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Oncologic Nursing

Situation 1 (Questions 1-5)

The client with bladder cancer is receiving Cisplatin (Platinol) and Vincristine (Oncovin).

1. The nurse preparing to give the medication understands that the purpose of administering both of
these medications is to:
a. prevent gastrointestinal side effects.
b. prevent alopecia.
c. decrease the destruction of cells.
d. increase the therapeutic response.

2. Which of the following is a priority to include in this client’s plan of care?

a. monitor the BUN and creatinine.
b. instruct the client to report tinnitus.
c. maintain IV hydration.
d. instruct the client to use a reliable method of birth control.

3. The client asks, “Why will I lose my hair from chemotherapy?” The appropriate response by the
nurse is based on which of the following?
a. It is difficult to predict.
b. chemotherapy affects normal cell that divide often.
c. all chemotherapy causes total alopecia.
d. special shampoos can be used to prevent alopecia.

4. The nurse is aware that the classification of Cisplatin (Platinol) is:

a. Anti-neoplastic
b. Antimetabolites
c. Alkylating agent
d. Antibiotics

5. Which of the following is the priority nursing action when a client states, “My IV sites hurts!” during
chemotherapy administration?
a. reposition the needle.
b. notify the physician.
c. stop the infusion.
d. apply a cold pack to the IV site.

Situation 2 (Questions 6-10)

The client is hospitalized for insertion of an internal cervical radiation implant. She was diagnosed
with cervical cancer

6. While giving care, the nurse finds the radiation implant in the bed. The initial action by the nurse is
to:
a. Call the physician.
b. Pick up the implant with gloved hands and flush it down the toilet.
c. Reinsert the implant into the vagina immediately.
d. Pick up the implant with long handled forceps and place it in a lead container.

7. The nurse understands that the most common cause of cervical cancer is:
a. Human Herpes Virus 4 (HHV4)
b. Human Papilloma Virus (HPV)
c. HIV
d. Herpes Simplex

8. When caring for the client, the nurse should observe which of the following principles?
a. Limit the time with the client to 2 hours per shift.
b. Do not allow pregnant women into the client's room.
 c. Individuals less than 16 years old may be allowed to go in the room as long as they are 6 feet
away from the client.
d. Remove dosimeter badge when entering the client's room.

9. The cervical radiation implant is placed in the client for treatment of cervical cancer. The nurse
initiates what most appropriate activity order for this client?
a. Out of the bed in chair only.
b. Ambulate to the bathroom only.
c. Bedrest.
d. Out of the bed ad lib.

10. During the visit, the client express that “if I can just live long enough to attend my daughter’s
graduation, I’ll be ready to die.” Which phase of coping is this client experiencing?
a. Denial
b. Bargaining
c. Depression
d. Anger.

Situation 3: Questions 11-15

The nurse in the oncology ward is having her morning rounds.

11. A client’s family asks the nurse, “Why can’t the chemotherapy be given once instead of in multiple
cycles?” The nurse response is based on which of the following?
a. certain chemotherapy works best during certain phases of the cell cycle.
b. No one could tolerate the entire dose in one administration.
c. chemotherapy is only covered by insurance if given in small doses.
d. most clients prefer several doses over one dose.

12. The client asks, “Why do I need to receive all these chemotherapy medicines on the same day?”
The nurse’s response is based on the understanding that chemotherapy given in combination:
a. is the only way it will be paid for by insurance.
b. achieves the greatest tumor cell kill.
c. shortens the length of administration.
e. decreases the chance of allergic reaction.

13. Her third patient is diagnosed as having a bowel tumor. Several diagnostic tests are prescribed.
The nurse understands that which of the following tests will confirm the diagnosis of malignancy?
a. Computerized tomography scan
b. Abdominal ultrasound
c. Magnetic resonance imaging
d. Biopsy of the tumor

14. The nurse is monitoring the laboratory results of a patient preparing to receive chemotherapy. The
nurse would determine that the white blood cell count is normal if which of the following results
were present?
a. 3000-8000 cells/mm³
b. 5000-10,000 cells/mm³
c. 7000-15000 cells/mm³
d. 2000-5000 cells/mm³

15. One of the patients develops thrombocytopenia. The nurse identifies which intervention as the
highest priority in the nursing care plan of care?
a. Ambulation 3 times daily
b. Monitoring temperature
c. Monitoring the platelet count
d. Monitoring the pathological fractures

Situation 4: Questions 16-20

The nurse is admitting a client with lung cancer to the nursing unit.
16. The nurse assesses for which most common risk factor for this type of cancer?
a. Use of chewing tobacco.
b. Cigarette smoking.
c. Urban living.
d. Alcohol abuse.

17. The nurse is preparing a client for surgery and notices that the client looks sad. The client says, “I
am scared of having cancer. It’s so horrible and I brought it on myself. I should have quit smoking
years ago.” What would be the nurse’s best response to the client?
a. “It’s okay to be scared. What is it about cancer that you’re afraid of?”
b. “It’s normal to be scared. I would be, too. We’ll help you through it.”
c. “Don’t be so hard on yourself. You don’t know if your smoking caused the cancer.”
d. “Do you feel guilty because you smoked?”

18. The patient underwent a left lower lobectomy. He has been out of surgery for 48 hours. She is
receiving morphine sulfate via a patient-controlled analgesia (PCA) system. She complains of
moderately severe pain in her left thorax that worsens when she coughs. The nurse should:
a. let the client rest, so that she is not stimulated to cough.
b. encourage the client to take deep breaths to help control the pain.
c. check the PCA device is functioning properly, and then reassure the client that the machine
is working and will relieve her pain.
d. Assess the pain systematically with the hospital approved scale.

19. The client asks, “Why do I need to receive all these chemotherapy medicines on the same day?”
The nurse’s response is based on the understanding that chemotherapy given in combination:
a. is the only way it will be paid for by insurance.
b. achieves the greatest tumor cell kill.
c. shortens the length of administration.
d. decreases the chance of allergic reaction.

20. Which of the following would be a major intervention to help prevent lung cancer?
a. Encourage cigarette smokers to have yearly chest radiographs.
b. Instruct people about techniques for smoking cessation.
c. Recommend that people have their houses and apartments checked for asbestos leakage.
d. Encourage people to install central air cleaners in their homes.