ATI RN
COMPREHENSIVE
EXIT EXAM WITH
QUESTIONS AND
FULLY SOLVED
CORRECT AND
VERIFIED
ANSWERS WITH
WELL
ELABORATE
RATIONALE
,- CORRECT ANSWERS -Anemia and thrombocytopenia occur secondary to bone
marrow suppression (myelosuppression).
■
Nursing Actions for Anemia
☐
Monitor for fatigue, pallor, dizziness, and shortness of breath.
☐
Help the client manage anemia-related fatigue by scheduling activities with rest periods
in
between and using energy saving measures (sitting during showers and ADLs).
☐
Administer erythropoietic medications such as epoetin alfa (Epogen) and antianemic
medications such as ferrous sulfate (Feosol) as prescribed.
☐
Monitor Hgb values to determine response to medications. Be prepared to administer
blood
if prescribed.
- CORRECT ANSWERS -Mucositis (stomatitis) is inflammation of tissues in the mouth,
such as the gums, tongue, roof and
floor of the mouth, and inside the lips and cheeks.
■
Nursing Actions
☐
Examine the client's mouth several times a day, and inquire about the presence of oral
lesions.
☐
Document the location and size of lesions that are present. Lesions should be cultured
and
reported to the provider.
☐
Avoid using glycerin-based mouthwashes or mouth swabs. Nonalcoholic, anesthetic
mouthwashes are recommended.
☐
Administer a topical anesthetic prior to meals.
☐
Discourage consumption of salty, acidic, or spicy foods.
☐
Offer oral hygiene before and after each meal. Use lubricating or moisturizing agents to
counteract dry mouth.
■
Client Education
☐
Encourage the client to rinse mouth with a solution of half 0.9% sodium chloride and
half
,peroxide at least twice a day, and to brush teeth using a soft-bristled toothbrush.
☐
Instruct client to take medications to control infection as prescribed (nystatin
[Mycostatin],
acyclovir [Zovirax]).
☐
Encourage the client to eat soft, bland foods and supplements that are high in calories
(mashed potatoes, scrambled eggs, cooked cereal, milk shakes, ice cream, frozen
yogurt,
bananas, and breakfast mixes)
- CORRECT ANSWERS -Nausea and vomiting/anorexia
■
Many of the medications used for chemotherapy are emetogenic (induce vomiting) or
cause
anorexia as well as an altered taste in the mouth.
■
Serotonin blockers, such as ondansetron (Zofran), have been found to be effective and
are often
administered with corticosteroids, phenothiazines, and antihistamines.
■
Nursing Actions
☐
Administer antiemetic medications at times that are appropriate for a chemotherapeutic
agent
(prior to treatment, during treatment, after treatment).
☐
Administer antiemetic medications for several days after each treatment as needed.
☐
Remove vomiting cues, such as odor and supplies associated with nausea.
☐
Implement nonpharmacological methods to reduce nausea (visual imagery, relaxation,
acupuncture, distraction).
☐
Perform calorie counts to determine intake. Provide liquid nutritional supplements as
needed. Add protein powders to food or tube feedings.
☐
Administer megestrol (Megace) to increase the appetite if prescribed.
☐
Assess for findings of dehydration or fluid and electrolyte imbalance.
☐
Perform mouth care prior to serving meals to enhance the client's appetite
Encourage the use of plastic eating utensils, sucking on hard candy, and avoiding red
meats
, to prevent or reduce the sensation of metallic taste
- CORRECT ANSWERS -Nursing Actions for Thrombocytopenia
☐
Monitor for petechiae, ecchymosis, bleeding of the gums, nosebleeds, and occult or
frank
blood in stools, urine, or vomitus.
☐
Institute bleeding precautions (avoid IVs and injections, apply pressure for
approximately
10 min after blood is obtained, handle client gently and avoid trauma).
☐
Administer thrombopoietic medications such as oprelvekin (Interleukin 11, Neumega)
to stimulate platelet production. Monitor platelet count, and be prepared to administer
platelets if the count falls below 30,000/mm
3
.
■
Client Education
☐
Instruct the client and family how to manage active bleeding.
☐
Instruct the client about measures to prevent bleeding (use electric razor and soft-
bristled
toothbrush, avoid blowing nose vigorously, ensure that dentures fit appropriately).
☐
Instruct the client to avoid the use of NSAIDs.
☐
Teach the client to prevent injury when ambulating (wear closed-toes shoes, remove
tripping hazards in the home) and apply cold if injury occurs
- CORRECT ANSWERS -Nursing Considerations
☐ Always ask clients whether they are allergic to sulfa. Acetazolamide is a sulfa-based
medication
___ lung expansion with age - CORRECT ANSWERS -decreased
_____ seconds is/are measured in each large box on ECG graph paper? - CORRECT
ANSWERS -0.20
__precautions with hsv - CORRECT ANSWERS -contact
◯ Client Education:
■ Avoid UV and sun exposure.
■ Use mild protein shampoo and avoid harsh hair treatments.
