Question 1: A patient is diagnosed with acute myelogenous leukemia (AML). The nurse
understands that the pathophysiology of this disease involves:
A. Overproduction of mature, functional white blood cells.
B. Uncontrolled proliferation of immature myeloid cells in the bone marrow.
C. A deficiency of all blood cell types due to bone marrow failure.
D. The presence of the Philadelphia chromosome.
CORRECT ANSWER: B. Uncontrolled proliferation of immature myeloid cells in the
bone marrow.
Rationale: AML is characterized by the rapid proliferation of immature myeloid cells
(myeloblasts) in the bone marrow, which interferes with normal hematopoiesis.
Question 2: The nurse is caring for a patient receiving cisplatin chemotherapy. Which
adverse e ect is most specifically associated with this medication?
A. Cardiotoxicity
B. Nephrotoxicity
C. Pulmonary fibrosis
D. Peripheral neuropathy
CORRECT ANSWER: B. Nephrotoxicity.
Rationale: Cisplatin is a platinum-based chemotherapy agent that is highly
nephrotoxic. Aggressive hydration and pre-treatment with mannitol are often used to
mitigate this e ect.
Question 3: A patient receiving doxorubicin (Adriamycin) is at risk for which serious,
dose-limiting adverse e ect?
A. Nephrotoxicity
B. Ototoxicity
C. Cardiotoxicity
D. Hepatotoxicity
CORRECT ANSWER: C. Cardiotoxicity.
Rationale: Doxorubicin is an anthracycline antibiotic that is associated with a risk of
cumulative, dose-related cardiotoxicity, which can lead to cardiomyopathy and heart
failure.
,Question 4: The nurse is providing education to a patient starting tamoxifen for
hormone receptor-positive breast cancer. Which side e ect should the nurse discuss
with the patient?
A. Hot flashes and increased risk of thromboembolism
B. Alopecia and nausea
C. Cardiotoxicity and nephrotoxicity
D. Neuropathy and myelosuppression
CORRECT ANSWER: A. Hot flashes and increased risk of thromboembolism.
Rationale: Tamoxifen is a selective estrogen receptor modulator (SERM). Common side
e ects include hot flashes, vaginal discharge, and an increased risk of deep vein
thrombosis (DVT) and pulmonary embolism.
Question 5: A patient with leukemia is undergoing chemotherapy and develops tumor
lysis syndrome (TLS). The nurse should monitor for which laboratory finding?
A. Hypokalemia
B. Hypophosphatemia
C. Hyperuricemia
D. Hypercalcemia
CORRECT ANSWER: C. Hyperuricemia.
Rationale: Tumor lysis syndrome is a metabolic emergency characterized by
hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia, resulting from
the rapid breakdown of tumor cells.
Question 6: The nurse is caring for a patient who is receiving radiation therapy for a
brain tumor. Which side e ect is most specific to cranial radiation?
A. Skin desquamation
B. Alopecia
C. Mucositis
D. Cystitis
CORRECT ANSWER: B. Alopecia.
Rationale: Cranial radiation causes hair loss (alopecia) in the radiation field. This is a
common and distressing side e ect for patients receiving brain radiation.
,Question 7: A patient is diagnosed with chronic lymphocytic leukemia (CLL). The nurse
understands that this malignancy is characterized by:
A. The overproduction of immature myeloid cells.
B. The accumulation of mature-appearing, but dysfunctional, B-lymphocytes.
C. A Philadelphia chromosome translocation.
D. The presence of Reed-Sternberg cells.
CORRECT ANSWER: B. The accumulation of mature-appearing, but dysfunctional,
B-lymphocytes.
Rationale: CLL is characterized by the clonal proliferation and accumulation of mature-
appearing, but immunologically incompetent, B-lymphocytes in the blood, bone
marrow, and lymphoid tissues.
Question 8: A patient is receiving trastuzumab (Herceptin) for HER2-positive breast
cancer. Before each dose, the nurse should monitor which parameter?
A. Serum creatinine
B. Liver function tests
C. Left ventricular ejection fraction (LVEF)
D. Complete blood count (CBC)
CORRECT ANSWER: C. Left ventricular ejection fraction (LVEF).
Rationale: Trastuzumab is a monoclonal antibody that can cause cardiotoxicity.
