NCLEX Practice Test for Oncology 1

1. A female client has an abnormal result on a Papanicolaou test. After admitting

she read his chart !hile the nurse !as out of the room the client as"s !hat
dysplasia means. #hich definition should the nurse pro$ide%
a. Presence of completely undifferentiated tumor cells that don&t resemble cells of
the tissues of their origin
b. 'ncrease in the number of normal cells in a normal arrangement in a tissue or an
organ
c. (eplacement of one type of fully differentiated cell by another in tissues !here the
second type normally isn&t found
d. Alteration in the si)e shape and organi)ation of differentiated cells
*. +or a female client !ith ne!ly diagnosed cancer the nurse formulates a nursing
diagnosis of An,iety related to the threat of death secondary to cancer diagnosis.
#hich e,pected outcome !ould be appropriate for this client%
a. -Client $erbali)es feelings of an,iety..
b. -Client doesn&t guess at prognosis..
c. -Client uses any effecti$e method to reduce tension..
d. -Client stops see"ing information..
/. A male client !ith a cerebellar brain tumor is admitted to an acute care facility.
The nurse formulates a nursing diagnosis of (is" for in0ury. #hich -related1to. phrase
should the nurse add to complete the nursing diagnosis statement%
a. (elated to $isual field deficits
b. (elated to difficulty s!allo!ing
c. (elated to impaired balance
d. (elated to psychomotor sei)ures
2. A female client !ith cancer is scheduled for radiation therapy. The nurse "no!s
that radiation at any treatment site may cause a certain ad$erse effect. Therefore
the nurse should prepare the client to e,pect3
a. hair loss.
b. stomatitis.
c. fatigue.
d. $omiting.
4. Nurse April is teaching a client !ho suspects that she has a lump in her breast.
The nurse instructs the client that a diagnosis of breast cancer is confirmed by3
a. breast self1e,amination.
b. mammography.
c. fine needle aspiration.
d. chest X1ray.
5. A male client undergoes a laryngectomy to treat laryngeal cancer. #hen teaching
the client ho! to care for the nec" stoma the nurse should include !hich
instruction%
a. -6eep the stoma unco$ered..
b. -6eep the stoma dry..
c. -7a$e a family member perform stoma care initially until you get used to the
procedure..
d. -6eep the stoma moist..
8. A female client is recei$ing chemotherapy to treat breast cancer. #hich
assessment finding indicates a fluid and electrolyte imbalance induced by
chemotherapy%
a. 9rine output of 2:: ml in ; hours
b. <erum potassium le$el of /.5 mE=>L
c. ?lood pressure of 1*:>52 to 1/:>8* mm 7g
d. @ry oral mucous membranes and crac"ed lips
;. Nurse April is teaching a group of !omen to perform breast self1e,amination. The
nurse should e,plain that the purpose of performing the e,amination is to disco$er3
a. cancerous lumps.
b. areas of thic"ness or fullness.
c. changes from pre$ious self1e,aminations.
d. fibrocystic masses.
A. A client age 21 $isits the gynecologist. After e,amining her the physician
suspects cer$ical cancer. The nurse re$ie!s the client&s history for ris" factors for this
disease. #hich history finding is a ris" factor for cer$ical cancer%
a. Onset of sporadic se,ual acti$ity at age 18
b. <pontaneous abortion at age 1A
c. Pregnancy complicated !ith eclampsia at age *8
d. 7uman papilloma$irus infection at age /*
1:. A female client is recei$ing methotre,ate BCe,ateD 1* g>m* '.E. to treat
osteogenic carcinoma. @uring methotre,ate therapy the nurse e,pects the client to
recei$e !hich other drug to protect normal cells%
a. probenecid B?enemidD
b. cytarabine Bara1C cytosine arabinoside FCytosar19GD
c. thioguanine B51thioguanine 51THD
d. leuco$orin Bcitro$orum factor or folinic acid F#ellco$orinGD
11. The nurse is inter$ie!ing a male client about his past medical history. #hich
pree,isting condition may lead the nurse to suspect that a client has colorectal
cancer%
a. @uodenal ulcers
b. 7emorrhoids
c. #eight gain
d. Polyps
1*. Nurse Amy is spea"ing to a group of !omen about early detection of breast
cancer. The a$erage age of the !omen in the group is 28. +ollo!ing the American
Cancer <ociety guidelines the nurse should recommend that the !omen3
a. perform breast self1e,amination annually.
b. ha$e a mammogram annually.
c. ha$e a hormonal receptor assay annually.
d. ha$e a physician conduct a clinical e,amination e$ery * years.
1/. A male client !ith a nagging cough ma"es an appointment to see the physician
after reading that this symptom is one of the se$en !arning signs of cancer. #hat is
another !arning sign of cancer%
a. Persistent nausea
b. (ash
c. 'ndigestion
d. Chronic ache or pain
12. +or a female client ne!ly diagnosed !ith radiation1induced thrombocytopenia
the nurse should include !hich inter$ention in the plan of care%
a. Administering aspirin if the temperature e,ceeds 1:*I + B/;.;I CD
b. 'nspecting the s"in for petechiae once e$ery shift
c. Pro$iding for fre=uent rest periods
d. Placing the client in strict isolation
14. Nurse Lucia is pro$iding breast cancer education at a community facility. The
American Cancer <ociety recommends that !omen get mammograms3
a. yearly after age 2:.
b. after the birth of the first child and e$ery * years thereafter.
c. after the first menstrual period and annually thereafter.
d. e$ery / years bet!een ages *: and 2: and annually thereafter.
