N316B Week 4 Questions With 100% Verified
Answers!!
1) A client is receiving chemotherapy with doxorubicin. Which development will the nurse
teach the client to report immediately?
A. Nausea
B. Sore throat
C. Loss of hair
D. Constipation
B. Sore Throat
A sore throat is indicative of a respiratory tract infection, which may be the first clinical sign of
bone marrow suppression, which can be life-threatening. Nausea is an expected side effect of
doxorubicin, but it is not life-threatening. Hair loss is not a side effect of doxorubicin but,
regardless, is not life-threatening. Constipation is an expected side effect of doxorubicin, but it is
not life-threatening.
2) A complete blood count is prescribed before each round of a client's cancer
chemotherapy. Which component of the complete blood count is of greatest concern to the
nurse?
A. Platelets
B. Hematocrit
C. Red blood cells (RBCs)
D. White blood cells (WBCs)
D. White blood cells (WBCs)
Antineoplastic medications depress bone marrow, which causes leukopenia; the client must be
protected from infection, which can be life-threatening. RBCs diminish slowly
and can be replaced with a transfusion of packed RBCs. Platelets decrease as rapidly asWBCs,
but complications can be limited with infusions of platelets.
,3) Which systemic side effect would the nurse monitor for in a client receiving combination
chemotherapy for the treatment of metastatic carcinoma?
A. Ascites
B. Nystagmus
C. Leukopenia
D. Polycythemia
C. Leukopenia
Leukopenia, a reduction in white blood cells, is a systemic effect of chemotherapy as a result of
myelosuppression. Ascites is not a side effect of chemotherapy. Chemotherapy does not affect
the eyes; nystagmus is an involuntary, rapid rhythmic movement of the eyeballs. Also,
nystagmus is a local, not a systemic, response. The red blood cells will be decreased, not
increased.
4) A client with laryngeal cancer is receiving chemotherapy. Which laboratory report is
most important for the nurse to monitor when considering the effects of chemotherapy?
A. Platelets
B. Hemoglobin level
C. Red blood cell count
D. White blood cell count
D. White blood cell count
Antineoplastic medications depress bone marrow, which results in leukopenia; the client must be
protected from infection, which is a primary cause of death in the client with cancer. Platelets
may decrease rapidly, but complications may be limited by infusions of platelets. Although the
hemoglobin level diminishes, a transfusion with packed red blood cells (PRBCs) will alleviate
the anemia. RBCs diminish slowly and maybe replaced with a transfusion of PRBCs.
5) A client with multiple myeloma who is receiving the alkylating agent melphalan returns
to the oncology clinic for a follow-up visit. For which adverse effect will the nurse monitor
the client?
A. Hirsutism
,B. Leukopenia
C. Constipation
D. Photosensitivity
B. Leukopenia
Melphalan depresses the bone marrow, causing a reduction in white blood cells(leukopenia), red
blood cells (anemia), and thrombocytes (thrombocytopenia);leukopenia increases the risk of
infection. Hirsutism occurs with the administration of androgens to women. Diarrhea, not
constipation, occurs with melphalan. Photosensitivity occurs with 5-fluorouracil, floxuridine, and
methotrexate, not with melphalan.
6) A client receiving cancer chemotherapy asks the nurse why an antibiotic was prescribed.
Which tissue affected by chemotherapy will the nurse consider when formulating a
response?
A. Liver
B. Blood
C. Bone marrow
D. Lymph nodes
C. Bone marrow
Prolonged chemotherapy may slow production of leukocytes in bone marrow, thus suppressing
the immune system. Antibiotics may be required to help counter infections that the body can no
longer handle easily. The liver does not produce leukocytes.Although leukocytes are in both
blood and lymph nodes, these cells are more mature than those found in the bone marrow and
thus are more resistant to the effects of chemotherapy.
7) A client is receiving combination chemotherapy for the treatment of
metastaticcarcinoma. For which systemic side effect would the nurse monitor the client?
A. Ascites
B. Nystagmus
C. Leukopenia
D. Polycythemia
, C. Leukopenia
Leukopenia, a reduction in white blood cells, is a systemic effect of chemotherapy as a result of
myelosuppression. Ascites is not a side effect of chemotherapy. Chemotherapy does not affect
the eyes; nystagmus is an involuntary, rapid rhythmic movement of theeyeballs. Also, nystagmus
is a local, not a systemic, response. The red blood cells will be decreased, not increased.
8) An adolescent is prescribed an antineoplastic agent. Which instruction would the nurse
give to the parents before discharge?
A. Limit contact with all peers and family members.
B. Withhold medications when nausea occurs to prevent vomiting.
C. Schedule laboratory blood tests to evaluate response to the medication.
D. Return weekly for a bone marrow aspiration to monitor effectiveness of therapy
C. Schedule laboratory blood tests to evaluate response to the medication.
Blood tests indicate response to therapy; if the white blood cell count drops precipitously,
therapy may be halted temporarily. Children undergo therapy for extended periods, and
prolonged separation from their peers may lead to social isolation. Contact with children who
have active infections should be avoided. Although nausea commonly occurs with this therapy,
antiemetic measures are instituted; the medication is not withdrawn for this reason. A bone
marrow aspiration is a painful procedure and is performed selectively (e.g., to confirm the
diagnosis), not routinely
9) The nurse is caring for a client who recently received an allogeneic bone marrow
transplant for the treatment of leukemia. Which nursing intervention is a priority for this
client?
A. Provide education on infection prevention in the community
B. Assist the client with ambulation every 2 hours
C. Monitor the client for signs of infection
D. Introduce the client to another bone marrow recipient
C. Monitor the client for signs of infection
Answers!!
