Question 1

Which of the following treatment measures should be implemented for a child with
leukemia who has been exposed to the chickenpox?

A No treatment is indicated.

B Acyclovir (Zovirax) should be started on exposure

C Varicella-zoster immunoglobulin (VZIG) should be given with the evidence of disease

D VZIG should be given within 72 hours of exposure.
Question 2

In the client with terminal lung cancer, the focus of nursing care is on which of the following
nursing interventions?

A Provide emotional support

B Provide nutritional support

C Provide pain control

D Prepare the client’s will
Question 3

The oncology nurse specialist provides an educational session to nursing staff regarding
the characteristics of Hodgkin’s disease. The nurse determines that further education is
needed if a nursing staff member states that which of the following is characteristic of the
disease?

A Presence of Reed-Sternberg cells

B Involvement of lymph nodes, spleen, and liver

C Occurs most often in the older client

D Prognosis depends on the stage of the disease
Question 4

Which of the following foods should a client with leukemia avoid?

A White bread

B Carrot sticks

C Stewed apples
D Medium rare steak
Question 5

A client with stomach cancer is admitted to the oncology unit after vomiting for 3 days.
Physical assessment findings include irregular pulse, muscle twitching, and complaints of
prickling sensations in the fingers and hands. Laboratory results include a potassium level
of 2.9 mEq/L, a pH of 7.46, and a bicarbonate level of 29 mEq/L. The client is experiencing:

A Respiratory alkalosis

B Respiratory acidosis

C Metabolic alkalosis
D Metabolic acidosis
Question 6

When a client has a lobectomy, what fills the space where the lobe was?

A The space stays empty.

B The surgeon fills the space with gel

C The lung space fills up with serous fluid

D The remaining lobe or lobes overexpand to fill the space.
Question 7

According to a standard staging classification of Hodgkin’s disease, which of the following

criteria reflects stage II?

A Involvement of extralymphatic organs or tissues

B Involvement of single lymph node region or structure

C Involvement of two or more lymph node regions or structures.

D Involvement of lymph node regions or structures on both sides of the diaphragm.
Question 8

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 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 examination should be done at least every 6 months.
Question 9

A child is seen in the pediatrician’s office for complaints of bone and joint pain. Which of
the following other assessment findings may suggest leukemia?

A Abdominal pain

B Increased activity level

C Increased appetite
D Petechiae
Question 10

At the time of diagnosis of Hodgkin’s lymphoma, which of the following areas is often
involved?

A Back

B Chest

C Groin
D Neck
Question 11

Which of the following tests in performed on a client with leukemia before initiation of
therapy to evaluate the child’s ability to metabolize chemotherapeutic agents?

A Lumbar puncture

B Liver function studies

C Complete blood count (CBC)

D Peripheral blood smear
Question 12

During a routine physical examination, a firm mass is palpated in the right breast of a 35-
year-old woman. Which of the following findings or client history would suggest cancer of
the breast as opposed to fibrocystic disease?

A History of early menarche

B Cyclic changes in mass size

C History of anovulatory cycles
D Increased vascularity of the breast
Question 13

The client with a benign lung tumor is treated in which of the following ways?

A The tumor is treated with radiation only.

B The tumor is treated with chemotherapy only.

C The tumor is left alone unless symptoms are present.

D The tumor is removed, involving the least possible amount of tissue.
Question 14

A nurse is providing education in a community setting about general measures to avoid

excessive sun exposure. Which of the following recommendations is appropriate?

A Apply sunscreen only after going in the water.

B Avoid peak exposure hours from 9am to 1pm

C Wear loosely woven clothing for added ventilation

D Apply sunscreen with a sun protection factor (SPF) of 15 or more before sun exposure.
Question 15

A pneumonectomy is a surgical procedure sometimes indicated for treatment of non-

small-cell lung cancer. A pneumonectomy involves removal of:

A An entire lung field

B A small, wedge-shaped lung surface

C One lobe of a lung
D One or more segments of a lung lobe
Question 16

The nurse is teaching a 17-year old client and the client’s family about what to expect with
high-dose chemotherapy and the effects of neutropenia. What should the nurse teach as
the most reliable early indicator of infection in a neutropenic client?

A Fever

B Chills

C Tachycardia
D Dyspnea
Question 17

Parents of pediatric clients who undergo irradiation involving the central nervous system
should be warned about postirradiation somnolence. When does this neurologic syndrome
usually occur?

A Immediately

B Within 1 to 2 weeks

C Within 5 to 8 weeks
D Within 3 to 6 months
Question 18

A centrally located tumor would produce which of the following symptoms?

A Coughing
B Hemoptysis

C Pleuritic pain
D Shoulder pain
Question 19

A 56-year-old woman is currently receiving radiation therapy to the chest wall for recurrent
breast cancer. She calls her health care provider to report that she has pain while
swallowing and burning and tightness in her chest. Which of the following complications of
radiation therapy is most likely responsible for her symptoms?

