1. Nina, an oncology nurse educator is speaking to a women’s group about breast cancer.

Questions and comments from the audience reveal a misunderstanding of some aspects of the disease. Various members of the audience have made all of the following statements. Which one is accurate? a. Mammography is the most reliable method for detecting breast cancer. b. Breast cancer is the leading killer of women of childbearing age. c. Breast cancer requires a mastectomy. d. Men can develop breast cancer. Answer D. Men can develop breast cancer, although they seldom do. The most reliable method for detecting breast cancer is monthly self-examination, not mammography. Lung cancer causes more deaths than breast cancer in women of all ages. A mastectomy may not be required if the tumor is small, confined, and in an early stage. 2. Nurse Meredith is instructing a premenopausal woman about breast self-examination. The nurse should tell the client to do her self-examination: 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. Answer D. Premenopausal women should do their self-examination immediately after the menstrual period, when the breasts are least tender and least lumpy. On the 1st and last days of the cycle, the woman’s breasts are still very tender. Postmenopausal women because their bodies lack fluctuation of hormone levels, should select one particular day of the month to do breast self-examination. 3. Nurse Kent is teaching a male client to perform monthly testicular self-examinations. Which of the following points would be appropriate to make? a. Testicular cancer is a highly curable type of cancer. b. Testicular cancer is very 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. Answer A. Testicular cancer is highly curable, particularly when it’s treated in its early stage. Self-examination allows early detection and facilitates the early initiation of treatment. The highest mortality rates from cancer among men are in men with lung cancer. Testicular cancer is found more commonly in younger men. 4. Rhea, has malignant lymphoma. As part of her chemotherapy, the physician prescribes chlorambucil (Leukeran), 10 mg by mouth daily. When caring for the client, the nurse teaches her about adverse reactions to chlorambucil, such as alopecia. How soon after the first administration of chlorambucil might this reaction occur? a. Immediately

That the best time for the examination is after a shower c. The nurse tells the client: a. 1 month Answer C. Options B and D. feeling for any lumps. Answer C. are not related directly to thrombocytopenia. the client should gently roll the testicles. c. The nurse is instructing the 35 year old client to perform a testicular self-examination. 6. That testicular self-examination should be done at least every 6 months Answer B. It interferes with deoxyribonucleic acid (DNA) replication only.b. a community health nurse is instructing a group of female clients about breast selfexamination. The client should stand to examine the testicles. The nurse identifies which intervention as the highest priority in the nursing plan of care? a. The testicular-self examination is recommended monthly after a warm bath or shower when the scrotal skin is relaxed. b. It destroys the cell membrane. although important in the plan of care. 8. d. A male client is receiving the cell cycle–nonspecific alkylating agent thiotepa (Thioplex). Monitoring temperature b. How does thiotepa exert its therapeutic effects? a. 7. The client asks the nurse how the drug works. It doesn’t destroy the cell membrane. Using both hands. Chlorambucil-induced alopecia occurs 2 to 3 weeks after therapy begins. To examine the testicles while lying down b. Gian. It interferes with DNA replication and RNA transcription. Every month during ovulation . 60 mg weekly for 4 weeks by bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. 1 week c. A major concern is monitoring for and preventing bleeding. 2 to 3 weeks d. Ambulation three times daily c. Monitoring the platelet count d. Option A elates to monitoring for infection. To gently feel the testicle with one finger to feel for a growth d. It interferes with ribonucleic acid (RNA) transcription only. The nurse instructs the client to perform the examination: a. 5. with fingers under the scrotum and thumbs on top. Thiotepa interferes with DNA replication and RNA transcription. causing lysis. Monitoring for pathological fractures Answer C. Thrombocytopenia indicates a decrease in the number of platelets in the circulating blood. At the onset of menstruation b. A female client with cancer is receiving chemotherapy and develops thrombocytopenia. particularly if leukopenia is present.

