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Oncology NCLEX Questions


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A client diagnosed with D. Tumor cells that enter the bone marrow reduce
widespread lung cancer asks the production of healthy white blood cells (WBCs),
the nurse why he must be which are needed for normal immune function.
careful to avoid crowds and Therefore clients who have cancer, especially
people who are ill. What is the leukemia, are at an increased risk for infection.
nurse's best response? Other people are not at risk for becoming infected
A. "With lung cancer, you are as a result of contact with a person who has lung
more likely to develop cancer. Lung cancer that has spread to the bone is
pneumonia and could pass this still lung cancer; it is not a bone marrow
on to other people who are malignancy. It is true that the person with lung
already ill." cancer may produce more mucus, which can harbor
B. "When lung cancer is in the microorganisms, but this is not the main reason why
bones, it becomes a bone the client should avoid crowds and people who are
marrow malignancy, which ill.
stops producing immune
system cells."
C. "The large amount of mucus
produced by the cancer cells is
a good breeding ground for
bacteria and other
microorganisms."
D. "When lung cancer is in the
bones, it can prevent
production of immune system
cells, making you less resistant
to infection."
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Which precaution is most C. Radiation therapy that is directed in or around the


important for the nurse to oral cavity has a variety of actions that increase the
teach a client receiving risk for dental caries (cavities) and tooth decay. The
radiation therapy for head and salivary glands are affected, which Click
changes the
on the plus button
neck cancer? to add
composition of the person's saliva and this set
often to your
causes
class
A. Avoid eating red meat "dry mouth." This result allows rapid bacterial
during treatment. overgrowth, which leads to cavity formation. In
B. Pace your leisure activities to addition, the radiation damages the integrity of theGot it
prevent fatigue. enamel and also damages some of the living cells in
C. See your dentist twice the tooth. All contribute to an increased risk for
yearly for the rest of your life. dental infections and cavities.
D. Avoid using headphones or
headsets until your hair grows
back.

A client receiving high-dose C. Epoetin alfa and other erythropoiesis-stimulating


chemotherapy who has bone agents (ESAs) such as darbepoetin alfa (Aranesp)
marrow suppression has been and epoetin alfa (Epogen, Procrit) increase the
receiving daily injections of production of many blood cell types, not just
epoetin alfa (Procrit). Which erythrocytes, which increases the client's risk for
assessment finding indicates to hypertension, blood clots, strokes, and heart
the nurse that today's dose attacks, especially among older adults. Dosing is
should be held and the health based on individual client hemoglobin and
care provider notified? hematocrit levels to ensure that just enough red
A. Hematocrit of 28% blood cells are produced to avoid the need for
B. Total white blood cell count transfusion but not to bring hemoglobin or
of 6200 cells/mm3 hematocrit levels up to normal. The increased
C. Blood pressure change from blood pressure is an indication to stop this therapy
130/90 mm Hg to 148/98 mm immediately.
Hg
D. Temperature change from
99° F (37.2 C) to 100 F (37.8 C)

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Which action is most important B. When emetogenic chemotherapy drugs are


for the nurse to implement to prescribed, the client should receive antiemetic
prevent nausea and vomiting in drugs before the chemotherapy drugs are
a client who is prescribed to administered. This allows time for prevention of
receive the first round of IV chemotherapy-associated nausea and vomiting;
chemotherapy? however, the antiemetic therapy cannot stop until all
A. Keep the client NPO during risks for nausea and vomiting have passed. Clients
the time chemotherapy is become nauseated and vomit even if they are NPO.
infusing.
B. Administer antiemetic drugs
before administering
chemotherapy.
C. Ensure that the
chemotherapy is infused over a
4- to 6-hour period.
D. Assess the client for
manifestations of dehydration
hourly during the infusion
period.

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A client being treated for C. The client's swollen face indicates possible
advanced breast cancer with superior vena cava syndrome, which is an oncologic
chemotherapy reports that she emergency. Manifestations result from the blockage
must be allergic to one of her of venous return from the head, neck, and upper
drugs because her entire face trunk. Early manifestations occur when the client
is swollen. What assessment arises after a night's sleep and include edema of the
does the nurse perform? face, especially around the eyes, and tightness of
A. Asks whether the client has the shirt or blouse collar. As the compression
other known allergies worsens, the client develops engorged blood
B. Checks the capillary refill on vessels and erythema of the upper body, edema in
fingernails bilaterally the arms and hands, dyspnea, and epistaxis.
C. Examines the client's neck Interventions at this stage are more likely to be
and chest for edema and successful. Late manifestations include hemorrhage,
engorged veins cyanosis, mental status changes, decreased cardiac
D. Compares blood pressure output, and hypotension. Death results if
measured in the right arm with compression is not relieved.
that in the left arm

The nurse is teaching the 47- A. A strong family history of breast cancer indicates
year-old female client about a risk for breast cancer. Annual screening may be
recommended screening indicated for a strong family history. The client may
practices for breast cancer. perform a self-breast examination monthly; a
Which statement by the client clinical examination by a health care provider is
indicates understanding of the indicated annually. An annual mammography is
nurse's instructions? performed after age 40 or in younger clients with a
A. "My mother and strong family history.
grandmother had breast
cancer, so I am at risk."
B. "I get a mammography every
2 years since I turned 30."
C. "A clinical breast
examination is performed
every month since I turned 40."
D. "A CT scan will be done
every year after I turn 50."
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The nurse is giving a group D. Pain in the back of the legs could indicate
presentation on cancer prostate cancer in an older man.
prevention and recognition.
Which statement by an older
adult client indicates
understanding of the nurse's
instructions?
A. "Cigarette smoking always
causes lung cancer."
B. "Taking multivitamins will
prevent me from developing
cancer."
C. "If I have only one shot of
whiskey a day, I probably will
not develop cancer."
D. "I need to report the pain
going down my legs to my
health care provider."