Baseline and periodic monitoring of LVEF is essential.
Question 9: The nurse is caring for a patient with neutropenia following chemotherapy.
Which of the following is the priority nursing intervention?
A. Administering prophylactic antibiotics.
B. Restricting visitors and fresh flowers.
C. Monitoring for signs of infection and performing meticulous hand hygiene.
D. Administering colony-stimulating factors (e.g., filgrastim).
CORRECT ANSWER: C. Monitoring for signs of infection and performing meticulous
hand hygiene.
Rationale: The priority in neutropenia is infection prevention. Meticulous hand hygiene
is the single most important measure.
, Question 10: A patient is receiving chemotherapy and develops a fever of 101.5°F
(38.6°C). The nurse's priority action is to:
A. Administer acetaminophen.
B. Obtain a blood culture and notify the healthcare provider.
C. Apply a cool compress.
D. Encourage oral fluids.
CORRECT ANSWER: B. Obtain a blood culture and notify the healthcare provider.
Rationale: In a neutropenic patient, a fever is a sign of a possible life-threatening
infection and requires immediate evaluation and treatment with broad-spectrum
antibiotics.
Question 11: The nurse is teaching a patient who is receiving an alkylating agent about
the risk of hemorrhagic cystitis. Which medication is often given concurrently to prevent
this complication?
A. Mesna
B. Leucovorin
C. Dexrazoxane
D. Filgrastim
CORRECT ANSWER: A. Mesna.
Rationale: Mesna is a uroprotective agent that binds to the toxic metabolites of
alkylating agents (like cyclophosphamide and ifosfamide) in the bladder, preventing
hemorrhagic cystitis.
Question 12: A patient with stage IV breast cancer is receiving palliative care. The nurse
understands that the primary goal of palliative care is to:
A. Cure the disease.
B. Prolong life at all costs.
C. Improve the patient's quality of life and manage symptoms.
D. Provide care only at the end of life.
CORRECT ANSWER: C. Improve the patient's quality of life and manage symptoms.
Rationale: Palliative care is a multidisciplinary approach that focuses on improving
quality of life and managing symptoms for patients with serious illnesses, regardless of
the stage of the disease.
understands that the pathophysiology of this disease involves:
A. Overproduction of mature, functional white blood cells.
B. Uncontrolled proliferation of immature myeloid cells in the bone marrow.
C. A deficiency of all blood cell types due to bone marrow failure.
D. The presence of the Philadelphia chromosome.
CORRECT ANSWER: B. Uncontrolled proliferation of immature myeloid cells in the
bone marrow.
Rationale: AML is characterized by the rapid proliferation of immature myeloid cells
(myeloblasts) in the bone marrow, which interferes with normal hematopoiesis.
Question 2: The nurse is caring for a patient receiving cisplatin chemotherapy. Which
adverse e ect is most specifically associated with this medication?
A. Cardiotoxicity
B. Nephrotoxicity
C. Pulmonary fibrosis
D. Peripheral neuropathy
CORRECT ANSWER: B. Nephrotoxicity.
Rationale: Cisplatin is a platinum-based chemotherapy agent that is highly
nephrotoxic. Aggressive hydration and pre-treatment with mannitol are often used to
mitigate this e ect.
Question 3: A patient receiving doxorubicin (Adriamycin) is at risk for which serious,
dose-limiting adverse e ect?
A. Nephrotoxicity
B. Ototoxicity
C. Cardiotoxicity
D. Hepatotoxicity
CORRECT ANSWER: C. Cardiotoxicity.
Rationale: Doxorubicin is an anthracycline antibiotic that is associated with a risk of
cumulative, dose-related cardiotoxicity, which can lead to cardiomyopathy and heart
failure.
,Question 4: The nurse is providing education to a patient starting tamoxifen for
hormone receptor-positive breast cancer. Which side e ect should the nurse discuss
with the patient?
A. Hot flashes and increased risk of thromboembolism
B. Alopecia and nausea
C. Cardiotoxicity and nephrotoxicity
D. Neuropathy and myelosuppression
CORRECT ANSWER: A. Hot flashes and increased risk of thromboembolism.
Rationale: Tamoxifen is a selective estrogen receptor modulator (SERM). Common side
e ects include hot flashes, vaginal discharge, and an increased risk of deep vein
thrombosis (DVT) and pulmonary embolism.
