The following sample questions are representative of actual test content, difficulty level, and question format. The answer key follows the set of questions.
Directions: Each question or incomplete statement below is followed by four suggested answers or completions. Select the one that is best in each case.
Nursing interventions for the management of nausea include encouraging patients to:
- use spicy sauces and gravies
- eat high-protein and high-potassium foods
- eat more frequent meals with smaller portions
- avoid brushing their teeth when they are nauseated
Which of the following is prescribed for a patient diagnosed with surgically unresectable renal cell carcinoma that has metastasized to the liver?
Initial treatment of a patient in early septic shock includes the administration of:
- IV antibiotics
- IV antifungals
- high-dose corticosteroids
An example of adaptive or specific immunity is:
- cell-mediated response
- inflammatory response
- large lymphocyte production
- acute-phase protein production
A patient with a life expectancy of five months is worried about using the Medicare Hospice Benefit Program because of increasing financial concerns. The nurse knows that the benefit includes providing:
- admission in a clinical trial
- durable medical equipment
- transportation for radiation treatments
- respite care lasting more than seven days
Rationale: Nausea may be caused by cancer treatment or the disease itself. In addition to pharmacological management, patients are taught self-care strategies to minimize nausea, such as consumption of foods that are cold or at room temperature. The smells from hot foods many increase nausea.
Reference: Eaton, L.H., & Tipton, J.M. (Eds.). (2009). Putting evidence into practice: Improving oncology patient outcomes. Pittsburgh, PA: Oncology Nursing Society, p. 80.
Rationale: About 30% of individuals with renal cell cancer present with metastasis at the time of diagnosis. Chemotherapy has not demonstrated a response in renal cell carcinoma, but various biological therapies have, including temsirolimus.
Reference:Yarbro, C.H., Wujcik, D., & Gobel, B.H. (Eds.). (2011). Cancer nursing: Principles and practice. (7th ed.). Burlington, MA: Jones and Bartlett, pp.1640-1641.
Rationale: The hallmark of progressive septic shock is profound hypotension. The goals of treatment are to maintain blood pressure and tissue perfusion while treating underlying pathogens. Broad-spectrum antibiotics should be initiated within one hour of drawing blood cultures. The choice of empiric antibiotic therapy is based on the suspected site of infection and most likely causative pathogen.
Reference: Kaplan, M. (Ed.). (2013). Understanding and managing oncologic emergencies: A resource for nurses. (2nd ed.).Pittsburgh, PA: Oncology Nursing Society, p. 305.
Rationale: An example of adaptive or specific immunity is cell-mediated immunity. Cell-mediated immunity is mediated by T-cells and their cytokine products. This type of immunity does not involve an antibody.
Reference: Polovich, M., Olsen, M., & LeFebvre, K.B. (Eds.). (2014). Chemotherapy and biotherapy guidelines and recommendations for practice. (4th ed.). Pittsburgh, PA: Oncology Nursing Society, pp.52-53.
Rationale: The Medicare Hospice Benefit program are provided to patients who have been certified as terminally ill with a prognosis for a life expectancy of six months or less. The program includes the following hospice services: medical and social services, physician services, short-term inpatient and respite care, medical appliances and supplies including drugs and biologicals.
Reference: Ferrell, B.R., & Coyle, N. (Eds.). (2010). Oxford textbook of palliative nursing. (3rd ed.). New York, NY: Oxford University Press, p. 16.