College of Nursing

NCM 41118L
Final Quiz 3
First Semester, SY 2021-2022

Name: ________________________________________ Date: __________________________

Section: ______________________________________ Score: _________________________

General Directions:

❖ Read and understand each statement carefully.

❖ Write the letter of your chosen answer.

Stem-Option. Choose the letter of the best/correct answer.

Situation: An acutely ill 10 year-old girl is hospitalized with an upper respiratory infection and
right otitis media. She is diagnosed with leukemia.

1. The nurse teaches the parents about leukemia. Which of the following descriptions given
by the mother best indicates that she understands the nature of leukemia?
a. The disease is infectious in nature & characterized by increased WBC production
b. The disease is neoplastic in nature & characterized by proliferation of immature
WBCs
c. The disease is inflammatory in nature & characterized by solid tumor formation in
the lymph nodes
d. The diasease is allergic in nature & characterized by increased circulating
antibodies in the blood stream
2. Laboratory findings show that the child is anemic. The nurse explains to the parents that
the anemia most likely has resulted from blood loss and:
a. Inadequate dietary iron intake
b. Decreased RBC production
c. Increase destruction of RBC by lymphocytes
d. Progressive replacement of the bone marrow with scar tissue
3. Which of the following statements would the nurse use to describe to the parents why
their child was prone to infections?
a. Play activities were too strenuous
b. Vitamin C intake had been inadequate over a period of time
c. RBCs were inadequate for carrying oxygen for tissue nourishment
d. WBCs were incapable of handling an infectious process
4. The nurse notes that the child has petechiae; that her gums, lips, & nose bleed easily;
and that she has bruises on various parts of her body. Which of the following laboratory
test results would the nurse expect?
a. Low platelet count
b. Low serum calcium level
c. Insufficient fibrinogen concentration
d. High red blood cell count
5. Which of the following measures should be kept to a minimum, when possible, because
the child is prone to bruise and bleed easily?
a. Administering stool softeners
b. Changing the position in bed
c. Offering food at frequent intervals
d. Administering drugs IM
6. Which of the following measures would be contraindicated when the nurse provides oral
hygiene for the child?
a. Applying petroleum jelly to the lips
b. Cleaning the teeth with a toothbrush
c. Swabbing the mouth with moistened cotton swabs
d. Rinsing the mouth with a nonirritating mouthwash
7. The nurse observes that an area in the child’s mouth is bleeding. Which of the following
items would the nurse use because it is most effective for promoting homeostasis over
the lesion?
a. Chewing gum c. a gauze sponge
b. A cotton ball d. a dry tea bag
8. Which of the following beverages would the nurse plan to give when she feels
nauseated?
a. Milk c. plain water
b. Weak water d. a carbonated beverage
9. The nurse should question the order if which drug is prescribed for the child help relieve
discomfort?
a. Acetaminophen (Tylenol) c. Acetylsalicylic Acid (aspirin)
b. Acetophenetidin (phenacitn) d. Propoxyphene Hydrochloride (Darvon)
10. The child is scheduled for a bone marrow aspiration. The nurse should prepare her for
entry of the needle over which of the following bone sites?
a. The radius c. a cervical vertebrae
b. The sternum d. the posterior iliac crest
11. Which of the following nursing diagnoses would the nurse identify as a priority in dealing
with this newly diagnosed leukemic child and family?
a. Potential for injury c. altered nutrition
b. Altered comfort d. anticipatory grieving
12. Mercaptopurine (Purinethol) 75mg daily is prescribed. Mercaptopurine is marketed in 50-
mg tablets for oral administration. How many tablets should the nurse give the child each
day?
a. ½ of 1 tablet c. 2 tablets
b. 1 & ½ tablets d. 2 & ½ tablets
13. Which of the following signs & symptoms would suggest to the nurse the client is
experiencing toxicity to mercaptopurine (Purinethol)?
a. Nausea, vomiting, & diarrhea
b. Skin rash, constipation, & polyuria
