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NCLEX Review: Oncology Questions Part 1 1. 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 2. 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.” 3. 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 4. 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. 5. 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. 6. 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.” 7. 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

8. Nurse April is teaching a group of women to perform breast selfexamination. 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. 9. 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 10. 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]) 11. 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 12. 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. 13. 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 14. 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 15. 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.

and call for help. b. b. Anorexia 27. cell division or mitosis during the M phase of the cell cycle. Suspecting gallbladder disease. b. Checking regularly for signs and symptoms of stomatitis 23. tactile agnosia. an antimetabolite drug. The nurse is preparing for a female client for magnetic resonance imaging (MRI) to confirm or rule out a spinal cord lesion. Which assessment finding suggests that the client has developed stomatitis (inflammation of the mouth)? a. Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly. c. Anticipatory grieving b. Impaired swallowing c. weight loss. How long after drug administration does bone marrow suppression become noticeable? a. especially after age 50. Which nursing intervention is most likely to decrease the pain of stomatitis? a. the chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (cell cycle–nonspecific). 7 to 14 days d. cottage cheese–like patches on the tongue b. Reproductive tract d. Put the implant back in place. A 35 years old client with ovarian cancer is prescribed hydroxyurea (Hydrea). 24. During the MRI scan. A 35 years old client has been receiving chemotherapy to treat cancer. d. d. White blood cells (WBCs) 28. b. Assessment 19. When teaching the client about this drug. with advanced breast cancer is prescribed tamoxifen (Nolvadex). Hearing loss c. Assisting with a naloxone challenge test before therapy begins b. Nurse Brian is developing a plan of care for marrow suppression. Yellow tooth discoloration c. contralateral homonymous hemianopia.16. d. Stand as far away from the implant as possible and call for help. 26. Actinic b. 29. a low serum protein level. d. She should perform breast self-examination during the first 5 days of each menstrual cycle. 21 to 28 days 30. Rust-colored sputum 22. c. Colon c. Leave the room and notify the radiation therapy department immediately. Pick up the implant with long-handled forceps and place it in a lead-lined container. When caring for a male client diagnosed with a brain tumor of the parietal lobe. infusion of morphine? a. She should have had a baseline mammogram before age 30. The ABCD method offers one way to assess skin lesions for possible skin cancer. normal cellular processes during the S phase of the cell cycle. the nurse expects to assess: a. Vision changes b. 21. Bence Jones protein in the urine. White. 2 to 4 days c. A female client is undergoing tests for multiple myeloma. and fatigue. Chronic low self-esteem 25. seizures. 18. Perform monthly testicular self-examinations. Arcus d. Two hours later. Discontinuing the drug immediately if signs of dependence appear c. Jeovina. Liver b. Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. d. Which of the following is one of the most common metastasis sites for cancer cells? a. Asymmetry c. Diagnostic study findings in multiple myeloma include: a. Which nursing diagnosis may be appropriate for this client? a. d. 20. using forceps and a shield for selfprotection. Changing the administration route to P. Monitoring the client’s platelet and leukocyte counts d. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly. The client asks questions. breast selfexaminations will no longer be necessary. What should the nurse do first? a. Providing a solution of hydrogen peroxide and water for use as a mouth rinse c. b. yellow skin. b. Obtaining baseline vital signs before administering the first dose 17. open sores on the oral mucosa d. c. When she begins having yearly mammograms. one or more stages of ribonucleic acid (RNA) synthesis. She isn’t considered at high risk for breast cancer. b. A male client complains of sporadic epigastric pain. the nurse should emphasize the importance of reporting which adverse reaction immediately? a. which reveals gallbladder cancer. if the client can tolerate fluids d. c. hypocalcemia. the physician orders a diagnostic workup. c. DNA synthesis.V. A female client with cancer is being evaluated for possible metastasis. Red. A 34-year-old female client is requesting information about mammograms and breast cancer. What should the nurse tell this client? a. the major dose-limiting adverse reaction to floxuridine (FUDR). The mechanism of action of antimetabolites interferes with: a. an oncology client has a nursing diagnosis of impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. During chemotherapy. A male client is in isolation after receiving an internal radioactive implant to treat cancer. What should a male client over age 52 do to help ensure early identification of prostate cancer? a. the nurse discovers the implant in the bed linens. Disturbed body image d. c. Headache d. vomiting. a decreased serum creatinine level. or both (cell cycle–nonspecific). The client lies still. . What does the A stand for? a. Recommending that the client discontinue chemotherapy b. 24 hours b.O. Have a transrectal ultrasound every 5 years. She should eat a low-fat diet to further decrease her risk of breast cancer. short-term memory impairment. nausea. Which intervention is appropriate for the nurse caring for a male client in severe pain receiving a continuous I. which of the following would pose a threat to the client? a.