COMPREHENSIVE
EXIT EXAM WITH
QUESTIONS AND
FULLY SOLVED
CORRECT AND
VERIFIED
ANSWERS WITH
WELL
ELABORATE
RATIONALE
,- CORRECT ANSWERS -Anemia and thrombocytopenia occur secondary to bone
marrow suppression (myelosuppression).
■
Nursing Actions for Anemia
☐
Monitor for fatigue, pallor, dizziness, and shortness of breath.
☐
Help the client manage anemia-related fatigue by scheduling activities with rest periods
in
between and using energy saving measures (sitting during showers and ADLs).
☐
Administer erythropoietic medications such as epoetin alfa (Epogen) and antianemic
medications such as ferrous sulfate (Feosol) as prescribed.
☐
Monitor Hgb values to determine response to medications. Be prepared to administer
blood
if prescribed.
- CORRECT ANSWERS -Mucositis (stomatitis) is inflammation of tissues in the mouth,
such as the gums, tongue, roof and
floor of the mouth, and inside the lips and cheeks.
■
Nursing Actions
☐
Examine the client's mouth several times a day, and inquire about the presence of oral
lesions.
☐
Document the location and size of lesions that are present. Lesions should be cultured
and
reported to the provider.
☐
Avoid using glycerin-based mouthwashes or mouth swabs. Nonalcoholic, anesthetic
mouthwashes are recommended.
☐
Administer a topical anesthetic prior to meals.
☐
Discourage consumption of salty, acidic, or spicy foods.
☐
Offer oral hygiene before and after each meal. Use lubricating or moisturizing agents to
counteract dry mouth.
■
Client Education
☐
Encourage the client to rinse mouth with a solution of half 0.9% sodium chloride and
half
,peroxide at least twice a day, and to brush teeth using a soft-bristled toothbrush.
☐
Instruct client to take medications to control infection as prescribed (nystatin
[Mycostatin],
acyclovir [Zovirax]).
☐
Encourage the client to eat soft, bland foods and supplements that are high in calories
(mashed potatoes, scrambled eggs, cooked cereal, milk shakes, ice cream, frozen
yogurt,
bananas, and breakfast mixes)
- CORRECT ANSWERS -Nausea and vomiting/anorexia
■
Many of the medications used for chemotherapy are emetogenic (induce vomiting) or
cause
anorexia as well as an altered taste in the mouth.
■
Serotonin blockers, such as ondansetron (Zofran), have been found to be effective and
are often
administered with corticosteroids, phenothiazines, and antihistamines.
■
Nursing Actions
☐
Administer antiemetic medications at times that are appropriate for a chemotherapeutic
agent
(prior to treatment, during treatment, after treatment).
☐
Administer antiemetic medications for several days after each treatment as needed.
☐
Remove vomiting cues, such as odor and supplies associated with nausea.
☐
Implement nonpharmacological methods to reduce nausea (visual imagery, relaxation,
acupuncture, distraction).
☐
Perform calorie counts to determine intake. Provide liquid nutritional supplements as
needed. Add protein powders to food or tube feedings.
☐
Administer megestrol (Megace) to increase the appetite if prescribed.
☐
Assess for findings of dehydration or fluid and electrolyte imbalance.
☐
Perform mouth care prior to serving meals to enhance the client's appetite
Encourage the use of plastic eating utensils, sucking on hard candy, and avoiding red
meats
, to prevent or reduce the sensation of metallic taste
- CORRECT ANSWERS -Nursing Actions for Thrombocytopenia
☐
Monitor for petechiae, ecchymosis, bleeding of the gums, nosebleeds, and occult or
frank
blood in stools, urine, or vomitus.
☐
Institute bleeding precautions (avoid IVs and injections, apply pressure for
approximately
10 min after blood is obtained, handle client gently and avoid trauma).
☐
Administer thrombopoietic medications such as oprelvekin (Interleukin 11, Neumega)
to stimulate platelet production. Monitor platelet count, and be prepared to administer
platelets if the count falls below 30,000/mm
3
.
■
Client Education
☐
Instruct the client and family how to manage active bleeding.
☐
Instruct the client about measures to prevent bleeding (use electric razor and soft-
bristled
toothbrush, avoid blowing nose vigorously, ensure that dentures fit appropriately).
☐
Instruct the client to avoid the use of NSAIDs.
☐
Teach the client to prevent injury when ambulating (wear closed-toes shoes, remove
tripping hazards in the home) and apply cold if injury occurs
- CORRECT ANSWERS -Nursing Considerations
☐ Always ask clients whether they are allergic to sulfa. Acetazolamide is a sulfa-based
medication
___ lung expansion with age - CORRECT ANSWERS -decreased
_____ seconds is/are measured in each large box on ECG graph paper? - CORRECT
ANSWERS -0.20
__precautions with hsv - CORRECT ANSWERS -contact
◯ Client Education:
■ Avoid UV and sun exposure.
■ Use mild protein shampoo and avoid harsh hair treatments.