15. #hich inter$ention is appropriate for the nurse caring for a male client in se$ere
pain recei$ing a continuous '.E. infusion of morphine%
a. Assisting !ith a nalo,one challenge test before therapy begins
b. @iscontinuing the drug immediately if signs of dependence appear
c. Changing the administration route to P.O. if the client can tolerate fluids
d. Obtaining baseline $ital signs before administering the first dose
18. A /4 years old client !ith o$arian cancer is prescribed hydro,yurea B7ydreaD an
antimetabolite drug. Antimetabolites are a di$erse group of antineoplastic agents
that interfere !ith $arious metabolic actions of the cell. The mechanism of action of
antimetabolites interferes !ith3
a. cell di$ision or mitosis during the C phase of the cell cycle.
b. normal cellular processes during the < phase of the cell cycle.
c. the chemical structure of deo,yribonucleic acid B@NAD and chemical binding
bet!een @NA molecules Bcell cycleJnonspecificD.
d. one or more stages of ribonucleic acid B(NAD synthesis @NA synthesis or both
Bcell cycleJnonspecificD.
1;. The A?C@ method offers one !ay to assess s"in lesions for possible s"in cancer.
#hat does the A stand for%
a. Actinic
b. Asymmetry
c. Arcus
d. Assessment
1A. #hen caring for a male client diagnosed !ith a brain tumor of the parietal lobe
the nurse e,pects to assess3
a. short1term memory impairment.
b. tactile agnosia.
c. sei)ures.
d. contralateral homonymous hemianopia.
*:. A female client is undergoing tests for multiple myeloma. @iagnostic study
findings in multiple myeloma include3
a. a decreased serum creatinine le$el.
b. hypocalcemia.
c. ?ence Kones protein in the urine.
d. a lo! serum protein le$el.
*1. A /4 years old client has been recei$ing chemotherapy to treat cancer. #hich
assessment finding suggests that the client has de$eloped stomatitis Binflammation
of the mouthD%
a. #hite cottage cheeseJli"e patches on the tongue
b. Lello! tooth discoloration
c. (ed open sores on the oral mucosa
d. (ust1colored sputum
**. @uring chemotherapy an oncology client has a nursing diagnosis of impaired oral
mucous membrane related to decreased nutrition and immunosuppression secondary
to the cytoto,ic effects of chemotherapy. #hich nursing inter$ention is most li"ely to
decrease the pain of stomatitis%
a. (ecommending that the client discontinue chemotherapy
b. Pro$iding a solution of hydrogen pero,ide and !ater for use as a mouth rinse
c. Conitoring the client&s platelet and leu"ocyte counts
d. Chec"ing regularly for signs and symptoms of stomatitis
*/. #hat should a male client o$er age 4* do to help ensure early identification of
prostate cancer%
a. 7a$e a digital rectal e,amination and prostate1specific antigen BP<AD test done
yearly.
b. 7a$e a transrectal ultrasound e$ery 4 years.
c. Perform monthly testicular self1e,aminations especially after age 4:.
d. 7a$e a complete blood count BC?CD and blood urea nitrogen B?9ND and creatinine
le$els chec"ed yearly.
*2. A male client complains of sporadic epigastric pain yello! s"in nausea
$omiting !eight loss and fatigue. <uspecting gallbladder disease the physician
orders a diagnostic !or"up !hich re$eals gallbladder cancer. #hich nursing
diagnosis may be appropriate for this client%
a. Anticipatory grie$ing
b. 'mpaired s!allo!ing
c. @isturbed body image
d. Chronic lo! self1esteem
*4. A male client is in isolation after recei$ing an internal radioacti$e implant to treat
cancer. T!o hours later the nurse disco$ers the implant in the bed linens. #hat
should the nurse do first%
a. <tand as far a!ay from the implant as possible and call for help.
b. Pic" up the implant !ith long1handled forceps and place it in a lead1lined
container.
c. Lea$e the room and notify the radiation therapy department immediately.
d. Put the implant bac" in place using forceps and a shield for self1protection and
call for help.
*5. Keo$ina !ith ad$anced breast cancer is prescribed tamo,ifen BNol$ade,D. #hen
teaching the client about this drug the nurse should emphasi)e the importance of
reporting !hich ad$erse reaction immediately%
a. Eision changes
b. 7earing loss
c. 7eadache
d. Anore,ia
*8. A female client !ith cancer is being e$aluated for possible metastasis. #hich of
the follo!ing is one of the most common metastasis sites for cancer cells%
a. Li$er
b. Colon
c. (eproducti$e tract
d. #hite blood cells B#?CsD
*;. A /21year1old female client is re=uesting information about mammograms and
breast cancer. <he isn&t considered at high ris" for breast cancer. #hat should the
nurse tell this client%
a. <he should ha$e had a baseline mammogram before age /:.
b. <he should eat a lo!1fat diet to further decrease her ris" of breast cancer.
c. <he should perform breast self1e,amination during the first 4 days of each
menstrual cycle.
d. #hen she begins ha$ing yearly mammograms breast self1e,aminations !ill no
longer be necessary.
