Chapter 24: Care of Patients with Cancer

Chapter 24: Care of Patients with Cancer

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. What statement indicates that the client understands teaching about neutropenia?

a.	“I need to use a soft toothbrush.”
b.	“I have to wear a mask at all times.”
c.	“My grandchildren may get an infection from me.”
d.	“I will call my doctor if I have an increase in temperature.”

 

 

ANS:  D

Bone marrow suppression leads to neutropenia and increases the client’s risk for infection. Decreased numbers of neutrophils and other white blood cells can minimize the clinical manifestations of infection. For this reason, the client may not develop a high temperature, even with severe infection, and any elevation of temperature should be reported immediately to the health care provider. The client does not need to wear a mask or use a soft toothbrush (although if the client has low platelets, he or she should use a soft toothbrush to avoid causing trauma). The client is not contagious.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)

MSC:  Integrated Process: Nursing Process (Evaluation)

 

2. A client is undergoing radiation therapy and asks the nurse about skin care for the exposed area. Which statement by the nurse is most accurate?

a.	“No products work well to reduce the skin reactions you get from radiation.”
b.	“No one product works best, so you can choose what you would like to use.”
c.	“The only medication that works well for skin reactions is very expensive.”
d.	“No good studies on skin care with radiation have been conducted to date.”

 

 

ANS:  B

A recent placebo-controlled study showed that none of three products used to manage radiation-related skin reactions was superior to the others. Researchers concluded that clients should use products that are easy to obtain and use and are within the client’s budget. Simply stating that no one product works well does not give the client enough information to make an informed choice. Prescription medications for skin reactions can be expensive, but again this response does not help the client make a decision.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 414

TOP:   Client Needs Category: Health Promotion and Maintenance (Self-Care)

MSC:  Integrated Process: Teaching/Learning

 

3. A client who has just had a mastectomy is crying. When the nurse asks about her crying, the client responds, “I know I shouldn’t cry because this surgery may well save my life.” What is the nurse’s best response?

a.	“It is all right to cry. Mourning this loss will help make you stronger.”
b.	“I know this is hard, but your chances of survival are better now.”
c.	“I can arrange for someone who had a mastectomy to come visit if you like.”
d.	“How have you coped with difficult situations in the past?”

 

 

ANS:  C

Often, cancer surgery involves the loss of a body part or a decrease in function. Mourning or grieving for a body image alteration is a healthy part of adapting or adjusting to a new image. Visiting with someone who has experienced the same situation as the client is very helpful in showing the client that many aspects of life can be the same afterward. If the opportunity to arrange this type of visit is available, this would be the nurse’s best response. The other options do not provide any assistance to the client in coping with her new body image and grieving for her loss.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 411

TOP:   Client Needs Category: Psychosocial Integrity (Therapeutic Communications)

MSC:  Integrated Process: Caring

 

4. In evaluating dietary teaching for a client with chemotherapy-induced neutropenia, the nurse becomes concerned when the client makes which food choice?

a.	Fruit salad
b.	Applesauce
c.	Steamed broccoli
d.	Baked potato

 

 

ANS:  A

The client who is neutropenic should be taught to eat a low-bacteria diet. This includes avoiding raw fruits or vegetables and undercooked meat, eggs, or fish.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Health Promotion and Maintenance (Self-Care)

MSC:  Integrated Process: Nursing Process (Evaluation)