A Hiatal hernia

B Stomatitis

C Radiation enteritis
D Esophagitis
Question 20

The nurse 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 Decreased number of plasma cells in the bone marrow.

B Increased WBC’s

C Increased calcium levels

D Decreased blood urea nitrogen
Question 21

If the client with lung cancer also has preexisting pulmonary disease, which of the following
statements best describes how the extent of that can be performed?
A It doesn’t affect it.

B It may require a whole lung to be removed.

C The entire tumor may not be able to be removed

D It may prevent surgery if the client can’t tolerate lung tissue removal.
Question 22

The nurse is reviewing the laboratory results of a client receiving chemotherapy. The
platelet count is 10,000 cells/mm. Based on this laboratory value, the priority nursing
assessment is which of the following?

A Assess level of consciousness

B Assess temperature

C Assess bowel sounds

D Assess skin turgor
Question 23

Warning signs and symptoms of lung cancer include persistent cough, bloody sputum,
dyspnea, and which of the other following symptoms?

A Dizziness

B Generalized weakness

C Hypotension
D Recurrent pleural effusion
Question 24
Which of the following immunizations should not be given to a 4-month-old sibling of a
client with leukemia?

A Diphtheria and tetanus and pertussis (DPT) vaccine.

B Hepatitis B vaccine

C Haemophilus influenzae type b vaccines (Hib)

D Oral poliovirus vaccine (OPV)
Question 25

Nausea and vomiting are common adverse effects of radiation and chemotherapy. When
should a nurse administer antiemetics?

A 30 minutes before the initiation of therapy.

B With the administration of therapy.

C Immediately after nausea begins.

D When therapy is completed.
Question 26

For which of the following conditions is a client with multiple myeloma (MM) monitored?

A Hypercalcemia

B Hyperkalemia

C Hypernatremia
D Hypermagnesemia
Question 27
Which of the following interventions is the key to increasing the survival rates of clients
with lung cancer?

A Early bronchoscopy

B Early detection

C High-dose chemotherapy
D Smoking cessation
Question 28

A client has been diagnosed with lung cancer and requires a wedge resection. How much
of the lung is removed?

A One entire lung

B A lobe of the lung

C A small, localized area near the surface of the lung

D A segment of the lung, including a bronchiole and its alveoli
Question 29

Giving instructions for breast self-examination is particularly important for clients with
which of the following medical problems?

A Cervical dysplasia

B A dermoid cyst

C Endometrial polyps
D Ovarian cancer
Question 30
In which of the following diseases would bone marrow transplantation not be indicated in a
newly diagnosed client?

A Acute lymphocytic leukemia

B Chronic myeloid leukemia

C Severe aplastic anemia

D Severe combined immunodeficiency
Question 31

A 32-year-old woman meets with the nurse on her first office visit since undergoing a left
mastectomy. When asked how she is doing, the woman states her appetite is still not good,
she is not getting much sleep because she doesn’t go to bed until her husband is asleep,
and she is really anxious to get back to work. Which of the following nursing interventions
should the nurse explore to support the client’s current needs?

A Call the physician to discuss allowing the client to return to work earlier.

B Suggest that the client learn relaxation techniques to help with her insomnia

C Perform a nutritional assessment to assess for anorexia

D Ask open-ended questions about sexuality issues related to her mastectomy
Question 32

Which of the following medications usually is given to a client with leukemia as prophylaxis
against P. carinii pneumonia?

A Bactrim

B Oral nystatin suspension

C Prednisone
D Vincristine (Oncovin)
Question 33

Which of the following clients is most at risk for developing multiple myeloma?

A A 20-year-old Asian woman

B A 30-year-old White man

C A 50-year-old Hispanic woman

D A 60-year-old Black man
Question 34

What are the three most important prognostic factors in determining long-term survival for
children with acute leukemia?

A Histologic type of disease, initial platelet count, and type of treatment

B Type of treatment and client’s sex

C Histologic type of disease, initial WBC count, and client’s age at diagnosis
D Progression
diagnosis.
of illness, WBC at the time of diagnosis, and client’s age at the time of

Question 35

One of the most serious blood coagulation complications for individuals with cancer and
for those undergoing cancer treatments is disseminated intravascular coagulation (DIC).
The most common cause of this bleeding disorder is:

A Underlying liver disease

B Brain metastasis

C Intravenous heparin therapy

D Sepsis
Question 36

Which of the following nursing interventions would be most helpful in making the
respiratory effort of a client with metastatic lung cancer more efficient?

A Teaching the client diaphragmatic breathing techniques

B Administering cough suppressants as ordered

C Teaching and encouraging pursed-lip breathing

D Placing the client in a low semi-Fowlers position
Question 37

The client with which of the following types of lung cancer has the best prognosis?

A Adenocarcinoma

B Oat cell

C Squamous cell
D Small cell
Question 38

When caring for a client with a central venous line, which of the following nursing actions
should be implemented in the plan of care for chemotherapy administration? Select all that
apply.

A Verify patency of the line by the presence of a blood return at regular intervals.

B Inspect the insertion site for swelling, erythema, or drainage.

