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: Neutropenic Fever
Clinical scenario:
A 67-year-old patient receiving chemotherapy for colon cancer
calls the clinic 8 days after treatment and reports a temperature
of 38.4°C (101.1°F), sore throat, chills, and profound fatigue.
The latest ANC is 650/mm³.
Question stem:
What is the nurse’s priority action?
Answer options:
A. Instruct the patient to take acetaminophen and recheck the
temperature in 2 hours.
B. Tell the patient to increase oral fluids and rest at home.
C. Notify the provider immediately and prepare for neutropenic
precautions and possible sepsis workup.
D. Reassure the patient that low-grade fever is expected after
chemotherapy.
Correct answer: C
Detailed rationale:
Fever with neutropenia is a medical emergency because
infection can progress rapidly without typical inflammatory
signs. Immediate provider notification and infection-control
precautions are priority.
,Incorrect option analysis:
• A: Incorrect. Masking fever delays treatment; this can
worsen outcomes.
• B: Incorrect. Hydration is helpful, but not the priority.
• D: Incorrect. Fever after chemotherapy is not something to
dismiss.
Nursing process linkage: Implementation
NCJMM competencies: Recognize Cues, Analyze Cues, Prioritize
Hypotheses, Take Action
Difficulty: Difficult
Bloom’s level: Analyze
NCLEX client needs category: Physiological Adaptation
Nursing diagnosis integration:
• Priority diagnosis: Risk for infection
• Risk factors: Myelosuppression, neutropenia
• Expected outcome: Patient receives urgent evaluation and
shows no evidence of sepsis progression
Key learning objective: Identify life-threatening infection
cues in the immunocompromised patient.
2) SATA — Cancer Care: Chemotherapy Safety Teaching
, Clinical scenario:
A patient is starting an outpatient chemotherapy regimen and
asks what safety measures are important at home.
Question stem:
Which statements show correct understanding? Select all that
apply.
Answer options:
A. “I should call the clinic if I have a fever of 38°C (100.4°F) or
higher.”
B. “I will use a soft toothbrush and electric razor.”
C. “I can take ibuprofen for headaches unless the pain is
severe.”
D. “I should avoid close contact with people who are sick.”
E. “If I feel nauseated, I should wait until vomiting starts before
using my antiemetic.”
F. “I should report unusual bruising or bleeding.”
Correct answers: A, B, D, F
Detailed rationale:
These actions reduce infection and bleeding risk, which are
common chemotherapy complications. Early fever reporting is
essential because neutropenic infections may worsen quickly.
Incorrect option analysis:
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,1) MCQ — Cancer Care: Neutropenic Fever
Clinical scenario:
A 67-year-old patient receiving chemotherapy for colon cancer
calls the clinic 8 days after treatment and reports a temperature
of 38.4°C (101.1°F), sore throat, chills, and profound fatigue.
The latest ANC is 650/mm³.
Question stem:
What is the nurse’s priority action?
Answer options:
A. Instruct the patient to take acetaminophen and recheck the
temperature in 2 hours.
B. Tell the patient to increase oral fluids and rest at home.
C. Notify the provider immediately and prepare for neutropenic
precautions and possible sepsis workup.
D. Reassure the patient that low-grade fever is expected after
chemotherapy.
Correct answer: C
Detailed rationale:
Fever with neutropenia is a medical emergency because
infection can progress rapidly without typical inflammatory
signs. Immediate provider notification and infection-control
precautions are priority.
,Incorrect option analysis:
• A: Incorrect. Masking fever delays treatment; this can
worsen outcomes.
• B: Incorrect. Hydration is helpful, but not the priority.
• D: Incorrect. Fever after chemotherapy is not something to
dismiss.
Nursing process linkage: Implementation
NCJMM competencies: Recognize Cues, Analyze Cues, Prioritize
Hypotheses, Take Action
Difficulty: Difficult
Bloom’s level: Analyze
NCLEX client needs category: Physiological Adaptation
Nursing diagnosis integration:
• Priority diagnosis: Risk for infection
• Risk factors: Myelosuppression, neutropenia
• Expected outcome: Patient receives urgent evaluation and
shows no evidence of sepsis progression
Key learning objective: Identify life-threatening infection
cues in the immunocompromised patient.
2) SATA — Cancer Care: Chemotherapy Safety Teaching
, Clinical scenario:
A patient is starting an outpatient chemotherapy regimen and
asks what safety measures are important at home.
Question stem:
Which statements show correct understanding? Select all that
apply.
Answer options:
A. “I should call the clinic if I have a fever of 38°C (100.4°F) or
higher.”
B. “I will use a soft toothbrush and electric razor.”
C. “I can take ibuprofen for headaches unless the pain is
severe.”
D. “I should avoid close contact with people who are sick.”
E. “If I feel nauseated, I should wait until vomiting starts before
using my antiemetic.”
F. “I should report unusual bruising or bleeding.”
Correct answers: A, B, D, F
Detailed rationale:
These actions reduce infection and bleeding risk, which are
common chemotherapy complications. Early fever reporting is
essential because neutropenic infections may worsen quickly.
Incorrect option analysis:
