ONCOLOGY UPDATED SCRIPTED EXAM QUESTIONS AND
ANSWERS MARKED A+
✔✔A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and
the nurse is aware that a significant side effect of this medication is thrombocytopenia.
Which symptom should the nurse assess for in patients at risk for thrombocytopenia?
A)Interrupted sleep pattern
B)Hot flashes
C)Epistaxis (nose bleed)
D)Increased weight - ✔✔C - Patients with thrombocytopenia are at risk for bleeding due
to decreased platelet counts. Patients with thrombocytopenia do not exhibit interrupted
sleep pattern, hot flashes, or increased weight.
✔✔The nurse is orienting a new nurse to the oncology unit. When reviewing the safe
administration of antineoplastic agents, what action should the nurse emphasize?
A)Adjust the dose to the patients present symptoms.
B)Wash hands with an alcohol-based cleanser following administration.
C)Use gloves and a lab coat when preparing the medication.
D)Dispose of the antineoplastic wastes in the hazardous waste receptacle. - ✔✔D - The
nurse should use surgical gloves and disposable long-sleeved gowns when
administering antineoplastic agents. The antineoplastic wastes are disposed of as
hazardous materials. Dosages are not adjusted on a short-term basis. Hand and arm
hygiene must be performed before and after administering the medication.
✔✔A nurse provides care on a bone marrow transplant unit and is preparing a female
patient for a hematopoietic stem cell transplantation (HSCT) the following day. What
information should the nurse emphasize to the patients family and friends?
A)Your family should likely gather at the bedside in case theres a negative outcome.
B)Make sure she doesnt eat any food in the 24 hours before the procedure.
C)Wear a hospital gown when you go into the patients room.
D)Do not visit if youve had a recent infection. - ✔✔D - Before HSCT, patients are at a
high risk for infection, sepsis, and bleeding. Visitors should not visit if they have had a
recent illness or vaccination. Gowns should indeed be worn, but this is secondary in
importance to avoiding the patients contact with ill visitors. Prolonged fasting is
unnecessary. Negative outcomes are possible, but the procedure would not normally be
so risky as to require the family to gather at the bedside.
✔✔A nurse is creating a plan of care for an oncology patient and one of the identified
nursing diagnoses is risk for infection related to myelosuppression. What intervention
addresses the leading cause of infection-related death in oncology patients?
A)Encourage several small meals daily.
B)Provide skin care to maintain skin integrity.
C)Assist the patient with hygiene, as needed.
D)Assess the integrity of the patients oral mucosa regularly. - ✔✔B - Nursing care for
patients with skin reactions includes maintaining skin integrity, cleansing the skin,
,promoting comfort, reducing pain, preventing additional trauma, and preventing and
managing infection. Malnutrition in oncology patients may be present, but it is not the
leading cause of infection-related death. Poor hygiene does not normally cause events
that result in death. Broken oral mucosa may be an avenue for infection, but it is not the
leading cause of death in an oncology patient.
✔✔You are caring for an adult patient who has developed a mild oral yeast infection
following chemotherapy. What actions should you encourage the patient to perform?
Select all that apply.
A)Use a lip lubricant.
B)Scrub the tongue with a firm-bristled toothbrush.
C)Use dental floss every 24 hours.
D)Rinse the mouth with normal saline.
E)Eat spicy food to aid in eradicating the yeast. - ✔✔A,C,D - Stomatitis is an
inflammation of the oral cavity. The patient should be encouraged to brush the teeth
with a soft toothbrush after meals, use dental floss every 24 hours, rinse with normal
saline, and use a lip lubricant. Mouthwashes and hot foods should be avoided.
✔✔The nurse on a bone marrow transplant unit is caring for a patient with cancer who
is preparing for HSCT. What is a priority nursing diagnosis for this patient?
A)Fatigue related to altered metabolic processes
B)Altered nutrition: less than body requirements related to anorexia
C)Risk for infection related to altered immunologic response
D)Body image disturbance related to weight loss and anorexia - ✔✔C - A priority
nursing diagnosis for this patient is risk for infection related to altered immunologic
response. Because the patients immunity is suppressed, he or she will be at a high risk
for infection. The other listed nursing diagnoses are valid, but they are not as high a
priority as is risk for infection.
✔✔An oncology nurse is caring for a patient who has developed erythema following
radiation therapy. What should the nurse instruct the patient to do?
A)Periodically apply ice to the area.
B)Keep the area cleanly shaven.
C)Apply petroleum jelly to the affected area.
D)Avoid using soap on the treatment area. - ✔✔D - Care to the affected area must
focus on preventing further skin irritation, drying, and damage. Soaps, petroleum
ointment, and shaving the area could worsen the erythema. Ice is also contraindicated.
✔✔The nurse is caring for a patient has just been given a 6-month prognosis following a
diagnosis of extensive stage small-cell lung cancer. The patient states that he would like
to die at home, but the team believes that the patients care needs are unable to be met
in a home environment. What might you suggest as an alternative?
