1 A male cllenL has an abnormal resulL on a apanlcolaou LesL AfLer admlLLlng he read hls charL whlle

Lhe nurse was ouL of Lhe room Lhe cllenL asks whaL dysplasla means Whlch deflnlLlon should Lhe nurse
provlde?
a resence of compleLely undlfferenLlaLed Lumor cells LhaL don'L resemble cells of Lhe Llssues of Lhelr
orlgln
b lncrease ln Lhe number of normal cells ln a normal arrangemenL ln a Llssue or an organ
c 8eplacemenL of one Lype of fully dlfferenLlaLed cell by anoLher ln Llssues where Lhe second Lype
normally lsn'L found
d AlLeraLlon ln Lhe slze shape and organlzaLlon of dlfferenLlaLed cells

2 lor a female cllenL wlLh newly dlagnosed cancer Lhe nurse formulaLes a nurslng dlagnosls of AnxleLy
relaLed Lo Lhe LhreaL of deaLh secondary Lo cancer dlagnosls Whlch expecLed ouLcome would be
approprlaLe for Lhls cllenL?
a CllenL verballzes feellngs of anxleLy"
b CllenL doesn'L guess aL prognosls"
c CllenL uses any effecLlve meLhod Lo reduce Lenslon"
d CllenL sLops seeklng lnformaLlon"

3 A male cllenL wlLh a cerebellar braln Lumor ls admlLLed Lo an acuLe care faclllLy 1he nurse
formulaLes a nurslng dlagnosls of 8lsk for ln[ury Whlch relaLedLo" phrase should Lhe nurse add Lo
compleLe Lhe nurslng dlagnosls sLaLemenL?
a 8elaLed Lo vlsual fleld deflclLs
b 8elaLed Lo dlfflculLy swallowlng
c 8elaLed Lo lmpalred balance
d 8elaLed Lo psychomoLor selzures

4 A female cllenL wlLh cancer ls scheduled for radlaLlon Lherapy 1he nurse knows LhaL radlaLlon aL any
LreaLmenL slLe may cause a cerLaln adverse effecL 1herefore Lhe nurse should prepare Lhe cllenL Lo
expecL
a halr loss
b sLomaLlLls
c faLlgue
d vomlLlng

3 nurse Aprll ls Leachlng a cllenL who suspecLs LhaL she has a lump ln her breasL 1he nurse lnsLrucLs
Lhe cllenL LhaL a dlagnosls of breasL cancer ls conflrmed by
a breasL selfexamlnaLlon
b mammography
c flne needle asplraLlon
d chesL xray

6 A male cllenL undergoes a laryngecLomy Lo LreaL laryngeal cancer When Leachlng Lhe cllenL how Lo
care for Lhe neck sLoma Lhe nurse should lnclude whlch lnsLrucLlon?
a keep Lhe sLoma uncovered"
b keep Lhe sLoma dry"
c Pave a famlly member perform sLoma care lnlLlally unLll you geL used Lo Lhe procedure"
d keep Lhe sLoma molsL"
A female cllenL ls recelvlng chemoLherapy Lo LreaL breasL cancer Whlch assessmenL flndlng
lndlcaLes a fluld and elecLrolyLe lmbalance lnduced by chemoLherapy?
a urlne ouLpuL of 400 ml ln 8 hours
b Serum poLasslum level of 36 mLq/L
c 8lood pressure of 120/64 Lo 130/2 mm Pg
d ury oral mucous membranes and cracked llps

8 nurse Aprll ls Leachlng a group of women Lo perform breasL selfexamlnaLlon 1he nurse should
explaln LhaL Lhe purpose of performlng Lhe examlnaLlon ls Lo dlscover
a cancerous lumps
b areas of Lhlckness or fullness
c changes from prevlous selfexamlnaLlons
d flbrocysLlc masses

9 A cllenL age 41 vlslLs Lhe gynecologlsL AfLer examlnlng her Lhe physlclan suspecLs cervlcal cancer
1he nurse revlews Lhe cllenL's hlsLory for rlsk facLors for Lhls dlsease Whlch hlsLory flndlng ls a rlsk facLor
for cervlcal cancer?
a CnseL of sporadlc sexual acLlvlLy aL age 1
b SponLaneous aborLlon aL age 19
c regnancy compllcaLed wlLh eclampsla aL age 2
d Puman paplllomavlrus lnfecLlon aL age 32

10 A female cllenL ls recelvlng meLhoLrexaLe (MexaLe) 12 g/m2 lv Lo LreaL osLeogenlc carclnoma
uurlng meLhoLrexaLe Lherapy Lhe nurse expecLs Lhe cllenL Lo recelve whlch oLher drug Lo proLecL
normal cells?
a probenecld (8enemld)
b cyLarablne (araC cyLoslne arablnoslde CyLosaru)
c Lhloguanlne (6Lhloguanlne 61C)
d leucovorln (clLrovorum facLor or follnlc acld Wellcovorln)

11 1he nurse ls lnLervlewlng a male cllenL abouL hls pasL medlcal hlsLory Whlch preexlsLlng condlLlon
may lead Lhe nurse Lo suspecL LhaL a cllenL has colorecLal cancer?
a uuodenal ulcers
b Pemorrholds
c WelghL galn
d olyps

12 nurse Amy ls speaklng Lo a group of women abouL early deLecLlon of breasL cancer 1he average
age of Lhe women ln Lhe group ls 4 lollowlng Lhe Amerlcan Cancer SocleLy guldellnes Lhe nurse
should recommend LhaL Lhe women
a perform breasL selfexamlnaLlon annually
b have a mammogram annually
c have a hormonal recepLor assay annually
d have a physlclan conducL a cllnlcal examlnaLlon every 2 years



13 A male cllenL wlLh a nagglng cough makes an appolnLmenL Lo see Lhe physlclan afLer readlng LhaL
Lhls sympLom ls one of Lhe seven warnlng slgns of cancer WhaL ls anoLher warnlng slgn of cancer?
a erslsLenL nausea
b 8ash
c lndlgesLlon
d Chronlc ache or paln