A 72-year-old client recovering D. Advancing age is the single most important risk
from lung cancer surgery asks factor for cancer. As a person ages, immune
the nurse to explain how she protection decreases.
developed cancer when she
has never smoked. Which
factor may explain the possible
cause?
A. A diagnosis of diabetes
treated with insulin and diet
B. An exercise regimen of
jogging 3 miles 4x/wk
C. A history of cardiac disease
D. Advancing age

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The nurse reviews the chart of B. T1 means that the tumor is increasing in size to
the client admitted with a about 2 cm, and that no regional lymph nodes are
diagnosis of glioblastoma with present in the brain. M0 means that no distant
a T1NXM0 classification. Which metastasis has occurred.
explanation does the nurse
offer when the client asks what
the terminology means?
A. "Two lymph nodes are
involved in this tumor of the
glial cells, and another tumor is
present."
B. "The brain tumor measures
about 1 to 2 cm and shows no
regional lymph nodes and no
distant metastasis."
C. "This type of tumor in the
brain is small with some lymph
node involvement; another
tumor is present somewhere
else in your body."
D. "Glioma means this tumor is
benign, so I will have to ask
your health care provider the
reason for the chemotherapy
and radiation."

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The client has a diagnosis of a-c, e. as well as the pancreas.


lung cancer. To which areas
does the nurse anticipate that
this client's tumor may
metastasize? Select all that
apply.
A. Brain
B. Bone
C. Lymph nodes
D. Kidneys
E. Liver

The nurse manager in a long- A. Testing of stool specimens for occult blood is
term care facility is developing done according to a standardized protocol and can
a plan for primary and be delegated to nursing assistants.
secondary prevention of
colorectal cancer. Which tasks
associated with the screening
plan will be delegated to
nursing assistants within the
facility?
A. Testing of stool specimens
for occult blood
B. Teaching about the
importance of dietary fiber
C. Referring clients for
colonoscopy procedures
D. Giving vitamin and mineral
supplements

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The nurse is conducting a B-D. Eating cruciferous vegetables such as broccoli,


community health education cauliflower, brussels sprouts, and cabbage may
class on diet and cancer risk reduce cancer risk.
reduction. What should be
included in the discussion?
Select all the apply.
A. Limit sodium intake.
B. Avoid beef and processed
meats.
C. Increase consumption of
whole grains.
D. Eat "colorful fruits and
vegetables," including greens.
E. Avoid gas-producing
vegetables such as cabbage.

The nurse presents a cancer D. Tobacco is the single most important source of
prevention program to teens. preventable carcinogenesis.
Which of the following will
have the greatest impact in
cancer prevention?
A. Avoid asbestos.
B. Wear sunscreen.
C. Get the human papilloma
virus (HPV) vaccine.
D. Do not smoke cigarettes.

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The nurse is teaching a group B,C,E: The heart does not contain cells that divide;
of clients about cancers therefore cardiac cancer is unlikely.
related to tobacco or tobacco
smoke. Identify the common
cancers related to tobacco
use. Select all that apply.
A. Cardiac cancer
B. Lung cancer
C. Cancer of the tongue
D. Skin cancer
E. Cancer of the larynx

The nurse suspects metastasis B. Typical sites of breast cancer metastasis include
from left breast cancer to the bone, manifested by back pain, lung, liver, and
thoracic spine when the client brain. Signs of metastasis to the spine may include
has which symptom? numbness, pain, paresthesias and tingling, and loss
A. Vomiting of bowel and bladder control.
B. Back pain
C. Frequent urination
D. Cyanosis of the toes

The nurse explains to the client A. Hepatitis B and C are risk factors for primary liver
that which risk factor most cancer. Consuming a diet high in animal fat may
likely contributed to his predispose to colon or breast cancer. Exposure to
primary liver carcinoma? radon is a risk factor for lung cancer. Familial
A. Infection with hepatitis B polyposis is a risk factor for colorectal cancer.
virus
B. Consuming a diet high in
animal fat
C. Exposure to radon
D. Familial polyposis

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The nurse is caring for an adult D. Leukemia is associated with Down syndrome and
client with Down syndrome Turner syndrome.
who reports fatigue and
shortness of breath. Which
type of cancer has been
identified in clients with Down
syndrome?
A. Breast cancer
B. Colorectal cancer
C. Malignant melanoma
D. Leukemia

The nurse includes which of A,B,D: Change in bowel habit, A sore that does not
the following in teaching heal, A lump or thickening in the breast or
regarding the warning signs of elsewhere is a warning signal of cancer.
cancer? Select all that apply.
A. Persistent constipation
B. Scab present for 6 months
C. Curdlike vaginal discharge
D. Axillary swelling
E. Headache

The nurse is assessing a client B. Dyspnea is a sign of lung cancer, as are cough,
with lung cancer. Which hoarseness, shortness of breath (SOB), bloody
symptom does the nurse sputum, arm or chest pain, and dysphagia.Night
anticipate finding? sweats is a symptom of the lymphomas.
A. Easy bruising
B. Dyspnea
C. Night sweats
D. Chest wound

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Which activity performed by B. Primary prevention involves avoiding exposure to


the community health nurse known causes of cancer; education assists clients
best reflects primary with this strategy. all the other options are
prevention of cancer? secondary levels of prevention.
A. Assisting women to obtain
free mammograms
B. Teaching a class on cancer
prevention
C. Encouraging long-term
smokers to get a chest x-ray
D. Encouraging sexually active
women to get annual (Pap)
smears

A 52-year-old client relates to C. Providing truthful information addresses the


the nurse that she has never client's concern.
had a mammogram because
she is terrified that she will
have cancer. Which response
by the nurse is therapeutic?
A. "Don't worry, most lumps are
discovered by women during
breast self-examination."
B. "Does anyone in your family
have breast cancer?"
C. "Finding a cancer in the
early stages increases the
chance for cure."
D. "Have you noticed a lump or
thickening in your breast?"

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Which information must the A. Use of immune suppressant medications to


organ transplant nurse prevent organ rejection increases the risk for
emphasize before each client cancer. Immune suppressant medications must be
is discharged? taken for the life of the organ; the risk for
A. Taking immune suppressant developing cancer remains.
medications increases your risk
for cancer and the need for
screenings.
B. You are at increased risk for
cancer when you reach 60
years of age.
C. Immunosuppressant
medications will decrease your
risk for developing cancers.
D. After 6 months, you may
stop immune suppressant
medications, and your risk for
cancer will be the same as that
of the general population.