*A. Nurse ?rian is de$eloping a plan of care for marro! suppression the ma0or dose1
limiting ad$erse reaction to flo,uridine B+9@(D. 7o! long after drug administration
does bone marro! suppression become noticeable%
a. *2 hours
b. * to 2 days
c. 8 to 12 days
d. *1 to *; days
/:. The nurse is preparing for a female client for magnetic resonance imaging BC('D
to confirm or rule out a spinal cord lesion. @uring the C(' scan !hich of the
follo!ing !ould pose a threat to the client%
a. The client lies still.
b. The client as"s =uestions.
c. The client hears thumping sounds.
d. The client !ears a !atch and !edding band.
Answer D. @ysplasia refers to an alteration in the si)e shape and organi)ation of
differentiated cells. The presence of completely undifferentiated tumor cells that
don&t resemble cells of the tissues of their origin is called anaplasia. An increase in
the number of normal cells in a normal arrangement in a tissue or an organ is called
hyperplasia. (eplacement of one type of fully differentiated cell by another in tissues
!here the second type normally isn&t found is called metaplasia.
*.Answer A. Eerbali)ing feelings is the client&s first step in coping !ith the
situational crisis. 't also helps the health care team gain insight into the client&s
feelings helping guide psychosocial care. Option ? is inappropriate because
suppressing speculation may pre$ent the client from coming to terms !ith the crisis
and planning accordingly. Option C is undesirable because some methods of reducing
tension such as illicit drug or alcohol use may pre$ent the client from coming to
terms !ith the threat of death as !ell as cause physiologic harm. Option @ isn&t
appropriate because see"ing information can help a client !ith cancer gain a sense of
control o$er the crisis.
/.Answer C. A client !ith a cerebellar brain tumor may suffer in0ury from impaired
balance as !ell as disturbed gait and incoordination. Eisual field deficits difficulty
s!allo!ing and psychomotor sei)ures may result from dysfunction of the pituitary
gland pons occipital lobe parietal lobe or temporal lobe M not from a cerebellar
brain tumor. @ifficulty s!allo!ing suggests medullary dysfunction. Psychomotor
sei)ures suggest temporal lobe dysfunction.
2.Answer C. (adiation therapy may cause fatigue s"in to,icities and anore,ia
regardless of the treatment site. 7air loss stomatitis and $omiting are site1specific
not generali)ed ad$erse effects of radiation therapy.
4.Answer C. +ine needle aspiration and biopsy pro$ide cells for histologic
e,amination to confirm a diagnosis of cancer. A breast self1e,amination if done
regularly is the most reliable method for detecting breast lumps early.
Cammography is used to detect tumors that are too small to palpate. Chest X1rays
can be used to pinpoint rib metastasis.
5.Answer D. The nurse should instruct the client to "eep the stoma moist such as
by applying a thin layer of petroleum 0elly around the edges because a dry stoma
may become irritated. The nurse should recommend placing a stoma bib o$er the
stoma to filter and !arm air before it enters the stoma. The client should begin
performing stoma care !ithout assistance as soon as possible to gain independence
in self1care acti$ities.
8.Answer D. Chemotherapy commonly causes nausea and $omiting !hich may lead
to fluid and electrolyte imbalances. <igns of fluid loss include dry oral mucous
membranes crac"ed lips decreased urine output Bless than 2: ml>hourD abnormally
lo! blood pressure and a serum potassium le$el belo! /.4 mE=>L.
;.Answer C. #omen are instructed to e,amine themsel$es to disco$er changes that
ha$e occurred in the breast. Only a physician can diagnose lumps that are
cancerous areas of thic"ness or fullness that signal the presence of a malignancy or
masses that are fibrocystic as opposed to malignant.
A.Answer D. Li"e other $iral and bacterial $enereal infections human papilloma$irus
is a ris" factor for cer$ical cancer. Other ris" factors for this disease include fre=uent
se,ual intercourse before age 15 multiple se, partners and multiple pregnancies. A
spontaneous abortion and pregnancy complicated by eclampsia aren&t ris" factors for
cer$ical cancer.
1:.Answer D. Leuco$orin is administered !ith methotre,ate to protect normal cells
!hich methotre,ate could destroy if gi$en alone. Probenecid should be a$oided in
clients recei$ing methotre,ate because it reduces renal elimination of methotre,ate
increasing the ris" of methotre,ate to,icity. Cytarabine and thioguanine aren&t used
to treat osteogenic carcinoma.
11.Answer D. Colorectal polyps are common !ith colon cancer. @uodenal ulcers and
hemorrhoids aren&t pree,isting conditions of colorectal cancer. #eight loss M not gain
M is an indication of colorectal cancer.
1*.Answer B. The American Cancer <ociety guidelines state N#omen older than
age 2: should ha$e a mammogram annually and a clinical e,amination at least
annually Fnot e$ery * yearsGO all !omen should perform breast self1e,amination
monthly Fnot annuallyG.N The hormonal receptor assay is done on a "no!n breast
tumor to determine !hether the tumor is estrogen1 or progesterone1dependent.
1/.Answer C. 'ndigestion or difficulty s!allo!ing is one of the se$en !arning signs
of cancer. The other si, are a change in bo!el or bladder habits a sore that does not
heal unusual bleeding or discharge a thic"ening or lump in the breast or else!here
an ob$ious change in a !art or mole and a nagging cough or hoarseness. Persistent
nausea may signal stomach cancer but isn&t one of the se$en ma0or !arning signs.
