Oncology HW Qs Flashcards

1
Q

A client is receiving chemotherapy with doxorubicin. Which development will the nurse teach the client to report immediately?
A. Nausea
B. Sore throat
C. Loss of hair
D. Constipation

A

B. Sore throat

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2
Q

A complete blood count is prescribed before each round of a client’s cancer chemotherapy. Which component of the complete blood count is of greatest concern to the nurse?
A. Platelets
B. Hematocrit
C. Red blood cells (RBCs)
D. White blood cells (WBCs)

A

D. White blood cells (WBCs)

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3
Q

Which systemic side effect would the nurse monitor for in a client receiving combination chemotherapy for the treatment of metastatic carcinoma?
A. Ascites
B. Nystagmus
C. Leukopenia
D. Polycythemia

A

C. Leukopenia

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4
Q

A client with laryngeal cancer is receiving chemotherapy. Which laboratory report is most important for the nurse to monitor when considering the effects of chemotherapy?
A. Platelets
B. Hemoglobin level
C. Red blood cell count
D. White blood cell count

A

D. White blood cell count

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5
Q

A client with multiple myeloma who is receiving the alkylating agent melphalan returns to the oncology clinic for a follow-up visit. For which adverse effect will the nurse monitor the client?
A. Hirsutism
B. Leukopenia
C. Constipation
D. Photosensitivity

A

B. Leukopenia

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6
Q

A client receiving cancer chemotherapy asks the nurse why an antibiotic was prescribed. Which tissue affected by chemotherapy will the nurse consider when formulating a response?
A. Liver
B. Blood
C. Bone marrow
D. Lymph nodes

A

C. Bone marrow

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7
Q

A client is receiving combination chemotherapy for the treatment of metastatic carcinoma. For which systemic side effect would the nurse monitor the client?
A. Ascites
B. Nystagmus
C. Leukopenia
D. Polycythemia

A

C. Leukopenia

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8
Q

An adolescent is prescribed an antineoplastic agent. Which instruction would the nurse give to the parents before discharge?
A. Limit contact with all peers and family members.
B. Withhold medications when nausea occurs to prevent vomiting.
C. Schedule laboratory blood tests to evaluate response to the medication.
D. Return weekly for a bone marrow aspiration to monitor effectiveness of therapy.

A

C. Schedule laboratory blood tests to evaluate response to the medication.

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9
Q

The nurse is caring for a client who recently received an allogeneic bone marrow transplant for the treatment of leukemia. Which nursing intervention is a priority for this client?
A. Provide education on infection prevention in the community
B. Assist the client with ambulation every 2 hours
C. Monitor the client for signs of infection
D. Introduce the client to another bone marrow recipient

A

C. Monitor the client for signs of infection

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10
Q

Which intervention would the nurse include in the plan of care for a client with breast cancer who received doxorubicin and cyclophosphamide 12 days ago and now has a white blood cell (WBC) count of 1.4 cells/mm 3 and reports shortness of breath and activity intolerance? Which of the responses is correct
A. Use an electric razor when shaving.
B. Institute neutropenic precautions.
C. Place client on airborne precautions.
D. Instruct nursing staff to wear a dosimeter badge.

A

B. Institute neutropenic precautions.

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11
Q

) A nurse is providing teaching to a client who has breast cancer about the adverse effects of chemotherapy. Which of the following client statements indicates an understanding of the teaching?
A. “I will take the antiemetic as soon as the chemotherapy infusion is complete.”
B. “I will run my toothbrush in the dishwasher every month.”
C. “I’ll call my doctor if I notice any unusual menstrual bleeding.”
D. “I will avoid crowds to keep from infecting others.”

A

C. “I’ll call my doctor if I notice any unusual menstrual bleeding.”

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12
Q

The nurse is assessing a child receiving chemotherapy for treatment of leukemia. Which side effect would the nurse anticipate due to lower platelets?
A. Epistaxis (nose bleed)
B. Tachycardia
C. Flushed skin
D. Increased temperature

A

A. Epistaxis (nose bleed)

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13
Q

The nurse observes bloody expectorant after a 4-year-old child with leukemia brushed his or her teeth. Which action should the nurse take next?
A. Secure a smaller toothbrush for the child to use.
B. Document and report the incident.
C. Tell the child to be more careful when brushing the teeth.
D. Rinse the child’s mouth with half-strength hydrogen peroxide.

