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Comprehensive Nursing Management in Complex Clinical Conditions: Integrating Oncology, Cri, Exams of Nursing

Queen Mary, University of London (QMUL)Nursing

Comprehensive Nursing Management in Complex Clinical Conditions: Integrating Oncology, Critical Care, Surgical, Transplant, and Palliative Care

Typology: Exams

2024/2025

Available from 07/12/2025

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Comprehensive Nursing Management in Complex
Clinical Conditions: Integrating Oncology, Critical Care,
Surgical, Transplant, and Palliative Care
1. A client receiving chemotherapy develops thrombocytopenia.
Which intervention should the nurse prioritize?
⬜ Ambulation three times daily
⬜ Monitoring temperature
✔ Monitoring for signs of bleeding
⬜ Monitoring for pathological fractures
2. The nurse is caring for a client with neutropenia. Which
precaution is most important?
✔ Implement neutropenic precautions (e.g., strict hand hygiene,
avoid crowds)
⬜ Encourage high-fiber diet
⬜ Promote bed rest only
⬜ Increase fluid intake only
3. A burn patient has a fluid resuscitation order. Which formula is
commonly used to calculate fluid needs?
⬜ Parkland formula
✔ Parkland formula
⬜ Broca’s formula
⬜ Harris-Benedict formula
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Comprehensive Nursing Management in Complex Clinical Conditions: Integrating Oncology, Critical Care, Surgical, Transplant, and Palliative Care

  1. A client receiving chemotherapy develops thrombocytopenia. Which intervention should the nurse prioritize?  ⬜ Ambulation three times daily  ⬜ Monitoring temperature  ✔ Monitoring for signs of bleeding  ⬜ Monitoring for pathological fractures
  2. The nurse is caring for a client with neutropenia. Which precaution is most important?  ✔ Implement neutropenic precautions (e.g., strict hand hygiene, avoid crowds)  ⬜ Encourage high-fiber diet  ⬜ Promote bed rest only  ⬜ Increase fluid intake only
  3. A burn patient has a fluid resuscitation order. Which formula is commonly used to calculate fluid needs?  ⬜ Parkland formula  ✔ Parkland formula  ⬜ Broca’s formula  ⬜ Harris-Benedict formula
  1. During the intraoperative phase, which action is the nurse’s priority?  ⬜ Monitoring vital signs  ⬜ Providing emotional support  ✔ Maintaining sterile technique  ⬜ Preparing discharge instructions
  2. A client is scheduled for a kidney transplant. What is the nurse’s priority preoperative action?  ⬜ Administer immunosuppressants  ✔ Obtain informed consent  ⬜ Begin dialysis  ⬜ Teach about wound care
  3. Which symptom indicates acute organ rejection after transplantation?  ⬜ Fever, tenderness over transplant site, decreased urine output  ✔ Fever, tenderness over transplant site, decreased urine output  ⬜ Hypertension only  ⬜ Weight gain only
  4. A patient in palliative care reports severe pain. What is the nurse’s best action?  ⬜ Suggest distraction techniques  ✔ Administer prescribed analgesics promptly

 ✔ Rinse mouth with saltwater or baking soda solution  ⬜ Avoid oral care  ⬜ Eat spicy foods

  1. Which lab value indicates neutropenia?  ⬜ WBC 8,000/mm³  ✔ WBC less than 1,500/mm³  ⬜ Platelets 150,000/mm³  ⬜ Hemoglobin 13 g/dL
  2. What is the main goal of fluid resuscitation in burn patients?  ⬜ Prevent infection  ✔ Restore circulating blood volume  ⬜ Promote wound healing  ⬜ Reduce pain
  3. Which of the following is a sign of fluid overload post-burn?  ⬜ Hypotension  ✔ Edema and crackles in lungs  ⬜ Dry mucous membranes  ⬜ Tachycardia
  4. During preoperative teaching, what should the nurse emphasize?  ⬜ Post-op diet restrictions only

 ✔ Importance of deep breathing and coughing exercises  ⬜ Avoiding all medications before surgery  ⬜ No need for consent

  1. A client is on immunosuppressants post-transplant. What is a priority nursing assessment?  ⬜ Signs of rejection only  ✔ Signs of infection  ⬜ Blood pressure monitoring only  ⬜ Pain assessment only
  2. Which statement about palliative care is true?  ⬜ It aims to cure the disease  ✔ It focuses on quality of life and symptom relief  ⬜ It is only for the last days of life  ⬜ It replaces all other treatments
  3. What electrolyte imbalance is common after large burns?  ⬜ Hyponatremia  ✔ Hyperkalemia  ⬜ Hypocalcemia  ⬜ Hypermagnesemia
  4. Which is a priority nursing action for a client with neutropenia?