(ash and chronic ache or pain seldom indicate cancer.
12.Answer B. ?ecause thrombocytopenia impairs blood clotting the nurse should
inspect the client regularly for signs of bleeding such as petechiae purpura
epista,is and bleeding gums. The nurse should a$oid administering aspirin because
it may increase the ris" of bleeding. +re=uent rest periods are indicated for clients
!ith anemia not thrombocytopenia. <trict isolation is indicated only for clients !ho
ha$e highly contagious or $irulent infections that are spread by air or physical
contact.
14.Answer A. The American Cancer <ociety recommends a mammogram yearly for
!omen o$er age 2:. The other statements are incorrect. 't&s recommended that
!omen bet!een ages *: and 2: ha$e a professional breast e,amination Bnot a
mammogramD e$ery / years.
15.Answer D. The nurse should obtain the client&s baseline blood pressure and pulse
and respiratory rates before administering the initial dose and then continue to
monitor $ital signs throughout therapy. A nalo,one challenge test may be
administered before using a narcotic antagonist not a narcotic agonist. The nurse
shouldn&t discontinue a narcotic agonist abruptly because !ithdra!al symptoms may
occur. Corphine commonly is used as a continuous infusion in clients !ith se$ere
pain regardless of the ability to tolerate fluids.
18.Answer B. Antimetabolites act during the < phase of the cell cycle contributing
to cell destruction or pre$enting cell replication. They&re most effecti$e against
rapidly proliferating cancers. Ciotic inhibitors interfere !ith cell di$ision or mitosis
during the C phase of the cell cycle. Al"ylating agents affect all rapidly proliferating
cells by interfering !ith @NAO they may "ill di$iding cells in all phases of the cell cycle
and may also "ill nondi$iding cells. Antineoplastic antibiotic agents interfere !ith one
or more stages of the synthesis of (NA @NA or both pre$enting normal cell gro!th
and reproduction.
1;.Answer B. #hen follo!ing the A?C@ method for assessing s"in lesions the A
stands for NasymmetryN the ? for Nborder irregularityN the C for Ncolor $ariationN
and the @ for Ndiameter.N
1A.Answer B. Tactile agnosia Binability to identify ob0ects by touchD is a sign of a
parietal lobe tumor. <hort1term memory impairment occurs !ith a frontal lobe tumor.
<ei)ures may result from a tumor of the frontal temporal or occipital lobe.
Contralateral homonymous hemianopia suggests an occipital lobe tumor.
*:.Answer C. Presence of ?ence Kones protein in the urine almost al!ays confirms
the disease but absence doesn&t rule it out. <erum calcium le$els are ele$ated
because calcium is lost from the bone and reabsorbed in the serum. <erum protein
electrophoresis sho!s ele$ated globulin spi"e. The serum creatinine le$el may also
be increased.
*1.Answer C. The tissue1destructi$e effects of cancer chemotherapy typically cause
stomatitis resulting in ulcers on the oral mucosa that appear as red open sores.
#hite cottage cheeseJli"e patches on the tongue suggest a candidal infection
another common ad$erse effect of chemotherapy. Lello! tooth discoloration may
result from antibiotic therapy not cancer chemotherapy. (ust1colored sputum
suggests a respiratory disorder such as pneumonia.
**.Answer B. To decrease the pain of stomatitis the nurse should pro$ide a solution
of hydrogen pero,ide and !ater for the client to use as a mouth rinse. BCommercially
prepared mouth!ashes contain alcohol and may cause dryness and irritation of the
oral mucosa.D The nurse also may administer $iscous lidocaine or systemic analgesics
as prescribed. <tomatitis occurs 8 to 1: days after chemotherapy beginsO thus
stopping chemotherapy !ouldn&t be helpful or practical. 'nstead the nurse should
stay alert for this potential problem to ensure prompt treatment. Conitoring platelet
and leu"ocyte counts may help pre$ent bleeding and infection but !ouldn&t decrease
pain in this highly susceptible client. Chec"ing for signs and symptoms of stomatitis
also !ouldn&t decrease the pain.
*/.Answer A. The incidence of prostate cancer increases after age 4:. The digital
rectal e,amination !hich identifies enlargement or irregularity of the prostate and
P<A test a tumor mar"er for prostate cancer are effecti$e diagnostic measures that
should be done yearly. Testicular self1e,aminations !on&t identify changes in the
prostate gland due to its location in the body. A transrectal ultrasound C?C and
?9N and creatinine le$els are usually done after diagnosis to identify the e,tent of
the disease and potential metastases
*2.Answer A. Anticipatory grie$ing is an appropriate nursing diagnosis for this client
because fe! clients !ith gallbladder cancer li$e more than 1 year after diagnosis.
'mpaired s!allo!ing isn&t associated !ith gallbladder cancer. Although surgery
typically is done to remo$e the gallbladder and possibly a section of the li$er it isn&t
disfiguring and doesn&t cause @isturbed body image. Chronic lo! self1esteem isn&t an
appropriate nursing diagnosis at this time because the diagnosis has 0ust been
made.