or masses that are fibrocystic as opposed to malignant. decreased urine output (less than 40 ml/hour). not generalized. human papillomavirus is a risk factor for cervical cancer. Signs of fluid loss include dry oral mucous membranes. is the most reliable method for detecting breast lumps early.Answer B. d. unusual bleeding or discharge. and organization of differentiated cells. contributing to cell destruction or preventing cell replication. Probenecid should be avoided in clients receiving methotrexate because it reduces renal elimination of methotrexate. Women are instructed to examine themselves to discover changes that have occurred in the breast. and anorexia regardless of the treatment site. NCLEX Review: Oncology Questions Part 1 Answers and Rationale May 10. 4. The nurse should obtain the client’s baseline blood pressure and pulse and respiratory rates before administering the initial dose and then continue to monitor vital signs throughout therapy.Answer C. pons. stomatitis. Chemotherapy commonly causes nausea and vomiting. Like other viral and bacterial venereal infections. abnormally low blood pressure. Verbalizing feelings is the client’s first step in coping with the situational crisis. Duodenal ulcers and hemorrhoids aren’t preexisting conditions of colorectal cancer. 15. parietal lobe. 7. purpura. Visual field deficits. skin toxicities. Frequent rest periods are indicated for clients with anemia. multiple sex partners. such as by applying a thin layer of petroleum jelly around the edges. 9. not thrombocytopenia. The American Cancer Society recommends a mammogram yearly for women over age 40.or progesterone-dependent. and vomiting are site-specific." The hormonal receptor assay is done on a known breast tumor to determine whether the tumor is estrogen. Persistent nausea may signal stomach cancer but isn’t one of the seven major warning signs. Fine needle aspiration and biopsy provide cells for histologic examination to confirm a diagnosis of cancer. because a dry stoma may become irritated. areas of thickness or fullness that signal the presence of a malignancy. Option D isn’t appropriate because seeking information can help a client with cancer gain a sense of control over the crisis. Colorectal polyps are common with colon cancer. an obvious change in a wart or mole. 3. Strict isolation is indicated only for clients who have highly contagious or virulent infections that are spread by air or physical contact. A breast selfexamination. Mammography is used to detect tumors that are too small to palpate. if done regularly.Answer D.c. and bleeding gums. adverse effects of radiation therapy.Answer B. Other risk factors for this disease include frequent sexual intercourse before age 16. Rash and chronic ache or pain seldom indicate cancer. Radiation therapy may cause fatigue. a sore that does not heal. 12. 8. they may kill dividing cells in all phases of the . is one of the seven warning signs of cancer. The other statements are incorrect. all women should perform breast self-examination monthly [not annually]. the nurse should inspect the client regularly for signs of bleeding. 16. which may lead to fluid and electrolyte imbalances. and psychomotor seizures may result from dysfunction of the pituitary gland. A naloxone challenge test may be administered before using a narcotic antagonist.Answer D. An increase in the number of normal cells in a normal arrangement in a tissue or an organ is called hyperplasia. Hair loss. and a nagging cough or hoarseness.Answer D.Answer D. 17. "Women older than age 40 should have a mammogram annually and a clinical examination at least annually [not every 2 years]. It’s recommended that women between ages 20 and 40 have a professional breast examination (not a mammogram) every 3 years. Dysplasia refers to an alteration in the size. and multiple pregnancies. 14. shape.Answer C.Answer C.Answer C. Leucovorin is administered with methotrexate to protect normal cells. Cytarabine and thioguanine aren’t used to treat osteogenic carcinoma. Chest X-rays can be used to pinpoint rib metastasis.Answer A.Answer D.Answer A. Weight loss — not gain — is an indication of colorectal cancer. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn’t found is called metaplasia. cracked lips. The American Cancer Society guidelines state. 