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Cancer Questions

1. A client returns to the clinic for follow-up treatment following a skin biopsy of
a suspicious lesion performed 1 week ago. The biopsy report indicates that
the lesion is a melanoma. The nurse understands that which of the following
describes a characteristic of this type of a lesion?
a. Metastasis is rare
b. Melanoma is encapsulated
c. Melanoma is highly metastatic
d. Melanoma is characterized by local invasion
2. When assessing a lesion diagnosed as malignant melanoma, the nurse most
likely expect to note which of the following?
a. An irregularly shaped lesion
b. A small papule with a dry, rough scale
c. A firm, nodular lesion topped with crust
d. A pearly papule with a central crater and a waxy border
3. The nurse is reviewing the laboratory results of a client diagnosed with
multiple myeloma. Which would the nurse expect to note specifically in this
disorder?
a. Increased calcium level
b. Increased white blood cells
c. Decreased blood urea nitrogen level
d. Decrease number of plasma cells in the bone marrow
4. The nurse is developing a plan of care for the client with multiple myeloma
and includes which priority intervention in the plan?
a. Encouraging fluids
b. Providing frequent oral care
c. Coughing and deep breathing
d. Monitoring the red blood cell count
5. The nurse is caring for a client with an internal radiation implant. When caring
for the client, the nurse should observe which principle?
a. Limit the time with the client to 1 hour per shift
b. Do not allow pregnant women into the clients room
c. Remove the dosimeter film badge when entering the clients room
d. 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
6. The client is hospitalized for insertion of an internal cervical radiation implant.
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. Reinsert the implant into the vagina immediately
c. Pick up the implant with gloved hands and flush it down the toilet
d. Pick up the implant with long-handled forceps and place it in a lead
container
7. The nurse is caring for a client experiencing neutropenia as a result of
chemotherapy and develops a plan of care for the client. The nurse plans to:
a. Restrict all visitors
b. Restrict fluid intake

c. Teach the client and family about he need for hand hygiene
d. Insert an indwelling urinary catheter to prevent skin breakdown
8. The home health care nurse is caring for a client with cancer and the client is
complaining of acute pain. The most appropriate nursing assessment of the
clients pain would include which of the following?
a. The clients pain rating
b. Nonverbal cues from the client
c. The nurses impression of the clients pain
d. Pain relief after appropriate nursing intervention
9. The nurse is caring for a client who is postoperative following a pelvic
examination and the physician changes the clients diet from NPO status to
clear liquids. The nurse makes which priority assessment before
administering the diet?
a. Bowel sounds
b. Ability to ambulate
c. Incision appearance
d. Urine specific gravity
10.The client is admitted to the hospital with a suspected diagnosis of Hodgkins
disease. Which assessment finding would the nurse expect to note
specifically in the client?
a. Fatigue
b. Weakness
c. Weight gain
d. Enlarged lymph nodes
11.During the admission assessment of a client with advanced ovarian cancer,
the nurse recognized which symptom as typical of the disease?
a. Diarrhea
b. Hypermenorrhea
c. Abnormal bleeding
d. Abdominal distention
12.When assessing the laboratory results of the client with bladder cancer and
bone metastasis, the nurse notes a calcium level of 12mg/dL. The nurse
recognized that this is consistent with which oncological emergency?
a. Hyperkalemia
b. Hypercalcemia
c. Spinal cord compression
d. Superior vena cava syndrome
13.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. The
nurse interprets that the client may be experiencing:
a. Rupture of the bladder
b. The development of a vesicovaginal fistula
c. Extreme stress caused by the diagnosis of cancer
d. Altered perineal sensation as a side effect of radiation therapy
14.The nurse is instructing the client to perform a testicular self-examination.
The nurse tells the client:
a. To examine the testicles while lying down
b. That the best time for the examination is after a shower

c. To gently feel the testicle with one finger to feel for a growth
d. That testicular self-examination should be done at least every 6
months
15.A client diagnosed with multiple myeloma and the client asks the nurse about
the diagnosis. The nurse bases the response on which description of this
disorder?
a. Altered red blood cell production
b. Altered production of lymph nodes
c. Malignant exacerbation in the number of leukocytes
d. Malignant proliferation of plasma cells within the bone
16.A gastrectomy is performed on a client with gastric cancer. In the immediate
postoperative period, the nurse notes bloody drainage from the nasogastric
tube. Which of the following is the appropriate nursing intervention?
a. Notify the physician
b. Measure abdominal girth
c. Irrigate the nasogastric tube
d. Continue to monitor the drainage
17.The nurse is teaching a client about eh risk factors associated with colorectal
cancer. The nurse determines that further teaching related to colorectal
cancer is necessary if the client indentifies which of the following as an
associated risk factor?
a. Age younger than 50 years
b. History of colorectal polyps
c. Family history of colorectal cancer
d. Chronic inflammatory bowel disease
18.The nurse is assessing the perineal wound in a client who has returned from
the operating room following an abdominal perineal resection and notes
serosanguinneous drainage form the wound. Which nursing intervention is
appropriate?
a. Notify the physician
b. Clamp the penrose drain
c. Change the dressing as prescribed
d. Remove and replace the perineal packing
19.The nurse is assessing the colostomy of a client who has had an abdominal
perineal resection for a bowel tumor which of the following assessment
finding indicates that the colostomy is beginning to function?
a. Absent bowel sounds
b. The passage of flatus
c. The clients ability to tolerate food
d. Bloody drainage from the colostomy
20.The nurse is reviewing the history of a client with bladder cancer. The nurse
expects to note documentation of which most common symptom of this type
of cancer?
a. Dysuria
b. Hematuria
c. Urgency on urination
d. Frequency of urination

