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: Febrile Neutropenia
Clinical scenario:
A 58-year-old patient is receiving chemotherapy for colon
cancer. The patient reports chills and feels “hot.” The
temperature is 38.4°C (101.1°F), ANC is 600/mm³, and the
mucous membranes are dry.
Question stem:
What is the nurse’s priority action?
Answer options:
A. Give acetaminophen and reassess in 1 hour.
B. Notify the oncology provider immediately.
C. Offer cold fluids and encourage rest.
D. Place the patient in a semi-private room near the nurses’
station.
Correct answer:
B
Detailed rationale:
Fever in a neutropenic patient is an oncologic emergency
because even minor infections can become rapidly life-
threatening. The nurse must notify the oncology provider
immediately so cultures, broad-spectrum antibiotics, and sepsis
evaluation can be initiated without delay.
,Incorrect option analysis:
• A: Incorrect. Fever should not be masked or delayed in a
neutropenic patient. Misconception: treating fever first is
safer than urgent escalation. Safety concern: delayed
sepsis treatment.
• C: Incorrect. Supportive care is not the priority.
Misconception: comfort measures are sufficient. Safety
concern: missed early sepsis.
• D: Incorrect. Room placement does not address the
emergency. Misconception: proximity to staff replaces
urgent intervention. Safety concern: progression to shock.
Nursing process linkage: Implementation
NCJMM competencies: Recognize Cues, Prioritize Hypotheses,
Take Action
Difficulty: Moderate
Bloom’s level: Analyze
NCLEX client needs: Physiological Adaptation / Safety and
Infection Control
Nursing diagnosis integration:
• Priority nursing diagnosis: Risk for Infection
• Risk factors: Myelosuppression, chemotherapy, ANC
600/mm³
, • Defining characteristics: Fever, chills, dry mucosa
Expected outcome: The patient will receive prompt sepsis
evaluation and appropriate antimicrobials within the
facility’s fever-neutropenia protocol.
Key learning objective: Identify fever in neutropenia as a
time-sensitive emergency requiring immediate escalation.
2. SATA — Cancer Care: Oral Mucositis During Chemotherapy
Clinical scenario:
A patient receiving chemotherapy reports a sore mouth,
burning with spicy foods, and painful swallowing. The oral
mucosa appears reddened with shallow ulcers.
Question stem:
Which nursing interventions should the nurse include in the
care plan? Select all that apply.
Answer options:
A. Use a soft-bristled toothbrush.
B. Rinse the mouth with saline or baking soda solution.
C. Use alcohol-based mouthwash to reduce bacteria.
D. Encourage cool, bland foods.
E. Avoid spicy, acidic, or rough-textured foods.
F. Use lemon-glycerin swabs to stimulate saliva.
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,1. MCQ — Cancer Care: Febrile Neutropenia
Clinical scenario:
A 58-year-old patient is receiving chemotherapy for colon
cancer. The patient reports chills and feels “hot.” The
temperature is 38.4°C (101.1°F), ANC is 600/mm³, and the
mucous membranes are dry.
Question stem:
What is the nurse’s priority action?
Answer options:
A. Give acetaminophen and reassess in 1 hour.
B. Notify the oncology provider immediately.
C. Offer cold fluids and encourage rest.
D. Place the patient in a semi-private room near the nurses’
station.
Correct answer:
B
Detailed rationale:
Fever in a neutropenic patient is an oncologic emergency
because even minor infections can become rapidly life-
threatening. The nurse must notify the oncology provider
immediately so cultures, broad-spectrum antibiotics, and sepsis
evaluation can be initiated without delay.
,Incorrect option analysis:
• A: Incorrect. Fever should not be masked or delayed in a
neutropenic patient. Misconception: treating fever first is
safer than urgent escalation. Safety concern: delayed
sepsis treatment.
• C: Incorrect. Supportive care is not the priority.
Misconception: comfort measures are sufficient. Safety
concern: missed early sepsis.
• D: Incorrect. Room placement does not address the
emergency. Misconception: proximity to staff replaces
urgent intervention. Safety concern: progression to shock.
Nursing process linkage: Implementation
NCJMM competencies: Recognize Cues, Prioritize Hypotheses,
Take Action
Difficulty: Moderate
Bloom’s level: Analyze
NCLEX client needs: Physiological Adaptation / Safety and
Infection Control
Nursing diagnosis integration:
• Priority nursing diagnosis: Risk for Infection
• Risk factors: Myelosuppression, chemotherapy, ANC
600/mm³
, • Defining characteristics: Fever, chills, dry mucosa
Expected outcome: The patient will receive prompt sepsis
evaluation and appropriate antimicrobials within the
facility’s fever-neutropenia protocol.
Key learning objective: Identify fever in neutropenia as a
time-sensitive emergency requiring immediate escalation.
2. SATA — Cancer Care: Oral Mucositis During Chemotherapy
Clinical scenario:
A patient receiving chemotherapy reports a sore mouth,
burning with spicy foods, and painful swallowing. The oral
mucosa appears reddened with shallow ulcers.
Question stem:
Which nursing interventions should the nurse include in the
care plan? Select all that apply.
Answer options:
A. Use a soft-bristled toothbrush.
B. Rinse the mouth with saline or baking soda solution.
C. Use alcohol-based mouthwash to reduce bacteria.
D. Encourage cool, bland foods.
E. Avoid spicy, acidic, or rough-textured foods.
F. Use lemon-glycerin swabs to stimulate saliva.