2.Answer D. such as illicit drug or alcohol use. occipital lobe. such as petechiae. or temporal lobe — not from a cerebellar brain tumor. Alkylating agents affect all rapidly proliferating cells by interfering with DNA.Answer B. The presence of completely undifferentiated tumor cells that don’t resemble cells of the tissues of their origin is called anaplasia.Answer D. The client hears thumping sounds. Morphine commonly is used as a continuous infusion in clients with severe pain regardless of the ability to tolerate fluids. Antimetabolites act during the S phase of the cell cycle.5 mEq/L. epistaxis. Option B is inappropriate because suppressing speculation may prevent the client from coming to terms with the crisis and planning accordingly. Option C is undesirable because some methods of reducing tension. Only a physician can diagnose lumps that are cancerous. 2010 By admin Leave a Comment View Questions 1. which methotrexate could destroy if given alone. not a narcotic agonist. 10. The nurse shouldn’t discontinue a narcotic agonist abruptly because withdrawal symptoms may occur. 11. Difficulty swallowing suggests medullary dysfunction. The client should begin performing stoma care without assistance as soon as possible to gain independence in selfcare activities. A client with a cerebellar brain tumor may suffer injury from impaired balance as well as disturbed gait and incoordination. Indigestion. The nurse should recommend placing a stoma bib over the stoma to filter and warm air before it enters the stoma. 5. The nurse should avoid administering aspirin because it may increase the risk of bleeding. 6. Because thrombocytopenia impairs blood clotting. The nurse should instruct the client to keep the stoma moist. increasing the risk of methotrexate toxicity. and a serum potassium level below 3. 13. The other six are a change in bowel or bladder habits. Miotic inhibitors interfere with cell division or mitosis during the M phase of the cell cycle.Answer C. The client wears a watch and wedding band. may prevent the client from coming to terms with the threat of death as well as cause physiologic harm. or difficulty swallowing. a thickening or lump in the breast or elsewhere. A spontaneous abortion and pregnancy complicated by eclampsia aren’t risk factors for cervical cancer. helping guide psychosocial care. Psychomotor seizures suggest temporal lobe dysfunction. difficulty swallowing. They’re most effective against rapidly proliferating cancers. It also helps the health care team gain insight into the client’s feelings.

The client should continue to perform monthly breast self-examinations even when receiving yearly mammograms. the nurse must not take any action that delays implant removal. cottage cheese–like patches on the tongue suggest a candidal infection.Answer D. which identifies enlargement or irregularity of the prostate. 23. Presence of Bence Jones protein in the urine almost always confirms the disease. Although surgery typically is done to remove the gallbladder and. Seizures may result from a tumor of the frontal. temporal. Testicular cancer is the number one cause of cancer deaths .Answer A.Answer A. The client must report changes in visual acuity immediately because this adverse effect may be irreversible. the A stands for "asymmetry. Men can develop breast cancer. the nurse should pick it up with long-handled forceps and place it in a lead-lined container. another common adverse effect of chemotherapy. 1. Contralateral homonymous hemianopia suggests an occipital lobe tumor. b." the B for "border irregularity. b.cell cycle and may also kill nondividing cells. preventing normal cell growth and reproduction. The colon. Although the drug may cause anorexia.Answer A. thus. because the strong magnetic field can pull on them. The nurse should tell the client to do her self-examination: a. on the same day each month. and PSA test. Bone marrow recovery occurs in 21 to 28 days. Checking for signs and symptoms of stomatitis also wouldn’t decrease the pain. 3.Answer B. Instead. a tumor marker for prostate cancer. not cancer chemotherapy. which are caused by the sound waves thumping on the magnetic field. Testicular self-examinations won’t identify changes in the prostate gland due to its location in the body. The liver is one of the five most common cancer metastasis sites. CBC. When following the ABCD method for assessing skin lesions. A transrectal ultrasound. Yellow tooth discoloration may result from antibiotic therapy.) The nurse also may administer viscous lidocaine or systemic analgesics as prescribed. and hot flashes. such as jewelry. 