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
,Question Bank: Cancer Care + Older Adult Care
1) MCQ
Clinical Scenario:
A patient with acute myeloid leukemia received the second
cycle of chemotherapy 10 days ago. The patient now reports
chills and feels “very weak.” Temperature is 38.6°C (101.5°F),
and the neutrophil count is critically low.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Administer acetaminophen and reassess the temperature in
1 hour.
B. Obtain blood cultures and prepare to start broad-spectrum IV
antibiotics promptly.
C. Encourage the patient to increase oral fluid intake and rest.
D. Place the patient on droplet precautions.
Correct Answer:
B
Detailed Rationale:
Fever in a neutropenic patient is a medical emergency because
it may be the only sign of life-threatening infection. The nurse
should obtain cultures and initiate the facility’s neutropenic
,fever protocol, which typically includes rapid broad-spectrum
antibiotics. Delays increase risk for sepsis.
Incorrect Option Analysis:
A: Antipyretics may mask fever and delay treatment; this
reflects a misconception that symptom control is enough.
C: Supportive care is helpful, but it does not address the urgent
infection risk.
D: Droplet precautions are not the standard first response for
neutropenia; protective precautions and infection control
measures are more relevant.
Nursing Process Linkage: Implementation
NCJMM Competencies: Recognize Cues, Prioritize Hypotheses,
Take Action
Difficulty Level: Difficult
Bloom’s Level: Analyze
NCLEX Client Needs Category: Physiological Adaptation
Priority Nursing Diagnosis: Risk for Infection related to
neutropenia
Expected Outcome: The patient will receive cultures and
antibiotics within the institution’s urgent sepsis/neutropenic
fever timeline.
Key Learning Objective: Recognize and act on an oncologic
emergency.
, 2) SATA
Clinical Scenario:
A patient is being discharged after the first outpatient
chemotherapy treatment.
Question Stem:
Which instructions should the nurse include? Select all that
apply.
Answer Options:
A. Report a temperature of 38°C (100.4°F) or higher
immediately.
B. Use a soft-bristled toothbrush and avoid flossing if the gums
are sore or bleeding.
C. Expect nausea only if the infusion caused an allergic reaction.
D. Avoid crowds and people who are ill during periods of low
blood counts.
E. Take aspirin for mild bone pain unless the provider says
otherwise.
F. Check the skin over the infusion site for redness, swelling, or
pain.
Correct Answers:
A, B, D, F
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,Question Bank: Cancer Care + Older Adult Care
1) MCQ
Clinical Scenario:
A patient with acute myeloid leukemia received the second
cycle of chemotherapy 10 days ago. The patient now reports
chills and feels “very weak.” Temperature is 38.6°C (101.5°F),
and the neutrophil count is critically low.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Administer acetaminophen and reassess the temperature in
1 hour.
B. Obtain blood cultures and prepare to start broad-spectrum IV
antibiotics promptly.
C. Encourage the patient to increase oral fluid intake and rest.
D. Place the patient on droplet precautions.
Correct Answer:
B
Detailed Rationale:
Fever in a neutropenic patient is a medical emergency because
it may be the only sign of life-threatening infection. The nurse
should obtain cultures and initiate the facility’s neutropenic
,fever protocol, which typically includes rapid broad-spectrum
antibiotics. Delays increase risk for sepsis.
Incorrect Option Analysis:
A: Antipyretics may mask fever and delay treatment; this
reflects a misconception that symptom control is enough.
C: Supportive care is helpful, but it does not address the urgent
infection risk.
D: Droplet precautions are not the standard first response for
neutropenia; protective precautions and infection control
measures are more relevant.
Nursing Process Linkage: Implementation
NCJMM Competencies: Recognize Cues, Prioritize Hypotheses,
Take Action
Difficulty Level: Difficult
Bloom’s Level: Analyze
NCLEX Client Needs Category: Physiological Adaptation
Priority Nursing Diagnosis: Risk for Infection related to
neutropenia
Expected Outcome: The patient will receive cultures and
antibiotics within the institution’s urgent sepsis/neutropenic
fever timeline.
Key Learning Objective: Recognize and act on an oncologic
emergency.
, 2) SATA
Clinical Scenario:
A patient is being discharged after the first outpatient
chemotherapy treatment.
Question Stem:
Which instructions should the nurse include? Select all that
apply.
Answer Options:
A. Report a temperature of 38°C (100.4°F) or higher
immediately.
B. Use a soft-bristled toothbrush and avoid flossing if the gums
are sore or bleeding.
C. Expect nausea only if the infusion caused an allergic reaction.
D. Avoid crowds and people who are ill during periods of low
blood counts.
E. Take aspirin for mild bone pain unless the provider says
otherwise.
F. Check the skin over the infusion site for redness, swelling, or
pain.
Correct Answers:
A, B, D, F