 ⬜ Hair growth  ✔ Nephrotoxicity  ⬜ Hyperglycemia  ⬜ Bradycardia

  1. Which perioperative phase involves patient teaching and assessment?  ⬜ Intraoperative  ✔ Preoperative  ⬜ Postoperative  ⬜ Recovery
  2. What is the priority nursing action for a client with suspected organ rejection?  ⬜ Increase fluids  ✔ Notify the healthcare provider immediately  ⬜ Administer analgesics  ⬜ Restrict activity
  3. Which symptom is common in terminal cancer patients?  ⬜ High-grade fever  ✔ Cachexia and fatigue  ⬜ Hypertension  ⬜ Hyperactivity
  1. What is the best way to prevent infection in neutropenic patients?  ⬜ Administer antibiotics prophylactically  ✔ Strict handwashing and protective isolation  ⬜ Encourage outdoor activities  ⬜ Avoid vaccinations
  2. Which electrolyte should be monitored closely in burn patients?  ⬜ Calcium  ✔ Potassium  ⬜ Magnesium  ⬜ Phosphorus
  3. What is the purpose of immunosuppressive therapy post- transplant?  ⬜ Prevent infection  ✔ Prevent organ rejection  ⬜ Promote wound healing  ⬜ Increase blood pressure
  4. Which intervention improves comfort in palliative care?  ⬜ Restricting fluids  ✔ Managing pain effectively  ⬜ Limiting family visits

 ⬜ Hyperglycemia  ⬜ Bradycardia

  1. Which action should the nurse take for a client with stomatitis?  ⬜ Encourage spicy foods  ✔ Teach gentle oral care and saltwater rinses  ⬜ Avoid oral hygiene  ⬜ Use alcohol mouthwash
  2. What is the priority nursing diagnosis for a burn patient?  ⬜ Risk for infection  ✔ Risk for fluid volume deficit  ⬜ Risk for impaired mobility  ⬜ Risk for impaired gas exchange
  3. Which is a sign of organ rejection?  ⬜ Weight loss  ✔ Fever and tenderness at transplant site  ⬜ Increased appetite  ⬜ Bradycardia
  4. What is the primary goal of palliative care?  ⬜ Cure illness  ✔ Improve quality of life

 ⬜ Prolong life at all costs  ⬜ Prevent hospital admission

  1. Which nursing action is essential for a client with neutropenia?  ⬜ Encourage visitors  ✔ Monitor for infection signs  ⬜ Provide high-protein diet only  ⬜ Limit fluids
  2. What is the best fluid to replace losses in burn patients?  ⬜ D5W  ✔ Lactated Ringer’s  ⬜ Normal saline  ⬜ Blood
  3. Which medication is commonly used in chemotherapy?  ⬜ Penicillin  ✔ Cyclophosphamide  ⬜ Insulin  ⬜ Digoxin
  4. What should the nurse monitor postoperatively?  ⬜ Vital signs and wound site  ✔ Vital signs and wound site

 ✔ Severe headache and vomiting  ⬜ Rash  ⬜ Fatigue

  1. What should the nurse do if a client requests discharge to hospice?  ⬜ Refuse request  ✔ Contact hospice to arrange care  ⬜ Transfer to another unit  ⬜ Delay discharge
  2. What is the key nursing intervention for neutropenic patients?  ⬜ Allow visitors freely  ✔ Use strict infection control  ⬜ Provide high-fiber diet  ⬜ Limit fluids
  3. Which sign indicates fluid overload in burn patients?  ⬜ Dry skin  ✔ Pulmonary crackles and edema  ⬜ Hypotension  ⬜ Tachycardia
  4. What is the priority assessment for a client post-kidney transplant?

 ⬜ Pain level only  ✔ Urine output and signs of rejection  ⬜ Diet tolerance  ⬜ Mobility status