18. Breast cancer requires a mastectomy. c.Answer C. c. or occipital lobe. A low-fat diet (one that maintains weight within 20% of recommended body weight) has been found to decrease a woman’s risk of breast cancer. immediately after her menstrual period. b.Answer B. Chronic low self-esteem isn’t an appropriate nursing diagnosis at this time because the diagnosis has just been made. The tissue-destructive effects of cancer chemotherapy typically cause stomatitis. 30. 22. Testicular cancer is very difficult to diagnose. d. such as pneumonia. The digital rectal examination. DNA. Short-term memory impairment occurs with a frontal lobe tumor. 29. Which of the following points would be appropriate to make? a. Mammography is the most reliable method for detecting breast cancer. Anticipatory grieving is an appropriate nursing diagnosis for this client because few clients with gallbladder cancer live more than 1 year after diagnosis. the client need not report these adverse effects immediately because they don’t warrant a change in therapy. bone. The client must lie still during the MRI but can talk to those performing the test by way of the microphone inside the scanner tunnel. 28. Serum protein electrophoresis shows elevated globulin spike.Answer C. are effective diagnostic measures that should be done yearly. an oncology nurse educator is speaking to a women’s group about breast cancer. Serum calcium levels are elevated because calcium is lost from the bone and reabsorbed in the serum. Monthly breast self-examinations should be done between days 7 and 10 of the menstrual cycle.Answer B. To decrease the pain of stomatitis. Tactile agnosia (inability to identify objects by touch) is a sign of a parietal lobe tumor. 21. Testicular cancer is a highly curable type of cancer. a section of the liver. Various members of the audience have made all of the following statements. headache. Impaired swallowing isn’t associated with gallbladder cancer.Answer A. Which one is accurate? a. The others are the lymph nodes. Questions and comments from the audience reveal a misunderstanding of some aspects of the disease. A baseline mammogram should be done between ages 30 and 40. or attempting to put it back in place can greatly increase the risk of harm to the client and the nurse from excessive radiation exposure." 19. 25. The serum creatinine level may also be increased. then notify the radiation therapy department immediately. at the end of her menstrual cycle. Monitoring platelet and leukocyte counts may help prevent bleeding and infection but wouldn’t decrease pain in this highly susceptible client. but absence doesn’t rule it out. Antineoplastic antibiotic agents interfere with one or more stages of the synthesis of RNA. 26.Answer B. the client should wear no metal objects. Standing as far from the implant as possible. The client should hear thumping sounds. therefore. White. Rust-colored sputum suggests a respiratory disorder. (Commercially prepared mouthwashes contain alcohol and may cause dryness and irritation of the oral mucosa." and the D for "diameter. on the 1st day of the menstrual cycle. Nurse Meredith is instructing a premenopausal woman about breast self-examination. Stomatitis occurs 7 to 10 days after chemotherapy begins. stopping chemotherapy wouldn’t be helpful or practical. and brain. Nurse Kent is teaching a male client to perform monthly testicular self-examinations. causing injury to the client and (if they fly off) to others." the C for "color variation. 20. the nurse should provide a solution of hydrogen peroxide and water for the client to use as a mouth rinse. it isn’t disfiguring and doesn’t cause Disturbed body image. 2. and WBCs are occasional metastasis sites. the nurse should stay alert for this potential problem to ensure prompt treatment. possibly. If a radioactive implant becomes dislodged. resulting in ulcers on the oral mucosa that appear as red. d. During an MRI. and BUN and creatinine levels are usually done after diagnosis to identify the extent of the disease and potential metastases 24. 27. Tamoxifen isn’t associated with hearing loss. reproductive tract. open sores. leaving the room with the implant still exposed. Bone marrow suppression becomes noticeable 7 to 14 days after floxuridine administration. Breast cancer is the leading killer of women of childbearing age.Answer B. Nina. The incidence of prostate cancer increases after age 50.Answer C. or both. The highest priority is to minimize radiation exposure for the client and the nurse. c. lung.