21.The nurse is assessing the stoma of a client following an ureterostomy. Which


of the following should the nurse expect to note?
a. A dry stoma
b. A pale stoma
c. A dark-colored stoma
d. A red and moist stoma
22.The nurse is caring for a client following a mastectomy. Which nursing
intervention would assist in preventing lymphedema of the affected arm?
a. Placing cool compresses on the affected arm
b. Elevating the affected arm on a pillow above heart level
c. Avoiding arm exercises in the immediate postoperative period
d. Maintaining an intravenous site below the antecubital area on the
affected side
23.A nurse is monitoring a client for signs and symptoms related to superior
vena cava syndrome. Which of the following is an early sign of this
oncological emergency?
a. Cyanosis
b. Arm edema
c. Periorbial edema
d. Mental status changes
24.A nurse manages is teaching the nursing staff about signs and symptoms
related to hypercalcemia in a client with metastatic prostate cancer and tells
the staff what which of the following is a serious late sign of this oncological
emergency?
a. Headache
b. Dysphagia
c. Constipation
d. Electrocardiographic changes
25.As part of chemotherapy education, the nurse teaches a female client about
the risk for bleeding and self-care during the period of the greatest bone
marrow suppression (the nadir). The nurse understands that further teaching
is needed when the client states:
a. I should avoid blowing my nose.
b. I may need a platelet transfusion if my platelet count is too low.
c. Im going to take aspirin for my headache as soon as I get home.
d. I will count the number of pads and tampons I use3 when
menstruating.
26.The community health nurse is instructing a group of female clients about
breast self-examination. The nurse instructs the clients to perform the
examination:
a. At the onset of menstruation
b. Every month during ovulation
c. Weekly at the same time of day
d. 1 week after menstruation begins
27.The 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. Biopsy of the tumor

b. Abdominal ultrasound
c. Magnetic resonance imaging
d. Computed tomography scan
28.A client with carcinoma of the lung develops syndrome of inappropriate
antidiuretic hormone (SIADH) as a complication of the cancer. The nurse
anticipates that which of the following may be prescribed? SELECT ALL THAT
APPLY
a. Radiation
b. Chemotherapy
c. Increased fluid intake
d. Serum sodium levels
e. Decreased oral sodium intake
f. Medication that is antagonistic to antidiuretic hormone
29.You are caring for a patient with esophageal cancer. Which task could be
delegated to a nursing assistant?
a. Assist the patient with oral hygiene
b. Observer the patients response to feedings
c. Facilitate expression of grief or anxiety
d. Initiate daily weighings
30.A 56 year old patient comes to the walk in clinic complaining of scant rectal
bleeding and intermittent diarrhea and constipation for the past several
months. There is a history of polyps and a family history of colorectal cancer.
While you are trying to teach about colonoscopy, the patient becomes angry
and threatens to leave. What is the priority diagnosis?
a. Diarrhea/constipation related to altered bowel patterns
b. Deficient knowledge related to the disease process and diagnostic
procedures
c. Risk for deficient fluid volume related to rectal bleeding and diarrhea
d. Anxiety related to unknown outcomes and perceived threats to body
integrity
31.Which patient is at greatest risk for pancreatic cancer?
a. An elderly African American man with a history of smoking and alcohol
use
b. A young white obese woman with gallbladder disease
c. A young African American man with juvenile-onset diabetes
d. An elderly white woman with a history of pancreatitis
32.You are caring for several children with cancer and are reviewing morning
laboratory results for all of your patients. Which of these patient conditions
combined with the indicated laboratory result caused you the greatest
immediate concern?
a. Nausea and vomiting with a potassium level of 2.3 mEq/L
b. A nosebleed with a platelet count of 100,000/mm
c. A fever with an absolute neutrophil count of 450/mm
d. Fatigue with a hemoglobin level of 8g/dL
33.When care assignments are being made for patients with alterations related
to gastrointestinal (GI) cancer, which patient would be the most appropriate
to assign to an LPN under the supervision of a team leader RN?
a. A patient with sever anemia secondary to GI bleeding

