Professional Documents
Culture Documents
2. A female client with breast cancer is 7. Nurse Anna is aware that early adaptation
currently receiving radiation therapy for of
treatment. The client is complaining of client with renal carcinoma is:
apathy, hard to concentrate on something, a. Nausea and vomiting
and feeling tired despite of having time to b. flank pain
rest and more sleep. These complains c. weight gain
suggest symptoms of d. intermittent hematuria
a. Hypocalcemia
b. radiation pneumonitis 8. A newly admitted client is diagnosed with
c. advanced breast cancer Hodgkin’s disease undergoes an excisional
d. fatigue cervical lymph node biopsy under local
anesthesia. What does the nurse assess first
3. A chemotherapeutic agent 5FU is ordered after the procedure?
as an adjunct measure to surgery. Which of a. Vital signs
the ff. statements about chemotherapy is b. Incision site
true? c. Airway
a. it is a local treatment affecting only tumor d. Level of consciousness
cells
b. it affects both normal and tumor cells 9. Cancer patients have special nutrition
c. it has been proven as a complete cure for needs and issues related to eating. The client
cancer receving chemotherapy refuses to eat the
d. it is often used as a palliative measure. food that was delivered to him and said that
the food tastes funny. The appropriate
4. Which of the following signs and symptoms nursing intervention is:
would Nurse Maureen include in teaching plan a. Obtain an order for total parenteral
as an early manifestation of laryngeal cancer? nutrition
a. Stomatitis b. Keep the client on NPO
b. Airway obstruction c. Administer anti-emetic as ordered by
c. Hoarseness physician
d. Dysphagia d. Provide oral hygiene care
5. Karina a client with myasthenia gravis is to 10. A client with testicular cancer is
receive immunosuppressive therapy. The scheduled for a right orchiectomy. The nurse
nurse understands that this therapy is knows that an orchiectomy is the
effective because it: a. surgical removal of the entire scrotum
a. Promotes the removal of antibodies that
impair the transmission of impulses
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b. surgical removal of a testicle c. Night sweats
c. dissection of related lymph nodes d. Headache
d. partial surgical removal of the penis
16. When teaching a client about the signs of
colorectal cancer, Nurse Trish stresses that
11. A client is being evaluated for cancer of the most common complaint of persons with
the colon. In preparing the client for barium colorectal cancer is:
enema, the nurse should: a. Abdominal pain
a. Give laxative the night before and a b. Hemorrhoids
cleansing enema in the morning before the c. Change in caliber of stools
test d. Change in bowel habits
b. Render an oil retention enema and give
laxative the night before 17. A patient with a left frontal lobe tumor has
c. Instruct the client to swallow 6 radiopaque a craniotomy. Four hours post surgery, which
tablets the evening before the study data indicates increased ICP?
d. Place the client on CBR a day before the a. BP 160/90
study b. Patient is difficult to arouse
c. Patient has a positive Babinski response
d. Patient has urinary incontinence
13. A client, who is suspected of having 19. A client on chemotherapy has a platelet
Pheochromocytoma, complains of sweating, count of 26,000 mm. Which nursing
palpitation and headache. Which assessment intervention must be included in the client's
is essential for the nurse to make first? care plan?
a. Pupil reaction a. Having the client use an electric razor and
b. Hand grips soft-bristle toothbrush
c. Blood pressure b. Premedicating the client 30 minutes before
d. Blood glucose chemotherapy with an antiemetic
c Preparing to administer leukocyte-poor
14. The nurse is conducting an education packed red blood cells (RBCs)
session for a group of smokers in a “stop d. Screening all visitors and staff for infection
smoking” class. Which finding would the prior to allowing them to enter the room
nurse state as a common symptom of lung
cancer? : 20. Which intervention would be most
a. Dyspnea on exertion appropriate for a client who is 12 days
b. Foamy, blood-tinged sputum postchemotherapy and being admitted with
c. Wheezing sound on inspiration shortness of breath, a dry hacking cough, and
d. Cough or change in a chronic cough a temperature of 101° F?
a. Having the dietary department serve the
15. A client admitted with newly diagnosed meals as hot as possible
with Hodgkin’s disease. Which of the following b. Initiating the prescribed I.V. antibiotics
would the nurse expect the client to report? after checking the white blood cell (WBC)
a. Lymph node pain count
b. Weight gain c. Limiting the protein and calories in the
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client's diet A. Reaction formation
d. Reassuring the client that fatigue is a B. Sublimation
common occurrence after chemotherapy C. Intellectualization
D. Projection
21. The nurse is planning the care for a client
with cancer who is about to enter a hospice 25. Which statement by the client indicates to
treatment program. Which nursing diagnosis the nurse that the patient understands
and outcome would be appropriate for this precautions necessary during internal
client? radiation therapy for cancer of the cervix?