14 lor a female cllenL newly dlagnosed wlLh radlaLlonlnduced LhrombocyLopenla Lhe nurse should
lnclude whlch lnLervenLlon ln Lhe plan of care?
a AdmlnlsLerlng asplrln lf Lhe LemperaLure exceeds 102 l (388 C)
b lnspecLlng Lhe skln for peLechlae once every shlfL
c rovldlng for frequenL resL perlods
d laclng Lhe cllenL ln sLrlcL lsolaLlon

13 nurse Lucla ls provldlng breasL cancer educaLlon aL a communlLy faclllLy 1he Amerlcan Cancer
SocleLy recommends LhaL women geL mammograms
a yearly afLer age 40
b afLer Lhe blrLh of Lhe flrsL chlld and every 2 years LhereafLer
c afLer Lhe flrsL mensLrual perlod and annually LhereafLer
d every 3 years beLween ages 20 and 40 and annually LhereafLer

16 Whlch lnLervenLlon ls approprlaLe for Lhe nurse carlng for a male cllenL ln severe paln recelvlng a
conLlnuous lv lnfuslon of morphlne?
a AsslsLlng wlLh a naloxone challenge LesL before Lherapy beglns
b ulsconLlnulng Lhe drug lmmedlaLely lf slgns of dependence appear
c Changlng Lhe admlnlsLraLlon rouLe Lo C lf Lhe cllenL can LoleraLe flulds
d CbLalnlng basellne vlLal slgns before admlnlsLerlng Lhe flrsL dose

1 A 33 years old cllenL wlLh ovarlan cancer ls prescrlbed hydroxyurea (Pydrea) an anLlmeLabollLe
drug AnLlmeLabollLes are a dlverse group of anLlneoplasLlc agenLs LhaL lnLerfere wlLh varlous meLabollc
acLlons of Lhe cell 1he mechanlsm of acLlon of anLlmeLabollLes lnLerferes wlLh
a cell dlvlslon or mlLosls durlng Lhe M phase of Lhe cell cycle
b normal cellular processes durlng Lhe S phase of Lhe cell cycle
c Lhe chemlcal sLrucLure of deoxyrlbonuclelc acld (unA) and chemlcal blndlng beLween unA
molecules (cell cyclenonspeclflc)
d one or more sLages of rlbonuclelc acld (8nA) synLhesls unA synLhesls or boLh (cell cycle
nonspeclflc)

18 1he A8Cu meLhod offers one way Lo assess skln leslons for posslble skln cancer WhaL does Lhe A
sLand for?
a AcLlnlc
b AsymmeLry
c Arcus
d AssessmenL



19 When carlng for a male cllenL dlagnosed wlLh a braln Lumor of Lhe parleLal lobe Lhe nurse expecLs
Lo assess
a shorLLerm memory lmpalrmenL
b LacLlle agnosla
c selzures
d conLralaLeral homonymous hemlanopla

20 A female cllenL ls undergolng LesLs for mulLlple myeloma ulagnosLlc sLudy flndlngs ln mulLlple
myeloma lnclude
a a decreased serum creaLlnlne level
b hypocalcemla
c 8ence !ones proLeln ln Lhe urlne
d a low serum proLeln level

21 A 33 years old cllenL has been recelvlng chemoLherapy Lo LreaL cancer Whlch assessmenL flndlng
suggesLs LhaL Lhe cllenL has developed sLomaLlLls (lnflammaLlon of Lhe mouLh)?
a WhlLe coLLage cheesellke paLches on Lhe Longue
b ?ellow LooLh dlscoloraLlon
c 8ed open sores on Lhe oral mucosa
d 8usLcolored spuLum

22 uurlng chemoLherapy an oncology cllenL has a nurslng dlagnosls of lmpalred oral mucous
membrane relaLed Lo decreased nuLrlLlon and lmmunosuppresslon secondary Lo Lhe cyLoLoxlc effecLs of
chemoLherapy Whlch nurslng lnLervenLlon ls mosL llkely Lo decrease Lhe paln of sLomaLlLls?
a 8ecommendlng LhaL Lhe cllenL dlsconLlnue chemoLherapy
b rovldlng a soluLlon of hydrogen peroxlde and waLer for use as a mouLh rlnse
c MonlLorlng Lhe cllenL's plaLeleL and leukocyLe counLs
d Checklng regularly for slgns and sympLoms of sLomaLlLls

23 WhaL should a male cllenL over age 32 do Lo help ensure early ldenLlflcaLlon of prosLaLe cancer?
a Pave a dlglLal recLal examlnaLlon and prosLaLespeclflc anLlgen (SA) LesL done yearly
b Pave a LransrecLal ulLrasound every 3 years
c erform monLhly LesLlcular selfexamlnaLlons especlally afLer age 30
d Pave a compleLe blood counL (C8C) and blood urea nlLrogen (8un) and creaLlnlne levels checked
yearly

24 A male cllenL complalns of sporadlc eplgasLrlc paln yellow skln nausea vomlLlng welghL loss and
faLlgue SuspecLlng gallbladder dlsease Lhe physlclan orders a dlagnosLlc workup whlch reveals
gallbladder cancer Whlch nurslng dlagnosls may be approprlaLe for Lhls cllenL?
a AnLlclpaLory grlevlng
b lmpalred swallowlng
c ulsLurbed body lmage
d Chronlc low selfesLeem

23 A male cllenL ls ln lsolaLlon afLer recelvlng an lnLernal radloacLlve lmplanL Lo LreaL cancer 1wo
hours laLer Lhe nurse dlscovers Lhe lmplanL ln Lhe bed llnens WhaL should Lhe nurse do flrsL?
a SLand as far away from Lhe lmplanL as posslble and call for help
b lck up Lhe lmplanL wlLh longhandled forceps and place lL ln a leadllned conLalner
c Leave Lhe room and noLlfy Lhe radlaLlon Lherapy deparLmenL lmmedlaLely
d uL Lhe lmplanL back ln place uslng forceps and a shleld for selfproLecLlon and call for help

