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The nurse is interviewing a 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 Several days before admission, a client reports finding a small lump in the left breast near the nipple. What should the nurse tell the client to do? a. Inform the physician immediately. b. Squeeze the nipple to check for drainage. c. Check the area after the next menstrual period. d. Put a heating pad on the area to reduce inflammation. The nurse 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. A client with vaginal cancer asks the nurse, "What is the usual treatment for this type of cancer?" Which treatment should the nurse name? a. Surgery b. Chemotherapy c. Radiation d. Immunotherapy A client suspected of having colorectal cancer will require which diagnostic study to confirm the diagnosis? a. Stool Hematest b. Carcinoembryonic antigen (CEA) c. Sigmoidoscopy d. Abdominal computed tomography (CT) scan The nurse 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. For a 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." A nurse is working with a dying client and his family. Which communication technique is most important to use? a. Reflection b. Interpretation c. Clarification d. Active listening Which finding is an early indicator of bladder cancer? a. Painless hematuria b. Occasional polyuria c. Nocturia d. Dysuria Which client has the highest risk of ovarian cancer? a. 30-year-old woman taking oral contraceptives b. 45-year-old woman who has never been pregnant c. 40-year-old woman with three children d. 36-year-old woman who had her first child at age 22

The nurse is instructing a premenopausal woman about breast self-examination. The nurse should tell the client to do her self-examination: a. at the end of her menstrual cycle. b. on the same day each month. c. on the 1st day of the menstrual cycle. d. immediately after her menstrual period. To combat the most common adverse effects of chemotherapy, the nurse would administer an: a. antiemetic. b. antimetabolite. c. antibiotic. d. anticoagulant. After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? a. Serving small portions of bland food b. Encouraging rhythmic breathing exercises c. Administering metoclopramide (Reglan) and dexamethasone (Decadron) as prescribed d. Withholding fluids for the first 4 to 6 hours after chemotherapy administration To treat cervical cancer, a client has had an applicator of radioactive material placed in the vagina. Which observation by the nurse indicates a radiation hazard? a. The client is maintained on strict bed rest. b. The head of the bed is at a 30-degree angle. c. The client receives a complete bed bath each morning. d. The nurse checks the applicator's position every 4 hours. A client receives a sealed radiation implant to treat cervical cancer. When caring for this client, the nurse should: a. consider the client's urine, feces, and vomitus to be highly radioactive. b. consider the client to be radioactive for 10 days after implant removal. c. allow soiled linens to remain in the room until after the client is discharged. d. maintain the client on complete bed rest with bathroom privileges only. A client seeks care for hoarseness that has lasted for 1 month. To elicit the most appropriate information about this problem, the nurse should ask which question? a. "Do you smoke cigarettes, cigars, or a pipe?" b. "Have you strained your voice recently?" c. "Do you eat a lot of red meat?" d. "Do you eat spicy foods?" A client with cancer is being evaluated for possible metastasis. Which of the following is one of the most common metastasis sites for cancer cells? a. Liver b. Colon c. Reproductive tract d. White blood cells (WBCs) A 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 A client in the terminal stage of cancer is receiving a continuous infusion of morphine (Duramorph) for pain management. Which assessment finding suggests that the client is experiencing an adverse effect of this drug? a. Voiding of 350 ml of concentrated urine in 8 hours b. Respiratory rate of 8 breaths/minute c. Irregular heart rate of 82 beats/minute d. Pupils constricted and equal