The home health RN is caring D. Clients taking immune suppressive drugs to


for a client who has a history of prevent rejection are at increased risk for
a kidney transplant and takes development of cancer; any lump should be
cyclosporine (Sandimmune) reported to the physician.
and prednisone (Deltasone) to
prevent rejection. Which
assessment data would be
most important to
communicate to the transplant
team?
A. The temperature is 96.6° F.
B. The client reports joint pain.
C. The oral mucosa appears
pink and dry.
D. A lump is palpable in the
Oncology
client's axilla. NCLEX Questions

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A client who is scheduled to C. Numbness and weakness should be reported to


undergo radiation for prostate the physician because paralysis caused by spinal
cancer is admitted to the cord compression can occur.
hospital by the registered
nurse. Which statement by the
client is most important to
communicate to the physician?
A. "I am allergic to iodine."
B. "My urinary stream is very
weak."
C. "My legs are numb and
weak."
D. "I am incontinent when I
cough."

When the nurse is counseling a A. lthough all of these are risk factors for lung
60-year-old African-American cancer, the client's tobacco use is the only factor
male client with all of these risk that he can change.
factors for lung cancer,
teaching should focus most on
which risk factor?
A. Tobacco use
B. Ethnicity
C. Gender
D. Increased age

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The registered nurse is B. These promoters increase cell division. If cell


teaching a group of nursing division is halted, this does not lead to cancer
students about malignant development in the initiation phase.In the initiation
transformation. Which phase, carcinogens invade the DNA of the nucleus
statement about the process of of a single cell. A 1-cm tumor consists of 1 billion
malignant transformation is cells. The latent phase occurs between initiation and
true? tumor formation. promotion phase consists of
A. Mutation of genes is an progression when the blood supply changes from
irreversible event that always diffusion to TAF.
leads to cancer development
in the initiation phase.
B. Insulin and estrogen
enhance the division of an
initiated cell during the
promotion phase.
C. Tumors form when
carcinogens invade the gene
structure of the cell in the
latency phase.
D. Nutrition of cancer cells is
provided by tumor
angiogenesis factor (TAF) in
the promotion stage.

The nurse receives report on a D. The prefix "glio-" is used when cancers of the
client with a glioblastoma. brain are named.
Recognizing that cancers are
classified by their tissue of
origin, the nurse begins to plan
care for a client with which
type of cancer?
A. Liver
B. Smooth muscle
C. Fatty tissue
D. Brain
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Which of these does the nurse B. The focus of palliative surgery is to improve
recognize as the goal of quality of life during the survival time.
palliative surgery for the client
with cancer?
A. Cure of the cancer
B. Relief of symptoms or
improved quality of life
C. Allowing other therapies to
be more effective
D. Prolonging the client's
survival time

Which statement made by the C. Brachytherapy refers to short-term insertion of a


client allows the nurse to radiation source.
recognize whether the client
who is receiving brachytherapy
for ovarian cancer understands
the treatment plan?
A. "I may lose my hair during
this treatment."
B. "I must be positioned in the
same way during each
treatment."
C. "I will have a radioactive
device in my body for a short
time."
D. "I will be placed in a
semiprivate room for
company."

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Which potential side effects a,c,d,e: Radiation therapy to any site produces
should be included in the fatigue,may cause clients to report changes in taste.
teaching plan for a client Radiation side effects are site specific; the larynx is
undergoing radiation therapy in this area, therefore changes in the skin may occur
for laryngeal cancer? select all and dysphagia may occur from radiation to the
that apply. throat area. Chemotherapy, which causes alopecia,
A. Fatigue may cause changes in the color or texture of hair.
B. Changes in color of hair
C. Change in taste
D. Changes in skin of the neck
E. Difficulty swallowing

The client receiving C. The lowest point of bone marrow function is


chemotherapy will experience referred to as the nadir. The peak of bone marrow
the lowest level of bone function occurs when the client's blood levels are at
marrow activity and their highest.Trough, which means low, is typically
neutropenia during which used in reference to drug levels.
period?
A. Peak
B. Trough
C. Nadir
D. Adjuvant

The nurse teaches the client D. Intraperitoneal chemotherapy is placed in the


that intraperitoneal peritoneal cavity or the abdominal cavity.
chemotherapy will be
delivered where?
A. Into the veins of the legs
B. Into the lung
C. Into the heart
D. Into the abdominal cavity

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The registered nurse is A. Bone marrow suppression causes anemia,


teaching a nursing student leukopenia, and thrombocytopenia; this client has
about the importance of anemia demonstrated by low hemoglobin and
observing for bone marrow hematocrit.
suppression during
chemotherapy. Select the
person who displays bone
marrow suppression.
A. Client with hemoglobin of
7.4 and hematocrit of 21.8
B. Client with diarrhea and
potassium level of 2.9 mEq/L
C. Client with 250,000 platelets
D. Client with 5000 white blood
cells/mm3

The registered nurse would C. Symptoms of neutropenia include low neutrophil


correct the nursing student count, fever, and signs and symptoms of infection;
when caring for a client with the student should be corrected.
neutropenia secondary to
chemotherapy in which
circumstance?
A. Student scrubs the hub of IV
tubing before administering an
antibiotic.
B. Nurse overhears the student
explaining to the client the
importance of handwashing.
C. Student teaches the client
that symptoms of neutropenia
include fatigue and weakness.
D. The nurse observes the
student providing oral hygiene
and perineal care.

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Which signs or symptoms A,C,D: Fever is a sign of infection secondary to


should the nurse report neutropenia.Pallor is a sign of anemia.
immediately because they
indicate thrombocytopenia
secondary to cancer
chemotherapy? Select all that
apply.
A. Bruises
B. Fever
C. Petechiae
D. Epistaxis
E. Pallor

Which intervention will be most C. Mouth swabs are soft and disposable and
helpful for the client with therefore clean. Commercial mouthwashes should
mucositis? be avoided because they may contain alcohol or
A. Administering a biological other drying agents that may further irritate the
response modifier mucosa.
B. Encouraging oral care with
commercial mouthwash
C. Providing oral care with a
disposable mouth swab
D. Maintaining NPO until the
lesions have resolved

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A client who is undergoing D. Although no specific intervention for the side


chemotherapy for breast effect is known, therapeutic communication and
cancer reports problems with listening may be helpful to the client.
concentration and memory.
Which intervention is indicated
at this time?
A. Explain that this occurs in
some clients and is usually
permanent.
B. Encourage the client that a
small glass of wine may help
her relax.
C. Protect the client from
infection.
D. Allow the client an
opportunity to express her
feelings.

