Oncology Review Questions (21-25)

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21. The nurse is preparing a client with a diagnosis of multiple myeloma for discharge. The nurse tells the client to:

a) maintain bedrest
b) restrict fluid intake to 1000 ml daily
c) maintain a high-calorie, low-fiber diet
d) notify the physician if anorexia and nausea occur and persist

22. The nurse provides discharge instructions to the client who had a mastectomy and axillary lymph node dissection. The nurse teaches the client to:

a) avoid use of insect repellent
b) wear protective gloves when doing the dishes
c) avoid the use of lanolin hand cream on the affected arm
d) cut the cuticles on the nails carefully using clean cuticle scissors

23. A client is receiving a course of chemotherapy on an outpatient basis for the diagnosis of lung cancer. Which home-care instruction should the nurse provide to the client?

a) a bathroom can be shared with any member of the family
b) urinary and bowel excreta are not considered contaminated
c) disposable plates and plastic utensils must be used during the entire course of chemotherapy
d) contaminated linens should be washed separately and then washed a second time, if necessary

24. The home-care nurse visits a client with bowel cancer who recently received a course of chemotherapy . The client has developed stomatitis, and the nurse provides instructions to the client about the care of the mouth. The nurse determines that the client needs further instructions if the client states the need to:

a) eat foods without spices
b) maintain a diet of soft foods
c) drink juices that are not citrus
d) drink foods and liquids that are hot

25. A client with leukemia receives a course of chemotherapy. The home-care nurse who is scheduled to visit the client receives a telephone call from the client's physician. The physician informs the nurse that the client's neutrophil count is 600/mm3. On the basis of this laboratory value, the home-care nurse tells the client to avoid doing which of the following?

a) straining at bowel movements
b) using a straight razor for shaving
c) eating any raw fruits or vegetables
d) taking aspirin or medications that contain aspirin






Oncology Review Questions
Answers and Rationale

21) D

- Clients with multiple myeloma need to be taught to monitor for signs of hypercalcemia and to report them immediately to the physician. Anorexia, nausea, vomiting, polyuria, weakness, fatigue, constipation, and signs of dehydration are signs of moderate hypercalcemia. Activity is encouraged. A fluid intake of 3000 mL daily is required to dilute the calcium overload and to prevent protein from precipitating in the renal tubules. Although a high-calorie diet is encouraged, a low-fiber diet can lead to constipation.

22) B

- After axillary lymph node dissection, the affected arm may swell and be at risk for infection. The client needs to be instructed regarding the several measures required to prevent complications. Protective gloves should be worn while doing dishes and cleaning. The client should use insect repellent to avoid bites and stings. Lanolin hand cream should be applied a few times daily. Picking at or cutting the cuticles should not be done, because this could cause an alteration in skin integrity and result in infection.

23) D

- The client may excrete the chemotherapeutic agent for 48 hours or more after administration, depending on the medication administered. Blood, emesis, and excreta may be considered contaminated during this time, and the client should not share a bathroom with children or pregnant women during this time. Any contaminated linens or clothing should be washed separately and then washed a second time, if necessary. All contaminated disposable items should be sealed in plastic bags and disposed of as hazardous waste. Option C is unnecessary

24) D

- Stomatitis is a term that is used to describe the inflammation and ulceration of the mucosal lining of the mouth. Dietary modifications for this condition include avoiding extremely hot foods, spices, and citrus fruits and juices. The client should be instructed to eat soft foods and to take nutritional supplements as prescribed. Food and fluid should be lukewarm or cold.

25) C

- Neutrophil counts should range between 3000 and 5800/mm3. A low neutrophil count places the client at risk for infection. When the client is at risk for infection, he or she should avoid exposure to individuals with colds or infections. All live plants, flowers, and objects that may harbor bacteria should be removed from the client's environment. The client should be on a low-bacteria diet and avoid eating any raw fruits and vegetables. Options A, B, and D are measures that would be implemented if the client was at risk for bleeding.



After you reviewed your answers through its rationale, you can go back to the first page to start from the beginning:

Oncology Review Questions (1-5)

Or proceed to the next set of questions:


Oncology Review Questions (26-30)