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

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

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

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

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

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

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

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

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

2 mEq/L. Eat foods that are hot in temperature.com/blog/nclex-and-local-board-prc-sampleexam/5ec63aeeb3953955c859a0cc6b6c00eb 36. . This indicates denial of his illness. increasing spices will improve flavor. 37. The nurses assesses that the client with cancer is not ready for teaching when the client asks: a. d. 34. and magnesium 2. weakness. Medicate with Compazine before meals. sodium 135 mEq/L. Knowing that chemotherapy affects the taste buds. The nurse should a. c. b. A nurse is assessing a client with metastatic breast cancer who reports nocturia.0 mEq/L. Increase the amount of spices in the food. 35. nausea and vomiting cause dehydration. The client is receiving internal radiation therapy. c. the correct nursing action is to increase the client's IV fluids. Therefore. b. nausea and vomiting. remember to give the badge to the next-shift nurse maintain a 30-minute close contact with the patient in a shift wear gloves. start client on fluid restriction administer calcium gluconate increase the client's IV fluids administer Allopurinol Answer C. Avoid red meats.blogcatalog. Answer A. c. “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. d.Answer D. Dosimeter badge is used to measure amount of exposure to radiation. 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. All of the other comments indicate an interest in what is going to happen to him. b. Source: http://www. Cancer screening for females who are above 40 years of age should be yearly. calcium 7. It should be endorsed to the next shift. b. d. the nurse would have the client a. Based on the assessment findings. Because taste buds are affected. the priority action for the nurse is to: a. The client's serum electrolytes include potassium 4. c. The question states he has cancer.0 mEq/L. Nocturia.

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

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