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
,Chapter 1 — Cancer Care
1) MCQ
Clinical scenario: A 56-year-old patient with acute myeloid
leukemia is receiving chemotherapy. The nurse notes a
temperature of 38.4°C (101.1°F), chills, and an absolute
neutrophil count of 300/mm³.
Question stem: What is the nurse’s priority action?
Answer options:
A. Give acetaminophen and reassess the temperature in 4
hours.
B. Place the patient on neutropenic precautions and notify the
oncology provider immediately.
C. Encourage ambulation to improve circulation.
D. Delay all assessments to reduce infection exposure.
Correct answer: B
Detailed rationale: This patient has probable febrile
neutropenia, a medical emergency in oncology. The priority is
to reduce infection exposure and rapidly notify the provider for
urgent evaluation and treatment. This reflects patient safety,
infection control, and early escalation of care.
Incorrect option analysis:
• A: Masks a serious infection and delays treatment.
, • C: Ambulation is not the priority during suspected
neutropenic fever.
• D: Unsafe because the patient still needs assessment and
prompt intervention.
Nursing process link: Implementation
NCJMM competencies: Recognize Cues, Prioritize Hypotheses,
Take Action
Difficulty: Difficult
Bloom’s level: Analyze
NCLEX category: Safety and Infection Control
Nursing diagnosis integration:
• Priority diagnosis: Risk for infection
• Related factors: Bone marrow suppression from
chemotherapy
• Risk factors: ANC 300/mm³, fever, chills
Expected outcome: The patient will receive timely
infection workup and remain free from sepsis.
Key learning objective: Identify and respond to oncologic
infection emergencies.
2) SATA
Clinical scenario: A patient receiving chemotherapy asks how to
reduce complications at home after discharge.
, Question stem: Which teaching points should the nurse
include? Select all that apply.
Answer options:
A. Use a soft toothbrush and nonalcoholic mouth rinses.
B. Eat raw sushi and unwashed salads for extra protein and
vitamins.
C. Check the temperature every day at the same time.
D. Avoid crowds and sick contacts.
E. Use rectal suppositories if constipated.
F. Wash hands before meals and after using the bathroom.
Correct answer(s): A, C, D, F
Detailed rationale: These actions reduce infection risk and
protect oral tissue during immunosuppression. Daily
temperature checks can help detect early infection. Hand
hygiene and avoiding crowds are foundational safety measures.
Incorrect option analysis:
• B: Raw or unwashed foods increase infection risk.
• E: Rectal medications can injure mucosa and increase
infection/bleeding risk in neutropenic patients.
Nursing process link: Planning
NCJMM competencies: Recognize Cues, Generate Solutions,
Take Action
Difficulty: Moderate
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,Chapter 1 — Cancer Care
1) MCQ
Clinical scenario: A 56-year-old patient with acute myeloid
leukemia is receiving chemotherapy. The nurse notes a
temperature of 38.4°C (101.1°F), chills, and an absolute
neutrophil count of 300/mm³.
Question stem: What is the nurse’s priority action?
Answer options:
A. Give acetaminophen and reassess the temperature in 4
hours.
B. Place the patient on neutropenic precautions and notify the
oncology provider immediately.
C. Encourage ambulation to improve circulation.
D. Delay all assessments to reduce infection exposure.
Correct answer: B
Detailed rationale: This patient has probable febrile
neutropenia, a medical emergency in oncology. The priority is
to reduce infection exposure and rapidly notify the provider for
urgent evaluation and treatment. This reflects patient safety,
infection control, and early escalation of care.
Incorrect option analysis:
• A: Masks a serious infection and delays treatment.
, • C: Ambulation is not the priority during suspected
neutropenic fever.
• D: Unsafe because the patient still needs assessment and
prompt intervention.
Nursing process link: Implementation
NCJMM competencies: Recognize Cues, Prioritize Hypotheses,
Take Action
Difficulty: Difficult
Bloom’s level: Analyze
NCLEX category: Safety and Infection Control
Nursing diagnosis integration:
• Priority diagnosis: Risk for infection
• Related factors: Bone marrow suppression from
chemotherapy
• Risk factors: ANC 300/mm³, fever, chills
Expected outcome: The patient will receive timely
infection workup and remain free from sepsis.
Key learning objective: Identify and respond to oncologic
infection emergencies.
2) SATA
Clinical scenario: A patient receiving chemotherapy asks how to
reduce complications at home after discharge.
, Question stem: Which teaching points should the nurse
include? Select all that apply.
Answer options:
A. Use a soft toothbrush and nonalcoholic mouth rinses.
B. Eat raw sushi and unwashed salads for extra protein and
vitamins.
C. Check the temperature every day at the same time.
D. Avoid crowds and sick contacts.
E. Use rectal suppositories if constipated.
F. Wash hands before meals and after using the bathroom.
Correct answer(s): A, C, D, F
Detailed rationale: These actions reduce infection risk and
protect oral tissue during immunosuppression. Daily
temperature checks can help detect early infection. Hand
hygiene and avoiding crowds are foundational safety measures.
Incorrect option analysis:
• B: Raw or unwashed foods increase infection risk.
• E: Rectal medications can injure mucosa and increase
infection/bleeding risk in neutropenic patients.
Nursing process link: Planning
NCJMM competencies: Recognize Cues, Generate Solutions,
Take Action
Difficulty: Moderate