Wear comfortable clothing and shoes for the procedure d. antiembolism stockings. Magnetic resonance imaging. A biopsy is done to determine whether a tumor is malignant or benign. 11. Performing the examination weekly is not recommended. . At the onset of menstruation and during ovulation. thus placing the client more at risk for deep vein thrombosis or thrombophlebitis. Magnetic resonance imaging d. The nurse understands that which test will confirm the diagnosis of malignancy? a. 10. the nurse implements measures that will prevent this complication. Weekly at the same time of day d. Eat a light breakfast only b. The nurse should avoid using the knee gatch in the bed. who is suspected of an ovarian tumor is scheduled for a pelvic ultrasound. Mina. An abdominal ultrasound may require that the client abstain from food or fluid for several hours before the procedure. Nurse Cecilia is caring for a client who has undergone a vaginal hysterectomy. For this reason. 9. The nurse provides which preprocedure instruction to the client? a. Removal of antiembolism stockings twice daily d. Elevating the knee gatch on the bed b. A male client is diagnosed as having a bowel tumor and several diagnostic tests are prescribed. Range-of-motion exercises. Checking placement of pneumatic compression boots Answer A. which inhibits venous return. as for any other major surgery. Assisting with range-of-motion leg exercises c. and ultrasound will visualize the presence of a mass but will not confirm a diagnosis of malignancy. Maintain an NPO status before the procedure c. Drink six to eight glasses of water without voiding before the test Answer D. The breast self-examination should be performed monthly 7 days after the onset of the menstrual period. 1 week after menstruation begins Answer D. hormonal changes occur that may alter breast tissue. The nurse avoids which of the following in the care of this client? a. computed tomography scan.c. The client is at risk of deep vein thrombosis or thrombophlebitis after this surgery. Biopsy of the tumor b. and pneumatic compression boots are helpful. A full bladder is necessary so that it will be visualized as such and not mistaken for a possible pelvic growth. Abdominal ultrasound c. Computerized tomography scan Answer A. A pelvic ultrasound requires the ingestion of large volumes of water just before the procedure. Option C is unrelated to this specific procedure.

anemia. Constipation . C. The male client is receiving external radiation to the neck for cancer of the larynx. Increased calcium b. 13. A female client diagnosed with multiple myeloma and the client asks the nurse about the diagnosis. Option C describes the leukemic process. The nurse bases the response on which description of this disorder? a. however. Decreased blood urea nitrogen level d. Malignant exacerbation in the number of leukocytes d. Alopecia b. Malignant proliferation of plasma cells within the bone Answer D. hypercalcemia caused by the release of calcium from the deteriorating bone tissue. Alopecia may occur. Findings indicative of multiple myeloma are an increased number of plasma cells in the bone marrow. Back pain may indicate metastasis to the retroperitoneal lymph nodes. Sore throat d. The nurse determines that further information needs to be provided if a community member states that which of the following is a sign of testicular cancer? a. a community health nurse conducts a health promotion program regarding testicular cancer to community members. Options B. Nurse Bea is reviewing the laboratory results of a client diagnosed with multiple myeloma.12. Back pain c. as a result of radiation or chemotherapy. Multiple myeloma is a B-cell neoplastic condition characterized by abnormal malignant proliferation of plasma cells and the accumulation of mature plasma cells in the bone marrow. Which of the following would the nurse expect to note specifically in this disorder? a. Altered production of lymph nodes c. Altered red blood cell production b. Diarrhea c. Painless testicular swelling d. and an elevated blood urea nitrogen level. Decreased number of plasma cells in the bone marrow Answer A. An increased white blood cell count may or may not be present and is not related specifically to multiple myeloma. The most likely side effect to be expected is: a. Options A and B are not characteristics of multiple myeloma. Heavy sensation in the scrotum Answer A. Dyspnea b. and D are assessment findings in testicular cancer. 14. Increased white blood cells c. Alopecia is not an assessment finding in testicular cancer. 15. Vanessa.

