AND ANSWERS + RATIONALES | STUDY GUIDE | 100%
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1. A patient is receiving chemotherapy for breast cancer. Which laboratory value would
indicate the patient should be placed on neutropenic precautions?
A) Hemoglobin 10.2 g/dL
B) Platelet count 120,000/mm³
C) White blood cell count 2,500/mm³
D) Hematocrit 32%
Correct Answer: C) White blood cell count 2,500/mm³
Rationale: Neutropenia, an absolute neutrophil count (ANC) less than 1,000/mm³, increases
infection risk. A WBC of 2,500 is below normal (4,500-11,000) and signals neutropenia,
requiring neutropenic precautions . Chemotherapy causes bone marrow suppression, and the
nadir typically occurs 7-14 days after treatment. A platelet count of 120,000 is low but does not
require neutropenic precautions; it indicates thrombocytopenia and bleeding risk.
2. The nurse is teaching a nursing student about the stages of cancer development. Which
statement by the student indicates a need for further teaching?
A) The promotion stage includes strategies for preventing cancer.
B) Progression indicates that abnormal cells are being produced at the same rate as
normal cells without stopping.
C) The event that begins the initiation stage is when the DNA in a cell is damaged or
altered.
D) The latent stage is when a tumor is present but there is no evidence of cancer.
Correct Answer: B) Progression indicates that abnormal cells are being produced at the same rate
as normal cells without stopping.
Rationale: Progression is the stage where the tumor has its own blood supply (angiogenesis),
increased growth rate, invading surrounding cells, and metastasizing . Abnormal cells are
produced faster than normal cells, not at the same rate. Initiation involves DNA damage to a
cell’s genetic structure . Promotion is the reversible stage where proliferation occurs . Latent is
the time between exposure and detectable cancer .
3. The nurse is caring for a patient with breast cancer who has had a right-sided
mastectomy. Which action should the nurse take?
A) Obtain blood pressure on the right arm
B) Administer injections in the right arm
C) Elevate the right arm to promote lymphatic flow
D) Perform venipuncture on the right arm
Correct Answer: C) Elevate the right arm to promote lymphatic flow
,Rationale: After a mastectomy, the patient is at risk for lymphedema due to removal of lymph
nodes. The affected arm should not be used for blood pressure, injections, or venipuncture .
Elevating the arm, exercise, and compression garments help prevent and manage lymphedema .
Blood pressure should be taken on the unaffected arm.
4. A patient who received chemotherapy 10 days ago has a platelet count of 30,000/mm³.
The nurse should prioritize which assessment?
A) Temperature
B) Signs of bleeding
C) Pain level
D) Respiratory rate
Correct Answer: B) Signs of bleeding
Rationale: A platelet count below 50,000/mm³ (thrombocytopenia) indicates a risk for
spontaneous bleeding . This is a delayed toxicity of chemotherapy due to bone marrow
suppression. The priority is assessing for bleeding (petechiae, purpura, mucosal bleeding) and
preventing injury . Infection risk is a priority for neutropenia (low WBC), not thrombocytopenia.
5. A patient receiving chemotherapy develops stomatitis. The nurse should recommend
which dietary modification?
A) Spicy foods to stimulate appetite
B) Soft, bland foods at room temperature
C) Citrus fruits to increase vitamin C
D) Very hot foods to improve taste
Correct Answer: B) Soft, bland foods at room temperature
Rationale: Stomatitis (inflammation of the mouth) is a common side effect of chemotherapy and
radiation to the head and neck . The nurse should recommend soft, bland foods at room
temperature, avoiding spicy, acidic, very hot, or very cold foods that can irritate inflamed
mucosa . Good oral hygiene with a soft toothbrush is also important.
6. A patient with lung cancer has a chest tube in place. What is the priority nursing action if
the chest tube becomes disconnected from the drainage system?
A) Clamp the chest tube
B) Place the end of the tube in sterile water
C) Reconnect the tube immediately
D) Notify the provider
Correct Answer: B) Place the end of the tube in sterile water
Rationale: If a chest tube becomes disconnected, the priority is to place the end of the tube in
sterile water or normal saline to create a water seal and prevent air from entering the pleural
space . Clamping is not recommended as it can cause tension pneumothorax. The provider
should be notified after the immediate safety measure is taken.
, 7. A patient with a chest tube has continuous bubbling in the water seal chamber. What is
the priority nursing action?
A) Assess for an air leak
B) Notify the provider
C) Clamp the chest tube
D) Document the finding
Correct Answer: A) Assess for an air leak
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the system .
The nurse must first assess the system to locate the source of the leak (loose connections, patient
site). Tidaling (fluctuation) in the water seal is normal . Clamping is not recommended because it
can cause tension pneumothorax.
8. A patient is 24 hours post-left mastectomy. The nurse notes the affected arm is swollen
and painful. Which intervention is most appropriate?
A) Apply a warm compress
B) Elevate the arm
C) Restrict fluids
D) Administer a diuretic
Correct Answer: B) Elevate the arm
Rationale: Lymphedema is a complication of mastectomy due to lymphatic obstruction .
Elevation of the affected arm promotes lymphatic drainage and reduces swelling . Range-of-
motion exercises, compression garments, and good skin care are also important for managing
lymphedema.
9. A patient is receiving external radiation therapy. Which skin care instruction should the
nurse provide?
A) Apply lotion containing alcohol to the treatment area
B) Use heating pads to soothe discomfort
C) Use aloe vera or lotion without perfume, metal, or alcohol
D) Wash the treatment area with soap and water
Correct Answer: C) Use aloe vera or lotion without perfume, metal, or alcohol
Rationale: Radiation therapy causes skin reactions (dryness, peeling, erythema). Patients should
use lotions without perfume, metal, alcohol, or additives . Heating pads and ice packs should be
avoided . Frequent skin assessments are also important. Aloe vera is often recommended for
soothing radiation dermatitis.
10. The nurse is assessing a patient with a chest tube. Tidaling (fluctuation) in the water seal
chamber is noted. How should the nurse interpret this finding?
A) The chest tube is obstructed
B) An air leak is present