A

B. Document and report the incident.

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14
Q

A client develops severe bone marrow suppression related to cancer treatment. Which instruction is important for the nurse to include in the client’s teaching?
A. Be prepared to experience alopecia.
B. Increase fluids to at least 3 liters per day.
C. Use a soft toothbrush for oral hygiene.
D. Monitor your intake and output of fluids.

A

C. Use a soft toothbrush for oral hygiene.

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15
Q

A client is admitted to the hospital with pancytopenia as a result of chemotherapy. Which information will the nurse provide to minimize the risk for complications?
A. Avoid activities that risk traumatic injuries and exposure to infection.
B. Perform frequent mouth care with a firm toothbrush.
C. Increase oral fluid intake to a minimum of 3 L daily.
D. Report any unusual muscle cramps or tingling sensations in the extremities.

A

A. Avoid activities that risk traumatic injuries and exposure to infection.

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16
Q

A client who was admitted with a diagnosis of acute lymphoblastic leukemia is receiving chemotherapy. Which assessment findings would NOT alert the nurse to the possible development of thrombocytopenia?
A. Diarrhea
B. Melena
C. Hematuria
D. Ecchymosis

A

A. Diarrhea

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17
Q

A client receiving chemotherapy develops bone marrow suppression. The nurse will NOT monitor for which thrombocytopenic (low platelets) effect?
A. Deep vein thrombosis (leg clot)
B. Melena (blood in stool)
C. Purpura (blood under skin, dots)
D. Hematuria (blood in urine)

A

A. Deep vein thrombosis (leg clot)

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18
Q

Which response would the nurse give to a client receiving chemotherapy who develops sores in the mouth and asks the nurse why this happened?
A. “The sores occur because of the direct irritating effects of the medication.”
B. “These tissues are poorly nourished because you have a decreased appetite.”
C. “The frequently dividing cells of the gastrointestinal tract are damaged by the medication.”
D. “This side effect occurs because it targets the cells of the gastrointestinal system.”
Rationale

A

C. “The frequently dividing cells of the gastrointestinal tract are damaged by the medication.”

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19
Q

A client with Hodgkin’s disease is started on chemotherapy. The nurse teaches the client to notify the health care provider for which adverse response to chemotherapy?
A. Hair loss
B. Sores in the mouth
C. Moderate diarrhea after treatment
D. Nausea for 6 hours after treatment

A

B. Sores in the mouth

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20
Q

Which nursing care will be included for a client who is receiving doxorubicin for acute myelogenous leukemia?
A. Increasing citrus foods
B. Providing frequent oral hygiene
C. Encouraging activity
D. Administering medications parenterally

A

B. Providing frequent oral hygiene

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21
Q

A 5-year-old child is receiving dactinomycin and doxorubicin therapy after nephrectomy for Wilms tumor. Which intervention would the nurse include when planning care?
A. Adding citrus juices to meals
B. Offering warm saline mouthwash
C. Scheduling booster immunizations
D. Reporting red-orange colored urine

A

B. Offering warm saline mouthwash

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22
Q

A child is prescribed dactinomycin and doxorubicin therapy after a nephrectomy for Wilms tumor. Which intervention would the nurse include in the plan of care?
A. Administering aspirin for pain
B. Offering citrus juices with meals
C. Ensuring meticulous oral hygiene
D. Eliminating spicy foods from the diet

A

C. Ensuring meticulous oral hygiene

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23
Q

Which information will the nurse share about alopecia characteristics to a client who is to receive chemotherapy after surgery for cancer?
A. Usually rare
B. Not permanent
C. Frequently prolonged
D. Usually preventable

A

B. Not permanent

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24
Q

An adolescent is to begin a chemotherapeutic medication regimen. Which side effect of vincristine is most important for the nurse to prepare the adolescent to expect before treatment?
A. Alopecia
B. Mild Constipation
C. Loss of appetite
D. Peripheral neuropathy

A

A. Alopecia

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25
Which anticipatory guidance would the nurse include when teaching an adolescent about side effects of dactinomycin and doxorubicin therapy? A. Wear a baseball cap. B. Eat three meals daily. C. Avoid dairy products. D. Dress in light clothing.
A. Wear a baseball cap.
26
Which concept is important to teach a client in relation to why medication cocktails are more effective than a single medication in cancer therapy? A. Medication resistance B. Tumor doubling time C. Cellular growth cycle D. Retained radioactive particles
C. Cellular growth cycle
27
A client is diagnosed with multiple myeloma. Which intervention would the nurse expect the plan of care to include? A. Radiotherapy on an outpatient basis B. Human leukocyte interferon therapy C. Surgery to remove the invasive lesions D. Chemotherapy employing a combination of medications
D. Chemotherapy employing a combination of medications
28
A client is diagnosed at stage IV Hodgkin disease. Which therapy option is indicated? A. Radiation therapy B. Combination chemotherapy C. Radiation with chemotherapy D. Surgical removal of the affected nodes
B. Combination chemotherapy
29
A client is scheduled to begin chemotherapy 2 weeks after surgery for colon cancer. Which explanation would the nurse give to explain the delay after surgery? A. Chemotherapy interferes with cell growth and delays wound healing. B. Because chemotherapy causes vomiting, it endangers the integrity of the incisional area. C. Chemotherapy decreases red blood cell production, and the resultant anemia will add to postoperative fatigue. D. Chemotherapy increases edema in areas distal to the incision by blocking lymph channels with destroyed lymphocytes.
A. Chemotherapy interferes with cell growth and delays wound healing.
30
A client with stage III Hodgkin's disease is started on a multiple-drug regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine. Why are so many drugs necessary? A. Using smaller doses of several drugs reduces the likelihood of serious side effects. B. Each drug destroys the cancer cell at a different time in the cell cycle. C. Several drugs are used to destroy cells that are not susceptible to radiation therapy. D. Because there are stages of Hodgkin's disease, if one drug is ineffective, another will work.
B. Each drug destroys the cancer cell at a different time in the cell cycle.
31
The nurse is caring for a child with an exacerbation of leukemia. The nurse would plan to administer the prescribed analgesic for bone pain at which time? A. At scheduled intervals B. When the child asks for it C. When pain becomes severe D. Before the pain becomes severe
A. At scheduled intervals
32
An adolescent with leukemia is to be given a chemotherapeutic agent. Which time is best for the nurse to administer the prescribed antiemetic? A. As nausea occurs B. An hour before meals C. Just before each meal is eaten D. Before each dose of chemotherapy
D. Before each dose of chemotherapy
33
) A child receiving methotrexate and undergoing cranial radiation is very weak. The mother asks the nurse if she should give her child vitamins with folic acid. Which response by the nurse is most appropriate? A. 'That’s an excellent idea. I’ll try to get a prescription for her.' B. 'Unfortunately, vitamins won’t make her feel any better now.' C. 'That won’t be possible. Vitamins interfere with the action of methotrexate.' D. 'After we receive the laboratory reports, your daughter will be getting vitamins.'
C. 'That won’t be possible. Vitamins interfere with the action of methotrexate.'
34
The parent of a toddler taking methotrexate asks the nurse whether the child should be started on vitamin supplements with folic acid. Which statement by the nurse is appropriate? A. 'That’s a fine suggestion, and I’ll ask for a prescription.' B. 'Vitamin supplements won’t help him feel any better right now.' C. 'He’ll benefit from a vitamin supplement and will be getting it soon.' D. 'Supplements that contain folic acid interfere with the effectiveness of chemotherapy.'
D. 'Supplements that contain folic acid interfere with the effectiveness of chemotherapy.'
35
A nurse is providing teaching to a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following information should the nurse provide? A. Expect to have a fever for the first days of therapy. B. Drink 2 to 3 L of water per day while on the medication. C. Administer the medication with an NSAID to enhance effectiveness. D. Take the medication in the morning to prevent insomnia.
B. Drink 2 to 3 L of water per day while on the medication.
36
A nurse is teaching a client who has rheumatoid arthritis about taking methotrexate. Which of the following information should the nurse include? A. Take an antiemetic 1 hr following administration. B. Drink 2 to 3 L of water per day. C. Take the medication with an NSAID. D. Rinse mouth 2 times per day with an alcohol based mouthwash.
B. Drink 2 to 3 L of water per day.
37
) A nurse is teaching a client who is starting to take methotrexate to treat rheumatoid arthritis. Which of the following instructions should the nurse include in the teaching? A. "Avoid eating foods high in vitamin K." B. "Use an alcohol-based mouthwash after each meal." C. "Take the medication daily." D. "Drink at least 2 liters of water daily."
D. "Drink at least 2 liters of water daily."
38
A nurse is caring for a female client who has rheumatoid arthritis and a new prescription for methotrexate. The client tells the nurse she is planning a pregnancy. Which of the following instructions should the nurse give the client? A. Dietary modifications occur during pregnancy when taking this medication. B. The medication should be discontinued 3 months prior to a planned pregnancy. C. Dosage of the medication will be reduced during pregnancy. D. The client can breast feed when taking this medication.
B. The medication should be discontinued 3 months prior to a planned pregnancy.
39
Leucovorin calcium is prescribed and is to be administered immediately after an infusion of methotrexate. Which result of laboratory testing indicates that leucovorin has been effective? A. Potassium level normalizes B. Folic acid level within normal limits C. Improved white blood cell count D. Decreased methotrexate level
D. Decreased methotrexate level
40
) A client with cancer is receiving leucovorin as part of a chemotherapy protocol. Which purpose does leucovorin serve? A. Potentiating the effect of alkylating agents B. Diminishing toxicity of folic acid antagonists C. Limiting vomiting associated with chemotherapy D. Preventing alopecia
B. Diminishing toxicity of folic acid antagonists
41
The nurse considers that the safe administration of high-dose methotrexate therapy would include which intervention? A. Maintaining an acidic urine B. Restricting intravenous fluids C. Providing a diet high in folic acid D. Monitoring plasma levels of the medication
D. Monitoring plasma levels of the medication
42
A nurse in a provider's clinic is assessing a client who has cancer and a prescription for methotrexate PO. Which of the following actions should the nurse take when the client reports bleeding gums? A. Explain to the client that this is an expected adverse effect. B. Check the value of the client's current platelet count. C. Instruct the client to use an electric toothbrush. D. Have the client make an appointment to see the dentist.
B. Check the value of the client's current platelet count.
43
The alkylating agent cyclophosphamide is prescribed for a school-age child with cancer. Which clinical manifestation would the nurse be alert for while the child is receiving this medication? A. Irritability B. Pain with urination C. Unpredictable nausea D. Hyperplasia of the gums
B. Pain with urination
44
The nurse is providing teaching to a client who has been prescribed cyclophosphamide for breast cancer treatment. Which of the following statements made by the client would indicate that additional teaching is needed? A. "I will probably need to plan on using a wig to cover my hair loss." B. "I should limit the amount of fluids I drink while taking this medication." C. "I will need to stay away from children when my white blood cell count is low." D. "I may have trouble getting pregnant due to the damaging effects of the medication."
B. "I should limit the amount of fluids I drink while taking this medication."
45
Which nursing assessment is most important for a child receiving cyclophosphamide? A. Extent of alopecia B. Changes in appetite C. Hyperplasia of gums D. Daily intake and output
D. Daily intake and output
46
Which toxic effect would a nurse monitor for in a client who is prescribed vincristine? A. Peripheral paresthesia B. Anginal-type chest pain C. Ophthalmic papilledema D. Bilateral crackles in the lung
A. Peripheral paresthesia
47
Which side effect would the nurse assess for in a child receiving vincristine? A. Hemolytic anemia B. Irreversible alopecia C. Hyperglycemia D. Neurological complications
D. Neurological complications
48
An adolescent with leukemia is receiving vincristine. The mother reports that the child is complaining of feeling 'tingles' all over. Which response by the nurse is most appropriate regarding the effect of this medication? A. 'It is a neurological side effect.' B. 'It is caused by an autoimmune reaction.' C. 'The skin becomes sensitive with chemotherapy.' D. 'The central nervous system has become hyperactive.'
A. 'It is a neurological side effect.'
49
A client with leukemia who is receiving vincristine reports lower leg numbness. Which statement about vincristine explains this occurrence? A. Vincristine acts on enlarged lymph nodes in the groin. B. Vincristine affects peripheral vascular circulation. C. Vincristine increases the risk for vascular occlusion. D. Peripheral neuropathies can result from vincristine chemotherapy.
D. Peripheral neuropathies can result from vincristine chemotherapy.
50
A school-age child with leukemia is receiving treatment with vincristine. Which toxic response would the nurse assess the child for? A. Diarrhea B. Alopecia C. Hemorrhagic cystitis D. Peripheral neuropathy
D. Peripheral neuropathy
51
A client is receiving ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) therapy for Hodgkin's disease. When the client reports burning and tingling of the feet, which medication would the nurse determine is the likely cause? A. Neurotoxicity caused by vinblastine B. Hypersensitivity caused by dacarbazine C. Endocrine alterations caused by doxorubicin D. Peripheral vasoconstriction caused by bleomycin
A. Neurotoxicity caused by vinblastine
52
A school-age child diagnosed with acute lymphocytic leukemia (ALL) becomes constipated after receiving induction therapy with prednisone, vincristine, and asparaginase. Which would the nurse suspect as the cause? A. Diet, which lacks bulk B. Inactivity, which results from illness C. Vincristine, which decreases peristalsis D. Prednisone, which causes gastric irritability
C. Vincristine, which decreases peristalsis
53
An adolescent who has been prescribed prednisone and vincristine for leukemia tells the nurse that he is constipated. Which reason would the nurse cite as the probable cause of the constipation? A. It is a side effect of the vincristine. B. The spleen is compressing the bowel. C. It is a toxic effect from the prednisone. D. The leukemic mass is obstructing the bowel.
A. It is a side effect of the vincristine.
54
To minimize the side effects of the vincristine that a client is receiving, which diet would the nurse advise? A. Low in fat B. High in iron C. High in fluids D. Low in residue
C. High in fluids
55
Which common side effect will the nurse address in the care plan of a client with cancer receiving the plant alkaloid vincristine? A. Color-blindness B. Anuria C. Constipation D. Hyperphosphatemia
C. Constipation
56
) Which laboratory test result would alert the nurse that fluid intake would need to be increased in a child receiving vincristine? A. Urine pH of 6, normal B. Urine specific gravity of 1.020, normal C. Blood uric acid level of 7.5 mg/dL, high D. Blood urea nitrogen level of 15 mg/dL, normal
C. Blood uric acid level of 7.5 mg/dL, high
57
A client with Hodgkin's disease is to receive the cyclic antineoplastic vincristine as part of a therapy protocol. Which mechanism of action would the nurse associate with this medication? A. Arresting mitosis in metaphase B. Inhibiting the synthesis of thymidine C. Alkylating nucleic acids needed for mitosis D. Inactivating DNA while inhibiting RNA synthesis
A. Arresting mitosis in metaphase
58
A nurse is administering vincristine to a client with cancer. The client asks the nurse how the medication works. Which statement by the nurse is appropriate? A. It stops the synthesis of proteins in cancer cells B. It prevents cell division of cancer cells C. It interrupts the S-phase of cancer cell reproduction D. It alters the DNA structure of cancer cells
B. It prevents cell division of cancer cells
59
A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary? A. An excess amount of doxorubicin can lead to myelosuppression. B. Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation. C. An excess amount of doxorubicin can lead to cardiomyopathy. D. Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat.
C. An excess amount of doxorubicin can lead to cardiomyopathy.
60
Which clinical finding indicates that doxorubicin toxicity may have occurred? A. Fever B. Blue tinge to the urine C. Alteration in cardiac rhythm D. Increasing anxiety
C. Alteration in cardiac rhythm
61
A client receives doxorubicin infusions for treatment of acute lymphocytic leukemia. Which clinical finding indicates that toxicity has occurred? A. Alopecia B. Dyspnea C. Metallic taste to food D. Cardiac rhythm abnormalities
D. Cardiac rhythm abnormalities
62
A client is receiving doxorubicin as part of a chemotherapy protocol. The nurse will assess the client for which system toxicity? A. Neurotoxicity B. Cardiotoxicity C. Ototoxicity D. Nephrotoxicity
B. Cardiotoxicity
63
A client receives doxorubicin as part of a chemotherapy protocol. The nurse would assess the client for signs and symptoms of which adverse effect? A. Toxic epidermal necrolysis B. Heart failure C. Pulmonary fibrosis D. Ototoxicity
B. Heart failure
64
A client with adenocarcinoma receives doxorubicin intravenously (IV) to reduce the tumor mass. Which clinical finding indicates that doxorubicin toxicity may have occurred? A. Fever B. Blue tinge to the urine C. Alteration in cardiac rhythm D. Increasing anxiety
C. Alteration in cardiac rhythm
65
A client diagnosed with breast cancer is prescribed doxorubicin. Which assessment finding would the nurse recognize as a toxic effect of this medication? A. Paralytic ileus B. Red-tinged urine C. Cardiac dysrhythmias D. Increased serum magnesium
C. Cardiac dysrhythmias
66
A child with Wilms tumor is prescribed doxorubicin hydrochloride. Which common side effect unique to doxorubicin would the nurse expect to observe in the child? A. Hair loss B. Vomiting C. Red urine D. Stomatitis
C. Red urine
67
A client with Hodgkin's disease adds doxorubicin to current therapy. Which advice will the nurse provide about this medication? A. Cease taking any medication that contains vitamin D. B. Keep the doxorubicin in a dark place protected from light. C. Expect urine to turn red for a few days after taking this medication. D. Take the doxorubicin on an empty stomach with large amounts of fluids.
C. Expect urine to turn red for a few days after taking this medication.
68
A client receiving doxorubicin (Adriamycin) intravenously (IV) complains of pain at the insertion site, and the nurse notes edema at the site. Which intervention is most important for the nurse to implement? A. Assess for erythema. B. Administer the antidote. C. Apply warm compresses. D. Discontinue the IV fluids.
D. Discontinue the IV fluids.
69
A nurse is preparing to administer doxorubicin to a client with bladder carcinoma. How will the nurse prepare this medication? A. While wearing sterile gloves B. In a biological safety cabinet C. Inside a temperature-controlled room D. By withdrawing into a syringe undiluted
B. In a biological safety cabinet
70
A nurse is preparing to administer reconstituted doxorubicin (Myocet) to a client with thyroid carcinoma. Nuclear medicine calls for the client, and the nurse is unable to administer the medication. Which action should the nurse perform with the medication? A. Save the medication in a syringe with an aluminum needle B. Store the medication in the refrigerator inside the syringe C. Discard the medication in the hazardous waste container D. Add the medication to the intravenous fluids in the client room
B. Store the medication in the refrigerator inside the syringe
71
The nurse is teaching a 68-year-old, postmenopausal, female client has about adverse effects of newly prescribed tamoxifen for breast cancer with bone metastases. Which information should the nurse include in the teaching? A. Stroke-like symptoms B. Insomnia C. Seizures D. Symptoms of hypocalcemia
A. Stroke-like symptoms
72
A nurse is teaching for a client who is to begin taking tamoxifen to treat breast cancer. The nurse should instruct the client to expect which of the following findings as an adverse effect of the medication? A. Tinnitus B. Constipation C. Urinary retention D. Hot flashes
D. Hot flashes
73
The client asks the nurse how long she will have to take tamoxifen for breast cancer treatment. Which response by the nurse is appropriate? A. 'You’ll have to take it for the rest of your life.' B. 'You’ll need to take it for 10 days, like an antibiotic.' C. 'You’ll need to take it for 5 years, after which it will be discontinued.' D. 'You’ll need to take it for several months, until the bone pain subsides.'
C. 'You’ll need to take it for 5 years, after which it will be discontinued.'
74
A client who is immunosuppressed is receiving filgrastim. When monitoring effectiveness, the nurse will check for an increase in which blood component? A. Platelets B. Erythrocytes C. Lymphocytes D. White blood cells
D. White blood cells
75
The nurse is reviewing the laboratory results for a client with cancer who is being treated with chemotherapy and recently started prescribed filgrastim. Which laboratory value indicates the treatment is effective? A. Hemoglobin level of 9.8 g/dL B. White blood cell count (WBC) of 5,200/mm3 C. Platelet count of 200,000/mm D. Red blood cell count (RBC) of 4 million/mm
B. White blood cell count (WBC) of 5,200/mm3
76
A nurse is teaching a parent how to administer oral iron supplements to a 2-year-old child. Which intervention should be included in the teaching? A. Stop the medication if the stools become tarry green B. Add the medicine to a bottle of formula C. Give the medicine with orange juice and through a straw D. Administer the iron with your child's meals
C. Give the medicine with orange juice and through a straw
77
A 3-year-old child is prescribed a liquid iron preparation. The nurse would include which intervention when teaching the parent about the administration of this medication? A. 'Monitor the stools for diarrhea.' B. 'Administer with meals to improve absorption.' C. 'Avoid giving the child orange juice with the iron preparation.' D. 'Have the child drink the diluted iron preparation through a straw.'
D. 'Have the child drink the diluted iron preparation through a straw.'
78
Which information would the nurse include when teaching parents about the side effects of iron supplements? A. The urine may turn red. B. The skin will turn yellow. C. The teeth may become stained. D. The stools will take on a clay color.
C. The teeth may become stained.
79
Which technique would the nurse use to administer ferrous sulfate to a 12-month-old infant? A. Through a straw B. Crushed in applesauce C. In an intramuscular injection D. Syringe directed toward the back of the mouth
D. Syringe directed toward the back of the mouth
80
A nurse in a pediatric clinic is caring for a child who has iron deficiency anemia and a new prescription for ferrous sulfate tablets. Which of the following instructions should the nurse provide the parents regarding administration of this medication? A. Give with a 240 mL (8 oz) glass of milk. B. Administer at mealtimes. C. Give with orange juice. D. Administer at bedtime.
C. Give with orange juice.
81
A nurse is providing teaching for a client who has anemia and a new prescription for ferrous sulfate liquid. Which of the following instructions should the nurse provide? A. Take the medication on an empty stomach to decrease gastrointestinal irritation. B. Take the medication with orange juice to enhance absorption. C. Take the medication with milk. D. Rinse the mouth before taking the iron.
B. Take the medication with orange juice to enhance absorption.
82
A nurse is caring for a client who has a new prescription for ferrous sulfate tablets twice daily for iron-deficiency anemia. The client asks the nurse why the provider instructed that she take the ferrous sulfate between meals. Which of the following responses should the nurse make? A. "Taking the medication between meals will help you avoid becoming constipated." B. "Taking the medication with food increases the risk of esophagitis." C. "Taking the medication between meals will help you absorb the medication more efficiently." D. "The medication can cause nausea if taken with food."
C. "Taking the medication between meals will help you absorb the medication more efficiently."
83
A client with anemia has a new prescription for ferrous sulfate. When teaching the client about diet and iron supplements, what should the nurse emphasize about taking an iron supplement? A. Lie down for about 10 minutes after taking the pill B. Take the iron tablet with a glass of orange juice C. Take an antacid with the iron supplement to reduce stomach upset D. Take the iron tablet with a glass of low-fat milk
B. Take the iron tablet with a glass of orange juice
84
Which drink would the nurse instruct a client with iron deficiency anemia to choose to drink with the supplement for efficient absorption? A. Water B. Skim milk C. Orange juice D. A strawberry milkshake
C. Orange juice
85
The nurse instructs a postpartum client on the administration of an iron supplement. Which drink selected by the client indicates the teaching was effective? A. Milk B. Water C. Cream soda D. Cranberry juice
D. Cranberry juice
86
The nurse would counsel a pregnant client to take her iron supplement at which time of the day for efficient absorption? A. Bedtime B. After lunch C. Dinnertime D. Before breakfast
D. Before breakfast
87
A client is being discharged with a prescription for an iron supplement. Which client statement indicates the need for further teaching by the nurse? A. "I will have greenish-black stools from the medication." B. "I will not take antacids with my iron supplement." C. "I will take the iron supplement with a full glass of milk." D. "I will take vitamin C along with the iron supplement."
C. "I will take the iron supplement with a full glass of milk."
88
A 9-month-old infant with iron-deficiency anemia has been getting supplements but shows no improvement. The nurse recognizes which action by the parents as the reason for the lack of improvement? A. Administering iron supplements through a straw B. Administering iron supplements with whole cow’s milk C. Administering iron supplements along with orange juice D. Administering iron supplements at the back of the mouth
B. Administering iron supplements with whole cow’s milk
89
A nurse is teaching a client who has a new prescription for ferrous sulfate. Which of the following statements by the client indicates an understanding of the teaching? A. "I will expect the color of my urine to be amber." B. "I should expect dark, tarry stools." C. "I should expect increased bruising." D. "I will not get as many infections."
B. "I should expect dark, tarry stools."
90
A child with iron-deficiency anemia is prescribed oral iron therapy. Anticipatory guidance regarding which side effect would the nurse provide? A. Bloody stool B. Orange urine C. Greenish-black tarry stool D. Staining of the mouth
C. Greenish-black tarry stool
91
The nurse receives an order to administer intravenous (IV) iron sucrose to a client with anemia. Which statement best describes the purpose of administering this medication using the IV route? A. To ensure that the entire dose of medication is given B. To prevent the drug from causing tissue irritation C. To provide more even distribution of the drug D. To enhance absorption of the medication
B. To prevent the drug from causing tissue irritation
92
Which action would the nurse take when administering iron dextran? A. Use a transdermal needle. B. Massage the injection site. C. Use the Z-track method. D. Apply a local anesthetic first.
C. Use the Z-track method.
93
Parents of a child with sickle cell anemia ask about their child taking iron supplements to help treat the anemia. How will the nurse respond? A. Taking supplements will not help with this condition. B. It is advised that iron be taken with orange juice to aid in absorption. C. An over-the-counter multivitamin with iron should meet the needs of the child. D. It is advised that liquid iron supplements be given through a straw to prevent staining the teeth.
A. Taking supplements will not help with this condition.
94
A client with upper gastrointestinal (GI) bleeding develops mild anemia. Which agent is indicated for treatment of this condition? A. Dextran B. Iron C. Vitamin B 12 D. Erythropoietin
B. Iron
95
Which client statement demonstrates an understanding of cyanocobalamin (vitamin B 12) prescribed for pernicious anemia? A. "I should have a vitamin B 12 injection every month." B. "I’ll take vitamin B 12 supplements every morning with my breakfast." C. "I’ll eat a diet high in green vegetables." D. "I will increase my intake of processed foods fortified with vitamin B 12."
A. "I should have a vitamin B 12 injection every month."
96
When discussing the therapeutic regimen of vitamin B 12 for pernicious anemia with a client, which teaching would the nurse provide? A. Weekly Z-track injections provide needed control. B. Daily intramuscular injections are required for control. C. Intramuscular injections once a month will maintain control. D. Oral vitamin B 12 tablets taken daily will provide symptom control.
C. Intramuscular injections once a month will maintain control.
97
The nurse provides teaching regarding vitamin B 12 injections to a client with pernicious anemia. Which statement by the client indicates that teaching was understood? A. 'I must take this medication for the rest of my life.' B. 'I should take this vitamin, as needed, when feeling fatigued.' C. 'Once my symptoms subside, I can stop taking this vitamin.' D. 'I need to have this available for use during exacerbations of anemia.'
A. 'I must take this medication for the rest of my life.'
98
A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication? A. The leukocyte count B. The platelet count C. The hematocrit (Hct) D. The erythrocyte sedimentation rate (ESR)
C. The hematocrit (Hct)
99
A client is prescribed epoetin injections. To ensure the client’s safety, which laboratory value would the nurse assess before administration? A. Hematocrit B. Platelet count C. Prothrombin time D. Partial thromboplastin time
A. Hematocrit
100
The nurse administers erythropoietin three times a week to a client receiving chemotherapy for cancer. Which client response demonstrates a therapeutic effect? A. Increase in band cells B. Elevated hematocrit C. Normalization of platelets D. Increase in the white blood cell (WBC) count
B. Elevated hematocrit
101
A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances? A. Iron B. Protein C. Potassium D. Sodium
A. Iron
102
The nurse is evaluating the results of treatment with erythropoietin. Which assessment finding indicates an improvement in the underlying condition being treated? A. 2+ pedal pulses B. Decreased pallor C. Decreased jaundice D. 2+ deep tendon reflexes
B. Decreased pallor
103
A client is receiving epoetin for the treatment of anemia associated with chronic renal failure. Which client statement indicates to the nurse that further teaching about this medication is necessary? A. 'I realize it is important to take this medication because it will cure my anemia.' B. 'Because I am at risk for seizures, I need to avoid hazardous activities.' C. 'I recognize that I may still need blood transfusions if my hemoglobin is very low.' D. 'I understand that I will still have to take supplemental iron therapy with this medication.'
A. 'I realize it is important to take this medication because it will cure my anemia.'