c. Dry mouth, blurred vision, & headache
d. Drowsiness, malaise, & low blood pressure
14. Mercaptopurine (Purinethol) and methotrexate (Amethopterin) are classified as
antimetabolites. The nurse explains to the child’s mother that antimetabolites function in
the body to:
a. Selectively destroy malignant cells, thereby slowing tumor growth
b. Create a hormonal imbalance within the body that acts to suppress tumor growth
c. Damage DNA within cell nuclei, which in turn disrupts cell growth & division
d. Imitate nutrients essential for malignant cell growth, thus preventing those cells
from using natural nutrients
15. The child is severely neutropeneic with a low absolute granulocyte count (AGC). The
nurse should:
a. Restrict staff & visitors with active infection
b. Allow the child to play with other hospitalized children
c. Consult with the physician about administering an antiemetic
d. Consult with the physician about the low platelet count
16. Allopurinol (Zyloprim) is prescribed. Which of the following nursing measures should be
observed for a client taking allopurinol?
a. Encouraging a high fluid intake c. giving foods high in potassium
b. Omitting carbonated fluids d. limiting foods high in natural sugar
17. Methotrexate (Amethopterin) is prescribed. The nurse should question the order if the
physician has not also ordered:
a. Keeping the child in the state of fasting
b. A white blood cell count
c. An X-ray examination of the spinal canal
d. Collection of a specimen for urinalysis
 18. Methotrexate (Amethopterin) is administered by injecting it into the spinal canal. The
nurse explains to the parents that this type of drug is called:
a. Subdural c. intraosseous
b. Intrathecal d. intra-arterial
19. The child’s absolute granulocyte count is now 900. The nurse would teach the mother
that:
a. The child should stay away from siblings
b. The child should stay away from crowds
c. Everyone who visits should wear a gown and mask
d. The child should be in isolation
20. The child fails to respond to therapy. Which of the following statements offers the nurse
the best guide in making plans to assist the parents in dealing with their child’s imminent
death?
a. Knowing that the prognosis is poor helps prepare relatives for the death of
children
b. Relatives are especially grieved when a child does well at first but then declines
rapidly
c. Trust in health personnel who wish to help relatives in grief is most often
destroyed by a death that is considered untimely
d. It is more difficult for relatives to accept the death of a 10-year-old than the death
of a younger child whose family membership has been short
21. Authorities generally agree that to help others deal with death, a nurse first must have:
a. Experienced the death of a loved one
b. Worked out a personal philosophy of life & death
c. Taken a course that examined how best to deal with death and grieving
d. Developed a belief that accepts a supreme being and a life after death
22. Which of the following nursing diagnoses would be a priority for the family at this time?
a. Ineffective family coping c. anxiety
b. Altered parenting d. grieving
23. Which of the following courses of action would be most appropriate for the nurse when
planning to meet the family’s emotional needs during the last days of their child’s life?
a. Restrict visitors to the parents so as not to overtax the child
b. Answer the child’s questions about the illness and imminent death honestly
c. Concentrate nursing efforts on meeting the child’s physical needs to help keep
her mind on other things.
d. Encourage the child to play quietly with a room mate to replace thoughts of
sadness with thoughts of pleasurable things
24. After the child dies, the mother asks the nurse, “What if we had brought her in when she
first complained of an earache?” Which of the following would be the nurse’s best
response to the mother?
a. Explain that everything possible was done for the child
b. Provide comfort by saying that the child is no longer suffering with an incurable
illness
c. Explain that the child’s physician is in the best position to explain what happened
d. Explain that infections are often the result of leukemia rather than the cause of it