A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: TIS, N0, M0. What does this classification mean? a. No evidence of primary tumor, no abnormal regional lymph nodes, and no evidence of distant metastasis b. Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis c. Can't assess tumor or regional lymph nodes and no evidence of metastasis d. Carcinoma in situ, no demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis A client who reports increasing difficulty swallowing, weight loss, and fatigue is diagnosed with esophageal cancer. Because this client has difficulty swallowing, the nurse should assign highest priority to: a. helping the client cope with body image changes. b. ensuring adequate nutrition. c. maintaining a patent airway. d. preventing injury. The nurse is caring for a client with bronchogenic carcinoma. Which nursing diagnosis takes highest priority? a. Disturbed body image related to changes in body functions b. Ineffective airway clearance related to obstruction by a tumor or secretions c. Anxiety related to actual threat to health status and changes in family dynamics d. Imbalanced nutrition: Less than body requirements related to anorexia and vomiting secondary to chemotherapy A client is in isolation after receiving an internal radioactive implant to treat cancer. Two hours later, the nurse discovers the implant in the bed linens. What should the nurse do first? a. Stand as far away from the implant as possible and call for help. b. Pick up the implant with long-handled forceps and place it in a lead-lined container. c. Leave the room and notify the radiation therapy department immediately. d. Put the implant back in place, using forceps and a shield for self-protection, and call for help. A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of Risk for impaired skin integrity. Which intervention should be part of this client's plan of care? a. Avoiding using soap on the irradiated areas b. Applying talcum powder to the irradiated areas daily after bathing c. Wearing a lead apron during direct contact with the client d. Removing thoracic skin markings after each radiation treatment The nurse is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover: a. cancerous lumps. b. areas of thickness or fullness. c. changes from previous self-examinations. d. fibrocystic masses. At a public health fair, a nurse discusses the dangers of sun exposure. Prolonged sun exposure has been blamed for which form of cancer? a. Malignant melanoma b. Squamous cell carcinoma c. Basal cell epithelioma d. All of the above

A 35-year-old female client is requesting information about mammograms and breast cancer. She isn't considered at high risk for breast cancer. What should the nurse tell this client? a. She should have had a baseline mammogram before age 30. b. She should eat a low-fat diet to further decrease her risk of breast cancer. c. She should perform breast self-examination during the first 5 days of each menstrual cycle. d. When she begins having yearly mammograms, breast self-examinations will no longer be necessary. What should a male client over age 50 do to help ensure early identification of prostate cancer? a. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly. b. Have a transrectal ultrasound every 5 years. c. Perform monthly testicular selfexaminations, especially after age 50. d. Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly. The American Cancer Society recommends routine screening to detect colorectal cancer. Which screening test for colorectal cancer should the nurse recommend? a. Carcinoembryonic antigen (CEA) test after age 50 b. Proctosigmoidoscopy after age 30 c. Annual digital examination after age 40 d. Barium enema after age 20 A client with ovarian cancer is prescribed hydroxyurea (Hydrea), an antimetabolite drug. Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. The mechanism of action of antimetabolites interferes with: a. cell division or mitosis during the M phase of the cell cycle. b. normal cellular processes during the S phase of the cell cycle. c. the chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (cell cyclenonspecific). d. one or more stages of ribonucleic acid (RNA) synthesis, DNA synthesis, or both (cell cyclenonspecific). A client asks the nurse what PSA is. The nurse should reply that it stands for: a. prostate-specific antigen, which is used to screen for prostate cancer. b. protein serum antigen, which is used to determine protein levels. c. pneumococcal strep antigen, which is a bacteria that causes pneumonia. d. Papanicolaou-specific antigen, which is used to screen for cervical cancer. A 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 The nurse is teaching a male client to perform monthly testicular self-examinations. Which of the following points would be appropriate to make? a. Testicular cancer is a highly curable type of cancer. b. Testicular cancer is very difficult to diagnose. c. Testicular cancer is the number one cause of cancer deaths in males.

d.

Testicular cancer is more common in older men.

During a breast examination, which finding most strongly suggests that the client has breast cancer? a. Slight asymmetry of the breasts b. A fixed nodular mass with dimpling of the overlying skin c. Bloody discharge from the nipple d. Multiple firm, round, freely movable masses that change with the menstrual cycle A client is undergoing a diagnostic workup for suspected testicular cancer. When obtaining the client's history, the nurse checks for known risk factors for this type of cancer. Testicular cancer has been linked to: a. testosterone therapy during childhood. b. sexually transmitted disease. c. early onset of puberty. d. cryptorchidism. A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis (inflammation of the mouth)? a. White, cottage cheeselike patches on the tongue b. Yellow tooth discoloration c. Red, open sores on the oral mucosa d. Rust-colored sputum The nurse 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. A client, age 42, 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 The nurse is teaching a class about breast self-examinations. A client asks if she should have an annual mammogram. According to the American Cancer Society, how should the nurse respond? a. All women over age 30 should have an annual mammogram. b. All women over age 40 should have an annual mammogram. c. Any woman over age 20 whose mother had breast cancer should have an annual mammogram. d. Any woman who feels she is at risk for breast cancer should have an annual mammogram. A client has an abnormal result on a Papanicolaou test. After admitting that she read her 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

A 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. At a health fair, an oncology nurse answers questions about risk factors for various types of cancer. One person with a family history of colon cancer asks the nurse to identify risk factors for this type of cancer. The nurse should identify: a. smoking. b. heavy alcohol consumption. c. obesity. d. saccharin consumption. A home care nurse assesses for disease complications in a client with bone cancer. The nurse knows that bone cancer may cause which electrolyte disturbance? a. Hyperkalemia b. Hypercalcemia c. Hyponatremia d. Hypomagnesemia On a visit to the gynecologist, a client complains of urinary frequency, pelvic discomfort, and weight loss. After a complete physical examination, blood studies, and a pelvic examination with a Papanicolaou test, the physician diagnoses stage IV ovarian cancer. The nurse expects to prepare the client for which initial treatment? a. Radiation therapy b. Major surgery c. Chemotherapy d. None (At this advanced stage, ovarian cancer isn't treatable.) During chemotherapy, 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. Which nursing intervention is most likely to decrease the pain of stomatitis? a. Recommending that the client discontinue chemotherapy b. Providing a solution of hydrogen peroxide and water for use as a mouth rinse c. Monitoring the client's platelet and leukocyte counts d. Checking regularly for signs and symptoms of stomatitis At a public health fair, the nurse teaches a group of women about breast cancer awareness. Possible signs of breast cancer include: a. fever. b. breast changes during menstruation. c. nipple discharge and a breast nodule. d. fever and erythema of the breast. As part of a primary cancer prevention program, an oncology nurse answers questions from the public at a health fair. When someone asks about laryngeal cancer, the nurse should explain that: a. laryngeal cancer is one of the most preventable types of cancer. b. inhaling polluted air isn't a risk factor for laryngeal cancer. c. laryngeal cancer occurs primarily in women. d. adenocarcinoma accounts for most cases of laryngeal cancer. A client with stage II ovarian cancer undergoes a total abdominal hysterectomy and bilateral salpingo-oophorectomy with tumor resection, omentectomy, appendectomy, and lymphadenectomy. During the second postoperative day, which of the following assessment findings would raise concern in the nurse? a. Abdominal pain b. Hypoactive bowel sounds c. Serous drainage from the incision

d.

Shallow breathing and increasing lethargy

A 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 The nurse administers chemotherapeutic drugs to a client with cancer. What adverse effects are most common? a. Painful mouth sores b. Frequent diarrhea c. Nausea and vomiting d. Constipation A client in the final stages of terminal cancer tells his nurse: "I wish I could just be allowed to die. I'm tired of fighting this illness. I have lived a good life. I only continue my chemotherapy and radiation treatments because my family wants me to." What is the nurse's best response? a. "Would you like to talk to a psychologist about your thoughts and feelings?" b. "Would you like to talk to your minister about the significance of death?" c. "Would you like to meet with your family and your physician about this matter?" d. "I know you are tired of fighting this illness, but death will come in due time." An oncology nurse educator is speaking to a women's group about breast cancer. Questions and comments from the audience reveal a misunderstanding of some aspects of the disease. Various members of the audience have made all of the following statements. Which one is accurate? a. Mammography is the most reliable method for detecting breast cancer. b. Breast cancer is the leading killer of women of childbearing age. c. Breast cancer requires a mastectomy. d. Men can develop breast cancer. A 52-year-old female tells the nurse that she has found a painless lump in her right breast during her monthly selfexamination. Which assessment finding would strongly suggest that this client's lump is cancerous? a. Eversion of the right nipple and mobile mass b. Nonmobile mass with irregular edges c. Mobile mass that is soft and easily delineated d. Nonpalpable right axillary lymph nodes The nurse is caring for a client with a diagnosis of cancer who is immunosuppressed. The nurse would consider implementingneutropenicprecautions if the clients white blood cell was which of the following? a. 2000 cells/cu.mm b. 5800 cells/cu.mm c. 8400 cells/cu.mm d. 11500 cells/cu.mm The nurse is instructing the client to perform a testicular selfexamination. The nurse tells the client: a. Examine the testicles while lying down b. That the best time for the examination is after a shower c. To gently feel the testicle with one finger to feel for a growth d. That testicular self-examination should be done at least once a month Which of the following, if identified by a client as a risk factor for cervical cancer, indicates a need for further teaching? a. Smoking b. Multiple sex partners c. First intercourse after the age of 20 d. Annual gynaecological examinations