Which client problem does the B. The highest priority is safety.


nurse set as the priority for the
client experiencing
chemotherapy-induced
peripheral neuropathy?
A. Potential for lack of
understanding related to side
effects of chemotherapy
B. Risk for Injury related to
sensory and motor deficits
C. Potential for ineffective
coping strategies related to
loss of motor control
D. Altered sexual function
related to erectile dysfunction

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The nurse is caring for a client B. Allergy is the most common side effect. Although
who is receiving rituximab fever & chills are side effect of monoclonal antibody
(Rituxan) for treatment of therapy, they would not take priority over an allergic
lymphoma. It is essential for the response that could potentially involve the airway.
nurse to observe for which side
effect?
A. Alopecia
B. Allergy
C. Fever
D. Chills

Which intervention will be most C. Sepsis is a major cause of DIC, especially in the
helpful in preventing oncology client. Heparin may be administered to
disseminated intravascular clients with DIC who have developed clotting, but
coagulation (DIC)? this has not been proven to prevent the disorder.
A. Monitoring platelets
B. Administering packed red
blood cells
C. Using strict aseptic
technique to prevent infection
D. Administering low-dose
heparin therapy for clients on
bedrest

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When caring for a client with a,b,e: ADH is secreted or produced ectopically,
suspected SIADH, the nurse resulting in water retention and sodium dilution
reviews the medical record to which causes confusion and changes in mental
uncover which signs and status and weakness. Tachycardia may result from
symptoms consistent with this fluid volume excess.
syndrome? (select all that
apply)
A. Hyponatremia
B. Mental status changes
C. Azotemia
D. Bradycardia
E. Weakness

The nurse anticipates B. Tumor lysis syndrome results in hyperuricemia,


administering which Allopurinol decreases uric acid production and is
medication to treat indicated in TLS.
hyperuricemia associated with
tumor lysis syndrome (TLS)?
A.Recombinant erythropoietin
(Procrit)
B. Allopurinol (Zyloprim)
C. Potassium chloride
D. Radioactive iodine 131

When caring for a client with A. Cachexia results in extreme body wasting and
cachexia, the nurse expects to malnutrition. Severe weight loss is expected.
note which symptom?
A. Weight loss
B. Anemia
C. Bleeding tendencies
D. Motor deficits

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When caring for a client who B,D,E


has had a colostomy created
as part of a regimen to treat
colon cancer, which activities
would help to support the
client in accepting changes in
appearance or function?
Select all that apply.
A. Explain to the client that the
colostomy is only temporary.
B. Encourage the client to
participate in changing the
ostomy.
C. Obtain a psychiatric
consultation.
D. Offer to have a person who
is coping with a colostomy visit.
E. Encourage the client and
family members to express
their feelings and concerns

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The nurse has received in A,C,D,F: Any temperature elevation in a client with
report that the client receiving neutropenia is considered a sign of infection and
chemotherapy has severe should be reported immediately. Administration of
neutropenia. Which of the biological response modifiers, such as filgrastim
following does the nurse plan (Neupogen) and pegfilgrastim (Neulasta), is
to implement? Select all that indicated in neutropenia to prevent infection and
apply. sepsis.
A. Assess for fever. All fruits and vegetables should be cooked well;
B. Observe for bleeding. raw fruits and vegetables may harbor organisms, as
C. Administer pegfilgrastim well as Flowers and plants. Thrombocytopenia
(Neulasta). cause bleeding, not low neutrophils.The client is at
D. Do not permit fresh flowers risk for infection, not the visitors, if they are well.
or plants in the room. However, very small children, who may get frequent
E. Do not allow his 16-year-old colds and viral infections, may pose a risk.
son to visit.
F. Teach the client to omit raw
fruits and vegetables from his
diet.

Which of the following findings C. A change in mental status could result from
would alarm the nurse when spontaneous bleeding; in this case, a cerebral
caring for a client receiving hemorrhage may have developed. Increasing
chemotherapy who has a shortness of breath is typically related to anemia,
platelet count of 17,000/mm3? not to thrombocytopenia.
A. Increasing shortness of
breath
B. Diminished bilateral breath
sounds
C. Change in mental status
D. Weight gain of 4 pounds in 1
day

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Which teaching is most C. A high-fiber diet will assist with constipation due
appropriate for a client with to neuropathy. Cotton gloves may prevent harm
chemotherapy-induced from scratching; protective gloves should be worn
neuropathy? for washing dishes and gardening. Wearing cotton
A. Bathe in cold water. gloves while cooking can increase the risk for burns
B. Wear cotton gloves when
cooking.
C. Consume a diet high in fiber.
D. Make sure shoes are snug.

The nurse is teaching a client D,F: Breast tenderness and shrinking breast tissue,
who is receiving an anti- Venous thromboembolism, Irregular menses or no
estrogen drug about the side menstrual period, Acne may develop,
effects she may encounter. Hypercalcemia, not hyperkalemia, is typical and
Which of these should the Fluid retention with weight gain may occur.
nurse include in the discussion?
Select all that apply.
A. Heavy menses
B. Smooth facial skin
C. Hyperkalemia
D. Breast tenderness
E. Weight loss
F. Deep vein thrombosis (DVT)

Which medication does the B. Ondansetron is a 5-HT3 receptor blocker that


nurse plan to administer to a blocks serotonin to prevent nausea and vomiting.
client before chemotherapy to Diazepam is a benzodiazepine, which is an
decrease the incidence of antianxiety medication only. Lorazepam, a
nausea? benzodiazepine, may be used for nausea.
A. Morphine
B. Ondansetron (Zofran)
C. Naloxone (Narcan)
D. Diazepam (Valium)