Situation: A junior high school student has seen the school nurse frequently with complaints of
nausea, headache, and difficulty seeing. She has begun to tilt her head to one side and has a
wide-based gait.

25. The nurse would decide to talk with the child’s parents concerning her behavior,
because thse symptoms are typical of:
a. Acute encephalopathy with fatty degeneration of the viscera
b. An abnormal involuntary neuromuscular activity
c. A psychological aversion to school
d. A space-occupying lesion in the cranial vault
26. The child is later admitted to the hospital with the diagnosis of infratentorial brain tumor.
During the child’s admission to the pediatric unit, the nurse would plan to:
a. Alleviate the parent’s anxiety
b. Implement seizure precautions
c. Introduce the child to other clients the same age
d. Prepare the child & parents for diagnostic procedures
27. A diagnosis of probable cerebellar astrocytoma is made, the surgical removal is
scheduled. Preoepratively, the nurse may should plan to tell the child and her parents
about the:
a. Child’s long term prognosis
b. Child’s post operative appearance
c. Long-term therapy for this type of tumor
d. Side effects of the planned chemotherapy
28. An infratentorial craniotomy is performed and the diagnosis of cerebellar astrocytoma,
stage 1, is confirmed. The parents want to know what “stage 1” means. The nurse
should explain that stage 1 describes a tumor that:
a. Has extended c. is localized
b. Has metastasized d. is undifferentiated
29. After the child is admitted to the ICU, the nurse’s first action would be to ensure
adequate:
a. Cardiorespiratory function c. pain control
b. Fluid and electrolyte balance d. infection protection
30. The nurse would keep the child in which position?
a. Prone c. side-lying
b. Reverse Trendelenburg d. Trendelenburg
31. The intubated child shows signs of decreased level of consciousness, and the physician
orders manual hyperventilation to keep the PCO2 between 25 and 29 mm Hg and the
PaO2 between 80-100 mmHg. The nurse would carry out this order to:
a. Decrease intracranial pressure c. lower the arousal level
b. Ensure a patent airway d. produce hypercapnia
32. The nurse notes clear drainage on the child’s dressing and on the linen under her head.
The nurse:
a. Changes the dressing c. tests the fluid for glucose
b. Elevates the head of the bed d. tests the fluid for protein
33. The child does well after infratentorial tumor removal and is transferred back to the
pediatric unit. Although she had been told having her head shaved for surgery, she is
very upset about her bald head. After exploring her feelings, the nurse should:
a. Ask her if she’d like to wear a hat or wig
b. Assure her that her hair will grow back
c. Explain to her parents that her reaction is normal
d. Suggest that the parents buy her a wig as a surprise
34. Which of the following statements made by the child’s mother would warrant further
exploration by the nurse?
a. “After this, I’ll never let her out of my sight again.”
b. “I hope that she’ll be able to go back to school soon.”
c. “I wonder how long it will be before she can ride her bike.”
d. “Her best friend is coming to lunch when we get home.”
35. As part of health education in the community, Cancer awareness should be discussed.
The warning signs of Cancer should be mention except for which of the following:
a. Change in bowel and bladder habits and sore that does not heal
b. Unusual bleeding or discharge and unexplained weight loss
c. Unexplained anemia and thickening or lump
d. Nagging cough, colds, fever and high pitch voice
36. To verify the difference of Benign and Malignant neoplasm, the nurse should emphasize
except for which of the following?
a. Benign is localized while malignant is infiltrating surrounding tissues
b. Benign is not encapsulated and malignant is capsulated
c. Malignant occurs metastasis while benign never occurs metastasis
d. Malignant is poorly differentiated and benign is well differentiated mature cells
37. Anorexia-Cachexia syndrome of Cancer was highlighted during discussion of the patient
with the attending physician. You expect the attending physician to discuss which of the
following except for which of the following?
a. It is final outcome of unstrained cancer cell growth
b. Malignant neoplasm deprive normal cells nutrition
c. Tumors take up Potassium, water retention makes malnutrition
d. Cancer cells produce anorexigenic substance
38. Cancer prevention was verified by a relative of a cancer patient, the nurse will specify
except which of the following?
a. The skin should be avoided over sun exposure and annual oral examination
b. Quarterly beast self-examination and annual x-ray for age 20 years old
c. Annual digital rectal examinations for age 40 years old and pap’s smear
d. Avoid cigarette smoking and annual physical examination
39. Dietary recommendations were also specified during the seminar against Cancer. The
speaker emphasized the appropriate diet except for which of the following?