A)Discuss a referral for rehabilitation hospital.
B)Panel the patient for a personal care home.
C)Discuss a referral for acute care.
, D)Discuss a referral for hospice care. - ✔✔D - Hospice care can be provided in several
settings. Because of the high cost associated with free-standing hospices, care is often
delivered by coordinating services provided by both hospitals and the community. The
primary goal of hospice care is to provide support to the patient and family. Patients
who are referred to hospice care generally have fewer than 6 months to live. Each of
the other listed options would be less appropriate for the patients physical and
psychosocial needs.
✔✔The clinic nurse is caring for a 42-year-old male oncology patient. He complains of
extreme fatigue and weakness after his first week of radiation therapy. Which response
by the nurse would best reassure this patient?
A)These symptoms usually result from radiation therapy; however, we will continue to
monitor your laboratory and x-ray studies.
B)These symptoms are part of your disease and are an unfortunately inevitable part of
living with cancer.
C)Try not to be concerned about these symptoms. Every patient feels this way after
having radiation therapy.
D)Even though it is uncomfortable, this is a good sign. It means that only the cancer
cells are dying. - ✔✔A - Fatigue and weakness result from radiation treatment and
usually do not represent deterioration or disease progression. The symptoms
associated with radiation therapy usually decrease after therapy ends. The symptoms
may concern the patient and should not be belittled. Radiation destroys both cancerous
and normal cells.
✔✔A 16-year-old female patient experiences alopecia resulting from chemotherapy,
prompting the nursing diagnoses of disturbed body image and situational low self-
esteem. What action by the patient would best indicate that she is meeting the goal of
improved body image and self-esteem?
A)The patient requests that her family bring her makeup and wig.
B)The patient begins to discuss the future with her family.
C)The patient reports less disruption from pain and discomfort.
D)The patient cries openly when discussing her disease. - ✔✔A - Requesting her wig
and makeup indicates that the patient with alopecia is becoming interested in looking
her best and that her body image and self-esteem may be improving. The other options
may indicate that other nursing goals are being met, but they do not necessarily indicate
improved body image and self-esteem.
✔✔A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would
the nurse do to combat the most common adverse effects of chemotherapy?
A)Administer an antiemetic.
B)Administer an antimetabolite.
C)Administer a tumor antibiotic.
D)Administer an anticoagulant. - ✔✔A - Antiemetics are used to treat nausea and
vomiting, the most common adverse effects of chemotherapy. Antihistamines and
certain steroids are also used to treat nausea and vomiting. Antimetabolites and tumor
ANSWERS MARKED A+
✔✔A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and
the nurse is aware that a significant side effect of this medication is thrombocytopenia.
Which symptom should the nurse assess for in patients at risk for thrombocytopenia?
A)Interrupted sleep pattern
B)Hot flashes
C)Epistaxis (nose bleed)
D)Increased weight - ✔✔C - Patients with thrombocytopenia are at risk for bleeding due
to decreased platelet counts. Patients with thrombocytopenia do not exhibit interrupted
sleep pattern, hot flashes, or increased weight.
✔✔The nurse is orienting a new nurse to the oncology unit. When reviewing the safe
administration of antineoplastic agents, what action should the nurse emphasize?
A)Adjust the dose to the patients present symptoms.
B)Wash hands with an alcohol-based cleanser following administration.
C)Use gloves and a lab coat when preparing the medication.
D)Dispose of the antineoplastic wastes in the hazardous waste receptacle. - ✔✔D - The
nurse should use surgical gloves and disposable long-sleeved gowns when
administering antineoplastic agents. The antineoplastic wastes are disposed of as
hazardous materials. Dosages are not adjusted on a short-term basis. Hand and arm
hygiene must be performed before and after administering the medication.
✔✔A nurse provides care on a bone marrow transplant unit and is preparing a female
patient for a hematopoietic stem cell transplantation (HSCT) the following day. What
information should the nurse emphasize to the patients family and friends?
A)Your family should likely gather at the bedside in case theres a negative outcome.
B)Make sure she doesnt eat any food in the 24 hours before the procedure.
C)Wear a hospital gown when you go into the patients room.
D)Do not visit if youve had a recent infection. - ✔✔D - Before HSCT, patients are at a
high risk for infection, sepsis, and bleeding. Visitors should not visit if they have had a
recent illness or vaccination. Gowns should indeed be worn, but this is secondary in
importance to avoiding the patients contact with ill visitors. Prolonged fasting is
unnecessary. Negative outcomes are possible, but the procedure would not normally be
so risky as to require the family to gather at the bedside.
✔✔A nurse is creating a plan of care for an oncology patient and one of the identified
nursing diagnoses is risk for infection related to myelosuppression. What intervention
addresses the leading cause of infection-related death in oncology patients?
A)Encourage several small meals daily.
B)Provide skin care to maintain skin integrity.
C)Assist the patient with hygiene, as needed.