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A newly graduated RN has just C. A new nurse after a 6-week oncology orientation
finished a 6-week orientation possesses the skills to care for clients with
to the oncology unit. Which of pancytopenia and with administration of
these clients would be most medications to stimulate the bone marrow. the other
appropriate to assign to the options are too complex
new graduate?
A. A 30-year-old with acute
lymphocytic leukemia who will
receive combination
chemotherapy today
B. A 40-year-old with
chemotherapy-induced nausea
and vomiting who has had no
urine output for 16 hours
C. A 45-year-old with
pancytopenia who will require
IV administration of
erythropoietin (Procrit)
D. A 72-year-old with tumor
lysis syndrome who is receiving
normal saline IV at a rate of
250 mL/hr

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The RN working on an A. Neutropenia poses high risk for life-threatening


oncology unit has just received sepsis and septic shock, which develop and
report on these clients. Which progress rapidly in immune suppressed people; the
client should be assessed first? nurse should see this client first.
A. A client with chemotherapy-
induced neutropenia who has
just been admitted with an
elevated temperature
B. A client with lymphoma who
will need administration of an
antiemetic before receiving
chemotherapy
C. A client with metastatic
breast cancer who is
scheduled for external beam
radiation in 1 hour
D. A client with xerostomia
associated with laryngeal
cancer who needs oral care
before breakfast

The outpatient client is D. Lighting of all types must be kept to a minimum. It


receiving photodynamic can lead to burns of the skin and damage to the
therapy. Which environmental eyes because they are sensitive to light. Any drug
factor is a priority for the client that the client is prescribed should be considered
to adjust for protection? for its photosensitivity properties. Drugs should be
A. Storing drugs in dark stored according to the recommendations, but this
locations at room temperature is not the primary concern for this client. The client
B. Wearing soft clothing will be homebound for 1 to 3 months after the
C. Wearing a hat and treatment and should not go outside.
sunglasses when going outside
D. Reducing all direct and
indirect sources of light

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Which manifestation of an B. Edema of the arms and hands indicates


oncologic emergency requires worsening compression of the superior vena cava
the nurse to contact the health consistent with superior vena cava syndrome. The
care provider immediately? compression must be relieved immediately, often
A. New onset of fatigue with radiation therapy, because death can result
B. Edema of arms and hands without timely intervention.
C. Dry cough
D. Weight gain

The nurse is caring for a patient B. TLS is a metabolic complication characterized by


receiving an initial dose of rapid release of intracellular components in
chemotherapy to treat a response to chemotherapy. This can rapidly lead to
rapidly growing metastatic acute renal failure. The hallmark signs of TLS are
colon cancer. The nurse is hyperuricemia, hyperphosphatemia, hyperkalemia,
aware that this patient is at risk and hypocalcemia.
for tumor lysis syndrome (TLS)
and will monitor the patient
closely for which of the
following abnormalities
associated with this oncologic
emergency?
A. Hypokalemia
B. Hypocalcemia
C. Hypouricemia
D. Hypophosphatemia

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The nurse is caring for a patient D. The nurse can increase the nutritional density of
suffering from anorexia foods by adding items high in protein and/or
secondary to chemotherapy. calories (such as peanut butter, skim milk powder,
Which of the following cheese, honey, or brown sugar) to foods the patient
strategies would be most will eat.
appropriate for the nurse to
use to increase the patient's
nutritional intake?
A. Increase intake of liquids at
mealtime to stimulate the
appetite.
B. Serve three large meals per
day plus snacks between each
meal.
C. Avoid the use of liquid
protein supplements to
encourage eating at mealtime.
D. Add items such as skim milk
powder, cheese, honey, or
peanut butter to selected
foods.

Which of the following items D. A salt-water mouth rinse will not cause further
would be most beneficial when irritation to oral tissue that is fragile because of
providing oral care to a patient mucositis, which is a side effect of chemotherapy.
with metastatic cancer who is
at risk for oral tissue injury
secondary to chemotherapy?
A. Firm-bristle toothbrush
B. Hydrogen peroxide rinse
C. Alcohol-based mouthwash
D. 1 tsp salt in 1 L water mouth
rinse

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Which of the following nursing D. Myelosuppression is accompanied by a high risk


diagnoses is most appropriate of infection and sepsis. Hypothermia,
for a patient experiencing powerlessness, and acute pain are also possible
myelosuppression secondary nursing diagnoses for patients undergoing
to chemotherapy for cancer chemotherapy, but the threat of infection is
treatment? paramount.
A. Acute pain
B. Hypothermia
C. Powerlessness
D. Risk for infection

Previous administrations of A. Patients experiencing diarrhea secondary to


chemotherapy agents to a chemotherapy and/or radiation therapy often
cancer patient have resulted in benefit from a diet low in seasonings and roughage.
diarrhea. Which of the Fresh fruits and vegetables are high in fiber and
following dietary modifications should be minimized during treatment. Whole and
should the nurse recommend? organic foods do not prevent diarrhea.
A. A bland, low-fiber diet
B. A high-protein, high-calorie
diet
C. A diet high in fresh fruits and
vegetables
D. A diet emphasizing whole
and organic foods

A 33-year-old patient has C. Stage II cancer is associated with local spread.


recently been diagnosed with Stage 0 denotes cancer in situ; stage III denotes
stage II cervical cancer. The extensive regional spread, and stage V denotes
nurse would understand that metastasis.
the patient's cancer
A. Is in situ.
B. Has metastasized.
C. Has spread locally.
D. Has spread extensively.

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A client newly diagnosed with A. For clients who understand that white blood cells
acute leukemia asks why he is are a great protection against infection, being at
at such extreme risk for great risk for infection even when WBC counts are
infection when his white blood sometimes ten times normal is confusing. These are
cell count is so high. What is leukemic cells that overgrow at a very immature
the nurse's best response? level. Therefore even though there can be huge
A. "Even though you have numbers of circulating WBCs, these cells are so
many white blood cells, they immature that they are nonfunctional. In addition,
are too immature to fight the heavy production of immature leukemic cells
infection." prevents normal WBCs, RBCs, and platelets from
B. "For now, your risk is low; forming and maturing into functional cells.
however, when the
chemotherapy begins, your risk
for infection will be high."
C. "These white blood cells are
cancerous and live longer than
normal white blood cells, so
they are too old to fight
infection."
D. "It is not the white blood
cells that provide protection; it
is the red blood cells, which
are very low in your blood
right now."