The nurse provides which preprocedure instruction to the client? a. Sore throat d. Nurse Joy is caring for a client with an internal radiation implant. The nurse is instructing the 35 year old client to perform a testicular self-examination. Assisting with range-of-motion leg exercises c. The most likely side effect to be expected is: a. A male client is diagnosed as having a bowel tumor and several diagnostic tests are prescribed. That the best time for the examination is after a shower c. Monitoring temperature b. The male client is receiving external radiation to the neck for cancer of the larynx. d. Painless testicular swelling d. Testicular cancer is more common in older men. It interferes with ribonucleic acid (RNA) transcription only. 4. Weekly at the same time of day d. Altered red blood cell production b. To examine the testicles while lying down b. 1 month 5. Which of the following would the nurse expect to note specifically in this disorder? a. Wear comfortable clothing and shoes for the procedure d. How does thiotepa exert its therapeutic effects? a. 10 mg by mouth daily. Elevating the knee gatch on the bed b. Magnetic resonance imaging d. Immediately b. Constipation 16. Remove the dosimeter badge when entering the client’s room d. 2 to 3 weeks d. How soon after the first administration of chlorambucil might this reaction occur? a. the nurse teaches her about adverse reactions to chlorambucil. Limit the time with the client to 1 hour per shift b. Biopsy of the tumor b. Maintain an NPO status before the procedure c. Ambulation three times daily c. It interferes with DNA replication and RNA transcription. the physician prescribes chlorambucil (Leukeran). 1 week after menstruation begins 9. The nurse determines that further information needs to be provided if a community member states that which of the following is a sign of testicular cancer? a. Checking placement of pneumatic compression boots 10. who is suspected of an ovarian tumor is scheduled for a pelvic ultrasound. That testicular self-examination should be done at least every 6 months 7. Monitoring the platelet count d. It interferes with deoxyribonucleic acid (DNA) replication only. c. Altered production of lymph nodes c. At the onset of menstruation b. Monitoring for pathological fractures 8. Do not allow pregnant women into the client’s room c. 6. Malignant exacerbation in the number of leukocytes d. Decreased blood urea nitrogen level d. A female client diagnosed with multiple myeloma and the client asks the nurse about the diagnosis. Vanessa. Back pain c. Malignant proliferation of plasma cells within the bone 13. Nurse Bea is reviewing the laboratory results of a client diagnosed with multiple myeloma. The nurse avoids which of the following in the care of this client? a. The nurse identifies which intervention as the highest priority in the nursing plan of care? a. such as alopecia. Eat a light breakfast only b. To gently feel the testicle with one finger to feel for a growth d. When caring for the client. As part of her chemotherapy. It destroys the cell membrane. Increased white blood cells c. Individuals younger than 16 years old may be allowed to go in the room as long as they are 6 feet away from the client . a community health nurse conducts a health promotion program regarding testicular cancer to community members. Decreased number of plasma cells in the bone marrow 14. Rhea. Mina. Abdominal ultrasound c. Drink six to eight glasses of water without voiding before the test 11. has malignant lymphoma. The nurse bases the response on which description of this disorder? a. Gian. causing lysis. 60 mg weekly for 4 weeks by bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. a community health nurse is instructing a group of female clients about breast self-examination. b. 1 week c. The nurse instructs the client to perform the examination: males. When caring for the client. Nurse Cecilia is caring for a client who has undergone a vaginal hysterectomy. A male client is receiving the cell cycle–nonspecific alkylating agent thiotepa (Thioplex). Increased calcium b. A female client with cancer is receiving chemotherapy and develops thrombocytopenia. the nurse should observe which of the following principles? a. Computerized tomography scan 12. The nurse understands that which test will confirm the diagnosis of malignancy? a. Dyspnea b. d. The nurse tells the client: a. The client asks the nurse how the drug works. Heavy sensation in the scrotum 15. Removal of antiembolism stockings twice daily d. Alopecia b. Diarrhea c. Every month during ovulation c.

