NURS 265 Exam 4 Study Guide
Questions with Correct Answers
The nurse has become aware of the following client situations. The nurse should first
see the client who is receiving
- external beam radiation therapy (EBRT) and is ambulating in the corridor with a visitor.
- IV chemotherapy has a white blood cell (WBC) count of 2,000 mm° and has developed
lethargy and purulent drainage from the central venous catheter site.
- brachytherapy for the treatment of cervical cancer and is reporting the development of
altered taste sensation and fatigue.
- oral chemotherapy has stomatitis and needs to have the peripherally inserted central
catheter (PICC) flushed. - Answer-IV chemotherapy has a white blood cell (WBC) count
of 2,000 mm° and has developed lethargy and purulent drainage from the central
venous catheter site.
The charge nurse is observing a newly hired nurse care for a client who has laryngeal
cancer and had a total laryngectomy 12 hours ago. Which of the following interventions
by the newly hired nurse requires follow-up by the charge nurse?
- Providing preprinted flashcards for communication
- Keeping the head of bed (HOB) elevated to enhance comfort.
- Applying humidified oxygen to the client's tracheostomy.
- Monitoring tissue flap integrity via Doppler every 2 hours. - Answer-Monitoring tissue
flap integrity via Doppler every 2 hours.
The nurse is caring for a client who is receiving radiation therapy and chemotherapy
and has developed tumor lysis syndrome (TLS). Which of the following actions should
the nurse take?
- Monitor the client's serum creatinine levels.
- Instruct the client to cough and deep breathe every hour.
- Initiate a high-potassium diet.
- Encourage the client to maintain bed rest. - Answer-Monitor the client's serum
creatinine levels.
The nurse is caring for a client who has cancer, has developed a spinal cord
compression, and is receiving high-dose corticosteroid therapy. Which of the following
additional treatment options should the nurse anticipate will be prescribed to alleviate
the client's symptoms?
- A fentanyl transdermal patch.
- Lumbar puncture.
- High-dose radiation therapy.
, - Buck's traction. - Answer-- High-dose radiation therapy.
The nurse is caring for a client who is receiving chemotherapy. Which of the following
findings alerts the nurse to the possibility that the client is developing disseminated
intravascular coagulation (DIC)?
- A platelet count of 150.000 mm.
- The development of paresthesia of upper extremities
- The development of petechiae on the anterior chest.
- A partial thromboplastin time (PTT) of 12 seconds. - Answer-The development of
petechiae on the anterior chest.
The nurse is caring for a client who has bone metastasis and has developed
hypercalcemia. Which medications from the box below should the nurse be prepared to
administer to lower the client's calcium level?
1. VitaminD
2. Calcitonin
3. Furosemide
4. NormalSaline
5. MagnesiumSulfate
6. Hydrochlorothiazide - Answer-2. Calcitonin
3. Furosemide
4. Normal Saline
The nurse is assessing a client who is suspected of having superior vena cava
syndrome (SVCS). Which of the following findings is consistent with this diagnosis?
- Swelling around the client's ankles upon awakening.
- Engorged blood vessels noted on the upper chest and arms.
- A blood pressure that is higher in one arm when compared to the other.
- The presence of enlarged lymph nodes in the client's axilla. - Answer-Engorged blood
vessels were noted on the upper chest and arms.
The nurse is caring for a male client who has a diagnosis of advanced oral cancer and
has had extensive surgery. Which of the following client statements indicates that the
diagnosis has been accepted?
- "I will be a better husband and father if I can just get through this."
- "When this is all over with, I'm taking my family on a big vacation."
- "The biopsy test results will be confirmed again next week."
- "I need to call my children to come home from college for a visit.". - Answer-"I need to
call my children to come home from college for a visit.".
The nurse is caring for a client who was recently diagnosed with metastatic breast
cancer. The client is a 40-year-old female who is a single parent of 4 school-aged
children. Upon entering the client's room, the client states to the nurse, "I'm so worried
about what will happen to my children after I die." Which of the following responses is
appropriate for the nurse to make?
- "It can be helpful for you to focus on the things that you can control right now."