Question 5: A patient with leukemia is undergoing chemotherapy and develops tumor
lysis syndrome (TLS). The nurse should monitor for which laboratory finding?
A. Hypokalemia
B. Hypophosphatemia
C. Hyperuricemia
D. Hypercalcemia
CORRECT ANSWER: C. Hyperuricemia.
Rationale: Tumor lysis syndrome is a metabolic emergency characterized by
hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia, resulting from
the rapid breakdown of tumor cells.
Question 6: The nurse is caring for a patient who is receiving radiation therapy for a
brain tumor. Which side e ect is most specific to cranial radiation?
A. Skin desquamation
B. Alopecia
C. Mucositis
D. Cystitis
CORRECT ANSWER: B. Alopecia.
Rationale: Cranial radiation causes hair loss (alopecia) in the radiation field. This is a
common and distressing side e ect for patients receiving brain radiation.
,Question 7: A patient is diagnosed with chronic lymphocytic leukemia (CLL). The nurse
understands that this malignancy is characterized by:
A. The overproduction of immature myeloid cells.
B. The accumulation of mature-appearing, but dysfunctional, B-lymphocytes.
C. A Philadelphia chromosome translocation.
D. The presence of Reed-Sternberg cells.
CORRECT ANSWER: B. The accumulation of mature-appearing, but dysfunctional,
B-lymphocytes.
Rationale: CLL is characterized by the clonal proliferation and accumulation of mature-
appearing, but immunologically incompetent, B-lymphocytes in the blood, bone
marrow, and lymphoid tissues.
Question 8: A patient is receiving trastuzumab (Herceptin) for HER2-positive breast
cancer. Before each dose, the nurse should monitor which parameter?
A. Serum creatinine
B. Liver function tests
C. Left ventricular ejection fraction (LVEF)
D. Complete blood count (CBC)
CORRECT ANSWER: C. Left ventricular ejection fraction (LVEF).
Rationale: Trastuzumab is a monoclonal antibody that can cause cardiotoxicity.
Baseline and periodic monitoring of LVEF is essential.
Question 9: The nurse is caring for a patient with neutropenia following chemotherapy.
Which of the following is the priority nursing intervention?
A. Administering prophylactic antibiotics.
B. Restricting visitors and fresh flowers.
C. Monitoring for signs of infection and performing meticulous hand hygiene.
D. Administering colony-stimulating factors (e.g., filgrastim).
CORRECT ANSWER: C. Monitoring for signs of infection and performing meticulous
hand hygiene.
Rationale: The priority in neutropenia is infection prevention. Meticulous hand hygiene
is the single most important measure.
, Question 10: A patient is receiving chemotherapy and develops a fever of 101.5°F
(38.6°C). The nurse's priority action is to:
A. Administer acetaminophen.
B. Obtain a blood culture and notify the healthcare provider.
C. Apply a cool compress.
D. Encourage oral fluids.
CORRECT ANSWER: B. Obtain a blood culture and notify the healthcare provider.
Rationale: In a neutropenic patient, a fever is a sign of a possible life-threatening
infection and requires immediate evaluation and treatment with broad-spectrum
antibiotics.
Question 11: The nurse is teaching a patient who is receiving an alkylating agent about
the risk of hemorrhagic cystitis. Which medication is often given concurrently to prevent
this complication?
A. Mesna
B. Leucovorin
C. Dexrazoxane
D. Filgrastim
CORRECT ANSWER: A. Mesna.
Rationale: Mesna is a uroprotective agent that binds to the toxic metabolites of
alkylating agents (like cyclophosphamide and ifosfamide) in the bladder, preventing
hemorrhagic cystitis.
Question 12: A patient with stage IV breast cancer is receiving palliative care. The nurse
understands that the primary goal of palliative care is to:
A. Cure the disease.
B. Prolong life at all costs.
C. Improve the patient's quality of life and manage symptoms.
D. Provide care only at the end of life.
CORRECT ANSWER: C. Improve the patient's quality of life and manage symptoms.
Rationale: Palliative care is a multidisciplinary approach that focuses on improving
quality of life and managing symptoms for patients with serious illnesses, regardless of
the stage of the disease.
