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: Chemotherapy Safety
Clinical Scenario:
A 58-year-old patient with colon cancer is scheduled to receive
the next cycle of chemotherapy. The nurse reviews the morning
assessment and notes a temperature of 38.4°C (101.1°F),
absolute neutrophil count of 420/mm³, and reports of chills and
weakness.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Administer the chemotherapy as scheduled to prevent
treatment delays
B. Encourage the patient to increase oral fluid intake and rest
C. Hold the chemotherapy and notify the oncology provider
immediately
D. Teach the patient that these symptoms are expected after
treatment
Correct Answer:
C. Hold the chemotherapy and notify the oncology provider
immediately
Detailed Rationale:
This patient has febrile neutropenia, a medical emergency in
oncology. The combination of fever, chills, and severe
neutropenia suggests a high risk for life-threatening infection.
,Chemotherapy should be held, and the oncology provider must
be notified immediately so cultures, antibiotics, and further
treatment can be initiated.
Incorrect Option Analysis:
• A is incorrect because giving chemotherapy during
suspected infection and severe neutropenia is unsafe. This
reflects the misconception that treatment should always
proceed on schedule.
• B is incorrect because hydration alone does not address
the urgent infection risk. This may reflect underestimation
of neutropenic fever.
• D is incorrect because fever is not an expected symptom to
ignore in this context. This is a serious patient safety
concern.
Nursing Process Linkage:
Implementation
Clinical Judgment Competencies (NCJMM):
Recognize Cues; Prioritize Hypotheses; Take Action
Difficulty Level: Difficult
Bloom’s Cognitive Level: Apply
NCLEX Client Needs Category:
Reduction of Risk Potential
, Nursing Diagnosis Integration:
Priority Nursing Diagnosis: Risk for infection
Risk Factors: Neutropenia, chemotherapy-induced bone
marrow suppression, fever
Expected Outcome:
The patient will be assessed promptly for possible infection, and
treatment will be modified to reduce the risk of sepsis.
Key Learning Objective:
Prioritize safe action when neutropenia and fever indicate a
high-risk oncologic emergency.
2. SATA — Cancer Care: Radiation Skin Care
Clinical Scenario:
A patient receiving external beam radiation to the neck says, “I
want to make sure I am caring for my skin the right way.” The
nurse provides teaching.
Question Stem:
Which statements by the patient indicate correct
understanding? Select all that apply.
Answer Options:
A. “I will wash the area gently with lukewarm water and mild
soap.”
B. “I can apply heating pads to the area if it feels sore.”
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,1. MCQ — Cancer Care: Chemotherapy Safety
Clinical Scenario:
A 58-year-old patient with colon cancer is scheduled to receive
the next cycle of chemotherapy. The nurse reviews the morning
assessment and notes a temperature of 38.4°C (101.1°F),
absolute neutrophil count of 420/mm³, and reports of chills and
weakness.
Question Stem:
What is the nurse’s priority action?
Answer Options:
A. Administer the chemotherapy as scheduled to prevent
treatment delays
B. Encourage the patient to increase oral fluid intake and rest
C. Hold the chemotherapy and notify the oncology provider
immediately
D. Teach the patient that these symptoms are expected after
treatment
Correct Answer:
C. Hold the chemotherapy and notify the oncology provider
immediately
Detailed Rationale:
This patient has febrile neutropenia, a medical emergency in
oncology. The combination of fever, chills, and severe
neutropenia suggests a high risk for life-threatening infection.
,Chemotherapy should be held, and the oncology provider must
be notified immediately so cultures, antibiotics, and further
treatment can be initiated.
Incorrect Option Analysis:
• A is incorrect because giving chemotherapy during
suspected infection and severe neutropenia is unsafe. This
reflects the misconception that treatment should always
proceed on schedule.
• B is incorrect because hydration alone does not address
the urgent infection risk. This may reflect underestimation
of neutropenic fever.
• D is incorrect because fever is not an expected symptom to
ignore in this context. This is a serious patient safety
concern.
Nursing Process Linkage:
Implementation
Clinical Judgment Competencies (NCJMM):
Recognize Cues; Prioritize Hypotheses; Take Action
Difficulty Level: Difficult
Bloom’s Cognitive Level: Apply
NCLEX Client Needs Category:
Reduction of Risk Potential
, Nursing Diagnosis Integration:
Priority Nursing Diagnosis: Risk for infection
Risk Factors: Neutropenia, chemotherapy-induced bone
marrow suppression, fever
Expected Outcome:
The patient will be assessed promptly for possible infection, and
treatment will be modified to reduce the risk of sepsis.
Key Learning Objective:
Prioritize safe action when neutropenia and fever indicate a
high-risk oncologic emergency.
2. SATA — Cancer Care: Radiation Skin Care
Clinical Scenario:
A patient receiving external beam radiation to the neck says, “I
want to make sure I am caring for my skin the right way.” The
nurse provides teaching.
Question Stem:
Which statements by the patient indicate correct
understanding? Select all that apply.
Answer Options:
A. “I will wash the area gently with lukewarm water and mild
soap.”
B. “I can apply heating pads to the area if it feels sore.”