a. Imbalanced nutrition: The client will eat a. “I should get out of bed and walk around in
three meals/snacks a day my room.”
b. Impaired social interaction: The client will b. “My 7 year old twins should not come to
attend one outing per week visit me while I’m receiving treatment.”
c. Anticipatory grieving: The client will c. “I will try not to cough, because the force
participate in end-of-life care planning might make me expel the application.”
d. Deficient knowledge: The client will state d. “I know that my primary nurse has to wear
three reasons for cancer therapy one of those badges like the people in the x-
ray department, but they are not necessary
22. The nurse knows that a 28-year-old for anyone else who comes in here.”
female client with Hodgkin's disease who is
receiving chemotherapy understands the 26. A post-operative complication of
discharge teaching when the client says mastectomy is lymphedema. This can be
which statement? prevented by
a. "I should begin to try to have a baby as a. ensuring patency of wound drainage tube
soon as possible." b. placing the arm on the affected side in a
b. "If I begin to run a fever, I should call my dependent position
doctor." c. restricting movement of the affected arm
c. "If I feel tired, I should go to the gym and d. frequently elevating the arm of the
work out." affected side above the level of the heart.
d. "If my mouth gets sore, I'll need to fast
until it goes away." 27. High uric acid levels may develop in
clients who are receiving chemotherapy. This
23. After chemotherapy, a client who is is caused by:
scheduled to begin treatment with a biologic a. The inability of the kidneys to excrete the
response modifier (BRM) asks the nurse how drug metabolites
this treatment will help him. The nurse bases b. Rapid cell catabolism
the response on the knowledge that this type c. Toxic effect of the antibiotic that are given
of treatment stimulates: concurrently
a. reproduction of cancer cells. d. The altered blood ph from the acid medium
b. the body's natural immune defenses. of the drugs
c. the liver to produce an anti-tumor
hormone. 28. Maria Sison, 40 years old, single, was
d. the pancreas to produce an anti-cancer admitted to the hospital with a diagnosis of
hormone. Breast Cancer. She was scheduled for radical
mastectomy. Nursing care during the
24. Larry is diagnosed as having myelocytic preoperative period should consist of:
leukemia and is admitted to the hospital for a. assuring Maria that she will be cured of
chemotherapy. Larry discusses his recent cancer
diagnosis of leukemia by referring to b. assessing Maria’s expectations and doubts
statistical facts and figures. The nurse c. maintaining a cheerful and optimistic
recognizes that Larry is using the defense environment
mechanism known as: d. keeping Maria’s visitors to a minimum so
she can have time for herself
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33. The client is admitted to the outpatient
29. Maria refuses to acknowledge that her surgery center for removal of a malignant
breast was removed. She believes that her melanoma. Which assessment data indicate
breast is intact under the dressing. The nurse the lesion is a malignant melanoma?
should a. The lesion is asymmetrical and has
a. call the MD to change the dressing so irregular borders.
Kathy can see the incision b. The lesion has a waxy appearance with
b. recognize that Kathy is experiencing pearl-like borders.
denial, a normal stage of the grieving c. The lesion has a thickened and scaly
process appearance.
c. reinforce Kathy’s belief for several days d. The lesion appeared as a thickened area
until her body can adjust to stress of surgery. after an injury.
d. remind Kathy that she needs to accept her
diagnosis so that she can begin rehabilitation 34. The female client admitted for an
exercises. unrelated diagnosis asks the nurse to check
her back because “it itches all the time in that
30. Mr. Pablo, diagnosed with Bladder Cancer, one spot.” When the nurse assesses the
is scheduled for a cystectomy with the client’s back, the nurse notes an irregular-
creation of an ileal conduit in the morning. He shaped lesion with some scabbed-over areas
is wringing his hands and pacing the floor surrounding the lesion. Which action should
when the nurse enters his room. What is the the nurse implement first?
best approach? a. Notify the HCP to check the lesion on
a. "Good evening, Mr. Pablo. Wasn't it a rounds.
pleasant day, today?" b. Measure the lesion and note the color.
b. "Mr, Pablo, you must be so worried, I'll c. Apply lotion to the lesion.
leave you alone with your thoughts. d. Instruct the client to make sure the HCP
c. “Mr. Pablo, you'll wear out the hospital checks the lesion.
floors and yourself at this rate."
d. "Mr. Pablo, you appear anxious to me. How 35. The nurse is caring for a client diagnosed
are you feeling about tomorrow's surgery?" with squamous cell skin cancer and writes a
psychosocial problem of “fear.” Which nursing
31. Mr. Perez is in continuous pain from interventions should be included in the plan
cancer that has metastasized to the bone. of care?