26 !eovlna wlLh advanced breasL cancer ls prescrlbed Lamoxlfen (nolvadex) When Leachlng Lhe cllenL
abouL Lhls drug Lhe nurse should emphaslze Lhe lmporLance of reporLlng whlch adverse reacLlon
lmmedlaLely?
a vlslon changes
b Pearlng loss
c Peadache
d Anorexla

2 A female cllenL wlLh cancer ls belng evaluaLed for posslble meLasLasls Whlch of Lhe followlng ls
one of Lhe mosL common meLasLasls slLes for cancer cells?
a Llver
b Colon
c 8eproducLlve LracL
d WhlLe blood cells (W8Cs)

28 A 34yearold female cllenL ls requesLlng lnformaLlon abouL mammograms and breasL cancer She
lsn'L consldered aL hlgh rlsk for breasL cancer WhaL should Lhe nurse Lell Lhls cllenL?
a She should have had a basellne mammogram before age 30
b She should eaL a lowfaL dleL Lo furLher decrease her rlsk of breasL cancer
c She should perform breasL selfexamlnaLlon durlng Lhe flrsL 3 days of each mensLrual cycle
d When she beglns havlng yearly mammograms breasL selfexamlnaLlons wlll no longer be necessary

29 nurse 8rlan ls developlng a plan of care for marrow suppresslon Lhe ma[or dosellmlLlng adverse
reacLlon Lo floxurldlne (luu8) Pow long afLer drug admlnlsLraLlon does bone marrow suppresslon
become noLlceable?
a 24 hours
b 2 Lo 4 days
c Lo 14 days
d 21 Lo 28 days

30 1he nurse ls preparlng for a female cllenL for magneLlc resonance lmaglng (M8l) Lo conflrm or rule
ouL a splnal cord leslon uurlng Lhe M8l scan whlch of Lhe followlng would pose a LhreaL Lo Lhe cllenL?
a 1he cllenL lles sLlll
b 1he cllenL asks quesLlons
c 1he cllenL hears Lhumplng sounds
d 1he cllenL wears a waLch and weddlng band

A81 2
1. A 25 year old patient is inquiring about the methods or ways to detect cancer earlier. The nurse least
likely identify this method by stating:
a. Annual chest x-ray.
b. Annual Pap smear for sexually active women only.
c. Annual digital rectal examination for persons over age 40.
d. Yearly physical and blood examination

2. The removal of entire breast, pectoralis major and minor muscles and neck lymph nodes which is
followed by skin grafting is a procedure called:
a. Simple mastectomy
b. Modified radical mastectomy
c. Radiation therapy
d. Radical mastectomy

3. Chemotherapy is one of the therapeutic modalities for cancer. This treatment is contraindicated to
which of the following conditions?
a. Recent surgery
b. Pregnancy
c. Bone marrow depression
d. All of the above

4. The nurse is preparing Cyclophosphamide (Cytoxan). Safe handling of the drug should be
implemented to protect the nurse from injury. Which of the following action by the nurse should be
corrected?
a. The nurse should wear mask and gloves.
b. Air bubbles should be expelled on wet cotton.
c. Label the hanging V bottle with ANTNEOPLASTC CHEMOTHERAPY sign.
d. Vent vials after mixing.

5. Neoplasm can be classified as either benign or malignant. The following are characteristics of
malignant tumor apart from:
a. Metastasis
b. nfiltrates surrounding tissues
c. Encapsulated
d. Poorly differentiated cells

6. On a clinic visit a client who has a relative with cancer, is asking about the warning signs that may
relate to cancer. The nurse correctly identifies the warning signs of cancer by responding:
a. "f a sore healing took a month or more to heal, cancer should be suspected.
b. "Presence of dry cough is one of the warning signs of cancer.
c. "A lump located only in the breast area may suggest the presence of cancer.
d. "Sudden weight loss of unexplained etiology can be a warning sign of cancer.

7. n staging and grading neoplasm TNM system is used. TNM stands for:
a. Time, neoplasm, mode of growth
b. Tumor, node, metastasis
c. Tumor, neoplasm, mode of growth
d. Time, node, metastasis

8. Breast self examination (BSE) is one of the ways to detect breast cancer earlier. The nurse is
conducting a health teaching to female clients in a clinic. During evaluation the clients are asked to state
what they learned. Which of the following statement made by a client needs further teaching about BSE?
a. "BSE is done after menstruation.
b. "BSE palpation is done by starting at the center going to the periphery in a circular motion.
c. "BSE can be done in either supine or standing position.
d. "BSE should start from age 20.

9. A client had undergone radiation therapy (external). The expected side effects include the following
apart from:
a. Hair loss
b. Ulceration of oral mucous membranes
c. Constipation
d. Headache

10. Nurse Janet is assigned in the oncology section of the hospital. Which of the following orders should
the nurse question if a client is on radiation therapy?
a. Analgesics before meals
b. Saline rinses every 2 hours
c. Aspirin every 4 hours
d. Bland diet

11. Skin reactions are common in radiation therapy. Nursing responsibilities on promoting skin integrity
should be promoted apart from:
a. Avoiding the use of ointments, powders and lotion to the area
b. Using soft cotton fabrics for clothing
c. Washing the area with a mild soap and water and patting it dry not rubbing it.
d. Avoiding direct sunshine or cold.

12. Nausea and vomiting is an expected side effect of chemotherapeutic drug use. Which of the
following drug should be administered to a client on chemotherapy to prevent nausea and vomiting?
a. Metochlopramide (Metozol)
b. Succimer (Chemet)
c. Anastrazole (Arimidex)
d. Busulfan (Myleran)

13. Radiation protection is very important to implement when performing nursing procedures. When the
nurse is not performing any nursing procedures what distance should be maintained from the client?
a. 1 feet
b. 2 feet
c. 2.5 feet
d. 3 feet

14. The following are teaching guidelines regarding radiation therapy except:
a. The therapy is painless
b. To promote safety, the client is assisted by therapy personnel while the machine is in operation.
c. The client may communicate all his concerns or needs or discomforts while the machine is operating.
d. Safety precautions are necessary only during the time of actual irradiation.