a pillow is placed between the knees and.Answer C. Ambulation to the bathroom only Answer A. nausea. A cervical radiation implant is placed in the client for treatment of cervical cancer. Do not allow pregnant women into the client’s room c. The nurse plans to: . the client is logrolled. and anorexia may occur with radiation to any site. and C are inaccurate interventions. B. the nurse should pick up the implant with long-handled forceps and place it in the lead container. The dosimeter badge must be worn when in the client’s room. The head of the bed is elevated to a maximum of 10 to 15 degrees for comfort. Pick up the implant with gloved hands and flush it down the toilet d. Out of bed ad lib c. Call the physician b. 18. 16. Answer D. A client receiving radiation to the larynx is most likely to experience a sore throat. Options B and D may occur with radiation to the gastrointestinal tract. The initial action by the nurse is to: a. 17. Individuals younger than 16 years old may be allowed to go in the room as long as they are 6 feet away from the client Answer B. The client with a cervical radiation implant should be maintained on bed rest in the dorsal position to prevent movement of the radiation source. The nurse initiates what most appropriate activity order for this client? a. Nurse Joy is caring for a client with an internal radiation implant. Children younger than 16 years of age and pregnant women are not allowed in the client’s room. The nurse is caring for a female client experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. Limit the time with the client to 1 hour per shift b. fatigue. If the implant becomes dislodged. The nurse avoids turning the client on the side. the nurse finds the radiation implant in the bed. Out of bed in a chair only d. Remove the dosimeter badge when entering the client’s room d. Reinsert the implant into the vagina immediately c. Bed rest b. the nurse should observe which of the following principles? a. In general. The time that the nurse spends in a room of a client with an internal radiation implant is 30 minutes per 8-hour shift. 19. A lead container and long-handled forceps should be kept in the client’s room at all times during internal radiation therapy. When caring for the client. Options A. While giving care. Skin reactions. Pick up the implant with long-handled forceps and place it in a lead container. Dyspnea may occur with lung involvement. whereas other side effects occur only when specific areas are involved in treatment. only the area in the treatment field is affected by the radiation. A female client is hospitalized for insertion of an internal cervical radiation implant. If turning is absolutely necessary. with the body in straight alignment.

and D are unrelated to the subject of the question. and staff. usually in 4 to 6 days. Incision appearance d. visitors. The appropriate nursing assessment of the client’s pain would include which of the following? a. If no distention occurs. Assessing pain relief is an important measure. Bowel sounds b. 21. The nurse should ask the client about the description of the pain and listen carefully to the client’s words used to describe the pain. Ability to ambulate c. Urine specific gravity Answer A. Not all visitors are restricted. Nurse Mickey is caring for a client who is postoperative following a pelvic exenteration and the physician changes the client’s diet from NPO status to clear liquids. Weakness c. C. The nurse makes which priority assessment before administering the diet? a. Nonverbal cues from the client c. Enlarged lymph nodes . Options B. Fatigue b. In the neutropenic client. Nonverbal cues from the client are important but are not the most appropriate pain assessment measure. but the client is protected from persons with known infections. Weight gain d.a. Restrict fluid intake c. When signs of bowel function return. clear fluids are given to the client. the diet is advanced as tolerated. A male client is admitted to the hospital with a suspected diagnosis of Hodgkin’s disease. meticulous hand hygiene education is implemented for the client. Which assessment findings would the nurse expect to note specifically in the client? a. Insert an indwelling urinary catheter to prevent skin breakdown Answer C. 20. The most important assessment is to assess bowel sounds before feeding the client. Invasive measures such as an indwelling urinary catheter should be avoided to prevent infections. The client’s self-report is a critical component of pain assessment. The nurse’s impression of the client’s pain is not appropriate in determining the client’s level of pain. Restrict all visitors b. 22. The home health care nurse is caring for a male client with cancer and the client is complaining of acute pain. Pain relief after appropriate nursing intervention Answer A. family. The nurse’s impression of the client’s pain d. The client is kept NPO until peristalsis returns. but this option is not related to the subject of the question. Fluids should be encouraged. The client’s pain rating b. Teach the client and family about the need for hand hygiene d.