*4.Answer B. 'f a radioacti$e implant becomes dislodged the nurse should pic" it
up !ith long1handled forceps and place it in a lead1lined container then notify the
radiation therapy department immediately. The highest priority is to minimi)e
radiation e,posure for the client and the nurseO therefore the nurse must not ta"e
any action that delays implant remo$al. <tanding as far from the implant as possible
lea$ing the room !ith the implant still e,posed or attempting to put it bac" in place
can greatly increase the ris" of harm to the client and the nurse from e,cessi$e
radiation e,posure.
*5.Answer A. The client must report changes in $isual acuity immediately because
this ad$erse effect may be irre$ersible. Tamo,ifen isn&t associated !ith hearing loss.
Although the drug may cause anore,ia headache and hot flashes the client need
not report these ad$erse effects immediately because they don&t !arrant a change in
therapy.
*8.Answer A. The li$er is one of the fi$e most common cancer metastasis sites. The
others are the lymph nodes lung bone and brain. The colon reproducti$e tract
and #?Cs are occasional metastasis sites.
*;.Answer B. A lo!1fat diet Bone that maintains !eight !ithin *:P of
recommended body !eightD has been found to decrease a !oman&s ris" of breast
cancer. A baseline mammogram should be done bet!een ages /: and 2:. Conthly
breast self1e,aminations should be done bet!een days 8 and 1: of the menstrual
cycle. The client should continue to perform monthly breast self1e,aminations e$en
!hen recei$ing yearly mammograms.
*A.Answer C. ?one marro! suppression becomes noticeable 8 to 12 days after
flo,uridine administration. ?one marro! reco$ery occurs in *1 to *; days.
/:.Answer D. @uring an C(' the client should !ear no metal ob0ects such as
0e!elry because the strong magnetic field can pull on them causing in0ury to the
client and Bif they fly offD to others. The client must lie still during the C(' but can
tal" to those performing the test by !ay of the microphone inside the scanner
tunnel. The client should hear thumping sounds !hich are caused by the sound
!a$es thumping on the magnetic field.
1. Nina an oncology nurse educator is spea"ing to a !omen&s group about breast
cancer. Questions and comments from the audience re$eal a misunderstanding of
some aspects of the disease. Earious members of the audience ha$e made all of the
follo!ing statements. #hich one is accurate%
a. Cammography is the most reliable method for detecting breast cancer.
b. ?reast cancer is the leading "iller of !omen of childbearing age.
c. ?reast cancer re=uires a mastectomy.
d. Cen can de$elop breast cancer.
*. Nurse Ceredith is instructing a premenopausal !oman about breast self1
e,amination. The nurse should tell the client to do her self1e,amination3
a. at the end of her menstrual cycle.
b. on the same day each month.
c. on the 1st day of the menstrual cycle.
d. immediately after her menstrual period.
/. Nurse 6ent is teaching a male client to perform monthly testicular self1
e,aminations. #hich of the follo!ing points !ould be appropriate to ma"e%
a. Testicular cancer is a highly curable type of cancer.
b. Testicular cancer is $ery difficult to diagnose.
c. Testicular cancer is the number one cause of cancer deaths in males.
d. Testicular cancer is more common in older men.
2. (hea has malignant lymphoma. As part of her chemotherapy the physician
prescribes chlorambucil BLeu"eranD 1: mg by mouth daily. #hen caring for the
client the nurse teaches her about ad$erse reactions to chlorambucil such as
alopecia. 7o! soon after the first administration of chlorambucil might this reaction
occur%
a. 'mmediately
b. 1 !ee"
c. * to / !ee"s
d. 1 month
4. A male client is recei$ing the cell cycleJnonspecific al"ylating agent thiotepa
BThiople,D 5: mg !ee"ly for 2 !ee"s by bladder instillation as part of a
chemotherapeutic regimen to treat bladder cancer. The client as"s the nurse ho! the
drug !or"s. 7o! does thiotepa e,ert its therapeutic effects%
a. 't interferes !ith deo,yribonucleic acid B@NAD replication only.
b. 't interferes !ith ribonucleic acid B(NAD transcription only.
c. 't interferes !ith @NA replication and (NA transcription.
d. 't destroys the cell membrane causing lysis.
5. The nurse is instructing the /4 year old client to perform a testicular self1
e,amination. The nurse tells the client3
a. To e,amine the testicles !hile lying do!n
b. That the best time for the e,amination is after a sho!er
c. To gently feel the testicle !ith one finger to feel for a gro!th
d. That testicular self1e,amination should be done at least e$ery 5 months
8. A female client !ith cancer is recei$ing chemotherapy and de$elops
thrombocytopenia. The nurse identifies !hich inter$ention as the highest priority in
the nursing plan of care%
a. Conitoring temperature
b. Ambulation three times daily
c. Conitoring the platelet count
d. Conitoring for pathological fractures
;. Hian a community health nurse is instructing a group of female clients about
breast self1e,amination. The nurse instructs the client to perform the e,amination3
a. At the onset of menstruation
b. E$ery month during o$ulation
c. #ee"ly at the same time of day
d. 1 !ee" after menstruation begins
A. Nurse Cecilia is caring for a client !ho has undergone a $aginal hysterectomy. The
nurse a$oids !hich of the follo!ing in the care of this client%
a. Ele$ating the "nee gatch on the bed
b. Assisting !ith range1of1motion leg e,ercises
c. (emo$al of antiembolism stoc"ings t!ice daily
d. Chec"ing placement of pneumatic compression boots
1:. Cina !ho is suspected of an o$arian tumor is scheduled for a pel$ic ultrasound.
