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RN ONCOLOGY A RELIAS Exam With 100 Questions And Answers With Rationales/Feedback 2024
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RN ONCOLOGY A RELIAS Exam With 100 Questions And Answers With Rationales/Feedback 2024
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RN ONCOLOGY A RELIAS Exam With 100 Questions AndAnswers With Rationales/Feedback 2024
A 62-year-old woman diagnosed with breast cancer is scheduled for a partial
mastectomy. The oncology nurse explained that the surgeon will want to take tissue
samples to ensure the disease has not spread to adjacent axillary lymph nodes. The
patient has asked if she will have her lymph nodes dissected, like her mother did
several years ago. What alternative to lymph node dissection will this patient most likely
undergo?
A)Lymphadenectomy
B)Needle biopsy
C)Open biopsy
D)Sentinel node biopsy - D - Sentinel lymph node biopsy (SLNB), also known as
sentinel lymph node mapping, is a minimally invasive surgical approach that, in some
instances, has replaced more invasive lymph node dissections (lymphadenectomy) and
their associated complications such as lymphedema and delayed healing. SLNB has
been widely adopted for regional lymph node staging in selected cases of melanoma
and breast cancer.
You are caring for a patient who has just been told that her stage IV colon cancer has
recurred and metastasized to the liver. The oncologist offers the patient the option of
surgery to treat the progression of this disease. What type of surgery does the
oncologist offer?
A)Palliative
B)Reconstructive
C)Salvage
D)Prophylactic - A - When cure is not possible, the goals of treatment are to make the
patient as comfortable as possible and to promote quality of life as defined by the
patient and his or her family. Palliative surgery is performed in an attempt to relieve
complications of cancer, such as ulceration, obstruction, hemorrhage, pain, and
malignant effusion. Reconstructive surgery may follow curative or radical surgery in an
attempt to improve function or obtain a more desirable cosmetic effect. Salvage surgery
is an additional treatment option that uses an extensive surgical approach to treat the
local recurrence of a cancer after the use of a less extensive primary approach.
Prophylactic surgery involves removing nonvital tissues or organs that are at increased
risk to develop cancer.
The nurse is caring for a patient with an advanced stage of breast cancer and the
patient has recently learned that her cancer has metastasized. The nurse enters the
room and finds the patient struggling to breath and the nurses rapid assessment reveals
that the patients jugular veins are distended. The nurse should suspect the
development of what oncologic emergency?
A)Increased intracranial pressure
,B)Superior vena cava syndrome (SVCS)
C)Spinal cord compression
D)Metastatic tumor of the neck - B - SVCS occurs when there is gradual or sudden
impaired venous drainage giving rise to progressive shortness of breath (dyspnea),
cough, hoarseness, chest pain, and facial swelling; edema of the neck, arms, hands,
and thorax and reported sensation of skin tightness and difficulty swallowing; as well as
possibly engorged and distended jugular, temporal, and arm veins. Increased
intracranial pressure may be a part of SVCS, but it is not what is causing the patients
symptoms. The scenario does not mention a problem with the patients spinal cord. The
scenario says that the cancer has metastasized, but not that it has metastasized to the
neck.
The hospice nurse is caring for a patient with cancer in her home. The nurse has
explained to the patient and the family that the patient is at risk for hypercalcemia and
has educated them on that signs and symptoms of this health problem. What else
should the nurse teach this patient and family to do to reduce the patients risk of
hypercalcemia?
A)Stool softeners are contraindicated.
B)Laxatives should be taken daily.
C)Consume 2 to 4 L of fluid daily.
D)Restrict calcium intake. - C - The nurse should identify patients at risk for
hypercalcemia, assess for signs and symptoms of hypercalcemia, and educate the
patient and family. The nurse should teach at-risk patients to recognize and report signs
and symptoms of hypercalcemia and encourage patients to consume 2 to 4 L of fluid
daily unless contraindicated by existing renal or cardiac disease. Also, the nurse should
explain the use of dietary and pharmacologic interventions, such as stool softeners and
laxatives for constipation, and advise patients to maintain nutritional intake without
restricting normal calcium intake.
The home health nurse is performing a home visit for an oncology patient discharged 3
days ago after completing treatment for non-Hodgkin lymphoma. The nurses
assessment should include examination for the signs and symptoms of what
complication?
A)Tumor lysis syndrome (TLS)
B)Syndrome of inappropriate antiduretic hormone (SIADH)
C)Disseminated intravascular coagulation (DIC)
D)Hypercalcemia - A - TLS is a potentially fatal complication that occurs spontaneously
or more commonly following radiation, biotherapy, or chemotherapy-induced cell
destruction of large or rapidly growing cancers such as leukemia, lymphoma, and small
cell lung cancer. DIC, SIADH and hypercalcemia are less likely complications following
this treatment and diagnosis.
The nurse is admitting an oncology patient to the unit prior to surgery. The nurse reads
in the electronic health record that the patient has just finished radiation therapy. With
knowledge of the consequent health risks, the nurse should prioritize assessments
related to what health problem?
, A)Cognitive deficits
B)Impaired wound healing
C)Cardiac tamponade
D)Tumor lysis syndrome - B - Combining other treatment methods, such as radiation
and chemotherapy, with surgery contributes to postoperative complications, such as
infection, impaired wound healing, altered pulmonary or renal function, and the
development of deep vein thrombosis
An oncology patient has just returned from the postanesthesia care unit after an open
hemicolectomy. This patients plan of nursing care should prioritize which of the
following?
A)Assess the patient hourly for signs of compartment syndrome.
B)Assess the patients fine motor skills once per shift.
C)Assess the patients wound for dehiscence every 4 hours.
D)Maintain the patients head of bed at 45 degrees or more at all times. - C -
Postoperatively, the nurse assesses the patients responses to the surgery and monitors
the patient for possible complications, such as infection, bleeding, thrombophlebitis,
wound dehiscence, fluid and electrolyte imbalance, and organ dysfunction. Fine motor
skills are unlikely to be affected by surgery and compartment syndrome is a
complication of fracture casting, not abdominal surgery. There is no need to maintain a
high head of bed.
The hospice nurse has just admitted a new patient to the program. What principle
guides hospice care?
A)Care addresses the needs of the patient as well as the needs of the family.
B)Care is focused on the patient centrally and the family peripherally.
C)The focus of all aspects of care is solely on the patient.
D)The care team prioritizes the patients physical needs and the family is responsible for
the patients emotional needs. - A - The focus of hospice care is on the family as well as
the patient. The family is not solely responsible for the patients emotional well-being
A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an
interstitial implant for high-dose radiation (HDR). What safety measure should the nurse
include in this patients subsequent plan of care?
A)Limit the time that visitors spend at the patients bedside.
B)Teach the patient to perform all aspects of basic care independently.
C)Assign male nurses to the patients care whenever possible.
D)Situate the patient in a shared room with other patients receiving brachytherapy. - A -
To limit radiation exposure, visitors should generally not spend more than 30 minutes
with the patient. Pregnant nurses or visitors should not be near the patient, but there is
no reason to limit care to nurses who are male. All necessary care should be provided
to the patient and a single room should be used.
An oncology patient has begun to experience skin reactions to radiation therapy,
prompting the nurse to make the diagnosis Impaired Skin Integrity: erythematous
reaction to radiation therapy. What intervention best addresses this nursing diagnosis?
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