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Which precaution is most B. Autocontamination is the overgrowth of the


important for the nurse to client's own normal flora or the translocation of his
teach a client with leukemia to or her normal flora from its normal location to a
prevent an infection by different one. Performing frequent mouth care can
autocontamination? reduce the number of normal flora organisms in the
A. Take antibiotics exactly as mouth and decrease the risk for developing an
prescribed. infection from autocontamination. Taking antibiotics
B. Perform mouth care three does not prevent autocontamination, nor does
times daily. reporting symptoms of an infection. Avoiding
C. Avoid the use of pepper and exposure to environmental organisms does not
raw foods. prevent autocontamination.
D. Report any burning on
urination immediately.

Six weeks after hematopoietic C. The WBC count is now within the normal range
stem cell transplantation for (5000 to 10,000/mm3) and is an indicator of
leukemia, the client's white successful engraftment. The client is not at any
blood cell (WBC) count is particular risk for infection at this time, nor is there
8200/mm3. What is the nurse's reason to believe an infection is present. (At any
best action in view of this post-transplantation check-up, the client is assessed
laboratory result? for infection.)
A. Notify the health care
provider immediately.
B. Assess the client for other
symptoms of infection.
C. Document the laboratory
report as the only action.
D. Remind the client to avoid
crowds and people who are ill.

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A. In an autologous blood transfusion, the client


receives his or her own blood components.
Which assessment is most
Therefore the chances for an incompatibility type
important for the nurse to
reaction do not exist. The main problems that can
perform for the client receiving
come from autologous transfusion are fluid
one unit of packed red blood
overload and infection from blood contamination
cells from an autologous
during the collection, storage, or infusion
donation?
processes. Fluid overload is very unlikely when only
A. Temperature
one unit is being transfused. Contamination and
B. Blood pressure
infection are just as likely with an autologous
C. Oxygen saturation
transfusion as they are with a transfusion of donated
D. IV site for hives
blood products. The most important assessment is
for signs of infection, including temperature.

B. There is no single-known cause for breast cancer.


When teaching women about
Being an older woman or man is the primary risk
the risk of breast cancer, which
factor, although some people are at higher risk than
risk factor does the nurse know
others. Having a first-degree relative (mother, sister,
is the most common for the
or daughter) with breast cancer can increase the
development of the disease?
risk; an aunt is not considered a first-degree relative.
A. Having an aunt with breast
Although Euro-American women older than 40
cancer
years are at a more increased risk than other
B. Being an older adult
racial/ethnic groups, the greater risk is being an
C. Being a Euro-American
older adult. Consuming a high-fat diet is considered
D. Consuming a low-fat diet
a risk factor.

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The nurse is assigned to care D. Assess the incision and flap for duskiness and
for a client immediately after decreased capillary refill during dressing changes,
breast-conserving surgery for which are signs of poor tissue perfusion. The client
cancer. What is the priority for should avoid sleeping in the prone position.
care of the client at this time? Emptying drains, documenting output, and
A. Teach the client to sleep in encouraging BSE are important but are not the
the prone position each night. priority in the immediate postoperative phase.
B. Empty wound drains and
record the output amount.
C. Remind the client how to
perform breast self-
examination.
D. Monitor the incision and flap
for adequate tissue perfusion.

A client had a transurethral D. Blood transfusions are commonly given after a


resection of the prostate TURP surgery; a blood transfusion is warranted for a
(TURP) yesterday. The staff hemoglobin reading of 8.2 g/dL. The nurse is
nurse notes that the capable of managing this situation with the
hemoglobin is 8.2 g/dL. What is physician, especially since blood transfusions after a
the nurse's best action? TURP are common. Irrigating the catheter is
A. Notify the charge nurse as necessary only if the color of the drainage indicates
soon as possible. bleeding or there is a presence of clots.
B. Irrigate the catheter with 30 Documentation should be done, but it is not the first
mL normal saline. priority.
C. Document the assessment in
the medical record.
D. Prepare for a blood
transfusion.

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A nurse is caring for a client D. Wheezes or crackles in the neutropenic client


with neutropenia. Which may be the first symptom of infection in the lungs.
clinical manifestation indicates
that an infection is present or
should be ruled out?
A. Coughing and deep
breathing
B. Evidence of pus
C. Fever of 102 deg. F or higher
D. Wheezes or crackles

A nurse is caring for a client C. Obtaining cultures to identify the infectious agent
with neutropenia who has a correctly is the priority for this client.
suspected infection. Which
intervention does the nurse
implement first?
A. Hydrates the client with 1000
mL of IV normal saline
B. Initiates the administration of
prescribed antibiotics
C. Obtains requested cultures
D. Places the client on
Bleeding Precautions

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The client who has recently B. The American Cancer Society's program "Reach
had breast cancer surgery for Recovery" provides volunteers who visit clients
requests a volunteer to visit her in the hospital or at home. They bring personal
home to help with recovery. messages of hope, informational materials on
Which community resource will breast cancer recovery, and a soft, temporary
the nurse recommend? breast form.
A. National Breast Cancer
Coalition
B. Reach for Recovery
C. Susan G. Komen for the
Cure
D. Young Survival Coalition

The client has been diagnosed B. No proven benefit has been found with using
with breast cancer. Which complementary and alternative therapy alone as a
treatment option chosen by cure for breast cancer. The nurse must ensure that
the client requires the nurse to the client's choices can be safely integrated with
discuss with the client the conventional treatment for breast cancer.
necessity of considering
additional therapy?
A. Chemotherapy
B. Complementary and
alternative therapy (CAM)
C. Hormonal therapy
D. Neoadjuvant therapy

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A client asks the nurse about D. The purpose of screening is early detection. BSE
early detection of breast does not prevent breast cancer.
masses. Which statement by
the nurse about early
detection of breast masses is
correct?
A. "A yearly breast examination
by a health care provider can
substitute for breast self-
examination (BSE)."
B. "Detection of breast cancer
before axillary node invasion
yields the same survival rate."
C. "Mammography as a
baseline screening is
recommended by the
American Cancer Society at 30
years of age."
D. "The goal of screening for
breast cancer is early
detection because BSE does
not prevent breast cancer."