The nurse pro$ides !hich preprocedure instruction to the client%
a. Eat a light brea"fast only
b. Caintain an NPO status before the procedure
c. #ear comfortable clothing and shoes for the procedure
d. @rin" si, to eight glasses of !ater !ithout $oiding before the test
11. A male client is diagnosed as ha$ing a bo!el tumor and se$eral diagnostic tests
are prescribed. The nurse understands that !hich test !ill confirm the diagnosis of
malignancy%
a. ?iopsy of the tumor
b. Abdominal ultrasound
c. Cagnetic resonance imaging
d. Computeri)ed tomography scan
1*. A female client diagnosed !ith multiple myeloma and the client as"s the nurse
about the diagnosis. The nurse bases the response on !hich description of this
disorder%
a. Altered red blood cell production
b. Altered production of lymph nodes
c. Calignant e,acerbation in the number of leu"ocytes
d. Calignant proliferation of plasma cells !ithin the bone
1/. Nurse ?ea is re$ie!ing the laboratory results of a client diagnosed !ith multiple
myeloma. #hich of the follo!ing !ould the nurse e,pect to note specifically in this
disorder%
a. 'ncreased calcium
b. 'ncreased !hite blood cells
c. @ecreased blood urea nitrogen le$el
d. @ecreased number of plasma cells in the bone marro!
12. Eanessa a community health nurse conducts a health promotion program
regarding testicular cancer to community members. The nurse determines that
further information needs to be pro$ided if a community member states that !hich
of the follo!ing is a sign of testicular cancer%
a. Alopecia
b. ?ac" pain
c. Painless testicular s!elling
d. 7ea$y sensation in the scrotum
14. The male client is recei$ing e,ternal radiation to the nec" for cancer of the
laryn,. The most li"ely side effect to be e,pected is3
a. @yspnea
b. @iarrhea
c. <ore throat
d. Constipation
15. Nurse Koy is caring for a client !ith an internal radiation implant. #hen caring for
the client the nurse should obser$e !hich of the follo!ing principles%
a. Limit the time !ith the client to 1 hour per shift
b. @o not allo! pregnant !omen into the client&s room
c. (emo$e the dosimeter badge !hen entering the client&s room
d. 'ndi$iduals younger than 15 years old may be allo!ed to go in the room as long as
they are 5 feet a!ay from the client
18. A cer$ical radiation implant is placed in the client for treatment of cer$ical cancer.
The nurse initiates !hat most appropriate acti$ity order for this client%
a. ?ed rest
b. Out of bed ad lib
c. Out of bed in a chair only
d. Ambulation to the bathroom only
1;. A female client is hospitali)ed for insertion of an internal cer$ical radiation
implant. #hile gi$ing care the nurse finds the radiation implant in the bed. The
initial action by the nurse is to3
a. Call the physician
b. (einsert the implant into the $agina immediately
c. Pic" up the implant !ith glo$ed hands and flush it do!n the toilet
d. Pic" up the implant !ith long1handled forceps and place it in a lead container.
1A. The nurse is caring for a female client e,periencing neutropenia as a result of
chemotherapy and de$elops a plan of care for the client. The nurse plans to3
a. (estrict all $isitors
b. (estrict fluid inta"e
c. Teach the client and family about the need for hand hygiene
d. 'nsert an ind!elling urinary catheter to pre$ent s"in brea"do!n
*:. The home health care nurse is caring for a male client !ith cancer and the client
is complaining of acute pain. The appropriate nursing assessment of the client&s pain
!ould include !hich of the follo!ing%
a. The client&s pain rating
b. Non$erbal cues from the client
c. The nurse&s impression of the client&s pain
d. Pain relief after appropriate nursing inter$ention
*1. Nurse Cic"ey is caring for a client !ho is postoperati$e follo!ing a pel$ic
e,enteration and the physician changes the client&s diet from NPO status to clear
li=uids. The nurse ma"es !hich priority assessment before administering the diet%
a. ?o!el sounds
b. Ability to ambulate
c. 'ncision appearance
d. 9rine specific gra$ity
**. A male client is admitted to the hospital !ith a suspected diagnosis of 7odg"in&s
disease. #hich assessment findings !ould the nurse e,pect to note specifically in the
client%
a. +atigue
b. #ea"ness
c. #eight gain
d. Enlarged lymph nodes
*/. @uring the admission assessment of a /4 year old client !ith ad$anced o$arian
cancer the nurse recogni)es !hich symptom as typical of the disease%
a. @iarrhea
b. 7ypermenorrhea
c. Abdominal bleeding
d. Abdominal distention
*2. Nurse 6ate is re$ie!ing the complications of coloni)ation !ith a client !ho has
microin$asi$e cer$ical cancer. #hich complication if identified by the client indicates
a need for further teaching%
a. 'nfection
b. 7emorrhage
c. Cer$ical stenosis
d. O$arian perforation
*4. Cr. Ciller has been diagnosed !ith bone cancer. Lou "no! this type of cancer is
classified as3
a. sarcoma.
b. lymphoma.
c. carcinoma.
d. melanoma.
