Hematology/Oncology

The nurse is caring for the patient who is at the nadir for bone marrow suppression. Which order does the nurse clarify with the provider?  

The nurse assesses the patient with acute myelogenous leukemia after a bone marrow transplant. Which symptom concerns the nurse the most?

The nurse is most concerned with encouraging the patient with multiple myeloma to ambulate frequently to prevent which complication? 

The nurse is selecting patients to receive a brochure about detecting testicular cancer. Which patient most needs the brochure? 

The patient is scheduled for a radical orchiectomy for treatment of testicular cancer. Which preprocedural teaching is most important to provide the patient? 

The nurse advocates for cervical cancer screening for patients with which complaints? Select all that apply. 

The patient is scheduled for a posterior pelvic exenteration and the nurse has provided preprocedural teaching. Which statement indicates a need for further teaching?  

The patient’s activated partial thromboplastin time (aPTT) is 138 seconds. Review the chart to determine the most important question for the charge nurse to ask the bedside nurse.

The nurse provides which instructions to the unlicensed assistive personnel who is assisting in the care of a patient postoperative day one following a radical hysterectomy? Select all that apply. 

Which interventions does the nurse include in care for the patient who underwent a total pelvic exenteration for a cancer diagnosis one day ago? Select all that apply.  

Which patient is most at risk for uterine cancer?  

The patient presents to the clinic with a chief complaint of constipation with occasional ribbon-like stools. The nurse anticipates which additional findings? Select all that apply.  

The patient presents to the emergency department with severe, unrelenting abdominal pain. Which findings prompt the nurse to suspect the patient will require a Whipple procedure? Select all that apply.  

The nurse is caring for the patient recently diagnosed with colon cancer. Which assessment prompts the nurse to call for the provider immediately?  

The patient presents to the emergency department complaining of severe gastrointestinal distress after meals that has persisted for 36 hours. He reports that these symptoms have occurred off and on for a few years now, but he is seeking care now because they are interrupting his ability to sleep. Which additional assessment indicates the poorest prognosis for this patient?  

The nurse reviews the patient’s chart and notes a positive sickle-turbidity test. Which statement does the nurse make to the patient’s parents?  

The nurse creates the plan of care for the patient with crescent-shaped hemoglobin who presented with severe joint pain and stiffness with priority given to which type intervention? 

The 13-year-old patient presents to the emergency room following a sports practice in the late summer heat with severe joint pain, malaise, splenomegaly, tachypnea, and tachycardia. Upon assessment, the patient’s oxygen saturation is 92%. Which order does the nurse carry out first?

The nurse is providing health promotion teaching to the parents of a child recently diagnosed with sickle cell anemia. Which statement does the nurse include in teaching? 

The nurse questions which orders for the 12-year-old patient in sickle cell crisis? Select all that apply.

The nurse is caring for a 12-year-old male patient with hemophilia A. Which statement is most likely true? 

The nurse is providing health promotion and disease prevention education to the 15-year-old patient receiving chemotherapy. Which statement does the nurse include?  

The 4-year-old patient with a history of sickle cell disease is brought to the emergency room complaining of severe chest pain and cough. Upon assessment, the nurse notes a respiratory rate of 32, a temperature of 39.1°C, and a heart rate of 128 bpm. Which test results does the nurse anticipate? Select all that apply.

The newborn male child experienced hemorrhage from a circumcision site at 2 days old. Coagulation studies revealed normal prothrombin time and a prolonged activated partial thromboplastin time (aPTT). The von Willebrand factor is found to be 0.5%. Which individuals need to undergo genetic testing?   

The patient is admitted to the hospital after fainting at home. Blood tests reveal a hypochromic, microcytic anemia with a large amount of fetal hemoglobin. Thrombocytopenia is noted as well. The lymph nodes, spleen, and liver are all within normal limits for size and consistency. A blood transfusion and platelet transfusion are administered, with less than expected results. The nurse anticipates administering antithymocyte globulin in response to which result?   