The client suspected of an ovarian tumor is scheduled for a pelvic ultrasound. The nurse provides which preprocedure instruction to the client? a. Eat light breakfast only b. Maintain an NPO status before the procedure c. Wear comfortable clothing and shoes for the procedure d. Drink six to eight glasses of water without voiding before the procedure. A client is diagnosed of colon tumor. The nurse understands that which test will confirm the diagnosis of malignancy? a. Biopsy of the tumor b. Abdominal ultrasound c. Magnetic resonance imaging d. Computed tomography scan 1.Which of the following is not a sign of testicular cancer? a. Alopecia b. Back pain c. Painless testicular swelling d. Heavy sensation in the scrotum 2.A client is receiving external radiation to the neck for cancer of the larynx. The most likely side effect would be: a. Dyspnea b. Diarrhea c. Sore throat d. Constipation 3.When caring for a patient with an internal radiation implant, the nurse should observe which of the following principles? a. Limit time with the client to 1 hour per shift b. Do not allow pregnant women in the clients room c. Remove dosimeter badge when entering the clients room d. Individuals younger than 16 year old may be allowed to go in the room as long as they are 6 feet away from the client 4.The nurse is expecting neutropenia as a result of chemotherapy. The nurse plans to: a. Restrict all visitors b. Restrict fluid intake c. Teach the client and family about the need for hand hygiene d. Insert indwelling urinary catheter to prevent skin breakdown 5.A client has an advanced ovarian cancer, the nurse recognizes which symptom as typical of this disease? a. Diarrhea b. Hypermenorrhea c. Abnormal bleeding d. Abdominal distension 6.Which statement by a client indicates a need for further teaching about testicular self examination? a. TSE is performed once a month b. TSE should be performed on the same day each month c. The scrotum is held in onehand and testicle rolled in the thumb and forefinger of theother hand d. It is best to do TSE first thing in the morning before bathing or shower. 7.A nurse is counselling a client about decreasing the risk for cervical cancer. Which statement by theclient indicates a need for further counseling? a. I need to keep appointments for Pap smear at the frequency advised by my physician b. I need to seek prompt treatment for vaginalis c. Condoms are needed only if I do not trust a new partner d. A partner who is uncircumcised will present an increased risk. 8.Early signs of cervical cancer is: a. Dark foul-smelling vaginal discharge b. Abdominal pain c. Constant and profuse bleeding d. Irregular vaginal bleeding or spotting