*5. <arah a hospice nurse $isits a client dying of o$arian cancer. @uring the $isit the
client e,presses that -'f ' can 0ust li$e long enough to attend my daughter&s
graduation '&ll be ready to die.. #hich phrase of coping is this client e,periencing%
a. Anger
b. @enial
c. ?argaining
d. @epression
*8. Nurse +arah is caring for a client follo!ing a mastectomy. #hich assessment
finding indicates that the client is e,periencing a complication related to the
surgery%
a. Pain at the incisional site
b. Arm edema on the operati$e side
c. <anguineous drainage in the Kac"son1Pratt drain
d. Complaints of decreased sensation near the operati$e site
*;. The nurse is admitting a male client !ith laryngeal cancer to the nursing unit.
The nurse assesses for !hich most common ris" factor for this type of cancer%
a. Alcohol abuse
b. Cigarette smo"ing
c. 9se of che!ing tobacco
d. E,posure to air pollutants
*A. The female client !ho has been recei$ing radiation therapy for bladder cancer
tells the nurse that it feels as if she is $oiding through the $agina. The nurse
interprets that the client may be e,periencing3
a. (upture of the bladder
b. The de$elopment of a $esico$aginal fistula
c. E,treme stress caused by the diagnosis of cancer
d. Altered perineal sensation as a side effect of radiation therapy
/:. The client !ith leu"emia is recei$ing busulfan BCyleranD and allopurinol
BRyloprimD. The nurse tells the client that the purpose if the allopurinol is to
pre$ent3
a. Nausea
b. Alopecia
c. Eomiting
d. 7yperuricemia
1. Answer D. Cen can de$elop breast cancer although they seldom do. The most
reliable method for detecting breast cancer is monthly self1e,amination not
mammography. Lung cancer causes more deaths than breast cancer in !omen of all
ages. A mastectomy may not be re=uired if the tumor is small confined and in an
early stage.
*. Answer D. Premenopausal !omen should do their self1e,amination immediately
after the menstrual period !hen the breasts are least tender and least lumpy. On
the 1st and last days of the cycle the !oman&s breasts are still $ery tender.
Postmenopausal !omen because their bodies lac" fluctuation of hormone le$els
should select one particular day of the month to do breast self1e,amination.
/. Answer A. Testicular cancer is highly curable particularly !hen it&s treated in its
early stage. <elf1e,amination allo!s early detection and facilitates the early initiation
of treatment. The highest mortality rates from cancer among men are in men !ith
lung cancer. Testicular cancer is found more commonly in younger men.
2. Answer C. Chlorambucil1induced alopecia occurs * to / !ee"s after therapy
begins.
4. Answer C. Thiotepa interferes !ith @NA replication and (NA transcription. 't
doesn&t destroy the cell membrane.
5. Answer B. The testicular1self e,amination is recommended monthly after a !arm
bath or sho!er !hen the scrotal s"in is rela,ed. The client should stand to e,amine
the testicles. 9sing both hands !ith fingers under the scrotum and thumbs on top
the client should gently roll the testicles feeling for any lumps.
8. Answer C. Thrombocytopenia indicates a decrease in the number of platelets in
the circulating blood. A ma0or concern is monitoring for and pre$enting bleeding.
Option A elates to monitoring for infection particularly if leu"openia is present.
Options ? and @ although important in the plan of care are not related directly to
thrombocytopenia.
;. Answer D. The breast self1e,amination should be performed monthly 8 days after
the onset of the menstrual period. Performing the e,amination !ee"ly is not
recommended. At the onset of menstruation and during o$ulation hormonal changes
occur that may alter breast tissue.
A. Answer A. The client is at ris" of deep $ein thrombosis or thrombophlebitis after
this surgery as for any other ma0or surgery. +or this reason the nurse implements
measures that !ill pre$ent this complication. (ange1of1motion e,ercises
antiembolism stoc"ings and pneumatic compression boots are helpful. The nurse
should a$oid using the "nee gatch in the bed !hich inhibits $enous return thus
placing the client more at ris" for deep $ein thrombosis or thrombophlebitis.
1:. Answer D. A pel$ic ultrasound re=uires the ingestion of large $olumes of !ater
0ust before the procedure. A full bladder is necessary so that it !ill be $isuali)ed as
such and not mista"en for a possible pel$ic gro!th. An abdominal ultrasound may
re=uire that the client abstain from food or fluid for se$eral hours before the
procedure. Option C is unrelated to this specific procedure.
11. Answer A. A biopsy is done to determine !hether a tumor is malignant or
benign. Cagnetic resonance imaging computed tomography scan and ultrasound
!ill $isuali)e the presence of a mass but !ill not confirm a diagnosis of malignancy.
1*. Answer D. Cultiple myeloma is a ?1cell neoplastic condition characteri)ed by
abnormal malignant proliferation of plasma cells and the accumulation of mature
plasma cells in the bone marro!. Options A and ? are not characteristics of multiple
myeloma. Option C describes the leu"emic process.
1/. Answer A. +indings indicati$e of multiple myeloma are an increased number of
plasma cells in the bone marro! anemia hypercalcemia caused by the release of
calcium from the deteriorating bone tissue and an ele$ated blood urea nitrogen
le$el. An increased !hite blood cell count may or may not be present and is not
related specifically to multiple myeloma.
12. Answer A. Alopecia is not an assessment finding in testicular cancer. Alopecia
may occur ho!e$er as a result of radiation or chemotherapy. Options ? C and @
are assessment findings in testicular cancer. ?ac" pain may indicate metastasis to
the retroperitoneal lymph nodes.
