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 — General Cancer Care: Priority Infection Risk
Clinical Scenario:
A 63-year-old patient with metastatic colon cancer is 8 days
post-chemotherapy. They report sore throat and chills. Vital
signs: T 38.5°C, HR 108/min, BP 100/62 mm Hg. CBC shows
WBC 1,100/mm³ and ANC 500/mm³.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Encourage increased oral fluids and recheck the temperature
in 4 hours.
B. Place the patient on neutropenic precautions and notify the
provider immediately.
C. Administer acetaminophen and teach relaxation breathing.
D. Reassure the patient that these findings are expected after
chemotherapy.
Correct Answer:
B
Detailed Rationale:
This patient has febrile neutropenia, a medical emergency in
oncology. Fever with a low ANC signals a high risk for rapid
,sepsis. Priority nursing action is to protect the patient from
infection exposure and escalate care immediately. Broad-
spectrum antibiotics and cultures are commonly anticipated.
Incorrect Option Analysis:
• A: Delays care; this is unsafe with fever and neutropenia.
Misconception: thinking mild symptoms can be watched.
• C: Fever suppression alone does not address the infection
source and may mask deterioration.
• D: Incorrect; fever is not expected or benign in
neutropenia.
Nursing Process Linkage: Implementation
NCJMM Competencies: Recognize Cues, Prioritize Hypotheses,
Take Action
Difficulty: Difficult
Bloom’s Level: Analyze
NCLEX Client Needs: Physiological Adaptation; Safety and
Infection Control
Nursing Diagnosis Integration:
• Priority Nursing Diagnosis: Risk for Infection
• Risk Factors: Chemotherapy-induced neutropenia, invasive
treatment, mucosal disruption
Expected Outcome: Patient remains hemodynamically
stable and receives prompt infection management.
, Key Learning Objective: Prioritize emergency oncology
care based on fever and neutropenia.
2) MCQ — Chemotherapy: Antiemetic Timing
Clinical Scenario:
A patient with breast cancer is scheduled for highly emetogenic
chemotherapy. They say, “I usually wait until I feel nauseated
before taking my medicine.”
Question Stem:
Which teaching point is most important?
Answer Options:
A. Take antiemetic medication only after vomiting begins.
B. Eat only one large meal after chemotherapy.
C. Take the prescribed antiemetic before chemotherapy begins.
D. Avoid all fluids on chemotherapy days.
Correct Answer:
C
Detailed Rationale:
Chemotherapy-induced nausea and vomiting are best
prevented by prophylactic antiemetic therapy. Taking
antiemetics before chemotherapy and then on schedule
improves symptom control and supports nutrition and
hydration.
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,1) MCQ — General Cancer Care: Priority Infection Risk
Clinical Scenario:
A 63-year-old patient with metastatic colon cancer is 8 days
post-chemotherapy. They report sore throat and chills. Vital
signs: T 38.5°C, HR 108/min, BP 100/62 mm Hg. CBC shows
WBC 1,100/mm³ and ANC 500/mm³.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Encourage increased oral fluids and recheck the temperature
in 4 hours.
B. Place the patient on neutropenic precautions and notify the
provider immediately.
C. Administer acetaminophen and teach relaxation breathing.
D. Reassure the patient that these findings are expected after
chemotherapy.
Correct Answer:
B
Detailed Rationale:
This patient has febrile neutropenia, a medical emergency in
oncology. Fever with a low ANC signals a high risk for rapid
,sepsis. Priority nursing action is to protect the patient from
infection exposure and escalate care immediately. Broad-
spectrum antibiotics and cultures are commonly anticipated.
Incorrect Option Analysis:
• A: Delays care; this is unsafe with fever and neutropenia.
Misconception: thinking mild symptoms can be watched.
• C: Fever suppression alone does not address the infection
source and may mask deterioration.
• D: Incorrect; fever is not expected or benign in
neutropenia.
Nursing Process Linkage: Implementation
NCJMM Competencies: Recognize Cues, Prioritize Hypotheses,
Take Action
Difficulty: Difficult
Bloom’s Level: Analyze
NCLEX Client Needs: Physiological Adaptation; Safety and
Infection Control
Nursing Diagnosis Integration:
• Priority Nursing Diagnosis: Risk for Infection
• Risk Factors: Chemotherapy-induced neutropenia, invasive
treatment, mucosal disruption
Expected Outcome: Patient remains hemodynamically
stable and receives prompt infection management.
, Key Learning Objective: Prioritize emergency oncology
care based on fever and neutropenia.
2) MCQ — Chemotherapy: Antiemetic Timing
Clinical Scenario:
A patient with breast cancer is scheduled for highly emetogenic
chemotherapy. They say, “I usually wait until I feel nauseated
before taking my medicine.”
Question Stem:
Which teaching point is most important?
Answer Options:
A. Take antiemetic medication only after vomiting begins.
B. Eat only one large meal after chemotherapy.
C. Take the prescribed antiemetic before chemotherapy begins.
D. Avoid all fluids on chemotherapy days.
Correct Answer:
C
Detailed Rationale:
Chemotherapy-induced nausea and vomiting are best
prevented by prophylactic antiemetic therapy. Taking
antiemetics before chemotherapy and then on schedule
improves symptom control and supports nutrition and
hydration.