Pain medication provides little relief and he a. Explain to the client that the fears are
refuses to move. The nurse should plan to: unfounded.
a. Reassure him that the nurses will not hurt b. Encourage the client to verbalize the
him feeling of being afraid.
b. Let him perform his own activities of daily c. Have the HCP discuss the client’s fear with
living the client.
c. Handle him gently when assisting with d. Instruct the client regarding all planned
required care procedures.
d. Complete A.M. care quickly as possible
when necessary 36. The client has had a squamous cell
carcinoma removed from the lip. Which
32. A client, who is suspected of having discharge instructions should the nurse
Pheochromocytoma, complains of sweating, provide?
palpitation and headache. Which assessment a. Notify the HCP if a lesion that does not heal
is essential for the nurse to make first? develops around the mouth.
a. Pupil reaction b. Squamous cell carcinoma tumors do not
b. Hand grips metastasize.
c. Blood pressure c. Limit foods to liquid or soft consistency for
d. Blood glucose 1 month.
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d. Apply heat to the area for 20 minutes every 41. The school nurse is preparing to teach a
4 hours. health promotion class to high school seniors.
Which information regarding self-care should
37. The nurse is caring for clients in an be included in the teaching?
outpatient surgery clinic. Which client should a. Wear a sunscreen with a protection factor
be assessed first? of 10 or less when in the sun.
a. The client scheduled for a skin biopsy who b. Try to stay out of the sun between 0300
is crying. and 0500 daily.
b. The client who had surgery three (3) hours c. Perform a thorough skin check monthly.
ago and is sleeping. d. Remember that caps and long sleeves do
c. The client who needs to void prior to not help prevent skin cancer.
discharge.
d. The client who has received discharge 42. Which client physiological outcome (goal)
instructions and is ready to go home. is appropriate for a client diagnosed with skin
cancer who has had surgery to remove the
38. The nurse and unlicensed assistive lesion?
personnel are caring for clients in a a. The client will express feelings of fear.
dermatology clinic. Which task should not be b. The client will ask questions about the
delegated to the unlicensed assistant? diagnosis.
a. Stock the rooms with the equipment c. The client will state a diminished level of
needed. pain.
b. Weigh the clients and position the clients d. The client will demonstrate care of
for the examination. operative site.
c. Discuss problems the client has
experienced since the previous visit. 43. The middle-aged client has had 2 lesions
d. Take the biopsy specimens to the diagnosed as basal cell carcinoma removed.
laboratory. Which discharge instruction should the nurse
include?
39. Which client is at the greatest risk for the a. Teach the client that there is no more risk
development of skin cancer? for cancer.
a. The African American male who lives in the b. Refer the client to a prosthesis specialist
northeast. for prosthesis.
b. The elderly Hispanic female who moved c. Instruct the client how to apply sunscreen
from Mexico as a child. to the area.
c. The client who has a family history of basal d. Demonstrate care of the surgical site.
cell carcinoma.
d. The client with fair complexion who cannot 44. The nurse is working on a renal surgery
get a tan. unit. After the afternoon report, which client
should the nurse assess first?
40. The nurse participating in a health fair is a. The male client who just returned from a
discussing malignant melanoma with a group CT scan and states that he left his glasses in
of clients. Which information regarding the the x-ray department.
use of sunscreen is important to include? b. The client who is one (1) day post-op and
a. Sunscreen is only needed during the has a moderate amount of serous drainage on
hottest hours of the day. the dressing.
b. Toddlers should not have sunscreen c. The client who is scheduled for surgery in
applied to their skin. the morning and wants an explanation of the
c. Sunscreen does not help prevent skin operative procedure before signing the
cancer. permit.
d. The higher the number of the sunscreen, d. The client who had ileal conduit surgery
the more it blocks UV rays. this morning and has not had any drainage in
the drainage bag.
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45. Which is a modifiable risk factor for the c. Administration of the prescribed
development of cancer of the bladder? antineoplastic medications.
a. Previous exposure to chemicals. d. Care for the client going for a MRI of the
b. Pelvic radiation therapy. kidneys.
c. Cigarette smoking.
d. Parasitic infections of the bladder. 50. The male client diagnosed with metastatic
cancer of the bladder is emaciated and
46. The client diagnosed with cancer of the refuses to eat. Which nursing action is an
bladder is scheduled to have a cutaneous example of the ethical principle of
urinary diversion procedure. Which paternalism?
preoperative teaching intervention specific to a. The nurse allows the client to talk about
the procedure should be included? not wanting to eat.
a. Demonstrate turn, cough, and deep b. The nurse tells the client that if he does not
breathing. eat, a feeding tube will be placed.
b. Explain that a bag will drain the urine from c. The nurse consults the dietitian about the
now on. client’s nutritional needs.
c. Instruct the client on the use of a PCA d. The nurse asks the family to bring favorite
pump. foods for the client to eat.