1) A client is receiving chemotherapy with doxorubicin. Which development will the nurse
teach the client to report immediately?
A. Nausea
B. Sore throat
C. Loss of hair
D. Constipation
B. Sore Throat
A sore throat is indicative of a respiratory tract infection, which may be the first clinical sign of
bone marrow suppression, which can be life-threatening. Nausea is an expected side effect of
doxorubicin, but it is not life-threatening. Hair loss is not a side effect of doxorubicin but,
regardless, is not life-threatening. Constipation is an expected side effect of doxorubicin, but it is
not life-threatening.
2) A complete blood count is prescribed before each round of a client's cancer
chemotherapy. Which component of the complete blood count is of greatest concern to the
nurse?
A. Platelets
B. Hematocrit
C. Red blood cells (RBCs)
D. White blood cells (WBCs)
D. White blood cells (WBCs)
Antineoplastic medications depress bone marrow, which causes leukopenia; the client must be
protected from infection, which can be life-threatening. RBCs diminish slowly
and can be replaced with a transfusion of packed RBCs. Platelets decrease as rapidly asWBCs,
but complications can be limited with infusions of platelets.
,3) Which systemic side effect would the nurse monitor for in a client receiving combination
chemotherapy for the treatment of metastatic carcinoma?
A. Ascites
B. Nystagmus
C. Leukopenia
D. Polycythemia
C. Leukopenia
Leukopenia, a reduction in white blood cells, is a systemic effect of chemotherapy as a result of
myelosuppression. Ascites is not a side effect of chemotherapy. Chemotherapy does not affect
the eyes; nystagmus is an involuntary, rapid rhythmic movement of the eyeballs. Also,
nystagmus is a local, not a systemic, response. The red blood cells will be decreased, not
increased.
4) A client with laryngeal cancer is receiving chemotherapy. Which laboratory report is
most important for the nurse to monitor when considering the effects of chemotherapy?
A. Platelets
B. Hemoglobin level
C. Red blood cell count
D. White blood cell count
D. White blood cell count
Antineoplastic medications depress bone marrow, which results in leukopenia; the client must be
protected from infection, which is a primary cause of death in the client with cancer. Platelets
may decrease rapidly, but complications may be limited by infusions of platelets. Although the
hemoglobin level diminishes, a transfusion with packed red blood cells (PRBCs) will alleviate
the anemia. RBCs diminish slowly and maybe replaced with a transfusion of PRBCs.
5) A client with multiple myeloma who is receiving the alkylating agent melphalan returns
to the oncology clinic for a follow-up visit. For which adverse effect will the nurse monitor
the client?
A. Hirsutism
,B. Leukopenia
C. Constipation
D. Photosensitivity
B. Leukopenia
Melphalan depresses the bone marrow, causing a reduction in white blood cells(leukopenia), red
blood cells (anemia), and thrombocytes (thrombocytopenia);leukopenia increases the risk of
infection. Hirsutism occurs with the administration of androgens to women. Diarrhea, not
constipation, occurs with melphalan. Photosensitivity occurs with 5-fluorouracil, floxuridine, and
methotrexate, not with melphalan.
6) A client receiving cancer chemotherapy asks the nurse why an antibiotic was prescribed.
Which tissue affected by chemotherapy will the nurse consider when formulating a
response?
A. Liver
B. Blood
C. Bone marrow
D. Lymph nodes
C. Bone marrow
Prolonged chemotherapy may slow production of leukocytes in bone marrow, thus suppressing
the immune system. Antibiotics may be required to help counter infections that the body can no
longer handle easily. The liver does not produce leukocytes.Although leukocytes are in both
blood and lymph nodes, these cells are more mature than those found in the bone marrow and
thus are more resistant to the effects of chemotherapy.
7) A client is receiving combination chemotherapy for the treatment of
metastaticcarcinoma. For which systemic side effect would the nurse monitor the client?
A. Ascites
B. Nystagmus
C. Leukopenia
D. Polycythemia
, C. Leukopenia
Leukopenia, a reduction in white blood cells, is a systemic effect of chemotherapy as a result of
myelosuppression. Ascites is not a side effect of chemotherapy. Chemotherapy does not affect
the eyes; nystagmus is an involuntary, rapid rhythmic movement of theeyeballs. Also, nystagmus
is a local, not a systemic, response. The red blood cells will be decreased, not increased.
8) An adolescent is prescribed an antineoplastic agent. Which instruction would the nurse
give to the parents before discharge?
A. Limit contact with all peers and family members.
B. Withhold medications when nausea occurs to prevent vomiting.
C. Schedule laboratory blood tests to evaluate response to the medication.
D. Return weekly for a bone marrow aspiration to monitor effectiveness of therapy
C. Schedule laboratory blood tests to evaluate response to the medication.
Blood tests indicate response to therapy; if the white blood cell count drops precipitously,
therapy may be halted temporarily. Children undergo therapy for extended periods, and
prolonged separation from their peers may lead to social isolation. Contact with children who
have active infections should be avoided. Although nausea commonly occurs with this therapy,
antiemetic measures are instituted; the medication is not withdrawn for this reason. A bone
marrow aspiration is a painful procedure and is performed selectively (e.g., to confirm the
diagnosis), not routinely
9) The nurse is caring for a client who recently received an allogeneic bone marrow
transplant for the treatment of leukemia. Which nursing intervention is a priority for this
client?
A. Provide education on infection prevention in the community
B. Assist the client with ambulation every 2 hours
C. Monitor the client for signs of infection
D. Introduce the client to another bone marrow recipient
C. Monitor the client for signs of infection