a. Cut down total fats and moderate consumption of salty foods
b. High fiber and Vitamin A & C daily
c. Avoid obesity and alcoholic beverages
d. Include crucifereous vegetables in diet such as eggplant, nuts and cabbage
40. Nita, 33 years old, diagnosed of breast cancer. She requested for different therapeutic
modalities of cancer management. Which of the following should be included?
a. Chemotherapy, radiation therapy, surgical interventions and Immunotherapy
b. Chemotherapy, bone marrow transplant, radiation therapy and surgical
interventions
c. Surgical interventions and chemotherapy
d. Radiation therapy and Chemotherapy
41. Nita would like to know more about chemotherapy. Chemotherapy was emphasized by
the attending physician as requested. The discussion about chemotherapy should
emphasized except for which of the following?
a. Chemotherapy destroy all malignant tumor cells without excessive destruction of
normal cells
b. Chemotherapy is contraindicated to patient with recent surgery, impaired renal
and hepatic functions and pregnancy
c. All of the above
d. None of the above
42. The staff nurse will prepare the patient for chemotherapy and safe handling of
chemotherapeutic agents is one of the nursing priorities. Which of the following is the
most important nursing priority?
a. No specified outfit and normal routines for handling the patients and
chemotherapeutic agents
b. Hand washing should be done before and after procedures
c. Wear mask, gloves and avoid skin contact with drugs
d. Wipe external surface of syringe and IV bottles
43. Nita started chemotherapy sessions and nursing interventions for chemotherapy side
effects are the priority of staff nurse. Which of the following is not a side effect of
chemotherapy?
a. Nausea, vomiting, diarrhea and constipation
b. Stomatitis, alopecia, skin pigmentation and nail changes
c. Metorrhagia, hemorrhagic cystitis and increase hemoglobin
d. Menopausal or ammenorhea, urine color changes and anemia
44. Nausea and vomiting was main concern of Nita after session of chemotherapy. Which of
the following medication should be requested for antiemetic ?
a. Metoclopramide c. dexamethasone
b. Lactulose d. milk of magnesia
45. The staff nurse differentiated the side effect of Radiation therapy while reading the chart
of patient who undergone the radiation process. Which of the following sign and
symptom should not be included in the side effect of radiation therapy?
a. Erythema, dry moist desquamation skin c. dizziness & hypertension
b. Fatigue and weight loss d. diarrhea & stomatitis
 46. Teaching guidelines of radiation therapy was posted at the room of the patient, which of
the following should not be included in the guidelines?
a. Its is painful but analgesic be given
b. No residual radioactivity after radiation therapy
c. Each treatment usually last for few minutes
d. Technologist will be outside the room while observing in a widow or by closed
circuit television you may communicate
47. Dianne was diagnosed of breast CA and the biopsy result stated Stage III. The nurse
was requested to document the result and as the nurse recalls the stage III breast Ca is
characterized by which of the following?
a. Tumor size up to 2 cm
b. Tumor size is up to 5cm with axillary node involvement
c. Tumor size is more than 5cm with axillary and neck lymph nodes involvement
d. Metastasis to distant organs (liver, lungs, bone and brain)
48. Tracy is receiving combination chemotherapy for treatment of metastatic carcinoma. Nurse
Ruby should monitor the client for the systemic side effect of:
a. Ascites
b. Nystagmus
c. Leukopenia
d. Polycythemia
49. Katrina has an abnormal result on a Papanicolaou test. After admitting that she read her
chart while the nurse was out of the room, Katrina asks what dysplasia means. Which definition
should the nurse provide?
a. Presence of completely undifferentiated tumor cells that don’t resemble cells of the
tissues of their origin.
b. Increase in the number of normal cells in a normal arrangement in a tissue or an
organ.
c. Replacement of one type of fully differentiated cell by another in tissues where the
second type normally isn’t found.
d. Alteration in the size, shape, and organization of differentiated cells.
50. During a routine checkup, Nurse Marianne assesses a male client with acquired
immunodeficiency syndrome (AIDS) for signs and symptoms of cancer. What is the most
common AIDS-related cancer?
a. Squamous cell carcinoma
b. Multiple myeloma
c. Leukemia
d. Kaposi’s sarcoma
51. Ricardo is scheduled for a prostatectomy, and the anesthesiologist plans to use a spinal
(subarachnoid) block during surgery. In the operating room, the nurse positions the client
according to the anesthesiologist’s instructions. Why does the client require special positioning
for this type of anesthesia?
a. To prevent confusion
b. To prevent seizures
c. To prevent cerebrospinal fluid (CSF) leakage
d. To prevent cardiac arrhythmias

