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 58-year-old patient is 10 days post-chemotherapy for
colorectal cancer. The patient reports a sore throat and chills.
The temperature is 38.3°C (101°F), heart rate is 112/min, and
absolute neutrophil count is 300/mm³.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Administer acetaminophen and reassess in 1 hour
B. Place the patient on protective precautions and notify the
oncology provider immediately
C. Encourage fresh fruits and vegetables to improve nutrition
D. Give the next chemotherapy dose as scheduled
Correct Answer:
B
Detailed Rationale:
This patient has neutropenic fever, which is an oncologic
emergency. The priority is to reduce infection exposure and
notify the provider immediately so cultures, empiric antibiotics,
and further evaluation can begin without delay.
,Incorrect Option Analysis:
A. Incorrect because fever in neutropenia must not be masked
or delayed; this can worsen sepsis risk.
Common misconception: treating the symptom instead of the
cause.
Patient safety: delays life-saving treatment.
C. Incorrect because raw produce may increase infection
exposure in immunocompromised patients.
Common misconception: assuming all healthy foods are safe
during neutropenia.
D. Incorrect because chemotherapy would typically be held
during suspected infection or severe neutropenia.
Common misconception: routine treatment continues despite
urgent complications.
Nursing Process Linkage: Assessment / Implementation
NCJMM Competencies: Recognize Cues; Prioritize Hypotheses;
Take Action
Difficulty Level: Difficult
Bloom’s Level: Analyze
NCLEX Client Needs Category: Physiological Adaptation
Nursing Diagnosis Integration:
Priority Nursing Diagnosis: Risk for Infection / possible infection
Risk Factors: Severe neutropenia, mucosal irritation, recent
chemotherapy
, Expected Outcome: The patient receives prompt sepsis
evaluation and remains hemodynamically stable with no
progression of infection.
Key Learning Objective: Prioritize urgent interventions for
immunocompromised patients with fever.
2) MCQ — Cancer Care
Clinical Scenario:
A patient receiving radiation therapy for breast cancer reports
dry, red skin over the treatment field and says the area is itchy.
Question Stem:
Which instruction should the nurse include in the teaching
plan?
Answer Options:
A. Apply a heating pad to reduce itching
B. Wash the area with mild soap and lukewarm water, then pat
dry
C. Scrub the area with a washcloth twice daily
D. Apply adhesive dressings to protect the skin
Correct Answer:
B
Detailed Rationale:
Radiation skin care should be gentle. Mild soap, lukewarm
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 58-year-old patient is 10 days post-chemotherapy for
colorectal cancer. The patient reports a sore throat and chills.
The temperature is 38.3°C (101°F), heart rate is 112/min, and
absolute neutrophil count is 300/mm³.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Administer acetaminophen and reassess in 1 hour
B. Place the patient on protective precautions and notify the
oncology provider immediately
C. Encourage fresh fruits and vegetables to improve nutrition
D. Give the next chemotherapy dose as scheduled
Correct Answer:
B
Detailed Rationale:
This patient has neutropenic fever, which is an oncologic
emergency. The priority is to reduce infection exposure and
notify the provider immediately so cultures, empiric antibiotics,
and further evaluation can begin without delay.
,Incorrect Option Analysis:
A. Incorrect because fever in neutropenia must not be masked
or delayed; this can worsen sepsis risk.
Common misconception: treating the symptom instead of the
cause.
Patient safety: delays life-saving treatment.
C. Incorrect because raw produce may increase infection
exposure in immunocompromised patients.
Common misconception: assuming all healthy foods are safe
during neutropenia.
D. Incorrect because chemotherapy would typically be held
during suspected infection or severe neutropenia.
Common misconception: routine treatment continues despite
urgent complications.
Nursing Process Linkage: Assessment / Implementation
NCJMM Competencies: Recognize Cues; Prioritize Hypotheses;
Take Action
Difficulty Level: Difficult
Bloom’s Level: Analyze
NCLEX Client Needs Category: Physiological Adaptation
Nursing Diagnosis Integration:
Priority Nursing Diagnosis: Risk for Infection / possible infection
Risk Factors: Severe neutropenia, mucosal irritation, recent
chemotherapy
, Expected Outcome: The patient receives prompt sepsis
evaluation and remains hemodynamically stable with no
progression of infection.
Key Learning Objective: Prioritize urgent interventions for
immunocompromised patients with fever.
2) MCQ — Cancer Care
Clinical Scenario:
A patient receiving radiation therapy for breast cancer reports
dry, red skin over the treatment field and says the area is itchy.
Question Stem:
Which instruction should the nurse include in the teaching
plan?
Answer Options:
A. Apply a heating pad to reduce itching
B. Wash the area with mild soap and lukewarm water, then pat
dry
C. Scrub the area with a washcloth twice daily
D. Apply adhesive dressings to protect the skin
Correct Answer:
B
Detailed Rationale:
Radiation skin care should be gentle. Mild soap, lukewarm