d. Take the client to the ICD so that he or she
can become familiar with it. 51. The client diagnosed with cancer of the
bladder states, “I have young children. I am
47. The client diagnosed with cancer of the too young to die.” Which statement is the
bladder is undergoing intravesical nurse’s best response?
chemotherapy. a. “This cancer is treatable and you should
Which instruction should the nurse provide not give up.”
the client about the pre-therapy routine? b. “Cancer occurs at any age. It is just one of
a. Instruct the client to remain NPO after those things.”
midnight before the procedure. c. “You are afraid of dying and what will
b. Explain the use of chemotherapy in bladder happen to your children.”
cancer. d. “Have you talked to your children about
c. Teach the client to administer Neupogen, a your dying?”
biologic response modifier.
d. Have the client take Tylenol, an analgesic, 52. The client with a continent urinary
before coming to the clinic. diversion is being discharged. Which
discharge instructions should the nurse
48. The nurse is planning the care of a include in the teaching?
postoperative client with an ileal conduit. a. Have the client demonstrate catheterizing
Which intervention should be included in the the stoma.
plan of care? b. Instruct the client on how to pouch the
1. Provide meticulous skin care and pouching. stoma.
2. Apply sterile drainage bags daily. c. Explain the use of a bedside drainage bag
3. Monitor the pH of the urine weekly. at night.
4. Assess the stoma site every day. d. Tell the client to call the HCP if the
temperature is 99_F or less.
49. The nurse and a licensed practical nurse 53. Which information regarding the care of a
(LPN) are caring for a group of clients. cutaneous ileal conduit should the nurse
Which intervention should be assigned to the teach?
LPN? a. Teach the client to instill a few drops of
a. Assessment of the client who has had a vinegar into the pouch.
Kock pouch procedure. b. Tell the client that the stoma should be
b. Monitoring of the post-op client with a WBC slightly dusky colored.
of 22,000 mm/dL.
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c. Inform the client that large clumps of d. Annual gynecological examinations
mucus are expected.
d. Tell the client that it is normal for the urine 58. The community health nurse is instructing
to be pink or red in color. a group of female clients about breast self-
examination. The nurse instructs the clients
54. The client is 2 days post to perform the examination:
ureterosigmoidostomy for cancer of the a. At the onset of menstruation
bladder. Which assessment data warrant b. Every month during ovulation
notification of the HCP by the nurse? c. Weekly at the same time of day
a. The client complains of pain at a “3,” 30 d. 1 week after menstruation begins
minutes after being medicated.
b. The client complains that it hurts to cough 59. The nurse is caring for a client who has
and deep breathe. undergone a vaginal hysterectomy. The nurse
c. The client ambulates to the end of the hall avoids which of the following in the care of
and back before lunch. this client?
d. The client is lying in a fetal position and a. Elevating the knee gatch on the bed
has a rigid abdomen. b. Assisting with range-of-motion leg
exercises
55. The female client diagnosed with bladder c. Removal of antiembolism stockings twice
cancer with a cutaneous urinary diversion daily
states, “Will I be able to have children now?” d. Checking placement of pneumatic
Which statement is the nurse’s best compression boots
response?
a. “Cancer does not make you sterile, but 60. The client is diagnosed as having a bowel
sometimes the therapy can.” tumor and several diagnostic tests are
b. “Are you concerned that you can’t have prescribed. The nurse understands that which
children?” test will confirm the diagnosis of malignancy?
c. “You will be able to have as many children a. Biopsy of the tumor
as you want.” b. Abdominal ultrasound
d. “Let me have the chaplain come to talk c. Magnetic resonance imaging
with you about this.” d. Computed tomography scan
128. Marco who was diagnosed with brain 134. The use of radiation therapy in the care
tumor was scheduled for craniotomy. In of a patient with abdominal cancer would be:
preventing the development of cerebral a. to relive metastatic pain as well as
edema after surgery, the nurse should expect symptoms from local extension of primary
the use of: disease.
a. Diuretics b. to be a palliative treatment to relieve pain
b. Antihypertensive and maintain symptom control for the
c. Steroids duration of the patient’s life.
d. Anticonvulsants c. to be used alone as a therapeutic agent.
d. to help tissue to shrink and possible tumor
129. A high-fiber diet is thought to reduce the eradication.
risk of colon cancer because it:
a. absorbs water from the intestinal wall. 135. In planning for pain control in a post-
b. promotes the excretion of bile. operative cancer patient, the nurse
c. stops diarrhea. understands:
d. is low in kilocalories. a. radiation therapy alone will be used.
b. noninvasive analgesic approaches should
130. Pain tolerance in an elderly patient with be tried before invasive palliative approaches.
cancer would: c. never use radiation therapy, unless you are
a. stay the same. sure the patient will die.
b. be lowered. d. radiation therapy is complementary to
c. be increased. analgesic drug therapies.
d. no effect on pain tolerance.