9.For a client with stomatitis resulting from chemotherapy, the care plan should include which intervention? a. Inspect mouth every week for fungus b. Encourage foods with neutral or cool temperatures c. Give the client spicy foods to stimulate the sense of taste d. Perform frequent oral hygiene using commercial or alcohol-based mouthwash 10.The most common risk factor for laryngeal cancer is: a. Alcohol abuse b. Cigarette smoking c. Use of chewing tobacco d. Exposure to air pollutants 11.A nurse provides teaching session to group of nursing students. Which statement, if made by a nurse, indicates need for further teaching? a. Bladder cancer most often occurs in women b. Using cigarettes and coffee drinking can increase the risk c. Bladder cancer generally is seen in clients older than 40 d. Environmental health hazards have been attributed as a cause 12.The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm? a. Placing cool compress on the affected arm b. Elevating the affected arm on a pillow above the heart level c. Avoiding arm exercises in the immediate postoperative period d. Maintaining an intravenous site below the antecubital area on the affected side 13.The nurse is preparing a client for a mammography. The nurse tells the client: a. That mammography takes about 1 hour b. That there is no discomfort associated with the procedure c. To maintain NPO status on the day of test d. To avoid the use of deodorants, powders or creams on the day of the test 14.A client has under mastectomy. The nurse interprets that the client is making the best adjustment to the loss of the breast if which of the following behavior is observed? a. Participating in the care of the surgical drain b. Reading the postoperative care booklet c. Refusing to look at the wound d. Asking for pain medication when needed 15.The nurse instructs the client in breast self examination. The nurse tells the client to lie down and to examine the left breast. The nurse should place a pillow under the: a. Right shoulder b. Left shoulder c. Small of the back d. Right scapula 16.A client is scheduled for Pap smear. The nurse provides instructions to the client regarding preparation for this test. The nurse tells the client that: a. The test can be performed during menstruation b. Fluids are restricted on the day of test c. The test is painless d. Vagina douching is required 2 hours before the test 66.When assessing the laboratory results of the client with bladder cancer and bone metastasis, the nurse notes a calcium level of 12 mg/dl. The nurse recognizes that this is consistent with which oncological emergency? a) hyperkalemia b) hypercalemia c) spinal cord compression d) superior vena cava syndrome

67. The client reports to the nurse that when performing testicular self-examination, he found a lump the size and shape of a pea. The appropriate response to the client is which of the following? a) lumps like that are normal, don't worry b) let me know if it gets bigger next month c) that could be cancer. I'll ask the doctor to examine you d) that's important to report even though it might not be serious 68. The hospice nurse visits a client dying of ovarian cancer. During the visit, the client expresses that "If I can just live long enough to attend my daughter's graduation, I'll be ready to die." Which phase of coping is this client experiencing? a) anger b) denial c) bargaining d) depression 69. The nurse is caring for a client following mastectomy. Which assessment finding indicates that the client is experiencing a complication related to the surgery? a) pain at the incisional site b) armedema on the operative side c) sanguineous drainage in the Jackson-Pratt drain d) complaints of decreased sensation near the operative side 70. The nurse is admitting a client with laryngeal cancer to the nursing unit. The nurse assesses for which most common risk factor for this type of cancer? a) alcohol abuse b) cigarette smoking c) use of chewing tobacco d) exposure to air pollutants 1. The physician has ordered 5 flourouracil, 700 mg IV once a week. When AlingNena hears this, she says to the nurse, "Am I going to lose my hair?" Which is the best response by the nurse? a) 5-flourouracil usually does nit cause loss of hair b) hair loss can occur but a wig can be worn until your hair grows back c) the physician will prescribe a medication to prevent this side effect from occurring d) losing your hair is less traumatic than losing breast 2. AlingNena is being assessed of her nutritional status. She weigh 100 lbs and is 5'8 ft. tall. Her assessment would include the following except: a) a diet history b) anthropometric measurements c) food preferences d) serum protein 3. Which nursing action would best attain the goal of providing and promoting coping for AlingNena? a) tellingAlingNena for her strengths and progress b) planning experienced for her that are conclusive c) helping her to identify her problems and solutions d) giving her information on how to handle her problems 4. The nurse evaluates that zofran (ondansetron) is effective in a client undergoing chemotherapy if which of the following is observed? a) urine output is 1,500 ml/day b) the client can tolerate mechanically soft diet c) the client's anxiety is relieved d) the client was able to sleep 5. A client with cancer of the colon who is receiving chemotherapy tells a nurse that some foods on the metal tray

