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Exam Prep Questions

1.A client on the oncology unit is to receive heparin sodium 5 units per kilogram of body weight by subcutaneous route every 4 hours. The client weighs 105.6 lbs. How many units should the client receive in a 24-hour period?

A.800

B.1080

C.1440

D.1960


2.A client diagnosed with metastatic cancer of the bone is exhibiting mental confusion and a BP of 160/100. Which laboratory value would correlate with the client’s symptoms reflecting a common complication with this diagnosis?

A.Potassium 5.2 mEq/l

B.Calcium 13 mg/dl

C.Inorganic phosphorus 1.7 mEq/l

D.Sodium 138 mEq/l


3.A client with cancer has been placed on TPN. The nurse notes air entering the client via the central line. Which initial action is most appropriate?

A.Notify the physician.

B.Elevate the head of the bed.

C.Place the client in the left lateral decubitus position.

D.Stop the TPN and hang D51/2 NS.


4.The nurse is preparing a client for cervical uterine radiation implant insertion. Which will the nurse expect to be included in the teaching plan?

A.TV or telephone use will not be allowed while the implant is in place.

B.A Foley catheter is usually inserted.

C.A high fiber diet is recommended.

D.Excretions will be considered radioactive.


5.The nurse is caring for a client with leukemia who is receiving the drug doxorubicin (Adriamycin). Which, if occurred, would be reported to the charge nurse immediately due to the toxic effects of this drug?

A.Rales and distended neck veins

B.Red discoloration of the urine and an output of 75 ml the previous hour

C.Nausea and vomiting

D.Elevated BUN and dry, flaky skin


6.A client with cancer received platelet infusions 24 hours ago. Which of the following assessment findings would indicate the most therapeutic effect from the transfusions?

A.A Hgb level decrease from 8.9 to 8.7

B.A temperature reading of 99.4

C.A white blood cell count of 11,000

D.A decrease in oozing of blood from the IV site


7.The nurse is caring for a client receiving chemotherapy who is experiencing neutropenia. Which intervention would be most appropriate to recommend for inclusion in the client’s plan of care?

A.Assess the client’s temperature every 4 hours due to risk of hypothermia.

B.Instruct the client to avoid large crowds and people who are sick.

C.Instruct the client in the use of a soft toothbrush.

D.Assess the client for hematuria.


8.A client who has a strong family history of breast cancer tells the nurse that she is taking a drug to prevent breast cancer. The nurse expects the drug that she is receiving is:

A.Tamoxifen (Nolvadex)

B.Cyclophosphamide (Cytoxan)

C.Estrogen (Premarin)

D.Doxorubicin (Adriamycin)


9.The nurse is caring for a client with possible cervical cancer. What clinical data would the nurse most expect to find in the client’s history?

A.Postcoital vaginal bleeding

B.Nausea and vomiting

C.Foul-smelling vaginal discharge

D.Hyperthermia


10.A client is scheduled to undergo a bone marrow aspiration. Which position would the nurse assist the client into for this procedure?

A.Dorsal recumbent

B.Supine

C.High Fowler’s

D.Lithotomy


Answer Rationales

1.Answer C is correct. The client weighs 48Kg and should receive 5 units/Kg, or 240 units every 4 hours. This would be 1440 units in 24 hours. The answers in A, B, and D are incorrect calculation.
2.Answer B is correct. Hypercalcemia is a common occurrence with cancer of the bone. The potassium level is elevated but does not relate to the diagnosis, so answer A is incorrect. Answers C and D are both normal levels, so they are incorrect.
3.Answer C is correct. The client is at risk for an air embolus. Placing the client in this position displaces air away from the right ventricle. Answers B and D would not help, so they are incorrect, and answer A would not be done first, so it’s incorrect.
4.Answer B is correct. A catheter allows urine elimination without possible disruption of the implant. There is usually no restriction on TV or phone use, so answer A is incorrect. The client is placed on a low residue diet, so answer C is incorrect. The client’s radiation is not internal; therefore, there are no special precautions with excretions, making answer D incorrect.
5.Answer A is correct. This drug can cause cardiotoxicity exhibited by changes in the ECG and congestive heart failure. Rales and distended neck veins are clinical manifestations of congestive heart failure, so answer A is correct. A reddish discoloration to the urine is a harmless side effect, so answer B is incorrect. An elevated BUN and dry, flaky skin are not specific to this drug, so answers C and D are incorrect.
6.Answer D is correct. Platelets deal with the clotting of blood. Lack of platelets can cause bleeding. Answers A, B, and C do not directly relate to platelets, so they are incorrect.
7.Answer B is correct. With neutropenia, the client is at risk for infection; therefore, he would need to avoid crowds and people who are ill. Answer A would not be appropriate. Answers C and D would correlate with a risk for bleeding, so they are incorrect.
8.Answer A is correct. Tamoxifen is indicated for prevention of breast cancer in high risk patients. It can also be given to delay recurrence of breast cancer and for palliative treatment. The drugs in answers B,C, and D are not indicated for prevention of breast cancer, so they are incorrect.
9.Answer A is correct. Vaginal bleeding or spotting is a common symptom of cervical cancer. Nausea and vomiting and foul-smelling discharge are not specific or common to cervical cancer, so B and C are incorrect. Hyperthermia does not relate to the diagnosis, so answer D is incorrect.
10.Answer C is correct. This procedure is usually done by the physician with specimens obtained from the sternum or the iliac crest. The high Fowler’s position would be the best position of the ones listed to obtain a specimen from the client’s sternum. Answers A, B, and D would be inappropriate positions for getting a biopsy from the sites indicated.


  

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