D)Assess the integrity of the patients oral mucosa regularly. - ✔✔B - Nursing care for
patients with skin reactions includes maintaining skin integrity, cleansing the skin,
,promoting comfort, reducing pain, preventing additional trauma, and preventing and
managing infection. Malnutrition in oncology patients may be present, but it is not the
leading cause of infection-related death. Poor hygiene does not normally cause events
that result in death. Broken oral mucosa may be an avenue for infection, but it is not the
leading cause of death in an oncology patient.
✔✔You are caring for an adult patient who has developed a mild oral yeast infection
following chemotherapy. What actions should you encourage the patient to perform?
Select all that apply.
A)Use a lip lubricant.
B)Scrub the tongue with a firm-bristled toothbrush.
C)Use dental floss every 24 hours.
D)Rinse the mouth with normal saline.
E)Eat spicy food to aid in eradicating the yeast. - ✔✔A,C,D - Stomatitis is an
inflammation of the oral cavity. The patient should be encouraged to brush the teeth
with a soft toothbrush after meals, use dental floss every 24 hours, rinse with normal
saline, and use a lip lubricant. Mouthwashes and hot foods should be avoided.
✔✔The nurse on a bone marrow transplant unit is caring for a patient with cancer who
is preparing for HSCT. What is a priority nursing diagnosis for this patient?
A)Fatigue related to altered metabolic processes
B)Altered nutrition: less than body requirements related to anorexia
C)Risk for infection related to altered immunologic response
D)Body image disturbance related to weight loss and anorexia - ✔✔C - A priority
nursing diagnosis for this patient is risk for infection related to altered immunologic
response. Because the patients immunity is suppressed, he or she will be at a high risk
for infection. The other listed nursing diagnoses are valid, but they are not as high a
priority as is risk for infection.
✔✔An oncology nurse is caring for a patient who has developed erythema following
radiation therapy. What should the nurse instruct the patient to do?
A)Periodically apply ice to the area.
B)Keep the area cleanly shaven.
C)Apply petroleum jelly to the affected area.
D)Avoid using soap on the treatment area. - ✔✔D - Care to the affected area must
focus on preventing further skin irritation, drying, and damage. Soaps, petroleum
ointment, and shaving the area could worsen the erythema. Ice is also contraindicated.
✔✔The nurse is caring for a patient has just been given a 6-month prognosis following a
diagnosis of extensive stage small-cell lung cancer. The patient states that he would like
to die at home, but the team believes that the patients care needs are unable to be met
in a home environment. What might you suggest as an alternative?
A)Discuss a referral for rehabilitation hospital.
B)Panel the patient for a personal care home.
C)Discuss a referral for acute care.
, D)Discuss a referral for hospice care. - ✔✔D - Hospice care can be provided in several
settings. Because of the high cost associated with free-standing hospices, care is often
delivered by coordinating services provided by both hospitals and the community. The
primary goal of hospice care is to provide support to the patient and family. Patients
who are referred to hospice care generally have fewer than 6 months to live. Each of
the other listed options would be less appropriate for the patients physical and
psychosocial needs.
✔✔The clinic nurse is caring for a 42-year-old male oncology patient. He complains of
extreme fatigue and weakness after his first week of radiation therapy. Which response
by the nurse would best reassure this patient?
A)These symptoms usually result from radiation therapy; however, we will continue to
monitor your laboratory and x-ray studies.
B)These symptoms are part of your disease and are an unfortunately inevitable part of
living with cancer.
C)Try not to be concerned about these symptoms. Every patient feels this way after
having radiation therapy.
D)Even though it is uncomfortable, this is a good sign. It means that only the cancer
cells are dying. - ✔✔A - Fatigue and weakness result from radiation treatment and
usually do not represent deterioration or disease progression. The symptoms
associated with radiation therapy usually decrease after therapy ends. The symptoms
may concern the patient and should not be belittled. Radiation destroys both cancerous
and normal cells.
✔✔A 16-year-old female patient experiences alopecia resulting from chemotherapy,
prompting the nursing diagnoses of disturbed body image and situational low self-
esteem. What action by the patient would best indicate that she is meeting the goal of
improved body image and self-esteem?
A)The patient requests that her family bring her makeup and wig.
B)The patient begins to discuss the future with her family.
C)The patient reports less disruption from pain and discomfort.
D)The patient cries openly when discussing her disease. - ✔✔A - Requesting her wig
and makeup indicates that the patient with alopecia is becoming interested in looking
her best and that her body image and self-esteem may be improving. The other options
may indicate that other nursing goals are being met, but they do not necessarily indicate
improved body image and self-esteem.
✔✔A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would
the nurse do to combat the most common adverse effects of chemotherapy?
A)Administer an antiemetic.
B)Administer an antimetabolite.
C)Administer a tumor antibiotic.
D)Administer an anticoagulant. - ✔✔A - Antiemetics are used to treat nausea and
vomiting, the most common adverse effects of chemotherapy. Antihistamines and
certain steroids are also used to treat nausea and vomiting. Antimetabolites and tumor