The 18-year-old patient presents with pallor, shortness of breath, and bleeding from the gums. Extensive testing is performed and a diagnosis of very severe aplastic anemia is made. Which additional information is most important to direct treatment? 

The 1-year-old with sickle cell disease is in crisis following gastroenteritis. While hospitalized, the patient abruptly exhibits seizures, decreased level of consciousness, right-sided facial asymmetry when crying, coughing and sputtering during a bottle feeding, and decreased movement of the right leg and arm. The nurse contacts the provider and prepares to provide which initial interventions? Select all that apply.  

The 3-year-old with sickle cell disease is preparing for discharge following a crisis during which the patient received several blood transfusions. The nurse is providing teaching regarding appropriate food choices for the child. Which foods, if selected by the parents, indicate a need for further teaching? Select all that apply.  

The nurse is providing medication teaching to the patient being treated for microcytic, hypochromic anemia. Which statement by the patient indicates effective teaching?  

The patient is hospitalized after being diagnosed with aplastic anemia. Which question is most important to ask the patient?   

The 18-year-old patient in sickle cell crisis has received multiple blood transfusions. During the shift assessment, the nurse notes the patient’s heart rate is 132 bpm, blood pressure is 102/58 mmHg, and the sclera are yellow. Which lab result would be surprising for this patient?  

The 8-year-old male patient presents complaining of warm, painful, swollen joints with decreased range of motion. Upon assessment, he is pale and tachycardic. The parent reports easy bruising and frequent nosebleeds. Which does the nurse most anticipate administering? 

The nurse is providing discharge education to the parents of the 7-day-old neonate who required a blood transfusion due to blood loss following circumcision. Which instruction is most important?  

The 12-year-old child who weighs 35 kg with hemophilia B is brought to the emergency department with signs of increased intracranial pressure after being hit in the head at a baseball game. The nurse prepares to carry out which order?  

The nurse who suspects that the 19-year-old patient being treated for β-thalassemia major is experiencing complications of therapy advocates for which tests? Select all that apply.  

The 18-year-old female patient reports menorrhagia, easy bruising, and epistaxis. Her family history is notable for maternal hypertension, a brother with hemophilia A, and a father who died of stroke at age 48. Which question is most important to ask the patient?   

The patient with β-thalassemia major exhibits complications of therapy. The nurse prepares to provide which intervention? 

The nurse is evaluating the patient’s response to therapy with 1-deamino-8-ᴅ-arginine vasopressin (DDAVP) for treatment of mild bleeding caused by hemophilia A. Which assessment indicates the patient is experiencing an adverse effect to therapy?  

The nurse learns the previously healthy 13-year-old child was walking at school and collapsed; x-ray revealed a broken femur. The nurse is most concerned about which disorder?  

The nurse is caring for the 16-year-old patient undergoing treatment for Ewing sarcoma. Which intervention is most helpful for the patient?  

The nurse is supervising the assessment of a 4-year-old patient with a Wilms tumor who was brought to the emergency department for profuse vomiting. Which statement by the student nurse requires prompt intervention by the nurse? 

The patient receiving chemotherapy for breast cancer develops a fever of 39.8°F and heart rate of 121 bpm. Within hours, the blood pressure drops from 128/89 mmHg to 91/54 mmHg, capillary refill time increases to 5 seconds, and urine output drops to less than 0.5 mL/kg/hour. Right-sided weakness, slurring of the words, and confusion occurs rapidly and subsides within 2 hours. Hemoptysis is also noted and the gums are oozing. Multiple transfusions are ordered. Which blood product does the nurse administer first?