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The nurse is instructing a client B,D: The setting should be private and comfortable
on how to perform breast self- to promote an environment conducive to learning
examination (BSE). Which and to prevent potential client embarrassment.
techniques will the nurse Before teaching breast palpation, ask the client to
include in teaching the client demonstrate her own method, so that the nurse can
about BSE? Select all that assess the client's understanding of BSE. For better
apply. visualization, the arm should be placed over the
A. Instruct the client to keep head.The client should undress from the waist up.
her arm by her side while The finger pads, which are more sensitive than the
performing the examination. fingertips, are used when palpating the breasts.
B. Ensure that the setting in
which BSE is demonstrated is
private and comfortable.
C. Ask the client to remove her
shirt. The bra may be left in
place.
D. Ask the client to
demonstrate her own method
of BSE.
E. Use the fingertips, which are
more sensitive than the finger
pads, to palpate the breasts.

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A client with a high genetic risk C. The American Cancer Society recommends that
for breast cancer asks the high-risk women (greater than 20% lifetime risk)
nurse about options for have an MRI and mammography every year
prevention and early detection. beginning at age 30.
Which option for prevention
and early detection is the
option of choice?
A. Breast self-examination
(BSE) beginning at 20 years of
age
B. Hormone replacement
therapy combining estrogen
and progesterone
C. Magnetic resonance
imaging (MRI) and
mammography every year
beginning at age 30
D. Prophylactic mastectomy

The nurse suspects that which A. People at high increased risk for breast cancer
client has the highest risk for include women aged 65 years and older with high
breast cancer? breast density.
A. Older adult woman with
high breast density
B. Nullipara older adult woman
C. Obese older adult male with
gynecomastia
D. Middle-aged woman with
high breast density

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The nurse is instructing a client C. Doxorubicin (Adriamycin) is an anthracycline, and


with breast cancer who will be clients must be instructed to be aware of and to
undergoing chemotherapy report cardiotoxic effects, including edema,
about side effects of shortness of breath, chronic cough, and excessive
doxorubicin (Adriamycin). fatigue.
Which side effect will the nurse
instruct the client to report to
the physician?
A. Diaphoresis
B. Dysphagia
C. Edema
D. Hearing loss

The client who has undergone C. Clients may prefer to lay a pillow over the
breast surgery is struggling surgical site or wear a bra or camisole to prevent
with issues concerning her contact with the surgical site during intercourse.
sexuality. What is the best way
for the nurse to address the
client's concerns?
A. Allow the client to bring up
the topic first.
B. Remind the client to avoid
sexual intercourse for 2 months
after the surgery.
C. Suggest that the client wear
a bra during intercourse.
D. Teach the client that birth
control is a priority.

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The client is struggling with A. Avoiding eye contact may be an indication of


body image after breast cancer decreased self-image.
surgery. Which behavior
indicates to the nurse that the
client is maladaptive?
A. Avoiding eye contact with
staff
B. Saying, "I feel like less of a
woman"
C. Requesting a temporary
prosthesis immediately
D. Saying, "This is the ugliest
scar ever"

Which assessment finding D. Nipple discharge and dimpling are high-risk


indicates to the nurse that the assessment findings for a malignant breast lesion.
client is at high risk for a
malignant breast lesion?
A. 1-cm freely mobile rubbery
mass discovered by the client
B. Ill-defined painful rubbery
lump in the outer breast
quadrant
C. Backache and breast fungal
infection
D. Nipple discharge and
dimpling

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The large-breasted client D. Breast reduction mammoplasty surgery removes


reports discomfort, backaches, excess breast tissue and repositions the nipple and
and fungal infections because remaining skin flaps to produce the best cosmetic
of her excessive breast size. effect.
The nurse plans to provide
information to the client about
which breast treatment option?
A. Augmentation
B. Compression
C. Reconstruction
D. Reduction mammoplasty

The nurse is teaching A. This is a correct description of how to perform


postmastectomy exercises to the pulley exercise properly.
the client. Which statement
made by the client indicates
that teaching has been
effective?
A. "For the pulley exercise, I'll
drape a 6-foot-long rope over
a shower curtain rod or over
the top of a door."
B. "In rope turning, I'll hold the
rope with my arms flexed."
C. "In rope turning, I'll start by
making large circles."
D. "With hand wall climbing, I'll
walk my hands up the wall and
back down until they are at
waist level."

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The nurse is discussing D. Typically, radiation therapy follows surgery to kill


treatment options with the residual tumor cells. Radiation therapy plays a
client newly diagnosed with critical role in the therapeutic regimen and is
breast cancer. Which statement effective treatment for almost all sites where breast
by the client indicates a need cancer can metastasize. The purpose of radiation
for further teaching? therapy is to reduce the risk for local recurrence of
A. "Hormonal therapy is only breast cancer.
used to prevent the growth of
cancer. It won't get rid of it."
B. "I might have chemotherapy
before surgery."
C. "If I get radiation, I am not
radioactive to others."
D. "Radiation will remove the
cancer, so I might not need
surgery."

The client is receiving A. It has long been believed that ginger helps
chemotherapy treatment for alleviate nausea and vomiting. Current studies are
breast cancer and asks for being done on the effect of ginger on
additional support for chemotherapy-induced nausea.
managing the associated
nausea and vomiting. Which
complementary therapy will
the nurse suggest?
A. Ginger
B. Journaling
C. Meditation
D. Yoga

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The client who has had a A. Many women want autogenous reconstruction
mastectomy asks the nurse after mastectomy.
about breast reconstructive
surgery. Which statement by
the nurse about breast
reconstruction is true?
A. "Many women want breast
reconstruction using their own
tissue immediately after
mastectomy."
B. "Placement of saline- or gel-
filled prostheses is not
recommended because of the
nature of the surgery."
C. "Reconstruction of the
nipple-areola complex is the
first stage in the reconstruction
of the breast."
D. "The surgeon should offer
the option of breast
reconstruction surgery once
healing has occurred after the
mastectomy."