14. Answer C. 'n general only the area in the treatment field is affected by the
radiation. <"in reactions fatigue nausea and anore,ia may occur !ith radiation to
any site !hereas other side effects occur only !hen specific areas are in$ol$ed in
treatment. A client recei$ing radiation to the laryn, is most li"ely to e,perience a
sore throat. Options ? and @ may occur !ith radiation to the gastrointestinal tract.
@yspnea may occur !ith lung in$ol$ement.
15. Answer B. The time that the nurse spends in a room of a client !ith an internal
radiation implant is /: minutes per ;1hour shift. The dosimeter badge must be !orn
!hen in the client&s room. Children younger than 15 years of age and pregnant
!omen are not allo!ed in the client&s room.
18. Answer A. The client !ith a cer$ical radiation implant should be maintained on
bed rest in the dorsal position to pre$ent mo$ement of the radiation source. The
head of the bed is ele$ated to a ma,imum of 1: to 14 degrees for comfort. The
nurse a$oids turning the client on the side. 'f turning is absolutely necessary a pillo!
is placed bet!een the "nees and !ith the body in straight alignment the client is
logrolled.
1;. Answer D. A lead container and long1handled forceps should be "ept in the
client&s room at all times during internal radiation therapy. 'f the implant becomes
dislodged the nurse should pic" up the implant !ith long1handled forceps and place
it in the lead container. Options A ? and C are inaccurate inter$entions.
1A. Answer C. 'n the neutropenic client meticulous hand hygiene education is
implemented for the client family $isitors and staff. Not all $isitors are restricted
but the client is protected from persons !ith "no!n infections. +luids should be
encouraged. 'n$asi$e measures such as an ind!elling urinary catheter should be
a$oided to pre$ent infections.
*:. Answer A. The client&s self1report is a critical component of pain assessment.
The nurse should as" the client about the description of the pain and listen carefully
to the client&s !ords used to describe the pain. The nurse&s impression of the client&s
pain is not appropriate in determining the client&s le$el of pain. Non$erbal cues from
the client are important but are not the most appropriate pain assessment measure.
Assessing pain relief is an important measure but this option is not related to the
sub0ect of the =uestion.
*1. Answer A. The client is "ept NPO until peristalsis returns usually in 2 to 5 days.
#hen signs of bo!el function return clear fluids are gi$en to the client. 'f no
distention occurs the diet is ad$anced as tolerated. The most important assessment
is to assess bo!el sounds before feeding the client. Options ? C and @ are
unrelated to the sub0ect of the =uestion.
**. Answer D. 7odg"in&s disease is a chronic progressi$e neoplastic disorder of
lymphoid tissue characteri)ed by the painless enlargement of lymph nodes !ith
progression to e,tralymphatic sites such as the spleen and li$er. #eight loss is most
li"ely to be noted. +atigue and !ea"ness may occur but are not related significantly
to the disease.
*/. Answer D. Clinical manifestations of o$arian cancer include abdominal
distention urinary fre=uency and urgency pleural effusion malnutrition pain from
pressure caused by the gro!ing tumor and the effects of urinary or bo!el
obstruction constipation ascites !ith dyspnea and ultimately general se$ere pain.
Abnormal bleeding often resulting in hypermenorrhea is associated !ith uterine
cancer.
*2. Answer D. Coni)ation procedure in$ol$es remo$al of a cone1shaped area of the
cer$i,. Complications of the procedure include hemorrhage infection and cer$ical
stenosis. O$arian perforation is not a complication.
*4. Answer A. Tumors that originate from bonemuscle and other connecti$e tissue
are called sarcomas.
*5. Answer C. @enial bargaining anger depression and acceptance are recogni)ed
stages that a person facing a life1threatening illness e,periences. ?argaining
identifies a beha$ior in !hich the indi$idual is !illing to do anything to a$oid loss or
change prognosis or fate. @enial is e,pressed as shoc" and disbelief and may be the
first response to hearing bad ne!s. @epression may be manifested by hopelessness
!eeping openly or remaining =uiet or !ithdra!n. Anger also may be a first response
to upsetting ne!s and the predominant theme is -!hy me%. or the blaming of
others.
*8. Answer B. Arm edema on the operati$e side BlymphedemaD is a complication
follo!ing mastectomy and can occur immediately postoperati$ely or may occur
months or e$en years after surgery. Options A C and @ are e,pected occurrences
follo!ing mastectomy and do not indicate a complication.
*;. Answer B. The most common ris" factor associated !ith laryngeal cancer is
cigarette smo"ing. 7ea$y alcohol use and the combined use of tobacco increase the
ris". Another ris" factor is e,posure to en$ironmental pollutants.
*A. Answer B. A $esico$aginal fistula is a genital fistula that occurs bet!een the
bladder and $agina. The fistula is an abnormal opening bet!een these t!o body
parts and if this occurs the client may e,perience drainage of urine through the
$agina. The client&s complaint is not associated !ith options A C and @.
/:. Answer D. Allopurinol decreases uric acid production and reduces uric acid
concentrations in serum and urine. 'n the client recei$ing chemotherapy uric acid
le$els increase as a result of the massi$e cell destruction that occurs from the
chemotherapy. This medication pre$ents or treats hyperuricemia caused by
chemotherapy. Allopurinol is not used to pre$ent alopecia nausea or $omiting.