the client expresses that “If I can just live long enough to attend my daughter’s graduation. Conization procedure involves removal of a cone-shaped area of the cervix. d. Nurse Kate is reviewing the complications of colonization with a client who has microinvasive cervical cancer. lymphoma. Infection b. as: a. Abdominal distention Answer D. I’ll be ready to die. During the admission assessment of a 35 year old client with advanced ovarian cancer. You know this type of cancer is classified sarcoma. c. constipation. Cervical stenosis d. Abdominal bleeding d. b. Anger b. Complications of the procedure include hemorrhage. melanoma. Ovarian perforation is not a complication. and cervical stenosis. urinary frequency and urgency. ascites with dyspnea. Mr.” Which phrase of coping is this client experiencing? a. indicates a need for further teaching? a. Denial . the nurse recognizes which symptom as typical of the disease? a. is associated with uterine cancer. 24. Tumors that originate from bone. Abnormal bleeding. Hemorrhage c. 23. malnutrition. Ovarian perforation Answer D. and ultimately general severe pain. pleural effusion. pain from pressure caused by the growing tumor and the effects of urinary or bowel obstruction. Clinical manifestations of ovarian cancer include abdominal distention. Hodgkin’s disease is a chronic progressive neoplastic disorder of lymphoid tissue characterized by the painless enlargement of lymph nodes with progression to extralymphatic sites.muscle.Answer D. Which complication. Weight loss is most likely to be noted. Sarah. Hypermenorrhea c. During the visit. Diarrhea b. often resulting in hypermenorrhea. 26. carcinoma. Miller has been diagnosed with bone cancer. Fatigue and weakness may occur but are not related significantly to the disease. if identified by the client. such as the spleen and liver. Answer A. a hospice nurse visits a client dying of ovarian cancer. infection. 25. and other connective tissue are called sarcomas.

Denial is expressed as shock and disbelief and may be the first response to hearing bad news. Arm edema on the operative side (lymphedema) is a complication following mastectomy and can occur immediately postoperatively or may occur months or even years after surgery. 27. The development of a vesicovaginal fistula c. Anger also may be a first response to upsetting news and the predominant theme is “why me?” or the blaming of others. 29. and acceptance are recognized stages that a person facing a life-threatening illness experiences. The most common risk factor associated with laryngeal cancer is cigarette smoking. The fistula is an abnormal opening between these two body parts and. and D are expected occurrences following mastectomy and do not indicate a complication. Arm edema on the operative side c. Depression may be manifested by hopelessness. The client’s complaint is not associated with options A. Which assessment finding indicates that the client is experiencing a complication related to the surgery? a. if this occurs. Pain at the incisional site b.c. A vesicovaginal fistula is a genital fistula that occurs between the bladder and vagina. Nurse Farah is caring for a client following a mastectomy. bargaining. and D. Use of chewing tobacco d. Bargaining identifies a behavior in which the individual is willing to do anything to avoid loss or change prognosis or fate. The nurse assesses for which most common risk factor for this type of cancer? a. The nurse is admitting a male client with laryngeal cancer to the nursing unit. Exposure to air pollutants Answer B. C. or remaining quiet or withdrawn. Rupture of the bladder b. weeping openly. . The female client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. C. Heavy alcohol use and the combined use of tobacco increase the risk. Complaints of decreased sensation near the operative site Answer B. Extreme stress caused by the diagnosis of cancer d. The nurse interprets that the client may be experiencing: a. Cigarette smoking c. depression. Denial. anger. Sanguineous drainage in the Jackson-Pratt drain d. Altered perineal sensation as a side effect of radiation therapy Answer B. the client may experience drainage of urine through the vagina. Depression Answer C. Bargaining d. 28. Another risk factor is exposure to environmental pollutants. Alcohol abuse b. Options A.