Hemorrhage c. Pick up the implant with long-handled forceps and place it in a lead container. The client’s pain rating b. Incision appearance d. Abdominal distention 24. During the visit. The nurse assesses for which most common risk factor for this type of cancer? a. The appropriate nursing assessment of the client’s pain would include which of the following? a. Restrict all visitors b.17. Which assessment findings would the nurse expect to note specifically in the client? a. Anger b. Enlarged lymph nodes 23. Urine specific gravity 22. lymphoma. I’ll be ready to die. Denial c. The nurse tells the client that the purpose if the allopurinol is to prevent: a. Altered perineal sensation as a side effect of radiation therapy 30. Infection b. the client expresses that “If I can just live long enough to attend my daughter’s graduation. Depression 27. Ability to ambulate c. Alcohol abuse b. Exposure to air pollutants 29. Mr. The nurse is caring for a female client experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. Hyperuricemia . Sanguineous drainage in the Jackson-Pratt drain d. Hypermenorrhea c. Sarah. The development of a vesicovaginal fistula c. Rupture of the bladder b. Pain relief after appropriate nursing intervention 21. Extreme stress caused by the diagnosis of cancer d. A male client is admitted to the hospital with a suspected diagnosis of Hodgkin’s disease. Arm edema on the operative side c. Cigarette smoking c. The nurse initiates what most appropriate activity order for this client? a. Diarrhea b. The female client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The home health care nurse is caring for a male client with cancer and the client is complaining of acute pain. The nurse makes which priority assessment before administering the diet? a. sarcoma. if identified by the client. Out of bed in a chair only d. The nurse’s impression of the client’s pain d. Reinsert the implant into the vagina immediately c. Nausea b. melanoma. c. Insert an indwelling urinary catheter to prevent skin breakdown 20. a hospice nurse visits a client dying of ovarian cancer.” Which phrase of coping is this client experiencing? a. Ovarian perforation 25. The nurse interprets that the client may be experiencing: a. Teach the client and family about the need for hand hygiene d. While giving care. Call the physician b. The initial action by the nurse is to: a. Weight gain d. carcinoma. Abdominal bleeding d. Bed rest b. Nurse Kate is reviewing the complications of colonization with a client who has microinvasive cervical cancer. Miller has been diagnosed with bone cancer. Use of chewing tobacco d. 26. Ambulation to the bathroom only 18. Which complication. Nurse Mickey is caring for a client who is postoperative following a pelvic exenteration and the physician changes the client’s diet from NPO status to clear liquids. The client with leukemia is receiving busulfan (Myleran) and allopurinol (Zyloprim). The nurse plans to: a. Fatigue b. Complaints of decreased sensation near the operative site 28. Which assessment finding indicates that the client is experiencing a complication related to the surgery? a. Pain at the incisional site b. Restrict fluid intake c. indicates a need for further teaching? a. Pick up the implant with gloved hands and flush it down the toilet d. the nurse recognizes which symptom as typical of the disease? a. the nurse finds the radiation implant in the bed. Bowel sounds b. Cervical stenosis d. Nonverbal cues from the client c. You know this type of cancer is classified as: a. A female client is hospitalized for insertion of an internal cervical radiation implant. Alopecia c. A cervical radiation implant is placed in the client for treatment of cervical cancer. d. Vomiting d. 19. During the admission assessment of a 35 year old client with advanced ovarian cancer. b. Nurse Farah is caring for a client following a mastectomy. Weakness c. The nurse is admitting a male client with laryngeal cancer to the nursing unit. Out of bed ad lib c. Bargaining d.

