy reports chills and a
sore throat. The nurse notes a temperature of 38.4°C (101.1°F),
neutrophils of 300/mm³, and fatigue.
Question Stem:
What should the nurse do first?
Answer Options:
A. Give acetaminophen and recheck the temperature in 1 hour.
B. Encourage oral fluids and rest.
C. Notify the provider immediately and prepare to obtain blood
cultures.
D. Place the client on contact precautions only.
Correct Answer:
C
Detailed Rationale:
Fever with profound neutropenia is an oncologic emergency.
The nurse must treat the finding as possible sepsis, notify the
provider promptly, and prepare for cultures and urgent broad-
spectrum antibiotics. This reflects patient safety, prioritization,
and infection control.
Incorrect Option Analysis:
A. Incorrect because antipyretics can mask worsening infection.
,Misconception: treating the fever treats the cause. Safety
concern: delayed sepsis response.
B. Incorrect because hydration alone does not address the
emergency. Misconception: supportive care is enough.
D. Incorrect because neutropenic precautions may be needed,
but they are not the first priority over rapid escalation.
Misconception: isolation replaces emergency treatment.
Nursing Process Linkage: Assessment → Implementation
NCJMM: Recognize Cues, Prioritize Hypotheses, Take Action
Difficulty: Difficult
Bloom’s Level: Analyze
NCLEX Client Needs: Physiological Adaptation / Safety and
Infection Control
Nursing Diagnosis Integration:
Priority Nursing Diagnosis: Risk for infection related to
myelosuppression.
Risk Factors: chemotherapy-induced neutropenia, mucosal
barrier injury.
Expected Outcome: Blood cultures are obtained and antibiotics
are started promptly.
Key Learning Objective: Recognize and respond to febrile
neutropenia as a time-sensitive cancer emergency.
2) SATA — Cancer Care: Thrombocytopenia Precautions
, Clinical Scenario:
A client who has completed chemotherapy has a platelet count
of 42,000/mm³ and asks how to reduce bleeding risk at home.
Question Stem:
Which instructions should the nurse include? Select all that
apply.
Answer Options:
A. Use a soft-bristled toothbrush.
B. Take aspirin for headache if needed.
C. Use an electric razor.
D. Report black stools or gum bleeding.
E. Use dental floss daily.
Correct Answers:
A, C, D
Detailed Rationale:
Low platelets increase bleeding risk. Soft oral care, an electric
razor, and prompt reporting of bleeding are standard safety
measures. This supports prevention and early recognition.
Incorrect Option Analysis:
B. Incorrect because aspirin worsens bleeding by impairing
platelet function. Misconception: all headache medicines are
equally safe. Safety concern: hemorrhage.
E. Incorrect because flossing can injure gums. Misconception:
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,1) MCQ — Cancer Care: Febrile Neutropenia
Clinical Scenario:
A client receiving cytotoxic chemotherapy reports chills and a
sore throat. The nurse notes a temperature of 38.4°C (101.1°F),
neutrophils of 300/mm³, and fatigue.
Question Stem:
What should the nurse do first?
Answer Options:
A. Give acetaminophen and recheck the temperature in 1 hour.
B. Encourage oral fluids and rest.
C. Notify the provider immediately and prepare to obtain blood
cultures.
D. Place the client on contact precautions only.
Correct Answer:
C
Detailed Rationale:
Fever with profound neutropenia is an oncologic emergency.
The nurse must treat the finding as possible sepsis, notify the
provider promptly, and prepare for cultures and urgent broad-
spectrum antibiotics. This reflects patient safety, prioritization,
and infection control.
Incorrect Option Analysis:
A. Incorrect because antipyretics can mask worsening infection.
,Misconception: treating the fever treats the cause. Safety
concern: delayed sepsis response.
B. Incorrect because hydration alone does not address the
emergency. Misconception: supportive care is enough.
D. Incorrect because neutropenic precautions may be needed,
but they are not the first priority over rapid escalation.
Misconception: isolation replaces emergency treatment.
Nursing Process Linkage: Assessment → Implementation
NCJMM: Recognize Cues, Prioritize Hypotheses, Take Action
Difficulty: Difficult
Bloom’s Level: Analyze
NCLEX Client Needs: Physiological Adaptation / Safety and
Infection Control
Nursing Diagnosis Integration:
Priority Nursing Diagnosis: Risk for infection related to
myelosuppression.
Risk Factors: chemotherapy-induced neutropenia, mucosal
barrier injury.
Expected Outcome: Blood cultures are obtained and antibiotics
are started promptly.
Key Learning Objective: Recognize and respond to febrile
neutropenia as a time-sensitive cancer emergency.
2) SATA — Cancer Care: Thrombocytopenia Precautions
, Clinical Scenario:
A client who has completed chemotherapy has a platelet count
of 42,000/mm³ and asks how to reduce bleeding risk at home.
Question Stem:
Which instructions should the nurse include? Select all that
apply.
Answer Options:
A. Use a soft-bristled toothbrush.
B. Take aspirin for headache if needed.
C. Use an electric razor.
D. Report black stools or gum bleeding.
E. Use dental floss daily.
Correct Answers:
A, C, D
Detailed Rationale:
Low platelets increase bleeding risk. Soft oral care, an electric
razor, and prompt reporting of bleeding are standard safety
measures. This supports prevention and early recognition.
Incorrect Option Analysis:
B. Incorrect because aspirin worsens bleeding by impairing
platelet function. Misconception: all headache medicines are
equally safe. Safety concern: hemorrhage.
E. Incorrect because flossing can injure gums. Misconception:
