ATI Oncology Questions

ATI Oncology Questions Related

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A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection-related death in oncology patients?

  • A. Encourage several small meals daily.
  • B. Provide skin care to maintain skin integrity.
  • C. Assist the patient with hygiene, as needed.
  • D. Assess the integrity of the patient¢â‚¬â„¢s oral mucosa regularly.
Correct Answer: B

Rationale: In oncology patients, particularly those undergoing chemotherapy or radiation therapy, myelosuppression (the decrease in bone marrow activity that leads to reduced white blood cells, red blood cells, and platelets) increases the risk of infection. Maintaining skin integrity is crucial because the skin acts as the body's first line of defense against infections. If the skin becomes compromised, such as through radiation burns, rashes, or breakdowns, it provides a potential entry point for pathogens, increasing the risk of infection. Since infections in oncology patients can quickly become severe due to their weakened immune systems, maintaining skin integrity is a critical intervention to reduce infection risk, especially for patients who are immunosuppressed.

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An oncology patient has just returned from the post-anesthesia care unit after an open hemicolectomy. This patient¢â‚¬â„¢s plan of nursing care should prioritize which of the following?

  • A. Assess the patient hourly for signs of compartment syndrome.
  • B. Assess the patient¢â‚¬â„¢s fine motor skills once per shift.
  • C. Assess the patient¢â‚¬â„¢s wound for dehiscence every 4 hours.
  • D. Maintain the patient¢â‚¬â„¢s head of bed at 45 degrees or more at all times.
Correct Answer: C

Rationale: After an open hemicolectomy (surgical removal of part of the colon), monitoring the surgical wound for signs of dehiscence (wound reopening) is a critical nursing priority. Dehiscence is a serious postoperative complication that can occur if the surgical site does not heal properly. Regular wound assessments every 4 hours allow the nurse to identify early signs of complications, such as redness, swelling, increased drainage, or separation of the wound edges. Early detection is key to preventing further complications, such as infection or evisceration (protrusion of abdominal organs through the wound).

The nurse is caring for a client who is at risk for tumor lysis syndrome. Which laboratory value requires the nurse to intervene?

  • A. Decreased blood urea nitrogen (BUN)
  • B. Increased serum calcium
  • C. Increased creatinine level
  • D. Increased blood glucose level
Correct Answer: C

Rationale: Tumor lysis syndrome (TLS) is a potentially life-threatening condition that occurs when large numbers of cancer cells die rapidly, releasing their contents into the bloodstream. This can overwhelm the kidneys and lead to acute kidney injury. Creatinine is a waste product filtered out of the blood by the kidneys, and an elevated creatinine level is a sign of kidney dysfunction or damage. In TLS, increased creatinine levels indicate that the kidneys are struggling to filter out the excess waste products from cell breakdown, requiring immediate intervention to prevent further complications, such as acute renal failure.

A client is receiving rituximab and asks how it works. What response by the nurse is best?

  • A. It causes rapid lysis of the cancer cell membranes.
  • B. It destroys the enzymes needed to create cancer cells.
  • C. It prevents the start of cell division in the cancer cells.
  • D. It sensitizes certain cancer cells to chemotherapy.
Correct Answer: C

Rationale: Rituximab is a monoclonal antibody that targets CD20, a protein found on the surface of certain B-cells, including some cancerous B-cells, such as in non-Hodgkin's lymphoma and chronic lymphocytic leukemia (CLL). Rituximab works by binding to the CD20 protein, which leads to the destruction of the cancerous B-cells through various mechanisms, including preventing the initiation of cell division. By blocking the division process, rituximab helps slow the growth and proliferation of cancer cells, allowing the immune system and additional treatments to clear them more effectively.

A client has been prescribed epoetin alfa for anemia related to chemotherapy. What lab value should the nurse monitor to determine the effectiveness of this medication?

  • A. Hemoglobin level.
  • B. Hematocrit level.
  • C. White blood cell count.
  • D. Platelet count.
Correct Answer: A

Rationale: Epoetin alfa is a medication used to treat anemia, particularly anemia related to chemotherapy or chronic kidney disease. It stimulates the bone marrow to produce more red blood cells, which increases the hemoglobin level. Monitoring hemoglobin is the best way to assess the effectiveness of epoetin alfa, as an increase in hemoglobin indicates that the body is producing more red blood cells and the anemia is improving.

A nurse is planning the care of a patient who has been admitted to the medical unit with a diagnosis of multiple myeloma. In the patients care plan, the nurse has identified a diagnosis of Risk for Injury. What pathophysiologic effect of multiple myeloma most contributes to this risk?

  • A. Labyrinthitis
  • B. Left ventricular hypertrophy
  • C. Decreased bone density
  • D. Hypercoagulation
Correct Answer: C

Rationale: In multiple myeloma, the malignant proliferation of plasma cells within the bone marrow leads to the secretion of osteoclast-activating factors, which increase the breakdown of bone tissue (osteolysis). This results in decreased bone density, osteoporosis, and osteolytic lesions, making bones fragile and more prone to pathologic fractures. Patients with multiple myeloma are at high risk for fractures even with minimal trauma due to the weakened bone structure, which is why Risk for Injury is a key diagnosis.

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