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
Clinical Scenario:
A patient with leukemia has just completed a chemotherapy
infusion. Six hours later, the patient’s temperature is 38.3°C
(100.9°F) and the absolute neutrophil count is 400/mm³.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Give acetaminophen and reassess the temperature in 1 hour.
B. Place the patient on neutropenic precautions and notify the
oncology provider immediately.
C. Encourage fresh fruit and vegetables to improve appetite.
D. Restrict oral fluids until blood cultures are drawn.
Correct Answer:
B
Detailed Rationale:
A fever with severe neutropenia is a medical emergency
because the patient may not show typical signs of infection until
rapidly ill. Immediate infection precautions and provider
notification are required so cultures, antibiotics, and further
treatment can be initiated quickly.
Incorrect Option Analysis:
, • A: Masks the fever and delays urgent treatment.
• C: Fresh produce can increase exposure to pathogens in
neutropenic patients.
• D: Fluid restriction is not appropriate and can worsen
dehydration.
Nursing Process Linkage:
Implementation
NCJMM Competencies:
Recognize Cues; Take Action
Difficulty Level:
Difficult
Bloom’s Cognitive Level:
Apply
NCLEX Client Needs Category:
Safety and Infection Control
Nursing Diagnosis Integration:
Priority Nursing Diagnosis: Risk for infection
Risk Factors: Bone marrow suppression, neutropenia, invasive
therapy
Expected Outcome:
The patient remains free of sepsis and receives prompt
infection management within the same hour.
, Key Learning Objective:
Prioritize rapid intervention for febrile neutropenia in a patient
receiving chemotherapy.
2) SATA — Cancer Care
Clinical Scenario:
A patient receiving chemotherapy asks what symptoms should
be reported immediately.
Question Stem:
Which findings should the nurse teach the patient to report at
once? Select all that apply.
Answer Options:
A. Temperature of 38.0°C (100.4°F) or higher
B. Mild hair thinning
C. New bleeding gums or unexplained bruising
D. Persistent vomiting or diarrhea
E. Appetite changes and a metallic taste only
Correct Answer:
A, C, D
Detailed Rationale:
Fever, bleeding, and persistent gastrointestinal loss are urgent
because they can signal infection, thrombocytopenia, or
dehydration during chemotherapy.
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,1) MCQ — Cancer Care
Clinical Scenario:
A patient with leukemia has just completed a chemotherapy
infusion. Six hours later, the patient’s temperature is 38.3°C
(100.9°F) and the absolute neutrophil count is 400/mm³.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Give acetaminophen and reassess the temperature in 1 hour.
B. Place the patient on neutropenic precautions and notify the
oncology provider immediately.
C. Encourage fresh fruit and vegetables to improve appetite.
D. Restrict oral fluids until blood cultures are drawn.
Correct Answer:
B
Detailed Rationale:
A fever with severe neutropenia is a medical emergency
because the patient may not show typical signs of infection until
rapidly ill. Immediate infection precautions and provider
notification are required so cultures, antibiotics, and further
treatment can be initiated quickly.
Incorrect Option Analysis:
, • A: Masks the fever and delays urgent treatment.
• C: Fresh produce can increase exposure to pathogens in
neutropenic patients.
• D: Fluid restriction is not appropriate and can worsen
dehydration.
Nursing Process Linkage:
Implementation
NCJMM Competencies:
Recognize Cues; Take Action
Difficulty Level:
Difficult
Bloom’s Cognitive Level:
Apply
NCLEX Client Needs Category:
Safety and Infection Control
Nursing Diagnosis Integration:
Priority Nursing Diagnosis: Risk for infection
Risk Factors: Bone marrow suppression, neutropenia, invasive
therapy
Expected Outcome:
The patient remains free of sepsis and receives prompt
infection management within the same hour.
, Key Learning Objective:
Prioritize rapid intervention for febrile neutropenia in a patient
receiving chemotherapy.
2) SATA — Cancer Care
Clinical Scenario:
A patient receiving chemotherapy asks what symptoms should
be reported immediately.
Question Stem:
Which findings should the nurse teach the patient to report at
once? Select all that apply.
Answer Options:
A. Temperature of 38.0°C (100.4°F) or higher
B. Mild hair thinning
C. New bleeding gums or unexplained bruising
D. Persistent vomiting or diarrhea
E. Appetite changes and a metallic taste only
Correct Answer:
A, C, D
Detailed Rationale:
Fever, bleeding, and persistent gastrointestinal loss are urgent
because they can signal infection, thrombocytopenia, or
dehydration during chemotherapy.