Questions with Correct Answers
The nurse has become aware of the following client situations. The nurse should first
see the client who is receiving
- external beam radiation therapy (EBRT) and is ambulating in the corridor with a visitor.
- IV chemotherapy has a white blood cell (WBC) count of 2,000 mm° and has developed
lethargy and purulent drainage from the central venous catheter site.
- brachytherapy for the treatment of cervical cancer and is reporting the development of
altered taste sensation and fatigue.
- oral chemotherapy has stomatitis and needs to have the peripherally inserted central
catheter (PICC) flushed. - Answer-IV chemotherapy has a white blood cell (WBC) count
of 2,000 mm° and has developed lethargy and purulent drainage from the central
venous catheter site.
The charge nurse is observing a newly hired nurse care for a client who has laryngeal
cancer and had a total laryngectomy 12 hours ago. Which of the following interventions
by the newly hired nurse requires follow-up by the charge nurse?
- Providing preprinted flashcards for communication
- Keeping the head of bed (HOB) elevated to enhance comfort.
- Applying humidified oxygen to the client's tracheostomy.
- Monitoring tissue flap integrity via Doppler every 2 hours. - Answer-Monitoring tissue
flap integrity via Doppler every 2 hours.
The nurse is caring for a client who is receiving radiation therapy and chemotherapy
and has developed tumor lysis syndrome (TLS). Which of the following actions should
the nurse take?
- Monitor the client's serum creatinine levels.
- Instruct the client to cough and deep breathe every hour.
- Initiate a high-potassium diet.
- Encourage the client to maintain bed rest. - Answer-Monitor the client's serum
creatinine levels.
The nurse is caring for a client who has cancer, has developed a spinal cord
compression, and is receiving high-dose corticosteroid therapy. Which of the following
additional treatment options should the nurse anticipate will be prescribed to alleviate
the client's symptoms?
- A fentanyl transdermal patch.
- Lumbar puncture.
- High-dose radiation therapy.
, - Buck's traction. - Answer-- High-dose radiation therapy.
The nurse is caring for a client who is receiving chemotherapy. Which of the following
findings alerts the nurse to the possibility that the client is developing disseminated
intravascular coagulation (DIC)?
- A platelet count of 150.000 mm.
- The development of paresthesia of upper extremities
- The development of petechiae on the anterior chest.
- A partial thromboplastin time (PTT) of 12 seconds. - Answer-The development of
petechiae on the anterior chest.
The nurse is caring for a client who has bone metastasis and has developed
hypercalcemia. Which medications from the box below should the nurse be prepared to
administer to lower the client's calcium level?
1. VitaminD
2. Calcitonin
3. Furosemide
4. NormalSaline
5. MagnesiumSulfate
6. Hydrochlorothiazide - Answer-2. Calcitonin
3. Furosemide
4. Normal Saline
The nurse is assessing a client who is suspected of having superior vena cava
syndrome (SVCS). Which of the following findings is consistent with this diagnosis?
- Swelling around the client's ankles upon awakening.
- Engorged blood vessels noted on the upper chest and arms.
- A blood pressure that is higher in one arm when compared to the other.
- The presence of enlarged lymph nodes in the client's axilla. - Answer-Engorged blood
vessels were noted on the upper chest and arms.
The nurse is caring for a male client who has a diagnosis of advanced oral cancer and
has had extensive surgery. Which of the following client statements indicates that the
diagnosis has been accepted?
- "I will be a better husband and father if I can just get through this."
- "When this is all over with, I'm taking my family on a big vacation."
- "The biopsy test results will be confirmed again next week."
- "I need to call my children to come home from college for a visit.". - Answer-"I need to
call my children to come home from college for a visit.".
The nurse is caring for a client who was recently diagnosed with metastatic breast
cancer. The client is a 40-year-old female who is a single parent of 4 school-aged
children. Upon entering the client's room, the client states to the nurse, "I'm so worried
about what will happen to my children after I die." Which of the following responses is
appropriate for the nurse to make?
- "It can be helpful for you to focus on the things that you can control right now."