b. A patient who needs enemas and antibiotics to control GI bacteria


c. A patient who needs preoperative teaching for bowel resection surgery
d. A patient who needs central line insertion for chemotherapy
34.The physician tells the patient with cancer that there will be an initial course
of treatment with continued maintenance treatments and ongoing
observation for signs and symptoms over a prolonged period of time. Which
patient statement would concern you the most?
a. My symptoms will eventually be cured; Im so happy that I dont have
to worry any longer.
b. My doctor is trying to help me control the symptoms; I am grated for
the extension of time with my family.
c. My pain will be relieved, but I am going to die soon; I would like to
have control over my own life and death.
d. Initially, I may have to take some time off of work for my treatments; I
can probably work full time in the future.
35.For a patient who is experiencing side effects of radiation therapy; which task
would be the most appropriate to delegate to the nursing assistant?
a. Help the patient to identify patterns of fatigue
b. Recommend participation in a walking program
c. Report the amount and type of food consumed from the tray
d. Check the skin for redness and irritation after the treatment
36.For a patient receiving the chemotherapeutic drug vincristine (Oncovin),
which side effect should be reported to the physician?
a. Fatigue
b. Nausea and vomiting
c. Paresthesia
d. Anorexia
37.For a patient who is receiving chemotherapy, which laboratory result is of
particular importance?
a. White blood cell count
b. Prothrombin time and partial thromboplastin time
c. Electrolyte levels
d. Blood urea nitrogen level
38.For care of a patient who has oral cancer, which task would be appropriate to
delegate to an LPN?
a. Assist the patient to brush and floss
b. Explain when brushing and flossing are contraindicated
c. Give antacids and sucralfate suspension as ordered
d. Recommend saliva substitutes
39.When staff assignments are made for the care of patients who are receiving
chemotherapy, what is the major consideration regarding chemotherapeutic
drugs?
a. During preparation, drugs may be absorbed through the skin or inhaled
b. Many chemotherapeutic drugs are vesicants
c. Chemotherapeutic drugs are frequently given through central venous
access devices
d. Oral and venous routes of administration are the most common

40.You have just received the morning report form the night shift nurse. List the
order of priority for assessing are caring for the following patients.
a. A patient who developing tumor lysis syndrome around 5AM
b. A patient with frequent reports of breakthrough pain over the past 24
hours
c. A patient schedule for exploratory laparotomy this morning
d. A patient with anticipatory nausea and vomiting for the past 24 hours
41.You are monitoring your patient who is at risk for spinal cord compression
related to tumor growth. Which patient statement is most likely to suggest an
early manifestation?
a. Last night my back really hurt, and I had trouble sleeping.
b. My leg has been giving out when I try to stand.
c. My bowels are just not moving like they usually do.
d. When I try to pass my urine, I have difficulty starting the stream.
42.You are caring for an older woman with liver cancer. The nursing assistant
informs you that the patients level of consciousness is diminished compared
to earlier in the shift. Prioritize the steps of assessment and intervention
related to this patients change of mental status.
a. Take vital signs, including pulse, respirations, blood pressure, and
temperature
b. Check responsiveness and level of consciousness
c. Obtain a blood glucose reading
d. Check electrolyte levels
e. Check ammonia level
f. Check the patency of existing intravenous lines
g. Administer oxygen if needed and check pulse oximeter readings
43.For a patient with osteogenic sarcoma, which laboratory value causes you the
most concern?
a. Sodium level of 135 mEq/L
b. Calcium level of 13mg/dL
c. Potassium level of 4.9mEq/L
d. Hematocrit of 40%
44.Which two cancer patients could potentially be placed together as
roommates?
a. A patient with a neutrophil count of 1000/mm
b. A patient who underwent debulking of a tumor to relieve pressure
c. A patient who just underwent a bone marrow transplant
d. A patient who has undergone laminectomy for spinal cord compression
45.Following chemotherapy a patient is being closely monitored for tumor lysis
syndrome. Which laboratory value requires particular attention?
a. Platelet count
b. Electrolyte levels
c. Hemoglobin level
d. Hemotocrit
46.Persons at risk are the target populations for cancer screening programs.
Which of these asymptomatic patients need(s) extra encouragement to
participate in cancer screenings? SELECT ALL THAT APPLY

a. A 21 year old white American woman who is sexually active, for a Pap
test
b. A 30 year old Asian American woman, for an annual mammogram
c. A 45 year old African American man, for a prostate-specific antigen
test
d. A 30 year old African American man, for a fecal occult blood test
e. A 50 year old white American woman, for a colonoscopy
f. A 70 year old Asian American woman with normal results on three Pap
tests, for a Pap test
47.You are caring for a patient with uterine cancer who is being treated with
intracavity radiation therapy. The nursing assistant reports that the patient
insisted on ambulating to the bathroom and now something feels like it is
coming out. What is the priority action?
a. Assess the nursing assistants knowledge; explain the rationale for
strict bed rest
b. Assess for dislodgment; use forceps to retrieve and a lead container to
store as needed
c. Assess the patients knowledge of the treatment plan and her
willingness to participate
d. Notify the physician about eh potential or confirmed dislodgement of
the radiation implant.