15. Contact of client on radiation therapy should be limited only to how many minutes to promote safety
of the therapy personnel?
a. 1 minute
b. 3 minutes
c. 5 minutes
d. 10 minutes

16. A client is taking Cyclophosphamide (Cytoxan) for the treatment of lymphoma. The nurse is very
cautious in administering the medication because this drug poses the fatal side effect of:
a. Alopecia
b. Myeloma
c. CNS toxicity
d. Hemorrhagic cystitis

17. Cytarabine (Ara-C) is an antimetabolite that can cause a common cytarabine syndrome which
includes the following apart from:
a. Fever
b. Myalgia
c. Chest pain
d. Diarrhea

18. To provide relief from the cytarabine syndrome, which drug is given?
a. Analgesic
b. Aspirin
c. Steroids
d. Allopurinol

19. Chemotherapeutic agents have different specific classifications. The following medications are
antineoplastic antibiotics except:
a. Doxorubicin (Adriamycin)
b. Fluorouracil (Adrucil)
c. Mitoxantrone (Novantrone)
d. Bleomycin (Blenoxane)
20. Specific classification of the chemotherapeutic agent, Vincristine ((Oncovin) is:
a. Hormone modulator
b. Mitotic inhibitor
c. Antineoplastic antibiotic
d. Antimetabolite

21. A client is diagnosed with progressive prostate cancer. The nurse expects which drug is given?
a. Anstrazole (arimidex)
b. Estramustine (Emcyt)
c. Pclitaxel (Taxol)
d. rinotecan (Camptosar)

22. A client taking a chemotherapeutic agent understands the effects of therapy by stating:
a. " will avoid eating hot and spicy foods.
b. " should stay in my room all the time.
c. " should limit my fluid intake to about 500 ml per day.
d. " should notify the physician immediately if a urine color change is observed.

23. A client is diagnosed with breast cancer. The tumor size is up to 5 cm with axillary and neck lymph
node involvement. The client is in what stage of breast cancer?
a. Stage
b. Stage
c. Stage
d. Stage V

24. The classic symptoms that define breast cancer includes the following except:
a. "pink peel skin
b. Solitary, irregularly shaped mass
c. Firm, nontender, nonmobile mass
d. Abnormal discharge from the nipple

25. Surgical procedure to treat breast cancer involves the removal of the entire breast, pectoralis major
muscle and the axillary lymph nodes is:
a. Simple mastectomy
b. Modified radical mastectomy
c. Halstead Surgery
d. Radical mastectomy