C Administer
present.
a cytotoxic agent to keep the regimen on schedule even if blood return is not
D If unable to aspirate blood, reposition the client and encourage the client to cough.
E Contact the health care provider about verifying placement if the status is questionable.

Question 39

Which of the following substances has abnormal values early in the course of multiple
myeloma (MM)?

A Immunoglobulins

B Platelets

C Red blood cells

D White blood cells
Question 40

The nurse is developing a plan of care for the client with multiple myeloma. The nurse
includes which priority intervention in the plan of care?

A Coughing and deep breathing

B Encouraging fluids

C Monitoring red blood cell count

D Providing frequent oral care
Question 41

Which of the following assessment findings in a client with leukemia would indicate that
the cancer has invaded the brain?

A Headache and vomiting.

B Restlessness and tachycardia

C Hypervigilant and anxious behavior
D Increased heart rate and decreased blood pressure.
Question 42

Which of the following laboratory values is expected for a client just diagnosed with chronic
lymphocytic leukemia?

A Elevated sedimentation rate

B Uncontrolled proliferation of granulocytes

C Thrombocytopenia and increased lymphocytes

D Elevated aspartate aminotransferase and alanine aminotransferase levels.
Question 43

Which of the following represents the most appropriate nursing intervention for a client
with pruritis caused by cancer or the treatments?

A Administration of antihistamines

B Steroids

C Silk sheets
D Medicated cool baths
Question 44

A 58-year-old man is going to have chemotherapy for lung cancer. He asks the nurse how
the chemotherapeutic drugs will work. The most accurate explanation the nurse can give is
which of the following?

A “Chemotherapy affects all rapidly dividing cells.”

B “The molecular structure of the DNA is altered.”

C “Cancer cells are susceptible to drug toxins.”

D “Chemotherapy encourages cancer cells to divide.”
Question 45

A 36-year-old man with lymphoma presents with signs of impending septic shock 9 days
after chemotherapy. The nurse could expect which of the following to be present?

A Flushing, decreased oxygen saturation, mild hypotension

B Low-grade fever, chills, tachycardia

C Elevated temperature, oliguria, hypotension

D High-grade fever, normal blood pressure, increased respirations
Question 46

Which of the following conditions is not a complication of Hodgkin’s disease?

A Anemia

B Infection

C Myocardial Infarction
D Nausea
Question 47

A client with leukemia has neutropenia. Which of the following functions must be
frequently assessed?

A Blood pressure
B Bowel sounds

C Heart sounds
D Breath sounds
Question 48

Which of the following types of leukemia carries the best prognosis?

A Acute lymphoblastic leukemia

B Acute myelogenous leukemia

C Basophilic leukemia
D Eosinophilic leukemia
Question 49

Which of the following complications are three main consequences of leukemia?

A Bone deformities, spherocytosis, and infection.

B Anemia, infection, and bleeding tendencies

C Lymphocytopoiesis, growth delays, and hirsutism

D Polycythemia, decreased clotting time, and infection.
Question 50

A client is diagnosed with multiple myeloma. The client asks the nurse about the diagnosis.
The nurse bases the response on which of the following descriptions of this disorder?

A Malignant exacerbation in the number of leukocytes.

B Altered red blood cell production.

C Altered production of lymph nodes

D Malignant proliferation of plasma cells and tumors within the bone.
Question 51

The community nurse is conducting a health promotion program at a local school and is
discussing the risk factors associated with cancer. Which of the following, if identified by
the client as a risk factor, indicates a need for further instructions?

A Viral factors

B Stress

C Low-fat and high-fiber diets

D Exposure to radiation
Question 52

The client with cancer is receiving chemotherapy and develops thrombocytopenia. The
nurse identifies which intervention as the highest priority in the nursing plan of care?

A Ambulation three times a day

B Monitoring temperature

C Monitoring the platelet count

D Monitoring for pathological factors
Question 53

Which of the following statements is correct about the rate of cell growth in relation to
chemotherapy?
A Faster growing cells are less susceptible to chemotherapy.

B Non-dividing cells are more susceptible to chemotherapy

C Faster growing cells are more susceptible to chemotherapy

D Slower growing cells are more susceptible to chemotherapy.
Question 54

The nurse is caring for a client following a modified radical mastectomy. Which assessment
finding would indicate that the client is experiencing a complication related to this surgery?

A Sanguineous drainage in the Jackson-Pratt drain

B Pain at the incisional site

C Complaints of decreased sensation near the operative site

D Arm edema on the operative side
Question 55

Which of the following is the reason to perform a spinal tap on a client newly diagnosed
with leukemia?

A To rule out meningitis

B To decrease intracranial pressure

C To aid in classification of the leukemia

D To assess for central nervous system infiltration
Question 56

Which of the following is the primary goal for surgical resection of lung cancer?
A To remove the tumor and all surrounding tissue.

B To remove the tumor and as little surrounding tissue as possible.

C To remove all of the tumor and any collapsed alveoli in the same region.
D To remove as much as the tumor as possible, without removing any alveoli.