136. What considerations should be noted by
131. When administering a narcotic with a the nurse when pharmacological support is
non-narcotic to relieve severe cancer pain, given for cancer patients having procedures?
the nurse must remember: a. The needs of the individual and the type of
a. this combination enhances pain relief. procedures to be done.
b. this combination treats pain both centrally b. All children and adults should have heavy
and peripherally. dosages of drugs.
c. the narcotic potentiates action of the non- c. All children no matter what age, should
narcotic. have hypnosis, distraction, imagery, and
d. each drug works in its own right. relaxation therapy.
132. A cancer patient has had a resurgence of d. No special considerations are necessary.
severe acute pain. Which of the following
routes of medication is most appropriate for 137. Cancer pain depends upon what?
this patient? a. the age of the patient and how much fear
a. oral administration NSAIDS and anxiety is present
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b. the type of cancer, the site of the cancer, 142. Which mnemonic is used to remember
and the time of the initial pain episode the seven warning signs of cancer?
c. the type of cancer, the stage of the cancer, a. CAUTION
and the threshold (tolerance for pain) b. DANGERS
d. the psychosocial state of the client, how c. WARNING
well they accept the diagnosis, and the sex of d. CANCERS
the patient
143. Cancer is characterized by which of the
138. A client received testing and was just following cell changes?
informed she has leukemia. Which statement a. Rapid proliferation
by the nurse is most therapeutic? b. Toxin production
a. “We have treatments for leukemia that are c. Increased differentiation
quite effective.” d. Indiscriminate proliferation
b. “Don’t worry, because your type of
leukemia is treatable.” 144. A client has a cancerous tumor on his
c. “Lots of people have leukemia and are tibia. What name is given this type of tumor?
successfully treated.” 1. Adenoma
d. “How does it feel for you to hear you have 2. Osteoma
leukemia?” 3. Fibroma
4. Meningioma
139. Which of the following may be a
complication of previous infection with human 145. A 54-year-old man is admitted to the
papilloma virus (HPV)? hospital for a colostomy related to a recent
a. Cervical cancer diagnosis of colon cancer.
b. Breast cancer During the preoperative period, what is the
c. Bone cancer most important aspect of this client’s nursing
d. Skin cancer care?
a. Assure the client that he will be cured of
140. A client has been treated for uterine cancer.
cancer with internal radiation therapy. Which b. Assess understanding of the procedure and
of the following complications may she expectation of bodily appearance after
develop later? surgery.
a. cystitis c. Maintain a cheerful and optimistic
b. arthritis environment.
c. hepatitis d. Keep visitors to a minimum, so that he can
d. neuritis have time to think things through.
141. The client, aged 28, was recently 146. A client who is getting radiation asks the
diagnosed with Hodgkin’s disease. After nurse why these sores developed in the
staging, therapy is planned to include client’s mouth. What is the most appropriate
combination radiation therapy and systemic response?
chemotherapy with MOPP (nitrogen mustard, a. “Don’t worry; it always happens with
vincristine {Onconvin}, prednisone, and radiation.”
procarbazine). In planning care for the client, b. “Your oral hygiene needs improvement.”
the nurse should anticipate which of the c. “It is a sign that the radiation is effective.”
following effects to contribute to a sense of d. “The sores result because the cells in the
altered body image? mouth are sensitive to the radiation.”
a. cushingoid appearance
b. alopecia 147. A client develops stomatitis during the
c. temporary or permanent sterility course of radiation therapy. Nursing care for
d. pathologic fractures this problem should include:
a. A soft, bland diet.
b. Restricting fluids to decrease salivation.
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c. Rinsing the mouth every two hours with a d. Avoid the question. Nurses are not
dilute mouthwash. specialists in providing sexual counseling.
d. Encouraging the client to drink hot liquids.
152. When a client is having external
148. The chemotherapeutic agent 5- radiation for lung cancer, what side effect is
fluorourcacil (5-FU) is ordered for a client as most likely to be experienced?
an adjunct measure to surgery. Which a. Alopecia
statement about chemotherapy is true? b. Bone marrow suppression
a. It is a local treatment affecting only tumor c. Stomatitis
cells. d. Dyspnea
b. It is a systemic treatment affecting both
tumor and normal cells. 153. A 25-year-old male client receiving
c. It has not yet been proved an effective external radiation treatments tells you that he
treatment for cancer. fears he is radioactive and a danger to his
d. It is often the drug of choice because it family and friends. How would the nurse
causes few if any side effects. dispel his fears?
a. Inform him that radiation machines are risk
149. Which instruction should be given in a free.
health education class regarding testicular b. Explain that once the machine is off,
cancer? radiation is no longer emitted.
a. All males should perform a testicular exam c. Avoid telling him that his fears are in fact
after the age of 30. true.