AnSWL8 kL?
1Answer u uysplasla refers Lo an alLeraLlon ln Lhe slze shape and organlzaLlon of dlfferenLlaLed cells 1he
presence of compleLely undlfferenLlaLed Lumor cells LhaL don'L resemble cells of Lhe Llssues of Lhelr orlgln ls called
anaplasla An lncrease ln Lhe number of normal cells ln a normal arrangemenL ln a Llssue or an organ ls called
hyperplasla 8eplacemenL of one Lype of fully dlfferenLlaLed cell by anoLher ln Llssues where Lhe second Lype
normally lsn'L found ls called meLaplasla
2Answer A verballzlng feellngs ls Lhe cllenL's flrsL sLep ln coplng wlLh Lhe slLuaLlonal crlsls lL also helps Lhe healLh
care Leam galn lnslghL lnLo Lhe cllenL's feellngs helplng gulde psychosoclal care CpLlon 8 ls lnapproprlaLe because
suppresslng speculaLlon may prevenL Lhe cllenL from comlng Lo Lerms wlLh Lhe crlsls and plannlng accordlngly
CpLlon C ls undeslrable because some meLhods of reduclng Lenslon such as llllclL drug or alcohol use may prevenL
Lhe cllenL from comlng Lo Lerms wlLh Lhe LhreaL of deaLh as well as cause physlologlc harm CpLlon u lsn'L
approprlaLe because seeklng lnformaLlon can help a cllenL wlLh cancer galn a sense of conLrol over Lhe crlsls
3Answer C A cllenL wlLh a cerebellar braln Lumor may suffer ln[ury from lmpalred balance as well as dlsLurbed galL
and lncoordlnaLlon vlsual fleld deflclLs dlfflculLy swallowlng and psychomoLor selzures may resulL from
dysfuncLlon of Lhe plLulLary gland pons occlplLal lobe parleLal lobe or Lemporal lobe noL from a cerebellar
braln Lumor ulfflculLy swallowlng suggesLs medullary dysfuncLlon sychomoLor selzures suggesL Lemporal lobe
dysfuncLlon
4Answer C 8adlaLlon Lherapy may cause faLlgue skln LoxlclLles and anorexla regardless of Lhe LreaLmenL slLe
Palr loss sLomaLlLls and vomlLlng are slLespeclflc noL generallzed adverse effecLs of radlaLlon Lherapy
3Answer C llne needle asplraLlon and blopsy provlde cells for hlsLologlc examlnaLlon Lo conflrm a dlagnosls of
cancer A breasL selfexamlnaLlon lf done regularly ls Lhe mosL rellable meLhod for deLecLlng breasL lumps early
Mammography ls used Lo deLecL Lumors LhaL are Loo small Lo palpaLe ChesL xrays can be used Lo plnpolnL rlb
meLasLasls
6Answer u 1he nurse should lnsLrucL Lhe cllenL Lo keep Lhe sLoma molsL such as by applylng a Lhln layer of
peLroleum [elly around Lhe edges because a dry sLoma may become lrrlLaLed 1he nurse should recommend
placlng a sLoma blb over Lhe sLoma Lo fllLer and warm alr before lL enLers Lhe sLoma 1he cllenL should begln
performlng sLoma care wlLhouL asslsLance as soon as posslble Lo galn lndependence ln selfcare acLlvlLles
Answer u ChemoLherapy commonly causes nausea and vomlLlng whlch may lead Lo fluld and elecLrolyLe
lmbalances Slgns of fluld loss lnclude dry oral mucous membranes cracked llps decreased urlne ouLpuL (less Lhan
40 ml/hour) abnormally low blood pressure and a serum poLasslum level below 33 mLq/L
8Answer C Women are lnsLrucLed Lo examlne Lhemselves Lo dlscover changes LhaL have occurred ln Lhe breasL
Cnly a physlclan can dlagnose lumps LhaL are cancerous areas of Lhlckness or fullness LhaL slgnal Lhe presence of a
mallgnancy or masses LhaL are flbrocysLlc as opposed Lo mallgnanL
9Answer u Llke oLher vlral and bacLerlal venereal lnfecLlons human paplllomavlrus ls a rlsk facLor for cervlcal
cancer CLher rlsk facLors for Lhls dlsease lnclude frequenL sexual lnLercourse before age 16 mulLlple sex parLners
and mulLlple pregnancles A sponLaneous aborLlon and pregnancy compllcaLed by eclampsla aren'L rlsk facLors for
cervlcal cancer
10Answer u Leucovorln ls admlnlsLered wlLh meLhoLrexaLe Lo proLecL normal cells whlch meLhoLrexaLe could
desLroy lf glven alone robenecld should be avolded ln cllenLs recelvlng meLhoLrexaLe because lL reduces renal
ellmlnaLlon of meLhoLrexaLe lncreaslng Lhe rlsk of meLhoLrexaLe LoxlclLy CyLarablne and Lhloguanlne aren'L used
Lo LreaL osLeogenlc carclnoma
11Answer u ColorecLal polyps are common wlLh colon cancer uuodenal ulcers and hemorrholds aren'L
preexlsLlng condlLlons of colorecLal cancer WelghL loss noL galn ls an lndlcaLlon of colorecLal cancer
12Answer 8 1he Amerlcan Cancer SocleLy guldellnes sLaLe Women older Lhan age 40 should have a
mammogram annually and a cllnlcal examlnaLlon aL leasL annually noL every 2 years all women should perform
breasL selfexamlnaLlon monLhly noL annually 1he hormonal recepLor assay ls done on a known breasL Lumor Lo
deLermlne wheLher Lhe Lumor ls esLrogen or progesLeronedependenL
13Answer C lndlgesLlon or dlfflculLy swallowlng ls one of Lhe seven warnlng slgns of cancer 1he oLher slx are a
change ln bowel or bladder hablLs a sore LhaL does noL heal unusual bleedlng or dlscharge a Lhlckenlng or lump ln
Lhe breasL or elsewhere an obvlous change ln a warL or mole and a nagglng cough or hoarseness erslsLenL
nausea may slgnal sLomach cancer buL lsn'L one of Lhe seven ma[or warnlng slgns 8ash and chronlc ache or paln
seldom lndlcaLe cancer
14Answer 8 8ecause LhrombocyLopenla lmpalrs blood cloLLlng Lhe nurse should lnspecL Lhe cllenL regularly for
slgns of bleedlng such as peLechlae purpura eplsLaxls and bleedlng gums 1he nurse should avold admlnlsLerlng
asplrln because lL may lncrease Lhe rlsk of bleedlng lrequenL resL perlods are lndlcaLed for cllenLs wlLh anemla
noL LhrombocyLopenla SLrlcL lsolaLlon ls lndlcaLed only for cllenLs who have hlghly conLaglous or vlrulenL lnfecLlons
LhaL are spread by alr or physlcal conLacL
13Answer A 1he Amerlcan Cancer SocleLy recommends a mammogram yearly for women over age 40 1he oLher
sLaLemenLs are lncorrecL lL's recommended LhaL women beLween ages 20 and 40 have a professlonal breasL
examlnaLlon (noL a mammogram) every 3 years
16Answer u 1he nurse should obLaln Lhe cllenL's basellne blood pressure and pulse and resplraLory raLes before
admlnlsLerlng Lhe lnlLlal dose and Lhen conLlnue Lo monlLor vlLal slgns LhroughouL Lherapy A naloxone challenge
LesL may be admlnlsLered before uslng a narcoLlc anLagonlsL noL a narcoLlc agonlsL 1he nurse shouldn'L
