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 58-year-old patient receiving chemotherapy for colon cancer
calls the clinic reporting a temperature of 38.4°C (101.1°F),
chills, and sore throat. The most recent absolute neutrophil
count is 420/mm³.
Question:
What is the nurse’s priority action?
A. Advise the patient to take acetaminophen and recheck the
temperature in 4 hours
B. Instruct the patient to eat more protein and increase oral
fluids
C. Initiate protective precautions and notify the oncology
provider immediately
D. Schedule the patient for the next outpatient chemotherapy
education class
Correct answer: C
Rationale:
Fever with severe neutropenia is a medical emergency because
infection can progress rapidly without a strong inflammatory
response. The nurse must treat this as a priority safety issue
,and notify the provider immediately while initiating protective
precautions.
Incorrect option analysis:
A. Incorrect. Antipyretics may mask fever and delay urgent
treatment.
B. Incorrect. Nutrition and fluids matter, but they do not
address the immediate infection risk.
D. Incorrect. Education is not the priority in an acute febrile
episode.
Nursing process link: Assessment / Implementation
NCJMM competencies: Recognize Cues, Prioritize Hypotheses,
Take Action
Difficulty: Difficult
Bloom’s level: Analyze
NCLEX client needs: Reduction of Risk Potential
Nursing diagnosis integration:
• Priority diagnosis: Risk for Infection
• Risk factors: Chemotherapy-induced neutropenia, fever,
mucosal barrier disruption
Expected outcome: The patient receives urgent evaluation
and infection management without delay.
Key learning objective: Recognize life-threatening infection
risk in immunocompromised patients and prioritize
immediate action.
, 2) SATA — Cancer Care: Chemotherapy Teaching
Clinical scenario:
A patient starting outpatient chemotherapy asks what
symptoms should be reported right away.
Question:
Which teaching points should the nurse include? Select all that
apply.
A. Report a fever of 38°C (100.4°F) or higher
B. Use a soft toothbrush and avoid flossing if gums bleed easily
C. Expect all nausea to disappear after the first treatment
D. Avoid crowds and people who are ill
E. Call the provider for uncontrolled vomiting or diarrhea
Correct answers: A, B, D, E
Rationale:
Chemotherapy can suppress bone marrow and irritate the GI
tract, so fever, bleeding risk, infection exposure, vomiting, and
diarrhea require prompt reporting or prevention strategies.
Incorrect option analysis:
C. Incorrect. Nausea may persist or recur across multiple cycles.
This reflects a misconception that side effects always resolve
quickly.
A. Correct. Fever may be the first sign of infection in a
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 58-year-old patient receiving chemotherapy for colon cancer
calls the clinic reporting a temperature of 38.4°C (101.1°F),
chills, and sore throat. The most recent absolute neutrophil
count is 420/mm³.
Question:
What is the nurse’s priority action?
A. Advise the patient to take acetaminophen and recheck the
temperature in 4 hours
B. Instruct the patient to eat more protein and increase oral
fluids
C. Initiate protective precautions and notify the oncology
provider immediately
D. Schedule the patient for the next outpatient chemotherapy
education class
Correct answer: C
Rationale:
Fever with severe neutropenia is a medical emergency because
infection can progress rapidly without a strong inflammatory
response. The nurse must treat this as a priority safety issue
,and notify the provider immediately while initiating protective
precautions.
Incorrect option analysis:
A. Incorrect. Antipyretics may mask fever and delay urgent
treatment.
B. Incorrect. Nutrition and fluids matter, but they do not
address the immediate infection risk.
D. Incorrect. Education is not the priority in an acute febrile
episode.
Nursing process link: Assessment / Implementation
NCJMM competencies: Recognize Cues, Prioritize Hypotheses,
Take Action
Difficulty: Difficult
Bloom’s level: Analyze
NCLEX client needs: Reduction of Risk Potential
Nursing diagnosis integration:
• Priority diagnosis: Risk for Infection
• Risk factors: Chemotherapy-induced neutropenia, fever,
mucosal barrier disruption
Expected outcome: The patient receives urgent evaluation
and infection management without delay.
Key learning objective: Recognize life-threatening infection
risk in immunocompromised patients and prioritize
immediate action.
, 2) SATA — Cancer Care: Chemotherapy Teaching
Clinical scenario:
A patient starting outpatient chemotherapy asks what
symptoms should be reported right away.
Question:
Which teaching points should the nurse include? Select all that
apply.
A. Report a fever of 38°C (100.4°F) or higher
B. Use a soft toothbrush and avoid flossing if gums bleed easily
C. Expect all nausea to disappear after the first treatment
D. Avoid crowds and people who are ill
E. Call the provider for uncontrolled vomiting or diarrhea
Correct answers: A, B, D, E
Rationale:
Chemotherapy can suppress bone marrow and irritate the GI
tract, so fever, bleeding risk, infection exposure, vomiting, and
diarrhea require prompt reporting or prevention strategies.
Incorrect option analysis:
C. Incorrect. Nausea may persist or recur across multiple cycles.
This reflects a misconception that side effects always resolve
quickly.
A. Correct. Fever may be the first sign of infection in a
