57.

A client, in the final stages of terminal cancer tells his nurse I wish I could just
be allowed to die. Im tired of fighting this illness. I have lived a good life. I continue
my chemotherapy and radiation treatments only because my family wants me to.
What is the nurses best response?
A. Would you like to talk to the psychologist about your thoughts and feelings?
B. Would you like to talk to your minister about thr significance of death?
C. Would you like to meet with your family and your physician about this matter?
D. I know you are tired of fighting this illness, but death will come in due

58. A nurse is completing an admission interview of a client newly diagnosed with

multiple myeloma. The client tells the nurse his insurance coverage and limited
savings wont pay for his care. Based on this information, the nurse identifies the
need for
A. Referral for pastoral care
B. Referral to hospital accounts
C. Referral to social services
D. Referral to case management

59. For a client newly diagnosed with radiation-induced thrombocytopenia, the

nurse should include which intervention in the care plan?
A. Administering aspirin if the temperature exceed 102 F (38.8 C)
B. Inspecting the skin for petechiae once every shift
C. Providing for frequent rest periods
D. Placing the client in strict isolation

60. A client who is receiving chemotherapy for breast cancer develops

myelosuppression. Which instructions should the nurse include in the clients
discharge teaching plan? Select all that apply.
i. Avoid people who have recently received attenuated vaccines
ii. Avoid activities that may cause bleeding

iii. wash hands frequently

iv. increase intake of fresh fruits and vegetables
v. avoid crowded places such as shopping malls
vi. Treat a sore with over-the-counter (OTC) products

A, I,ii,iii,v
B. I, ii,iii,iv
C. I,ii,iii,vi
D. all of the above

61. For a client newly diagnosed cancer, the nurse formulates a nursing diagnosis
of Anxiety related to the threat of death secondary to cancer diagnosis. Which
expected outcome is appropriate for this client?
A. Client verbalizes feelings of anxiety.
B. Client doesnt guess at prognosis.
C. Client uses any effective method to reduce tension.
D. Client stops seeking information.

62. A registered nurse is making assignments on a busy 20-bed oncology unit. The
licensed staff scheduled for the current shift consists of three RNs and two licensed
practical nurses (LPNs). The nurse assigns 10 clients wholl be receiving
chemotherapy treatments to the three RNs and assigns the remaining clients to the
two LPNs. In making this decision, the RN likely considered:
A. Staff preference
B. Staff competency
C. Staff exposure
D. Staff comfort

63. A nurse is caring for a client with end-stage testicular cancer who has been
referred to hospice care. Which criterion indicates that the client requires more
teachinf about hospice care?
A. The client doesnt want to discuss death around his girlfriend
B. The client entered a clinical trial through the National Cancer Institute
C. The physician orders weekly blood transfusions to be given at home
D. The client explains that he isnt ready to complete his will

64. A client has just begun treatment with busulfan (Myleran), 4 mg by mouth daily,
for chronic myelogenous leukemia. The client receives busulfan until his white blood
cells (WBC) count falls between 10,000/mm3 and 25,000/mm3. Then the drug is
stopped. When should the treatment resume?
A. When the WBC falls to 5000/mm3
B. When lost hair begins to grow back
C. When the WBC count rises to 50,000/mm3
D. When the client displays anemia
65. A client tells the nurse that she has found painless lump in her right breast
during her monthly self-examination. Which assessment finding would strongly
suggest that this clients lump is cancerous?
A. Eversion of the right nipple and mobile mass
B. Non mobile mass with irregular edges
C. Mobile mass that is soft and easily delineated
D. Nonpalpable right axillary lymph nodes