dlsconLlnue a narcoLlc agonlsL abrupLly because wlLhdrawal sympLoms may occur Morphlne commonly ls used as
a conLlnuous lnfuslon ln cllenLs wlLh severe paln regardless of Lhe ablllLy Lo LoleraLe flulds
1Answer 8 AnLlmeLabollLes acL durlng Lhe S phase of Lhe cell cycle conLrlbuLlng Lo cell desLrucLlon or prevenLlng
cell repllcaLlon 1hey're mosL effecLlve agalnsL rapldly prollferaLlng cancers MloLlc lnhlblLors lnLerfere wlLh cell
dlvlslon or mlLosls durlng Lhe M phase of Lhe cell cycle AlkylaLlng agenLs affecL all rapldly prollferaLlng cells by
lnLerferlng wlLh unA Lhey may klll dlvldlng cells ln all phases of Lhe cell cycle and may also klll nondlvldlng cells
AnLlneoplasLlc anLlbloLlc agenLs lnLerfere wlLh one or more sLages of Lhe synLhesls of 8nA unA or boLh
prevenLlng normal cell growLh and reproducLlon
18Answer 8 When followlng Lhe A8Cu meLhod for assesslng skln leslons Lhe A sLands for asymmeLry Lhe 8 for
border lrregularlLy Lhe C for color varlaLlon and Lhe u for dlameLer
19Answer 8 1acLlle agnosla (lnablllLy Lo ldenLlfy ob[ecLs by Louch) ls a slgn of a parleLal lobe Lumor ShorLLerm
memory lmpalrmenL occurs wlLh a fronLal lobe Lumor Selzures may resulL from a Lumor of Lhe fronLal Lemporal
or occlplLal lobe ConLralaLeral homonymous hemlanopla suggesLs an occlplLal lobe Lumor
20Answer C resence of 8ence !ones proLeln ln Lhe urlne almosL always conflrms Lhe dlsease buL absence
doesn'L rule lL ouL Serum calclum levels are elevaLed because calclum ls losL from Lhe bone and reabsorbed ln Lhe
serum Serum proLeln elecLrophoresls shows elevaLed globulln splke 1he serum creaLlnlne level may also be
lncreased
21Answer C 1he LlssuedesLrucLlve effecLs of cancer chemoLherapy Lyplcally cause sLomaLlLls resulLlng ln ulcers
on Lhe oral mucosa LhaL appear as red open sores WhlLe coLLage cheesellke paLches on Lhe Longue suggesL a
candldal lnfecLlon anoLher common adverse effecL of chemoLherapy ?ellow LooLh dlscoloraLlon may resulL from
anLlbloLlc Lherapy noL cancer chemoLherapy 8usLcolored spuLum suggesLs a resplraLory dlsorder such as
pneumonla
22Answer 8 1o decrease Lhe paln of sLomaLlLls Lhe nurse should provlde a soluLlon of hydrogen peroxlde and
waLer for Lhe cllenL Lo use as a mouLh rlnse (Commerclally prepared mouLhwashes conLaln alcohol and may cause
dryness and lrrlLaLlon of Lhe oral mucosa) 1he nurse also may admlnlsLer vlscous lldocalne or sysLemlc analgeslcs
as prescrlbed SLomaLlLls occurs Lo 10 days afLer chemoLherapy beglns Lhus sLopplng chemoLherapy wouldn'L be
helpful or pracLlcal lnsLead Lhe nurse should sLay alerL for Lhls poLenLlal problem Lo ensure prompL LreaLmenL
MonlLorlng plaLeleL and leukocyLe counLs may help prevenL bleedlng and lnfecLlon buL wouldn'L decrease paln ln
Lhls hlghly suscepLlble cllenL Checklng for slgns and sympLoms of sLomaLlLls also wouldn'L decrease Lhe paln
23Answer A 1he lncldence of prosLaLe cancer lncreases afLer age 30 1he dlglLal recLal examlnaLlon whlch
ldenLlfles enlargemenL or lrregularlLy of Lhe prosLaLe and SA LesL a Lumor marker for prosLaLe cancer are
effecLlve dlagnosLlc measures LhaL should be done yearly 1esLlcular selfexamlnaLlons won'L ldenLlfy changes ln
Lhe prosLaLe gland due Lo lLs locaLlon ln Lhe body A LransrecLal ulLrasound C8C and 8un and creaLlnlne levels are
usually done afLer dlagnosls Lo ldenLlfy Lhe exLenL of Lhe dlsease and poLenLlal meLasLases
24Answer A AnLlclpaLory grlevlng ls an approprlaLe nurslng dlagnosls for Lhls cllenL because few cllenLs wlLh
gallbladder cancer llve more Lhan 1 year afLer dlagnosls lmpalred swallowlng lsn'L assoclaLed wlLh gallbladder
cancer AlLhough surgery Lyplcally ls done Lo remove Lhe gallbladder and posslbly a secLlon of Lhe llver lL lsn'L
dlsflgurlng and doesn'L cause ulsLurbed body lmage Chronlc low selfesLeem lsn'L an approprlaLe nurslng dlagnosls
aL Lhls Llme because Lhe dlagnosls has [usL been made
23Answer 8 lf a radloacLlve lmplanL becomes dlslodged Lhe nurse should plck lL up wlLh longhandled forceps
and place lL ln a leadllned conLalner Lhen noLlfy Lhe radlaLlon Lherapy deparLmenL lmmedlaLely 1he hlghesL
prlorlLy ls Lo mlnlmlze radlaLlon exposure for Lhe cllenL and Lhe nurse Lherefore Lhe nurse musL noL Lake any
acLlon LhaL delays lmplanL removal SLandlng as far from Lhe lmplanL as posslble leavlng Lhe room wlLh Lhe lmplanL
sLlll exposed or aLLempLlng Lo puL lL back ln place can greaLly lncrease Lhe rlsk of harm Lo Lhe cllenL and Lhe nurse
from excesslve radlaLlon exposure
26Answer A 1he cllenL musL reporL changes ln vlsual aculLy lmmedlaLely because Lhls adverse effecL may be
lrreverslble 1amoxlfen lsn'L assoclaLed wlLh hearlng loss AlLhough Lhe drug may cause anorexla headache and
hoL flashes Lhe cllenL need noL reporL Lhese adverse effecLs lmmedlaLely because Lhey don'L warranL a change ln
Lherapy
2Answer A 1he llver ls one of Lhe flve mosL common cancer meLasLasls slLes 1he oLhers are Lhe lymph nodes
lung bone and braln 1he colon reproducLlve LracL and W8Cs are occaslonal meLasLasls slLes
28Answer 8 A lowfaL dleL (one LhaL malnLalns welghL wlLhln 20 of recommended body welghL) has been found
Lo decrease a woman's rlsk of breasL cancer A basellne mammogram should be done beLween ages 30 and 40
MonLhly breasL selfexamlnaLlons should be done beLween days and 10 of Lhe mensLrual cycle 1he cllenL should
conLlnue Lo perform monLhly breasL selfexamlnaLlons even when recelvlng yearly mammograms
29Answer C 8one marrow suppresslon becomes noLlceable Lo 14 days afLer floxurldlne admlnlsLraLlon 8one
marrow recovery occurs ln 21 Lo 28 days
30Answer u uurlng an M8l Lhe cllenL should wear no meLal ob[ecLs such as [ewelry because Lhe sLrong
magneLlc fleld can pull on Lhem causlng ln[ury Lo Lhe cllenL and (lf Lhey fly off) Lo oLhers 1he cllenL musL lle sLlll
durlng Lhe M8l buL can Lalk Lo Lhose performlng Lhe LesL by way of Lhe mlcrophone lnslde Lhe scanner Lunnel 1he
cllenL should hear Lhumplng sounds whlch are caused by Lhe sound waves Lhumplng on Lhe magneLlc fleld

