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: Neutropenic Fever
Clinical Scenario
A 58-year-old client receiving chemotherapy for colon cancer
calls the clinic reporting chills and a temperature of 38.3°C
(100.9°F). The client completed the most recent chemotherapy
cycle 5 days ago and has mouth soreness and fatigue.
Question Stem
What is the nurse’s priority action?
Answer Options
A. Encourage the client to drink extra fluids and rest at home
B. Instruct the client to take acetaminophen and recheck the
temperature in 1 hour
C. Advise the client to come to the emergency department
immediately
D. Teach the client to avoid crowded places until the next clinic
visit
Correct Answer
C. Advise the client to come to the emergency department
immediately
Detailed Rationale
Fever after chemotherapy suggests neutropenic fever, a
medical emergency because infection can progress rapidly
when neutrophil counts are low. Immediate evaluation,
,cultures, and prompt empiric treatment are needed to reduce
the risk of sepsis.
Incorrect Option Analysis
• A is incorrect because home rest is unsafe when infection
is possible; it reflects the misconception that post-chemo
fever is minor.
• B is incorrect because antipyretics may mask worsening
infection and delay treatment.
• D is incorrect because infection prevention is important,
but it does not address the urgent fever.
Nursing Process Linkage
Assessment / Implementation
Clinical Judgment Competencies (NCJMM)
Recognize Cues; Prioritize Hypotheses; Take Action
Difficulty Level
Difficult
Bloom’s Cognitive Level
Analyze
NCLEX Client Needs Category
Physiological Adaptation
Nursing Diagnosis Integration
• Priority Nursing Diagnosis: Risk for infection
, • Risk Factors: Bone marrow suppression from
chemotherapy, mucosal breakdown
• Defining Characteristics: Fever, chills, recent
chemotherapy
Expected Outcome
The client will receive urgent evaluation and treatment to
prevent progression to sepsis.
Key Learning Objective
Identify neutropenic fever as an emergency requiring
immediate escalation of care.
2. SATA — Cancer Care: Chemotherapy Teaching
Clinical Scenario
A client starting outpatient chemotherapy asks what self-care
measures may reduce complications during treatment.
Question Stem
Which instructions should the nurse include? Select all that
apply.
Answer Options
A. Use a soft toothbrush for oral care
B. Report a fever of 38°C (100.4°F) or higher
C. Use alcohol-based mouthwash to reduce oral bacteria
D. Eat small, frequent meals if nausea occurs
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,1. MCQ — Cancer Care: Neutropenic Fever
Clinical Scenario
A 58-year-old client receiving chemotherapy for colon cancer
calls the clinic reporting chills and a temperature of 38.3°C
(100.9°F). The client completed the most recent chemotherapy
cycle 5 days ago and has mouth soreness and fatigue.
Question Stem
What is the nurse’s priority action?
Answer Options
A. Encourage the client to drink extra fluids and rest at home
B. Instruct the client to take acetaminophen and recheck the
temperature in 1 hour
C. Advise the client to come to the emergency department
immediately
D. Teach the client to avoid crowded places until the next clinic
visit
Correct Answer
C. Advise the client to come to the emergency department
immediately
Detailed Rationale
Fever after chemotherapy suggests neutropenic fever, a
medical emergency because infection can progress rapidly
when neutrophil counts are low. Immediate evaluation,
,cultures, and prompt empiric treatment are needed to reduce
the risk of sepsis.
Incorrect Option Analysis
• A is incorrect because home rest is unsafe when infection
is possible; it reflects the misconception that post-chemo
fever is minor.
• B is incorrect because antipyretics may mask worsening
infection and delay treatment.
• D is incorrect because infection prevention is important,
but it does not address the urgent fever.
Nursing Process Linkage
Assessment / Implementation
Clinical Judgment Competencies (NCJMM)
Recognize Cues; Prioritize Hypotheses; Take Action
Difficulty Level
Difficult
Bloom’s Cognitive Level
Analyze
NCLEX Client Needs Category
Physiological Adaptation
Nursing Diagnosis Integration
• Priority Nursing Diagnosis: Risk for infection
, • Risk Factors: Bone marrow suppression from
chemotherapy, mucosal breakdown
• Defining Characteristics: Fever, chills, recent
chemotherapy
Expected Outcome
The client will receive urgent evaluation and treatment to
prevent progression to sepsis.
Key Learning Objective
Identify neutropenic fever as an emergency requiring
immediate escalation of care.
2. SATA — Cancer Care: Chemotherapy Teaching
Clinical Scenario
A client starting outpatient chemotherapy asks what self-care
measures may reduce complications during treatment.
Question Stem
Which instructions should the nurse include? Select all that
apply.
Answer Options
A. Use a soft toothbrush for oral care
B. Report a fever of 38°C (100.4°F) or higher
C. Use alcohol-based mouthwash to reduce oral bacteria
D. Eat small, frequent meals if nausea occurs