Situation: Stacy is diagnosed with acute lymphoid leukemia (ALL) and beginning chemotherapy.
52. Stacy is discharged from the hospital following her chemotherapy treatments. Which
statement of Stacy’s mother indicated that she understands when she will contact the
physician?
a. “I should contact the physician if Stacy has difficulty in sleeping”.
b. “I will call my doctor if Stacy has persistent vomiting and diarrhea”.
c. “My physician should be called if Stacy is irritable and unhappy”.
d. “Should Stacy have continued hair loss, I need to call the doctor”.
53. Stacy’s mother states to the nurse that it is hard to see Stacy with no hair. The best
response for the nurse is:
a. “Stacy looks very nice wearing a hat”.
b. “You should not worry about her hair, just be glad that she is alive”.
c. “Yes it is upsetting. But try to cover up your feelings when you are with her or else she
may be upset”.
d. “This is only temporary; Stacy will re-grow new hair in 3-6 months, but may be
different in texture”.
54. Stacy has beginning stomatitis. To promote oral hygiene and comfort, the nurse in-charge
should:
a. Provide frequent mouthwash with normal saline.
b. Apply viscous Lidocaine to oral ulcers as needed.
c. Use lemon glycerine swabs every 2 hours.
d. Rinse mouth with Hydrogen Peroxide.
55. During the administration of chemotherapy agents, Nurse Oliver observed that the IV site is
red and swollen, when the IV is touched Stacy shouts in pain. The first nursing action to take is:
a. Notify the physician
b. Flush the IV line with saline solution
c. Immediately discontinue the infusion
d. Apply an ice pack to the site, followed by warm compress.
56. To check for wound hemorrhage after a client has had a surgery for the removal of a tumor
in the neck, nurse grace should:
A. Loosen an edge of the dressing and lift it to see the wound
B. Observe the dressing at the back of the neck for the presence of blood
C. Outline the blood as it appears on the dressing to observe any progression
D. Press gently around the incision to express accumulated blood from the wound
57. After a muscle biopsy, nurse Willy should teach the client to:
A. Change the dressing as needed
B. Resume the usual diet as soon as desired
C. Bathe or shower according to preference
D. Expect a rise in body temperature for 48 hours
58. After a mastectomy or hysterectomy, clients may feel incomplete as women. The statement
that should alert nurse Gina to this feeling would be:
A. “I can’t wait to see all my friends again”
B. “I feel washed out; there isn’t much left”
C. “I can’t wait to get home to see my grandchild”
D. “My husband plans for me to recuperate at our daughter’s home”
59. Nurse Vicky is aware that teaching about colostomy care is understood when the client
states, “I will contact my physician and report ____”:
A. If I notice a loss of sensation to touch in the stoma tissue”
B. When mucus is passed from the stoma between irrigations”
C. The expulsion of flatus while the irrigating fluid is running out”
D. If I have difficulty in inserting the irrigating tube into the stoma”