A81 2
1 Answer u Men can develop breasL cancer alLhough Lhey seldom do 1he mosL rellable meLhod for deLecLlng
breasL cancer ls monLhly selfexamlnaLlon noL mammography Lung cancer causes more deaLhs Lhan breasL cancer
ln women of all ages A masLecLomy may noL be requlred lf Lhe Lumor ls small conflned and ln an early sLage
2 Answer u remenopausal women should do Lhelr selfexamlnaLlon lmmedlaLely afLer Lhe mensLrual perlod
when Lhe breasLs are leasL Lender and leasL lumpy Cn Lhe 1sL and lasL days of Lhe cycle Lhe woman's breasLs are
sLlll very Lender osLmenopausal women because Lhelr bodles lack flucLuaLlon of hormone levels should selecL
one parLlcular day of Lhe monLh Lo do breasL selfexamlnaLlon
3 Answer A 1esLlcular cancer ls hlghly curable parLlcularly when lL's LreaLed ln lLs early sLage SelfexamlnaLlon
allows early deLecLlon and faclllLaLes Lhe early lnlLlaLlon of LreaLmenL 1he hlghesL morLallLy raLes from cancer
among men are ln men wlLh lung cancer 1esLlcular cancer ls found more commonly ln younger men
4 Answer C Chlorambuclllnduced alopecla occurs 2 Lo 3 weeks afLer Lherapy beglns
3 Answer C 1hloLepa lnLerferes wlLh unA repllcaLlon and 8nA LranscrlpLlon lL doesn'L desLroy Lhe cell
membrane
6 Answer 8 1he LesLlcularself examlnaLlon ls recommended monLhly afLer a warm baLh or shower when Lhe
scroLal skln ls relaxed 1he cllenL should sLand Lo examlne Lhe LesLlcles uslng boLh hands wlLh flngers under Lhe
scroLum and Lhumbs on Lop Lhe cllenL should genLly roll Lhe LesLlcles feellng for any lumps
Answer C 1hrombocyLopenla lndlcaLes a decrease ln Lhe number of plaLeleLs ln Lhe clrculaLlng blood A ma[or
concern ls monlLorlng for and prevenLlng bleedlng CpLlon A elaLes Lo monlLorlng for lnfecLlon parLlcularly lf
leukopenla ls presenL CpLlons 8 and u alLhough lmporLanL ln Lhe plan of care are noL relaLed dlrecLly Lo
LhrombocyLopenla
8 Answer u 1he breasL selfexamlnaLlon should be performed monLhly days afLer Lhe onseL of Lhe mensLrual
perlod erformlng Lhe examlnaLlon weekly ls noL recommended AL Lhe onseL of mensLruaLlon and durlng
ovulaLlon hormonal changes occur LhaL may alLer breasL Llssue
9 Answer A 1he cllenL ls aL rlsk of deep veln Lhrombosls or LhrombophleblLls afLer Lhls surgery as for any oLher
ma[or surgery lor Lhls reason Lhe nurse lmplemenLs measures LhaL wlll prevenL Lhls compllcaLlon 8angeof
moLlon exerclses anLlembollsm sLocklngs and pneumaLlc compresslon booLs are helpful 1he nurse should avold
uslng Lhe knee gaLch ln Lhe bed whlch lnhlblLs venous reLurn Lhus placlng Lhe cllenL more aL rlsk for deep veln
Lhrombosls or LhrombophleblLls
10 Answer u A pelvlc ulLrasound requlres Lhe lngesLlon of large volumes of waLer [usL before Lhe procedure A
full bladder ls necessary so LhaL lL wlll be vlsuallzed as such and noL mlsLaken for a posslble pelvlc growLh An
abdomlnal ulLrasound may requlre LhaL Lhe cllenL absLaln from food or fluld for several hours before Lhe
procedure CpLlon C ls unrelaLed Lo Lhls speclflc procedure
11 Answer A A blopsy ls done Lo deLermlne wheLher a Lumor ls mallgnanL or benlgn MagneLlc resonance
lmaglng compuLed Lomography scan and ulLrasound wlll vlsuallze Lhe presence of a mass buL wlll noL conflrm a
dlagnosls of mallgnancy
12 Answer u MulLlple myeloma ls a 8cell neoplasLlc condlLlon characLerlzed by abnormal mallgnanL
prollferaLlon of plasma cells and Lhe accumulaLlon of maLure plasma cells ln Lhe bone marrow CpLlons A and 8 are
noL characLerlsLlcs of mulLlple myeloma CpLlon C descrlbes Lhe leukemlc process
13 Answer A llndlngs lndlcaLlve of mulLlple myeloma are an lncreased number of plasma cells ln Lhe bone
marrow anemla hypercalcemla caused by Lhe release of calclum from Lhe deLerloraLlng bone Llssue and an
elevaLed blood urea nlLrogen level An lncreased whlLe blood cell counL may or may noL be presenL and ls noL
relaLed speclflcally Lo mulLlple myeloma
14 Answer A Alopecla ls noL an assessmenL flndlng ln LesLlcular cancer Alopecla may occur however as a resulL
of radlaLlon or chemoLherapy CpLlons 8 C and u are assessmenL flndlngs ln LesLlcular cancer 8ack paln may
lndlcaLe meLasLasls Lo Lhe reLroperlLoneal lymph nodes
13 Answer C ln general only Lhe area ln Lhe LreaLmenL fleld ls affecLed by Lhe radlaLlon Skln reacLlons faLlgue
nausea and anorexla may occur wlLh radlaLlon Lo any slLe whereas oLher slde effecLs occur only when speclflc
areas are lnvolved ln LreaLmenL A cllenL recelvlng radlaLlon Lo Lhe larynx ls mosL llkely Lo experlence a sore LhroaL
CpLlons 8 and u may occur wlLh radlaLlon Lo Lhe gasLrolnLesLlnal LracL uyspnea may occur wlLh lung lnvolvemenL
16 Answer 8 1he Llme LhaL Lhe nurse spends ln a room of a cllenL wlLh an lnLernal radlaLlon lmplanL ls 30
mlnuLes per 8hour shlfL 1he doslmeLer badge musL be worn when ln Lhe cllenL's room Chlldren younger Lhan 16