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Which client being cared for D. A nurse working in the ICU would be familiar with
on the medical-surgical unit postoperative monitoring and care of clients with
will be best to assign to a nurse Jackson-Pratt drains.
who has floated from the
intensive care unit (ICU)?
A. Recent radical mastectomy
client who requires
chemotherapy administration
B. Modified radical
mastectomy client who needs
discharge teaching
C. Stage III breast cancer client
who is requesting information
about radiation and
chemotherapy
D. A client with a Jackson-Pratt
drain in place who has just
arrived from the
postanesthesia care unit
(PACU) after a quadrantectomy

Which action can the same-day B. Vital sign assessment is included in nursing
surgery charge nurse delegate assistant education and usually is part of the job
to an experienced unlicensed description for UAP working in a hospital setting.
assistive personnel (UAP) who
is helping with the care of a
client who is having a breast
biopsy?
A. Assess anxiety level about
the surgery.
B. Monitor the vital signs after
surgery.
C. Obtain data about breast
cancer risk factors.
D. Teach about postoperative
Oncology
routine care. NCLEX Questions
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A client who has just been D. Reinforcement of previously taught information


discharged from the hospital about hand and arm care should be done by all
after a modified radical caregivers.
mastectomy is referred to a
home health agency. Which
nursing action will be most
appropriate to delegate to an
experienced home health
aide?
A. Assessing the safety of the
home environment
B. Developing a plan to
decrease lymphedema risk
C. Monitoring pain level and
analgesic effectiveness
D. Reinforcing the guidelines
for hand and arm care

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A client who has just been A. The client's statement may indicate shock and
notified that the breast biopsy denial or a request for more information. To provide
indicates a malignancy tells the appropriate care, further assessment is needed
nurse, "I just don't know how about the client's psychosocial status. The first
this could have happened to action by the nurse in this situation is to obtain more
me." Which of these responses data by asking open-ended questions.
by the nurse will be most
appropriate?
A. "Tell me what you mean
when you say you don't know
how this could have happened
to you."
B. "Do you have a family history
that might make you more
likely to develop breast
cancer?"
C. "Would you like me to help
you find more information
about how breast cancer
develops?"
D. "Many risk factors for breast
cancer have been identified, so
it is difficult to determine what
might have caused it."

A premenopausal client C. Leuprolide (Lupron) is used in premenopausal


diagnosed with breast cancer women whose main estrogen source is the ovaries
will be receiving hormonal and who may benefit from luteinizing hormone-
therapy. The nurse anticipates releasing hormone (LH-RH) agonists that inhibit
that the physician will request estrogen synthesis.
which medication for this
client?
A. Anastrazole (Arimdex)
B. Fulvestrant (Faslodex)
C. Leuprolide (Lupron)
Oncology NCLEX
D. C. Trastuzumab Questions
(Herceptin)

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The client with prostate cancer A,B,D,E: American Cancer Society's Man to Man
asks the nurse for more program helps the client and partner cope with
information and counseling. prostate cancer. This program provides one-on-one
Which resources will the nurse education, personal visits, educations presentations,
suggest? Select all that apply. and the opportunity to engage in open and candid
A. American Cancer Society's discussions. Us TOO International is a prostate
Man to Man program. cancer support group that is sponsored by the
B. Us TOO International. Prostate Cancer Education and Support Network.
C. American Prostate Cancer The National Prostate Cancer Coalition provides
Society. prostate cancer information.The client's church,
D. National Prostate Cancer synagogue or place of worship is a community
Coalition. support service that may be important for many
E. The client's church, clients.
synagogue, or place of
worship.

The client with prostate cancer B. Because some localized prostate cancers are
asks why he must have surgery resistant to radiation, surgery is the most common
instead of radiation, even if it is intervention for a cure.
the least invasive type. What is
the nurse's best response?
A."It is because your cancer
growth is large."
B. "Surgery is the most
common intervention to cure
the disease."
C. "Surgery slows the spread of
cancer."
D. "The surgery is to promote
urination."

Oncology NCLEX Questions


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With which male client will the C. A man who is 50 years or older is at higher risk for
nurse conduct prostate prostate cancer.
screening and education?
A. Young adult with a history of
urinary tract infections.
B. Client who has sustained an
injury to the external genitalia.
C. Adult who is older than 50
years.
D. Sexually active client.

The issue that is often foremost D. : Altered sexual function is one of the biggest
in the minds of men who have concerns of men after cancer treatment.
been diagnosed with prostate
cancer and must be addressed
by the nurse is the alteration of
which factor?
A. Comfort because of surgical
pain.
B. Mobility because of
treatment.
C. Nutrition because of
radiation treatment.
D. Sexual function after
treatment.

Oncology NCLEX Questions


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The client with benign prostatic A-C: Drugs used to treat erectile dysfunction can
hyperplasia (BPH) is being worsen side effects, such as hypotension. Alpha-
discharged with alpha- adrenergic blockers may cause orthostatic
adrenergic blockers. Which hypotension, can cause liver damage, do not affect
information is important for the hearing and should be taken in the evening to
nurse to include when teaching decrease the risk of problems related to
the client about this type of hypotension.
pharmacologic management?
Select all that apply.
A. Avoid drugs used to treat
erection problems.
B. Be careful when changing
positions.
C. Keep all appointments for
follow-up laboratory testing.
D. Hearing tests will need to be
conducted periodically.
E. Take the medication in the
afternoon.

The client has undergone A. Antispasmodic drugs can be administered to


transurethral resection of the decrease the bladder spasms that may occur after
prostate (TURP). Which TURP.
intervention will the nurse
incorporate in this client's
postoperative care?
A. Administer antispasmodic
medications.
B. Encourage the client to
urinate around the catheter if
pressure is felt.
C. Perform intermittent urinary
catheterization every 4 to 6
hours.
D. Place the client in a supine
Oncology
position, with hisNCLEX Questions
knees flexed.

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The nurse understands that D. Hormone therapy, particularly anti-androgen


hormone treatment for drugs, inhibits tumor progression by blocking the
prostate cancer works by uptake of testicular and adrenal androgens at the
which action? prostate tumor site. Anti-androgens may be used
A. Decreases blood flow to the alone or in combination with luteinizing hormone-
tumor. releasing hormone agonists for a total androgen
B. Destroys the tumor. blockade (hormone ablation).
C. Shrinks the tumor.
D. Suppresses growth of the
tumor.

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