b. Testicular exams should be performed on a d. Instruct him to spend short periods of time
daily basis. with his family and friends.
c. Reddening or darkening of the scrotum is a
normal finding. 154. The nurse assesses for findings of early
d. Testicular exams should be performed after cervical cancer by which of the following?
a warm bath or shower. a. A dark, foul-smelling vaginal discharge
b. Pressure on the bladder or bowel, or both
150. During surgery, it is found that a client c. Back and leg pain and weight loss
with adenocarcinoma of the rectum has d. Vaginal discharge (leucorrhea)
positive peritoneal lymph nodes. What is the
next most likely site of metastasis? 155. The nurse discusses with a client in the
a. Brain healthcare clinic the possibility of endometrial
b. Bone cancer. Which of the following statements is
c. Liver incorrect concerning endometrial cancer?
d. Mediastinum a. Diagnosis is most frequently established by
a dilation and curettage (D&C).
151. Medical treatment for a client with b. Prolonged use of exogenous estrogen
cervical cancer will include a hysterectomy increases the occurrence.
followed by internal radiation. Although she is c. The first and most important symptom is
32 years old and has three children, the client abnormal bleeding.
tells the nurse that she is anxious regarding d. This malignancy tends to spread rapidly to
the impending treatment and loss of her other organs.
femininity. Which interaction is most
appropriate? 156. The Pap smear reveals that a client has
a. Tell the client that now she does not have cancer of the cervix. The mode of treatment
to worry about pregnancy. is an abdominal hysterectomy. The client
b. Provide the client with adequate voices concern about undergoing menopause.
information about the effects of treatment on In counseling her, which statement would be
sexual functioning. most appropriate?
c. Refer her to the physician.
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a. A surgical menopause will occur, and Her discharge teaching should include:
treatment with estrogen therapy will be a. Manage sore throat with over-the-counter
necessary. preparations.
b. The ovaries will continue to function and b. Wear a mask when going out to shop.
produce estrogen, thus preventing c. You can babysit ill grandchildren.
menopause as a result of surgery. d. Avoid activities that may cause bleeding.
c. Ovarian hormone secretion ceases, but the
hypothalamus will continue to secrete FSH, 162. Antimetabolites used for cancer
and this prevents menopause. treatment work by:
d. The ovaries will cease functioning, and it a. Enhancing cell growth.
will be necessary to take estrogen. b. Bone marrow ablation.
c. Inhibiting cell growth and proliferation.
157. Cancer of the lungs is caused by: d. Limiting the ability of the cancer to
a. Airway atrisia. metastasize.
b. Hepatitis A.
c. Cigarette smoking. 163. The synthetic cannabis derivative
d. Congenital defects. dronabinol
(Marinol) can be used to treat cancer patients
158. A client begins a regimen of for:
chemotherapy. Her platelet counts falls to a. Depression.
98,000. Which action is least necessary at b. Nausea.
this time? c. Pain.
a. Test all excreta for occult blood. d. Mucositis.
b. Use a soft toothbrush or foam cleaner for
oral hygiene. 164. Which statement is incorrect regarding
c. Implement reverse isolation. lung cancer?
d. Avoid IM injections. a. The 5-year survival rate depends on tumor
histology and disease stage at the time
159. High uric acid levels may develop in treatment is initiated.
clients who are receiving chemotherapy. This b. Small-cell lung cancer has an excellent
is caused by: prognosis.
a. The inability of the kidneys to excrete the c. The 5-year survival rate for lung cancer is
drug metabolites. less than 15 percent.
b. Rapid cell catabolism. d. Lung cancer is usually widespread by the
c. Toxic effects of the prophylactic antibiotics time it is detected on chest x-ray.
that are given concurrently.
d. The altered blood pH from the acid medium 165. A client is scheduled for external
of the drugs. radiation treatment for laryngeal cancer. Of
the following, which is not a common
160. Which of the following statements, if systemic side effect of this treatment?
made by a cancer patient with hair loss a. Nausea
secondary to chemotherapy, indicates the b. Fatigue
goal for new coping patterns is being met? c. Malaise
a. “I think I’ll get some new barrettes for my d. Dry desquamation of the skin
hair.”
b. “I washed my wig today.” 166. When teaching the client about
c. “I asked my mom to bring my shampoo.” upcoming external radiation treatments, the
d. “I’m thinking about changing my hair nurse should stress the importance of:
color.” a. Massaging the area daily.
b. Exposing the area to sunlight for 30
161. A patient with breast cancer is minutes each day.
undergoing chemotherapy. She develops c. Not using soap on the treatment area and
myelosuppression. ink markings.