Self-examination allows early detection and facilitates the early initiation of treatment. On the 1st and last days of the cycle. with fingers under the scrotum and thumbs on top. Thrombocytopenia indicates a decrease in the number of platelets in the circulating blood. 7. The most reliable method for detecting breast cancer is monthly self-examination. however. hypercalcemia caused by the release of calcium from the deteriorating bone tissue. 8. when the breasts are least tender and least lumpy.1. The highest mortality rates from cancer among men are in men with lung cancer. The time that the nurse spends in a room of a client with an internal radiation implant is 30 minutes per 8-hour shift. visitors. Men can develop breast cancer. although important in the plan of care. Dyspnea may occur with lung involvement. Findings indicative of multiple myeloma are an increased number of plasma cells in the bone marrow. particularly when it’s treated in its early stage. Answer A. Thiotepa interferes with DNA replication and RNA transcription. Premenopausal women should do their selfexamination immediately after the menstrual period. the client is logrolled. the nurse should pick up the implant with long-handled forceps and place it in the lead container. A mastectomy may not be required if the tumor is small. Answer C. If turning is absolutely necessary. 12. Alopecia is not an assessment finding in testicular cancer. confined. Answer A. Option C describes the leukemic process. as a result of radiation or chemotherapy. Magnetic resonance imaging. The head of the bed is elevated to a maximum of 10 to 15 degrees for comfort. computed tomography scan. Answer A. as for any other major surgery. Lung cancer causes more deaths than breast cancer in women of all ages. In the neutropenic client. B. fatigue. Answer D. feeling for any lumps. The client is at risk of deep vein thrombosis or thrombophlebitis after this surgery. Options A and B are not characteristics of multiple myeloma. 4. The client with a cervical radiation implant should be maintained on bed rest in the dorsal position to prevent movement of the radiation source. Back pain may indicate metastasis to the retroperitoneal lymph nodes. Answer A. only the area in the treatment field is affected by the radiation. Children younger than 16 years of age and pregnant women are not allowed in the client’s room. and anorexia may occur with radiation to any site. Performing the examination weekly is not recommended. Testicular cancer is found more commonly in younger men. 16. Option A elates to monitoring for infection. The testicular-self examination is recommended monthly after a warm bath or shower when the scrotal skin is relaxed. Answer C. Answer D. 14. Answer C. Answer B. Range-of-motion exercises. Alopecia may occur. the nurse implements measures that will prevent this complication. 17. family. Answer D. C. the client should gently roll the testicles. thus placing the client more at risk for deep vein thrombosis or thrombophlebitis. Options B. are not related directly to thrombocytopenia. and D are assessment findings in testicular cancer. Options A. a pillow is placed between the knees and. although they seldom do. Options B and D may occur with radiation to the gastrointestinal tract. 13. Answer D. and C are inaccurate interventions. The dosimeter badge must be worn when in the client’s room. It doesn’t destroy the cell membrane. Answer C. Testicular cancer is highly curable. should select one particular day of the month to do breast self-examination. Answer D. with the body in straight alignment. 10. A client receiving radiation to the larynx is most likely to experience a sore throat. 6. If the implant becomes dislodged. A full bladder is necessary so that it will be visualized as such and not mistaken for a possible pelvic growth. The client should stand to examine the testicles. 2. The nurse should avoid using the knee gatch in the bed. Answer C. 18. 5. Skin reactions. 9. A biopsy is done to determine whether a tumor is malignant or benign. A major concern is monitoring for and preventing bleeding. meticulous hand hygiene education is implemented for the client. antiembolism stockings. For this reason. the woman’s breasts are still very tender. A pelvic ultrasound requires the ingestion of large volumes of water just before the procedure. 11. not mammography. and ultrasound will visualize the presence of a mass but will not confirm a diagnosis of malignancy. Chlorambucil-induced alopecia occurs 2 to 3 weeks after therapy begins. Answer A. whereas other side effects occur only when specific areas are involved in treatment. anemia. Using both hands. and an elevated blood urea nitrogen level. An increased white blood cell count may or may not be present and is not related specifically to multiple myeloma. nausea. which inhibits venous return. particularly if leukopenia is present. . 3. Answer D. and pneumatic compression boots are helpful. Options B and D. An abdominal ultrasound may require that the client abstain from food or fluid for several hours before the procedure. hormonal changes occur that may alter breast tissue. The nurse avoids turning the client on the side. Option C is unrelated to this specific procedure. Postmenopausal women because their bodies lack fluctuation of hormone levels. and in an early stage. 19. Multiple myeloma is a B-cell neoplastic condition characterized by abnormal malignant proliferation of plasma cells and the accumulation of mature plasma cells in the bone marrow. 15. A lead container and long-handled forceps should be kept in the client’s room at all times during internal radiation therapy. Answer A. In general. The breast self-examination should be performed monthly 7 days after the onset of the menstrual period. Answer B. At the onset of menstruation and during ovulation.