years of age and pregnanL women are noL allowed ln Lhe cllenL's room
1 Answer A 1he cllenL wlLh a cervlcal radlaLlon lmplanL should be malnLalned on bed resL ln Lhe dorsal poslLlon
Lo prevenL movemenL of Lhe radlaLlon source 1he head of Lhe bed ls elevaLed Lo a maxlmum of 10 Lo 13 degrees
for comforL 1he nurse avolds Lurnlng Lhe cllenL on Lhe slde lf Lurnlng ls absoluLely necessary a plllow ls placed
beLween Lhe knees and wlLh Lhe body ln sLralghL allgnmenL Lhe cllenL ls logrolled
18 Answer u A lead conLalner and longhandled forceps should be kepL ln Lhe cllenL's room aL all Llmes durlng
lnLernal radlaLlon Lherapy lf Lhe lmplanL becomes dlslodged Lhe nurse should plck up Lhe lmplanL wlLh long
handled forceps and place lL ln Lhe lead conLalner CpLlons A 8 and C are lnaccuraLe lnLervenLlons
19 Answer C ln Lhe neuLropenlc cllenL meLlculous hand hyglene educaLlon ls lmplemenLed for Lhe cllenL
famlly vlslLors and sLaff noL all vlslLors are resLrlcLed buL Lhe cllenL ls proLecLed from persons wlLh known
lnfecLlons llulds should be encouraged lnvaslve measures such as an lndwelllng urlnary caLheLer should be
avolded Lo prevenL lnfecLlons
20 Answer A 1he cllenL's selfreporL ls a crlLlcal componenL of paln assessmenL 1he nurse should ask Lhe cllenL
abouL Lhe descrlpLlon of Lhe paln and llsLen carefully Lo Lhe cllenL's words used Lo descrlbe Lhe paln 1he nurse's
lmpresslon of Lhe cllenL's paln ls noL approprlaLe ln deLermlnlng Lhe cllenL's level of paln nonverbal cues from Lhe
cllenL are lmporLanL buL are noL Lhe mosL approprlaLe paln assessmenL measure Assesslng paln rellef ls an
lmporLanL measure buL Lhls opLlon ls noL relaLed Lo Lhe sub[ecL of Lhe quesLlon
21 Answer A 1he cllenL ls kepL nC unLll perlsLalsls reLurns usually ln 4 Lo 6 days When slgns of bowel funcLlon
reLurn clear flulds are glven Lo Lhe cllenL lf no dlsLenLlon occurs Lhe dleL ls advanced as LoleraLed 1he mosL
lmporLanL assessmenL ls Lo assess bowel sounds before feedlng Lhe cllenL CpLlons 8 C and u are unrelaLed Lo Lhe
sub[ecL of Lhe quesLlon
22 Answer u Podgkln's dlsease ls a chronlc progresslve neoplasLlc dlsorder of lymphold Llssue characLerlzed by
Lhe palnless enlargemenL of lymph nodes wlLh progresslon Lo exLralymphaLlc slLes such as Lhe spleen and llver
WelghL loss ls mosL llkely Lo be noLed laLlgue and weakness may occur buL are noL relaLed slgnlflcanLly Lo Lhe
dlsease
23 Answer u Cllnlcal manlfesLaLlons of ovarlan cancer lnclude abdomlnal dlsLenLlon urlnary frequency and
urgency pleural effuslon malnuLrlLlon paln from pressure caused by Lhe growlng Lumor and Lhe effecLs of urlnary
or bowel obsLrucLlon consLlpaLlon asclLes wlLh dyspnea and ulLlmaLely general severe paln Abnormal bleedlng
ofLen resulLlng ln hypermenorrhea ls assoclaLed wlLh uLerlne cancer
24 Answer u ConlzaLlon procedure lnvolves removal of a coneshaped area of Lhe cervlx CompllcaLlons of Lhe
procedure lnclude hemorrhage lnfecLlon and cervlcal sLenosls Cvarlan perforaLlon ls noL a compllcaLlon
23 Answer A 1umors LhaL orlglnaLe from bonemuscle and oLher connecLlve Llssue are called sarcomas
26 Answer C uenlal bargalnlng anger depresslon and accepLance are recognlzed sLages LhaL a person faclng a
llfeLhreaLenlng lllness experlences 8argalnlng ldenLlfles a behavlor ln whlch Lhe lndlvldual ls wllllng Lo do anyLhlng
Lo avold loss or change prognosls or faLe uenlal ls expressed as shock and dlsbellef and may be Lhe flrsL response
Lo hearlng bad news uepresslon may be manlfesLed by hopelessness weeplng openly or remalnlng quleL or
wlLhdrawn Anger also may be a flrsL response Lo upseLLlng news and Lhe predomlnanL Lheme ls why me?" or Lhe
blamlng of oLhers
2 Answer 8 Arm edema on Lhe operaLlve slde (lymphedema) ls a compllcaLlon followlng masLecLomy and can
occur lmmedlaLely posLoperaLlvely or may occur monLhs or even years afLer surgery CpLlons A C and u are
expecLed occurrences followlng masLecLomy and do noL lndlcaLe a compllcaLlon
28 Answer 8 1he mosL common rlsk facLor assoclaLed wlLh laryngeal cancer ls clgareLLe smoklng Peavy alcohol
use and Lhe comblned use of Lobacco lncrease Lhe rlsk AnoLher rlsk facLor ls exposure Lo envlronmenLal
polluLanLs
29 Answer 8 A veslcovaglnal flsLula ls a genlLal flsLula LhaL occurs beLween Lhe bladder and vaglna 1he flsLula ls
an abnormal openlng beLween Lhese Lwo body parLs and lf Lhls occurs Lhe cllenL may experlence dralnage of
urlne Lhrough Lhe vaglna 1he cllenL's complalnL ls noL assoclaLed wlLh opLlons A C and u
30 Answer u Allopurlnol decreases urlc acld producLlon and reduces urlc acld concenLraLlons ln serum and
urlne ln Lhe cllenL recelvlng chemoLherapy urlc acld levels lncrease as a resulL of Lhe masslve cell desLrucLlon LhaL
occurs from Lhe chemoLherapy 1hls medlcaLlon prevenLs or LreaLs hyperurlcemla caused by chemoLherapy
Allopurlnol ls noL used Lo prevenL alopecla nausea or vomlLlng