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d. Applying cosmetic creams over the area to c. Have the client brush his teeth before
conceal reddened areas. collection of the specimen.
d. Keep the client NPO for 24 hours before
167. A recent diagnosis of cancer has caused collection of the specimen.
a patient severe anxiety. The plan of care
should include: 172. A 4-year-old Mexican American client
a. Teaching the stages of grieving. has recently been diagnosed with leukemia.
b. Providing distraction during time of stress. What intervention would be appropriate when
c. Teaching chemotherapy aspects. considering the client’s culture?
d. Encouraging verbalization of concerns a. Limit all visitors, including extended family.
regarding diagnosis. b. Encourage visits from extended as well as
immediate family.
168. A patient is undergoing chemotherapy c. Ban all visits from alternative healers.
following a laryngectomy for laryngeal d. Make diet selections for the child and
cancer. The patient begins complaining of a family.
sore mouth. The nurse should assess for:
a. Xerostomia. 173. An 85-year-old man with end-stage
b. Halatosis. prostate cancer has a living will expressing
c. Stomatitis. his desire for a dignified death and comfort
d. Dysgeusia. care measures without resuscitation
measures. Advocate, your role is to:
169. The main goal of cancer chemotherapy a. Support the daughter’s decision.
is to: b. Encourage the patient to revoke his living
a. Limit the toxic side effects. will.
b. Attack the cancer as early as possible. c. Support the patient’s decision and
c. Cure or provide palliation if the cancer is encourage him to discuss his feeling with his
not curable. daughter.
d. Provide the patient with a suitable quality d. Ignore the patient’s decision for non-
of life. resuscitation.
170. A client receiving radiation therapy for a 174. Mr. Davis, an 80 year old, is being
cancer tumor asked the nurse, “How is the discharged from the hospital with a new
radiation treatments done?” The nurse replied diagnosis of lung cancer. The adult children
that: have made arrangements for him to live with
a. The agents act on inhibiting DNA synthesis. his youngest son. To promote optimal
b. The therapy can be either internal or continuity of care, the nurse should:
external beam. a. Immediately arrange for hospice care.
c. The agents used kill all the cancer cells. b. Convince the family that institutionalized
d. The therapy of the beam of radiation is for care would be better.
the total body. c. Assist with the discharge as planned.
d. Explore options for community health
171. A 67-year-old man is admitted to the services with the family.
hospital with a tentative diagnosis of
bronchogenic carcinoma. His chief complaint 175. A patient with advanced cancer of the
is dyspnea and a chronic cough. The stomach is undergoing surgery to take out
physician orders a sputum sample for part or debulk the tumor. This is known as
cytologic testing. Important nursing ______ surgery.
implications involved with obtaining a sputum a. Tertiary
sample for cytology should include which of b. Restorative
the following? c. Curative
a. Obtain the specimen in the evening hours. d. Palliative
b. Collect the specimen in the morning before
the client eats and drinks.
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176. Which of the following primary 180. What interventions would be appropriate
precautions is aimed at reducing the risk of for a client admitted to the oncology unit for
breast cancer in a female 50 years of age and chemotherapy and radiation therapy who is
older? experiencing dysgeusia?
a. Pap smear a. Premedicate the client with an antiemetic.
b. Colonoscopy b. Observe the client for signs of dehydration.
c. Ultrasound c. Use highly seasoned foods to stimulate
d. Mammography taste buds.
d. Obtain an order for zinc and give with food
177. Your patient is considering participating or milk to treat symptoms.
in a multi-site trial of a new cancer
medication. According to the “Patient’s Bill of 181. Mr. Hart is your patient who has a new
Rights,” it is important for the patient to know diagnosis of lung cancer who is deemed
that: terminally ill. During your assessment of
a. All costs of research are paid by the discharge needs, you find that he has no
patient. available caregiver in the home but will need
b. He has the right to refuse to participate in assistance with ADLs. You discuss with the
research without fear of loss of care. discharge planner:
c. The physicians will no longer be caring for a. Home care.
him if he does not participate in the research. b. Adult day care.
d. The research study is his only hope of c. Long-term care with hospice services.
treatment. d. Respite care.
178. Which of the following statements about 182. Which assessment finding would indicate
cancer cachexia is true? to the nurse that an antitussive medication
a. It is no different than simple starvation administered to a client with bronchogenic
because the metabolic rate declines in cancer is having the desired effect?
response to tumor growth. a. Dyspnea is relieved.
b. Cancer cachexia occurs as a result of b. Coughing is decreased.
chemotherapy but not radiation therapy. c. Expectoration is increased.
c. Cancer cachexia occurs as a result of d. Wheezes and gurgles have diminished.
tumorinduced changes.