The 8-month-old patient has had 4 skin abscesses in the past 3 months that have required draining. Each abscess drains less than 5 mL non-purulent fluid. The infant appears well otherwise and the parents deny respiratory infections. The infant’s complete blood count shows an elevated white blood cell count without bands or segmented cells. Immunoglobulin levels are appropriate for the age of the infant. The patient has a positive nitroblue test. The nurse plans care to include which intervention? 

The nurse is planning care for the 78-year-old patient with recurrent fecal impaction. The patient has prostate cancer that has metastasized to the bone. In addition to palliative chemotherapy, the patient receives a fentanyl transdermal patch and intravenous hydromorphone. The patient is neutropenic and thrombocytopenic. The nurse works with the provider to plan which intervention to manage the opioid-induced constipation and subsequent fecal impaction? 

The nurse is caring for a 57-year-old woman who is intubated and sedated in the post-anesthesia care unit following a radical hysterectomy. The patient remained stable throughout the 6 hour surgery during which she experienced a 2 L blood loss. The nurse has emptied the patient’s indwelling catheter every hour for the 3 hours the patient has been in the PACU with the following volumes: 54 mL, 23 mL, 12 mL, and 5 mL. Her heart rate is 112 bpm, oxygen saturation is 99%, and blood pressure is 82/54 mmHg. The nurse contacts the provider to report these findings and advocate for which initial order?  

The nurse is caring for a 57-year-old woman who is intubated and sedated in the post-anesthesia care unit following a radical hysterectomy. The patient remained stable throughout the 6 hour surgery during which she experienced a 2 L blood loss. The nurse has emptied the patient’s indwelling catheter every hour for the 3 hours the patient has been in the PACU with the following volumes: 54 mL, 23 mL, 12 mL, and 5 mL. Her heart rate is 112 bpm, oxygen saturation is 99%, and blood pressure is 82/54mmHg. The patient received maintenance fluids during the procedure and no blood transfusions. How many liters of isotonic fluid does the nurse anticipate administering to the patient during the postoperative period? Enter your response using a whole number. 

The 48-year-old patient is brought via ambulance to the emergency room after being found unresponsive by her son. She has a prescription for transdermal fentanyl patches for treatment of cancer pain related to her breast cancer that has metastasized to her pelvis. The patient’s heart rate is 72 bpm, respiratory rate is 4 breaths per minute, and her oxygen saturation is 88%. Her arterial blood gas results are: pH 7.21, PaCO₂ 72 mmHg, PaO₂ 74, HCO₃¯ 23. A thorough assessment reveals 2 fentanyl patches on the patient’s skin. The nurse advocates for which initial action?  

The 34-year-old male patient is brought by ambulance to the emergency department an hour after a witnessed car accident occurred in which he sustained a laceration to his right femoral artery. The paramedics placed a tourniquet and held pressure until arrival to the emergency department, but significant blood loss is estimated. The nurse anticipates the initial complete blood count will reveal which results?  

The 23-year-old patient is brought to the emergency department after contacting emergency services to report profound weakness that started in his feet and worsened and spread cranially over the past few days. He reports severe diarrhea after a camping trip a week ago. Upon assessment, strength, sensation, and deep tendon reflexes are significantly reduced, with the lower extremities more severely affected than his upper extremities. Vital signs are normal and the patient seems to be breathing well. There is increased protein in the cerebrospinal fluid found after a lumbar puncture. The patient is admitted to the intensive care unit for further management and observation. The ICU nurse includes which interventions in the plan of care? Select all that apply.  

The 23-year-old patient is brought to the emergency department after contacting emergency services to report profound weakness that started in his feet and worsened and spread cranially over the past few days. He reports severe diarrhea after a camping trip a week ago. Upon assessment, strength, sensation, and deep tendon reflexes are significantly reduced, with the lower extremities more severely affected than his upper extremities. There is increased protein in the cerebrospinal fluid found after a lumbar puncture. The patient begins taking more shallow breaths and becomes confused. The patient is intubated and mechanically ventilated. Once the patient is stable, the nurse anticipates administering which medication?