taste bitter. The nurse would try ti limit which of the following foods that is most likely to cause this taste for the client? a) cantaloupe b) potatoes c) beef d) custard 6. A client suspected of having lung tumor is scheduled for a computerized tomography (CT) scan with dye injection. A nurse tells the client that a) the test may be painful b) the dye injected may cause a warm, flushing sensation c) fluids will be restricted following the test d) the test takes approximately 2 hours 7. Which of the following is a nursing responsibility for a client undergoing external radiation therapy? a) wear gown, gloves and mask b) observe time, distance, and shielding c) provide the client adequate rest and schedule activity d) place the client in isolation for few days 8. Who among these clients is at high risk to develop testicular cancer? a) the client has undescended testes at birth b) the client has human papilloma virus c) the client has recurrent urinary tract infection d) the client is uncircumcised 9. A nursing assistant is taking care of a patient who had undergone liver biopsy. When should the registered nurse intervene? a) when the nursing assistant monitors the patient's vital signs every 15 minutes for the 1st two hours after the procedure b) when the nursing assistant tells the patient to remain in bed for several hours c) when the nursing assistant positions the patient on the left side d) when the nursing assistant checks the biopsy site for bleeding 10. Which of the following is a risk factor to cancer of the colon? a) diabetes mellitus b) peptic ulcer c) abdominal hernia d) high fat, high calorie diet 11. Which of the following should the nurse assess prior to administration of cisplatin? a) hydration b) hemoglobin c) weight d) ECG 12. The client is receiving internal radiation therapy. What is the appropriate nursing action to minimize radiation contamination? a) put the soiled linens in double bag b) keep clients things close to her bedside c) always wear gloves when entering the client's room d) minimize contact with the client 13. A client is suspected of having pheochromocytoma. Which of the following signs and symptoms would help support this diagnosis? a) abdominal pain b) anuria c) hypertension d) weight gain

14. Before uterine radioactive implant is inserted, which of the following physician's orders does the nurse expect? a) administer analgesic b) administer sedative c) administer enema d) administer antibiotic 15. The nurse is admitting a patient with jaundice, due to pancreatic cancer. Which of the following would the nurse give highest priority? a) body image b) nutrition c) skin integrity d) anticipatory grieving 16. After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/cu.mm. What term should the nurse use to describe this low platelet count? thrombocytopenia - the normal thrombocyte count is 150,000 to 450,000/ cu.mm 17. Which of the following should the nurse include when providing health teachings for patients at risk of developing prostatic cancer? a) participate in smoking cessation program b) perform monthly self-testicular examination c) maintain daily walking exercise d) undergo monthly digital rectal examination 18. Which of the following questions should the nurse ask in a client who is at risk for breast cancer? a) does your family have a history of multiple gestation? b) does your family have a history of ovarian cancer? c) does your family have a history of early menopause? d) does your family have a history of late menarche? 19. Which of the following client history increases risk for anorectal cancer? a) chronic constipation b) highfiber diet c) alcohol abuse d) chronic inflammatory bowel disease 20. A client will be for uterine radium implant. Which of the following statement when made by the client indicates the need for further teaching? a) my sister is coming to stay with me today after implant insertion b) I will be in bed for the duration of the treatment c) I will have a foley catheter in place d) I will have enema before the procedure 21. Which of the following nursing actions is most appropriate when caring for a client with radium implant? a) wear gloves when entering the client's room b) wear masks and gloves when performing procedures to the client c) avoid staying with the client for more than 30 minutes in a shift d) place client's soiled gowns and linens in a plastic bag 22. A woman had been diagnosed to have breast cancer. Which of the following factors is most significant to her prognosis? a) she had her menarche at age 12 years b) her sister died of breast cancer 5 years ago c) she delivered her first born at age 25 years d) she had her menopause at age 50 years 23. Which of the following are characteristics of a client most susceptible to develop malignant melanoma?