60. A client is experiencing stomatitis as a result of chemotherapy. An appropriate nursing

intervention related to this condition would be to:
A. Provide frequent saline mouthwashes
B. Use karaya powder to decrease irritation
C. Increase fluid intake to compensate for the diarrhea
D. Provide meticulous skin care of the abdomen with Betadine
61. A client is diagnosed with cancer of the jaw. A course of radiation therapy is to be followed
by surgery. The client is concerned about the side effects related to the radiation treatments.
Nurse Ria should explain that the major side effects that will experienced is:
A. Fatigue B. Alopecia C. Vomiting D. Leucopenia
62. When planning care with a client during the postoperative recovery period following an
abdominal hysterectomy and bilateral salpingo-oophorectomy, nurse Frida should include the
explanation that:
A. Surgical menopause will occur
B. Urinary retention is a common problem
C. Weight gain is expected, and dietary plan are needed
D. Depression is normal and should be expected
63. Nurse Wally knows that the most important aspect of the preoperative care for a child with
Wilms’ tumor would be:
A. Checking the size of the child’s liver
B. Monitoring the child’s blood pressure
C. Maintaining the child in a prone position
D. Collecting the child’s urine for culture and sensitivity
64. A male client has an abnormal result on a Papanicolaou test. After admitting, he read his
chart while the nurse was out of the room, the client asks what dysplasia means. Which
definition should the nurse provide?
a. Presence of completely undifferentiated tumor cells that don’t resemble cells of the
tissues of their origin
b. Increase in the number of normal cells in a normal arrangement in a tissue or an
organ
c. Replacement of one type of fully differentiated cell by another in tissues where the
second type normally isn’t found
d. Alteration in the size, shape, and organization of differentiated cells
65. For a female client with newly diagnosed cancer, the nurse formulates a nursing diagnosis
of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected
outcome would be appropriate for this client?
a. “Client verbalizes feelings of anxiety.”
b. “Client doesn’t guess at prognosis.”
c. “Client uses any effective method to reduce tension.”
d. “Client stops seeking information.”
66. A male client with a cerebellar brain tumor is admitted to an acute care facility. The nurse
formulates a nursing diagnosis of Risk for injury. Which “related-to” phrase should the nurse add
to complete the nursing diagnosis statement?
a. Related to visual field deficits
b. Related to difficulty swallowing
c. Related to impaired balance
d. Related to psychomotor seizures
67. A female client with cancer is scheduled for radiation therapy. The nurse knows that
radiation at any treatment site may cause a certain adverse effect. Therefore, the nurse should
prepare the client to expect:
a. hair loss. b. stomatitis. c. fatigue. d. vomiting.
68. Nurse April is teaching a client who suspects that she has a lump in her breast. The nurse
instructs the client that a diagnosis of breast cancer is confirmed by:
a. breast self-examination.
b. mammography.
c. fine needle aspiration.
d. chest X-ray.
69. A male client undergoes a laryngectomy to treat laryngeal cancer. When teaching the
client how to care for the neck stoma, the nurse should include which instruction?
a. “Keep the stoma uncovered.”
b. “Keep the stoma dry.”
c. “Have a family member perform stoma care initially until you get used to the
procedure.”
d. “Keep the stoma moist.”
70. A female client is receiving chemotherapy to treat breast cancer. Which assessment
finding indicates a fluid and electrolyte imbalance induced by chemotherapy?
a. Urine output of 400 ml in 8 hours
b. Serum potassium level of 3.6 mEq/L
c. Blood pressure of 120/64 to 130/72 mm Hg
d. Dry oral mucous membranes and cracked lips
71. Nurse April is teaching a group of women to perform breast self-examination. The nurse
should explain that the purpose of performing the examination is to discover:
a. cancerous lumps.
b. areas of thickness or fullness.
c. changes from previous self-examinations.
d. fibrocystic masses.
72. A client, age 41, visits the gynecologist. After examining her, the physician suspects
cervical cancer. The nurse reviews the client’s history for risk factors for this disease. Which
history finding is a risk factor for cervical cancer?
a. Onset of sporadic sexual activity at age 17
b. Spontaneous abortion at age 19
c. Pregnancy complicated with eclampsia at age 27
d. Human papillomavirus infection at age 32
73. A female client is receiving methotrexate (Mexate), 12 g/m2 I.V., to treat osteogenic
carcinoma. During methotrexate therapy, the nurse expects the client to receive which other
drug to protect normal cells?
a. probenecid (Benemid)
b. cytarabine (ara-C, cytosine arabinoside [Cytosar-U])
c. thioguanine (6-thioguanine, 6-TG)
d. leucovorin (citrovorum factor or folinic acid [Wellcovorin])
74. The nurse is interviewing a male client about his past medical history. Which preexisting
condition may lead the nurse to suspect that a client has colorectal cancer?
a. Duodenal ulcers
b. Hemorrhoids
c. Weight gain
d. Polyps
75. Nurse Amy is speaking to a group of women about early detection of breast cancer. The
