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
,Cancer Care Questions
1) MCQ
Clinical scenario: A 58-year-old client received the second cycle
of chemotherapy 7 days ago and now reports a temperature of
38.4°C (101.1°F), sore throat, and chills. The ANC is 400/mm³.
Stem: What is the nurse’s priority action?
Answer options:
A. Give acetaminophen and encourage oral fluids
B. Initiate neutropenic precautions and notify the oncology
provider immediately
C. Obtain a rectal temperature to confirm the fever
D. Reassure the client that this is an expected post-
chemotherapy effect
Correct answer: B
Rationale: Fever with severe neutropenia is a medical
emergency because the client may not be able to mount an
effective immune response. Protective precautions and
immediate provider notification support rapid treatment and
infection prevention.
Incorrect option analysis:
A: Incorrect; symptomatic treatment alone delays urgent
management. Misconception: assuming fever is minor after
chemotherapy.
,C: Incorrect; rectal temperatures increase mucosal injury and
infection risk in neutropenic clients.
D: Incorrect; this is not expected and may indicate life-
threatening infection.
Nursing process link: Implementation
NCJMM competencies: Recognize Cues, Prioritize Hypotheses,
Take Action
Difficulty: Difficult
Bloom’s level: Analyze
NCLEX client needs: Physiological Adaptation
Nursing diagnosis integration:
• Priority diagnosis: Risk for infection
• Risk factors: Neutropenia, recent chemotherapy, impaired
host defenses
Expected outcome: Client will remain afebrile and receive
prompt antimicrobial treatment if infection is confirmed.
Key learning objective: Recognize febrile neutropenia as
an oncologic emergency and select immediate protective
interventions.
2) SATA
Clinical scenario: A client is starting external beam radiation
therapy to the chest for lung cancer.
, Stem: Which teaching points should the nurse include? Select
all that apply.
Answer options:
A. Clean the skin gently with lukewarm water and mild soap
B. Apply perfumed lotion to the treatment area to reduce
dryness
C. Wear loose cotton clothing over the area
D. Protect the treatment site from direct sunlight
E. Scrub off the radiation markings after each shower
F. Avoid heating pads or ice packs on the treatment area
Correct answers: A, C, D, F
Rationale: Radiation skin becomes fragile and irritated. Gentle
cleansing, loose clothing, sun protection, and avoiding extreme
temperatures reduce tissue injury.
Incorrect option analysis:
B: Incorrect; perfumed products can irritate irradiated skin.
E: Incorrect; markings should be preserved unless the oncology
team instructs otherwise. Misconception: thinking hygiene
should override treatment-site protection.
Nursing process link: Planning / Implementation
NCJMM competencies: Generate Solutions, Take Action
Difficulty: Moderate
Bloom’s level: Apply
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,Cancer Care Questions
1) MCQ
Clinical scenario: A 58-year-old client received the second cycle
of chemotherapy 7 days ago and now reports a temperature of
38.4°C (101.1°F), sore throat, and chills. The ANC is 400/mm³.
Stem: What is the nurse’s priority action?
Answer options:
A. Give acetaminophen and encourage oral fluids
B. Initiate neutropenic precautions and notify the oncology
provider immediately
C. Obtain a rectal temperature to confirm the fever
D. Reassure the client that this is an expected post-
chemotherapy effect
Correct answer: B
Rationale: Fever with severe neutropenia is a medical
emergency because the client may not be able to mount an
effective immune response. Protective precautions and
immediate provider notification support rapid treatment and
infection prevention.
Incorrect option analysis:
A: Incorrect; symptomatic treatment alone delays urgent
management. Misconception: assuming fever is minor after
chemotherapy.
,C: Incorrect; rectal temperatures increase mucosal injury and
infection risk in neutropenic clients.
D: Incorrect; this is not expected and may indicate life-
threatening infection.
Nursing process link: Implementation
NCJMM competencies: Recognize Cues, Prioritize Hypotheses,
Take Action
Difficulty: Difficult
Bloom’s level: Analyze
NCLEX client needs: Physiological Adaptation
Nursing diagnosis integration:
• Priority diagnosis: Risk for infection
• Risk factors: Neutropenia, recent chemotherapy, impaired
host defenses
Expected outcome: Client will remain afebrile and receive
prompt antimicrobial treatment if infection is confirmed.
Key learning objective: Recognize febrile neutropenia as
an oncologic emergency and select immediate protective
interventions.
2) SATA
Clinical scenario: A client is starting external beam radiation
therapy to the chest for lung cancer.
, Stem: Which teaching points should the nurse include? Select
all that apply.
Answer options:
A. Clean the skin gently with lukewarm water and mild soap
B. Apply perfumed lotion to the treatment area to reduce
dryness
C. Wear loose cotton clothing over the area
D. Protect the treatment site from direct sunlight
E. Scrub off the radiation markings after each shower
F. Avoid heating pads or ice packs on the treatment area
Correct answers: A, C, D, F
Rationale: Radiation skin becomes fragile and irritated. Gentle
cleansing, loose clothing, sun protection, and avoiding extreme
temperatures reduce tissue injury.
Incorrect option analysis:
B: Incorrect; perfumed products can irritate irradiated skin.
E: Incorrect; markings should be preserved unless the oncology
team instructs otherwise. Misconception: thinking hygiene
should override treatment-site protection.
Nursing process link: Planning / Implementation
NCJMM competencies: Generate Solutions, Take Action
Difficulty: Moderate
Bloom’s level: Apply