a) dark skin, black hair b) coarse skin, black hair c) fair skin, blond hair d) oily skin, brown hair 24. Which of the following statements when made by the client with implant radiation therapy needs intervention by the nurse? a) I will have to go to the toilet to void b) my visitors are allowed to visit me for 30 minutes only in a day c) the nurse needs to wear a badge when caring for me d) I need to remain in bed during the entire duration of the treatment 25. Which of the following statements when made by the client with leukemia indicates that the client understands the health teachings given by the nurse? Select all that apply a) I am allowed to eat raw foods b) I have to avoid raw fruits and vegetables c) fresh flowers should not be allowed in my room d) if I developed joint pains, I should apply cold compress to the area e) if I developed high fever, I should take aspirin f) I am allowed to watch baseball games g) I should use soft-bristled toothbrush 26. A 40-year old woman is admitted to the hospital for a radiation implant therapy to treat recently diagnosed cervical cancer. The most important consideration when planning care is her a) level of anxiety b) loss of income due to inability to work c) support system d) energy level to perform ADL's 27. When the nurse is discussing risk factors for cervical cancer, which of these women would be at greatest risk? a) a 25-year old woman with family history of cancer and using birth control pills b) a 50-year old woman who has several exposures to radiation and has chronic anemia c) a 19-year old woman who initiated sexual intercourse early with multiple partners d) a 60-year old woman who had smoked cigarettes for 5 years and used diaphragm for birth control 28. Which of the following nursing diagnoses would rank as the most important in the planning of care for a client in two weeks after the chemotherapy has begun? a) potential for infection b) activity intolerance c) impaired skin integrity d) self-esteem disturbance 29. During the administration of a chemotherapeutic drug, the nurse observes that there is a lack of blood return from the intravenous catheter. The priority action by the nurse would be to a) stop the administration of the drug immediately b) reposition the client's arm and continue with the administration of the drug c) apply a tourniquet to the patient's affected arm and notify the doctor d) continue to administer the drug and assess for edema at the IV site 30. A patient who is receiving chemotherapy develops stomatitis. Which of the following actions would be priority for the nurse to incorporate into the plan of care? a) rinse the patient's mouth with full strength hydrogen peroxide every 4 hours b) use a soft toothbrush after each meal

c) provide hot tea with honey to soothe the patient's painful oral mucosa d) use dental floss only 31. Which of these findings in the breast of a patient who is suspected of having breast cancer would support the diagnosis? a) complaints of dull, achy, pain b) palpation of a mobile mass c) presence of an inverted nipple d) area of discoloration skin 32. A nurse is caring for a client with an internal radiation implant. Which of the following instructions is appropriate? a) allow the client to go to the bathroom b) avoid creams and lotions c) visitors are allowed to stay in the room d) the client should remain in bed during the entire duration of treatment 33. How often should a female who is above 40 years old, go for cancer detection examination? a) daily b) weekly c) monthly d) yearly 34. The client is receiving internal radiation therapy. The nurse should a) remember to give the badge to the next-shift nurse b) maintain a 30-minute close contact with the patient in a shift c) wear gloves, mask and gown when entering the client's room d) instruct relatives no to visit the client during the entire duration of the treatment 35. A nurse is assessing a client with metastatic breast cancer who reports nocturia, weakness, nausea and vomiting. The client's serum electrolytes include potassium 4.2 mEq/L, sodium 135 mEq/L, calcium 7.0 mEq/L, and magnesium 2.0 mEq/L. Based on the assessment findings, the priority action for the nurse is to: a) start client on fluid restriction b) administer calcium gluconate c) increase the client's IV fluids d) administer Allopurinol 36. The nurse on the oncology unit enters the room of the client with lung cancer. Which action is most appropriate for the nurse to do first? a) check the client's IV infusion pump and IV fluid rate b) take the client's blood pressure and pulse c) assess the client's mental status d) elevate the client's head of the bed 37. The nurse on the oncology unit is planning care for the client with colon cancer who is refusing a diagnostic test. Which action is most appropriate for the nurse to take first? a) call the radiology department to let them know the client will not be going to take the test b) speak with the client to determine the reason for refusing the test c) inform the health care provider that the client is refusing the test d) ask the client's spouse why the client is refusing the test 38. A nurse is admitting a 63-year old male reporting hemoptysis and weight loss. The nurse identifies that the highest priority risk factor for lung cancer for this client is: a) family history of lung cancer b) the client works in a chemical factory c) the client lives in a coal mining area