d. Cancer cachexia is only seen in clients who 183. Which assessment finding should the
have limited caloric intake. nurse interpret as indicative of impending
spinal cord compression in a client with
179. A 52-year-old male client being treated metastatic prostate cancer?
for cancer doesn’t understand why he is a. Increasing back pain, which is worse when
being given a “female hormone,” megesterol standing than when lying down
acetate (Megace), as part of the treatment b. Lower extremity weakness and/or
regimen. He is afraid that it will alter his paresthesias
appearance. How would you respond to the c. Urgency accompanied by bladder spasms
client’s concern of altered body image? d. Lower extremity muscle cramping
a. Tell the client that the physical changes are
only temporary. 184. A client having cryosurgery for removal
b. Tell the client that this medication is used of a squamous cell carcinoma asks if the
for its ability to stimulate appetite. procedure will hurt. Which is the correct
c. Tell the client that you understand his answer for the nurse to give?
concern and that he should not take it. a. “You will not feel anything.”
d. Tell the client that the medication will be b. “There will be a brief tingling pain.”
used for a short time and any effects will be c. “There will be no pain but you may
self-limiting. experience a slight odd smell.”
d. “There will be a momentary, stabbing
pain.”
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b. Cancer has metastasized to the GI tract
185. When teaching at a health fair, the nurse c. Rectovaginal fistula has developed
is asked if there is really a relationship d. Rectum is being compressed by the tumor
between tobacco smoke and lung cancer. mass
Which information should serve as the basis
for the nurse’s response? 190. Which assessment finding is
a. There is a relationship and it is between characteristic of advanced ovarian cancer?
certain types of lung cancer and both a. Ascites
smoking and being exposed to second-hand b. Purpura
smoke. c. Splenomegaly
b. Exposure to carcinogens such as asbestos d. Hypoactive DTRs
and uranium account for a greater portion of
lung cancer than does tobacco use. 191. Which client with breast cancer is a
c. Radon takes precedence over tobacco candidate for treatment with Tamoxifen?
smoke as a factor responsible for lung cancer. a. A 32-year-old client with a lumpectomy for
d. Tobacco smoking is associated with the a small tumor and no sign of spread
majority of lung cancers of all types. b. A 58-year-old client with negative estrogen
receptor
186. What symptom reported in the health (ER) status
history of a 55- year-old woman should be c. A 41-year-old client with metastatic disease
interpreted by the nurse as requiring d. A 66-year-old client with estrogen sensitive
immediate follow-up evaluation for cancer of disease
the right colon?
a. Black, tarry stools 192. Which test confirms the diagnosis of
b. Loose, frothy stool prostate cancer?
c. Flat, ribbon-shaped stool a. PSA
d. Mahogany-colored, formed stool b. Alkaline phosphatase
c. Ultrasound of the prostate
187. When teaching a local club group about d. Prostate biopsy
oral cancer, which comment by a participant
indicates that the nurse needs to clarify the 193. Lupron is prescribed for a client with
information presented? prostate cancer. Which assessment data best
a.“Most oral cancers occur on the tongue.” indicates that the medication is having the
b. “The most rapidly spread oral cancer is on desired effect?
the floor of the mouth.” a. Client reports pain is controlled
c. “Early oral cancers are generally b. Vomiting has stopped
asymptomatic.” c. Urine is free of blood
d. “Smoking is a risk factor for cancer of the d. PSA level has dropped
lip.”
194. Which condition can pain in young
women with ovarian cancer mimic?
188. Which symptom should the nurse a. Appendicitis
interpret as requiring a check for endometrial b. Constipation
cancer? c. PMS
a. Postmenopausal bleeding d. Urinary tract infection
b. Persistent leukorrhea
c. Painful sexual intercourse 195. When caring for a client having
d. Intermittent amenorrhea radiation therapy the nurse receives a report
that the client’s laboratory values are normal
189. How should the nurse interpret the and there are no signs of anemia, infection, or
leakage of fecal matter from the vagina of a bleeding. Which conclusion should the nurse
client with advanced cancer? draw from this information?
a. Anal sphincter has been impaired
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a. Radiation has not yet reached a 200. A client who had a dose of
therapeutic level. chemotherapy at 8 a.m. calls the clinic at
b. The client is free of side effects of 2:30 p.m. complaining of nausea and
radiation. vomiting despite having taken the prescribed
c. Nutritional status is normal. medication. She asks how much worse the
d. Bone-marrow suppression is not a problem. nausea and vomiting is going to get. On
which fact should the nurse’s answer be
196. When assessing skin of a client having based?
external radiation therapy, which fact should a. Nausea and vomiting is totally
the nurse keep in mind? unpredictable.
a. Skin damage is preceded by changes in b. Nausea and vomiting typically peak in the
oral mucous membranes. first 12 hours.
b. Most skin changes occur 4–8 weeks after c. Nausea and vomiting will ease on going to
the start of radiation. bed.
c. Skin areas with poor blood flow are at d. Vomiting should cease in about 36 hours
greatest risk for injury. but nausea may persist for 7–10 days.
d. Intertriginous areas are at particular risk
for skin reactions.