ATI Med-Surg Cancer and Sti

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Sample questions from ATI Med-Surg Cancer and Sti

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.During an outpatient infusion, a client receiving doxorubicin reports new shortness of breath when climbing stairs. Which action is the priority before the next dose?

   • A.Ask the client to describe dietary sodium intake before contacting the provider
   • B.Encourage increased oral fluids and continue the infusion as scheduled
   • C.Review the cumulative dose and obtain an assessment of left ventricular function
   • D.Administer an antiemetic and reassess the shortness of breath after treatment

   Rationale: New exertional dyspnea during doxorubicin therapy can signal cardiotoxicity and developing heart failure, so the nurse should assess cardiac function and cumulative exposure before further treatment. Hydration does not address possible myocardial injury, and an antiemetic is unrelated to the finding. Sodium history may be useful later, but it must not delay evaluation of a potentially serious treatment complication.

2. 2.A client with bulky lymphoma begins chemotherapy and, 12 hours later, has a potassium level of 6.3 mEq/L, a uric acid level of 11 mg/dL, and new peaked T waves. Which action should the nurse take first?

   • A.Place the client on continuous cardiac monitoring and initiate the prescribed emergency hyperkalemia treatment
   • B.Administer the prescribed phosphate binder and reassess the electrocardiogram at the end of the shift
   • C.Encourage oral fluids and recheck the potassium level in 4 hours
   • D.Hold the next chemotherapy dose and wait for the oncology provider to round

   Rationale: The findings are consistent with tumor lysis syndrome, and hyperkalemia with peaked T waves creates an immediate risk of lethal dysrhythmia. Continuous monitoring and emergency treatment take priority over delayed reassessment or routine supportive measures. Holding later chemotherapy may require a provider decision, but it does not treat the current cardiac threat.

3. 3.A client receiving chemotherapy for ovarian cancer has a platelet count of 18,000/mm3 and reports new bleeding from the gums while brushing. Which instruction is most important?

   • A.Use a firm-bristled toothbrush to remove plaque without irritating the gums
   • B.Use a soft toothbrush and report any further bleeding or signs of internal bleeding promptly
   • C.Floss carefully each day to prevent gingival infection
   • D.Take an aspirin-containing medication for any headache

   Rationale: Severe thrombocytopenia increases bleeding risk, and gentle oral care helps reduce mucosal injury; new or persistent bleeding warrants prompt reporting. Flossing can injure the gums, and aspirin impairs platelet function and should be avoided unless specifically directed. A firm-bristled brush increases trauma rather than preventing it.

4. 4.Refer to the client's chart. Which findings require immediate nursing action for the client receiving treatment for cancer? Select all that apply.

   • A.The heart rate has risen from 92/min to 124/min while blood pressure has fallen from 118/72 mm Hg to 88/54 mm Hg
   • B.The client reports sudden chest pressure and appears increasingly restless
   • C.The client reports mild nausea after chemotherapy and is tolerating sips of water
   • D.The platelet count is 92,000/mm3 with no bleeding and stable vital signs
   • E.The client has jugular venous distention and muffled heart sounds

   Answer and rationale are in the full material.

5. 5.At change of shift, the nurse receives report on four clients. Which client should be assessed first?

   • A.A client with cervical cancer who reports burning with urination after radiation therapy
   • B.A client with lymphoma who reports mild nausea after the first chemotherapy dose
   • C.A client with prostate cancer who has a stable hemoglobin of 9.8 g/dL and fatigue
   • D.A client with lung cancer who has new unilateral calf swelling and sudden dyspnea

   Answer and rationale are in the full material.