d. In the client receiving chemotherapy. Alopecia c. Vomiting d. c. This medication prevents or treats hyperuricemia caused by chemotherapy. Allopurinol decreases uric acid production and reduces uric acid concentrations in serum and urine.html 31. The nurse tells the client that the purpose if the allopurinol is to prevent: a. The client with internal radiation implant should be on bed rest. 33. How often should a female who is above 40 years old. Nausea b. allow the client to go to the bathroom avoid creams and lotions visitors are allowed to stay in the room the client should remain in bed during the entire duration of treatment Answer D. A nurse is caring for a client with an internal radiation implant. c. uric acid levels increase as a result of the massive cell destruction that occurs from the chemotherapy. A cancerous lesion is non-mobile. b.com/nclex-review/oncology/nclex-review-oncologyquestions-part-2. nausea.30. b. daily weekly monthly yearly . or vomiting. achy. 32. This is to prevent dislodgment of the implant. Hyperuricemia Answer D. Which of the following instructions is appropriate? a. The client with leukemia is receiving busulfan (Myleran) and allopurinol (Zyloprim). complaints of dull. Source/ Reference: http://nclexreviewers. Inversion of nipple is one of the manifestations of breast cancer. b. d. c. d. Which of these findings in the breast of a patient who is suspected of having breast cancer would support the diagnosis? a. go for cancer detection examination? a. pain palpation of a mobile mass presence of an inverted nipple area of discoloration skin Answer C. Allopurinol is not used to prevent alopecia.

It should be endorsed to the next shift. increasing spices will improve flavor. remember to give the badge to the next-shift nurse maintain a 30-minute close contact with the patient in a shift wear gloves.0 mEq/L. Increase the amount of spices in the food. b. Based on the assessment findings. d. Knowing that chemotherapy affects the taste buds. Medicate with Compazine before meals. the nurse would have the client a. the priority action for the nurse is to: a.blogcatalog. Nocturia. Source: http://www. sodium 135 mEq/L. the correct nursing action is to increase the client's IV fluids. This indicates denial of his illness. A nurse is assessing a client with metastatic breast cancer who reports nocturia.2 mEq/L. . Dosimeter badge is used to measure amount of exposure to radiation. d.0 mEq/L. c. b. 35. Because taste buds are affected.Answer D. Eat foods that are hot in temperature. The nurse should a. “Am I going to loose my hair?” “Should I get a second opinion?” “Will this make me really sick?” “Will I have to stop exercising at the gym?” Answer B. d.com/blog/nclex-and-local-board-prc-sampleexam/5ec63aeeb3953955c859a0cc6b6c00eb 36. and magnesium 2. 34. b. c. nausea and vomiting. The nurses assesses that the client with cancer is not ready for teaching when the client asks: a. 37. Therefore. mask and gown when entering the client's room instruct relatives no to visit the client during the entire duration of the treatment Answer A. d. All of the other comments indicate an interest in what is going to happen to him. start client on fluid restriction administer calcium gluconate increase the client's IV fluids administer Allopurinol Answer C. Cancer screening for females who are above 40 years of age should be yearly. c. calcium 7. Answer A. nausea and vomiting cause dehydration. The question states he has cancer. The client is receiving internal radiation therapy. Avoid red meats. c. The client's serum electrolytes include potassium 4. b. weakness.

b. 40.” “Most people with your kind of cancer live a long time. A client with terminal cancer yells at the nurse and says. Who’s going to take care of my children?” What is the best initial response for the nurse to make? a. “I don’t need your help.net/2010/06/nclex-review-cancer-hematology/ .” Which stage of grief is the client most likely experiencing? a. c. Stable weight indicates adequate nutritional status. #1 is really a “why” question which would put the client on the defensive. Projection Denial Anger Depression Answer C. I can bathe myself. Source: http://nurse. In evaluating the client with cancer what best indicates that nutritional status is adequate? a. “I’m really afraid of dying. This empathetic response will open communication. b. #2 and #4 do not focus on the client’s feelings.” Denial would be denying that he was terminally ill or that he had cancer. c.nonoy. “What makes you think you are going to die?” “How old are your children?” “This must be a difficult time for you. A client who is depressed would be apathetic and probably not have the energy to yell at the nurse. Projection is putting his feelings on the nurse “You are angry at me. d.38. 39. d. d. Yelling at the nurse would be typical of anger. Calorie intake Weight is stable Amount of nausea and vomiting Serum protein levels Answer B. b. An adult client with newly diagnosed cancer says.” Answer C. c.

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