average age of the women in the group is 47. Following the American Cancer Society
guidelines, the nurse should recommend that the women:
a. perform breast self-examination annually.
b. have a mammogram annually.
c. have a hormonal receptor assay annually.
d. have a physician conduct a clinical examination every 2 years.
76. A male client with a nagging cough makes an appointment to see the physician after
reading that this symptom is one of the seven warning signs of cancer. What is another warning
sign of cancer?
a. Persistent nausea
b. Rash
c. Indigestion
d. Chronic ache or pain
77. For a female client newly diagnosed with radiation-induced thrombocytopenia, the nurse
should include which intervention in the plan of care?
a. Administering aspirin if the temperature exceeds 102° F (38.8° C)
b. Inspecting the skin for petechiae once every shift
c. Providing for frequent rest periods
d. Placing the client in strict isolation
78. Nurse Lucia is providing breast cancer education at a community facility. The American
Cancer Society recommends that women get mammograms:
a. yearly after age 40.
b. after the birth of the first child and every 2 years thereafter.
c. after the first menstrual period and annually thereafter.
d. every 3 years between ages 20 and 40 and annually thereafter.
79. Which intervention is appropriate for the nurse caring for a male client in severe pain
receiving a continuous I.V. infusion of morphine?
a. Assisting with a naloxone challenge test before therapy begins
b. Discontinuing the drug immediately if signs of dependence appear
c. Changing the administration route to P.O. if the client can tolerate fluids
d. Obtaining baseline vital signs before administering the first dose
80. A 35 years old client with ovarian cancer is prescribed hydroxyurea (Hydrea), an
antimetabolite drug. Antimetabolites are a diverse group of antineoplastic agents that interfere
with various metabolic actions of the cell. The mechanism of action of antimetabolites interferes
with:
a. cell division or mitosis during the M phase of the cell cycle.
b. normal cellular processes during the S phase of the cell cycle.
c. the chemical structure of deoxyribonucleic acid (DNA) and chemical binding
between DNA molecules (cell cycle–nonspecific).
d. one or more stages of ribonucleic acid (RNA) synthesis, DNA synthesis, or both (cell
cycle–nonspecific).
81. The ABCD method offers one way to assess skin lesions for possible skin cancer. What
does the A stand for?
a. Actinic
b. Asymmetry
c. Arcus
d. Assessment
82. A female client is undergoing tests for multiple myeloma. Diagnostic study findings in
multiple myeloma include:
a. a decreased serum creatinine level.
b. hypocalcemia.
c. Bence Jones protein in the urine.
d. a low serum protein level.
83. A 35 years old client has been receiving chemotherapy to treat cancer. Which assessment
finding suggests that the client has developed stomatitis (inflammation of the mouth)?
a. White, cottage cheese–like patches on the tongue
b. Yellow tooth discoloration
c. Red, open sores on the oral mucosa
d. Rust-colored sputum
84.A client with lung cancer has received oxycodone 10 mg orally for pain. When the student
nurse assesses the client, which finding should you instruct the student to report immediately?
a. Respiratory rate of 8 to 10 per minute
b. Pain level decreased from 6/10 to 2/10
c. Client requests room door be closed.
d. Heart rate 90-100 per minute
85.A client is admitted to the unit for chemotherapy. To prevent an acid-base problem, which of
the following would you instruct the nursing assistant to report?
a. Repeated episodes of nausea and vomiting
b. Complaints of pain associated with exertion
c. Failure to eat all food on breakfast tray
d. Client hair loss during morning bath
86. A 68-year-old woman is diagnosed with thrombocytopenia due to acute lymphocytic
leukemia. She is admitted to the hospital for treatment. The nurse should assign the patient
a.) to a private room so she will not infect other patients and health care workers.
b.) to a private room so she will not be infected by other patients and health care
workers.
c.) to a semiprivate room so she will have stimulation during her hospitalization.
d.) to a semiprivate room so she will have the opportunity to express her feelings about
her illness.
87. Mrs. Jane Gately has been dealing with uterine cancer for several months. Pain
management is the primary focus of her current admission to your oncology unit. Her vital signs
on admission are BP 110/64, pulse 78, respirations 18, and temperature 99.2 F. Morphine
sulfate 6mg IV, q 4 hours, prn has been ordered. During your assessment after lunch, your
findings are: BP 92/60, pulse 66, respirations 10, and temperature 98.8. Mrs. Gately is crying
and tells you she is still experiencing severe pain. Your action should be to
a.) give her the next ordered dose of MS.
b.)give her a back rub, put on some light music, and dim the lights in the room.
c.) report your findings to the RN, requesting an alternate medication order
d.)be obtained from the physician.
88. Which instruction should nurse Tom give to a male client who is having external radiation
therapy:
a. Protect the irritated skin from sunlight.
b. Eat 3 to 4 hours before treatment.
c. Wash the skin over regularly.
d. Apply lotion or oil to the radiated area when it is red or sore.