Fluids should be encouraged. Another risk factor is exposure to environmental pollutants. and other connective tissue are called sarcomas. Answer B. Conization procedure involves removal of a cone-shaped area of the cervix. Tumors that originate from bone. pain from pressure caused by the growing tumor and the effects of urinary or bowel obstruction. the client may experience drainage of urine through the vagina. nausea. The nurse’s impression of the client’s pain is not appropriate in determining the client’s level of pain. Complications of the procedure include hemorrhage. pleural effusion. Clinical manifestations of ovarian cancer include abdominal distention. If no distention occurs. 29. uric acid levels increase as a result of the massive cell destruction that occurs from the chemotherapy. Assessing pain relief is an important measure. The client is kept NPO until peristalsis returns. Answer B. usually in 4 to 6 days. and cervical stenosis. Bargaining identifies a behavior in which the individual is willing to do anything to avoid loss or change prognosis or fate. . Answer D. Allopurinol is not used to prevent alopecia. Answer A. Options A. clear fluids are given to the client. Invasive measures such as an indwelling urinary catheter should be avoided to prevent infections. Answer A. or remaining quiet or withdrawn.muscle. bargaining. Allopurinol decreases uric acid production and reduces uric acid concentrations in serum and urine. the diet is advanced as tolerated. Denial. Answer A. Not all visitors are restricted. if this occurs. Nonverbal cues from the client are important but are not the most appropriate pain assessment measure. Abnormal bleeding. 24. but this option is not related to the subject of the question. 21. C. 23. Answer D. 25. infection. The most important assessment is to assess bowel sounds before feeding the client. Depression may be manifested by hopelessness. 28. Arm edema on the operative side (lymphedema) is a complication following mastectomy and can occur immediately postoperatively or may occur months or even years after surgery. and D are unrelated to the subject of the question. Answer C. 26. depression. C. Options B. constipation. but the client is protected from persons with known infections. The most common risk factor associated with laryngeal cancer is cigarette smoking. C. malnutrition. and acceptance are recognized stages that a person facing a lifethreatening illness experiences. Answer D. Answer D. 30. Heavy alcohol use and the combined use of tobacco increase the risk. 20. Denial is expressed as shock and disbelief and may be the first response to hearing bad news. Weight loss is most likely to be noted. urinary frequency and urgency. Fatigue and weakness may occur but are not related significantly to the disease. anger. or vomiting. This medication prevents or treats hyperuricemia caused by chemotherapy. The client’s complaint is not associated with options A. ascites with dyspnea. often resulting in hypermenorrhea. When signs of bowel function return. Ovarian perforation is not a complication. Hodgkin’s disease is a chronic progressive neoplastic disorder of lymphoid tissue characterized by the painless enlargement of lymph nodes with progression to extralymphatic sites. Anger also may be a first response to upsetting news and the predominant theme is “why me?” or the blaming of others. Answer B. such as the spleen and liver. is associated with uterine cancer. weeping openly. 27. 22. The nurse should ask the client about the description of the pain and listen carefully to the client’s words used to describe the pain.and staff. and ultimately general severe pain. The client’s self-report is a critical component of pain assessment. A vesicovaginal fistula is a genital fistula that occurs between the bladder and vagina. and D. The fistula is an abnormal opening between these two body parts and. and D are expected occurrences following mastectomy and do not indicate a complication. In the client receiving chemotherapy.