Situation: The results of the diagnostic tests indicate that Manuel has a malignant intracranial
brain tumor. He is scheduled for a supratentorial craniotomy.

89. Manuel tells the nurse he is going to die soon. Which response by the nurse would be most
therapeutic?
a. You have been getting better each day. The chemotherapy has you in remission
b. You must be very depressed. Would you like to play a game of cards?
c. I’m sure you have these feelings because of your diagnosis, but you will survive
d. Did someone say something, or did something happen to make you feel that
way?
90. The doctors have told Manuel ‘s wife that her husband has cancer. She asks
the nurse if she should tell her husband. The nurse replies, “Based on
research of people who have cancer, a majority report that:
a. They want to be told they have cancer even though it causes intense
anxiety and depression
b. They desire to be told they have cancer and suffer no long-term
negative effects from being told
c. They wish to avoid all discussion of their condition with anyone
d. They feel the manner in which they are told is tactless and insensitive
91. Preoperatively, the physician orders tap-water enemas until the return is
clear. What is the nurse’s best response?
a. Question the order because enemas are usually contraindicated in
this situation
b. Tell the client that the enemas will be given at 6am
c. Recognize that a cleansed bowel will decrease the incidence of
postoperative cerebral edema
d. Ask the client if he would prefer to self-administer the enema
92. Manuel has a supratentorial craniotomy with removal of a malignant
intracranial tumor. To promote venous drainage postoperatively, Manuel
should be positioned:
a. Flat in bed
b. In trendelenburg’s position
c. With the head of the bed elevated about 30˚-45˚
d. In a high Fowler’s position with the knee gatch elevated
 93. On the day after surgery, the nurse notes that Manuel has generalized facial
edema that distorts his features. When his wife sees him, she cries, “Oh my
poor husband.” What is the most appropriate action by the nurse?
a. Recognize that the edema is a poor prognostic sign and notify the
physician
b. Reassure Manuel’s wife that swelling is normal and will subside in a
few days
c. Tell the wife that the edema develops when the tumor is particularly
large
d. Record “observe foe renal failure” on the nursing plan
94. On the second postoperative day, Manuel’s temperature is 37.8˚C. The nurse
should recognize that this:
a. Warrants use of a hypothermia blanket
b. Necessitates administration of antipyretics
c. Is a usual occurrence during this time
d. Is an early indication of meningitis
95. The nurse observes Manuel for respiratory acidosis. Which group of arterial
blood gases reflect compensated respiratory acidosis?
a. pH > 7.35; HCO3 > 26 mEq; PaCO2 < 35 mmHg
b. pH > 7.35; HCO3 <22 mEq; PaCO2 normal
c. pH < 7.35; PaCO2 >45 mmHg; HCO3 >26 mEq
d. pH < 7.35; PaCO2 >45 mmHg; HCO3 Normal
96. To control postoperative cerebral edema, the physician orders an intravenous
solution of Mannitol, 20 g in 300 ml of isotonic sodium chloride solution. Client
response to the medication is considered adequate with:
a. A central venous pressure reading of 17cm of water
b. Serum sodium of 125 mEq/liter
c. Urinary output of 45 ml/hr for 2 to 3 hours
d. Specific gravity of urine 1.001
97. While inspecting the head dressing, the nurse notices yellow drainage on the
dressing. The nurse should:
a. Circle the area of drainage on the dressing and record on the
progress note
b. Recognize that this is normal drainage of mucus
c. Notify the physician
d. Take a wound culture and send it to the laboratory

Situation: Ching, a 67-year-old man, is admitted to the hospital with tentative diagnosis of
bronchogenic carcinoma. His chief complaint is dyspnea and a chronic cough.

98. Three of the following statements are true regarding lung cancer. Which of
the following statement is incorrect?
a. The 5-year survival rate depends on tumor histology and disease stage at the
time treatment is initiated
b. Small-cell survival has excellent prognosis
c. The 5-year survival rate for lung cancer is less than 15%
d. Lung cancer is usually widespread by the time it is detected on chest x-ray
99. Ching’s physician orders a sputum sample for cytological testing. Important
nursing implications involved with obtaining sputum sample for cytology
should include which of the following ?
a. Obtain the specimen in the evening hours
b. Collect the specimen before the clients eats and drinks
c. Have the client brush his teeth before collection of the specimen
d. Keep the client NPO for 24 hours before collection of specimen
100. Which of the following is not included in safety principles of Radiation
therapy?
a. Distance c. time
b. Shielding d. isolation