d) the client uses chewing tobacco 39. The nurse is caring for a client with a diagnosis of cancer who is immunosuppressed. The nurse would consider implementing neutropenic precautions if the client's white blood cell count was which of the following? a) 2,000 cells/mm3 b) 5,800 cells/mm3 c) 8,400 cells/mm3 d) 11,500 cells/mm3 40. A nurse is caring for a child after removal of a brain tumor. The nurse assesses the child for which of the following signs that would indicate that brainstem involvement occurred during the surgical procedure? a) inability to swallow b) elevated temperature c) altered hearing ability d) orthostatic hypotension 41. The health education nurse provides instructions to a group of clients regarding measures that will assist in preventing skin cancer. Which statement by a client indicates a need for further instructions? a) I will avoid sun exposure after 3 pm b) I will use sunscreen when participating in outdoor activities c) I will wear a hat, opaque clothing, and sunglasses when in the sun d) I will examine my body monthly for any lesions that may be suspicious 42. The client is undergoing radiation therapy to treat lung cancer. Following treatment, the nurse notes erythema on the client's chest and neck, and the client is complaining of pain at the radiation site. The nurse interprets this assessment data a(n): a) allergic reaction to the radiation b) superficial injury to tissue from the radiation c) cutaneous reaction to products formed by the lysis of the neoplastic cells d) ischemic injury, much like pressure ulcer formation. caused by pressure from the linear accelerator 43. The community nurse is conducting a health promotion program at a local school and is discussing the risk factors associated with cervical cancer. Which of the following, if identified by the client as a risk factor to cervical cancer, indicates a need for further teaching? a) smoking b) multiple sex partners c) first intercourse after age 20 d) annualgynecological examinations 44. The client is diagnosed as having a bowel tumor and several diagnostic tests are prescribed. The nurse understands that which test will confirm the diagnosis of malignancy? a) biopsy of tumor b) abdominal ultrasound c) magnetic resonance imaging d) computed tomography scan 45. The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which of the following would the nurse expect to note specifically in this disorder? a) increased calcium level b) increased white blood cells c) decreased blood urea nitrogen level d) decreased number of plasma cells in the bone marrow 46. The nurse is instructing the client to perform a testicular self-examination. The nurse tells the client: a) to examine the testicles while lying down b)that the best time for the examination is after a shower

c) to gently feel the testicles with one finger to feel for a growth d) that testicular self-examinations should be done at least every 6 months 47. The client with cancer is receiving chemotherapy and develops thrombocytopenia. The nurse identifies which intervention as the highest priority in the nursing plan of care? a) monitoring temperature b) ambulation three times daily c) monitoring the platelet count d) monitoring for pathological fractures 48. The nurse is monitoring the laboratory results of a client preparing to receive chemotherapy. The nurse determines that the white blood cell count is normal if which of the following results were present? a) 2000 to 5000 cells/mm3 b) 3000 to 8000 cells/mm3 c) 5000 to 10000 cells/mm3 d) 7000 to 15000 cells/mm3 49. The community health nurse is instructing a group of female clients about breast self-examination. The nurse instructs the clients to perform the examination: a) at the onset of menstruation b) every month during ovulation c) weekly at the same time of day d) 1 week after menstruation begins 50. The nurse is caring for a client who has undergone vaginal hysterectomy. The nurse avoids which of the following in the care of this client? a) elevating the knee on the bed b) assisting with range-of-motion leg exercises c) removal of antiembolism stockings twice a day d) checking placement of pneumatic compression boots 51. The client suspected of an ovarian tumor is scheduled for a pelvic ultrasound. The nurse provides which pre-procedure instruction to the client? a) eat a light breakfast only b) maintain an NPO before the procedure c) wear comfortable clothing and shoes for the procedure d) drink six to eight glasses of water without voiding before the test 52. A client is diagnosed with multiple myeloma and the client asks the nurse about the diagnosis. The nurse bases the response on which description of this disorder? a) altered red blood cell production b) altered production of lymph nodes c) malignant exacerbation in the number of leukocytes d) malignant proliferation of plasma cells within the bone 53. The oncology nurse specialist provides an educational session to nursing staff regarding the characteristics of Hodgkin's disease. The nurse determines that further teaching is needed if a nursing staff member states that which of the following is a characteristic of the disease? a) presence of Reed-Sternberg cells b) occurs most often in the older client c) prognosis depending on the stage of the disease d) involvement of lymph nodes, spleen, and liver 54. The community health nurse conducts a health promotion program regarding testicular cancer to community members. 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) alopecia b) back pain c) painless testicular swelling

d) heavy sensation in the scrotum 55. The client is receiving external radiation to the neck for cancer of the larynx. The most likely side effect to be expected is: a) dyspnea b) diarrhea c) sore throat d) constipation 56. The nurse is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which of the following principles? a) limit the time with the client to 1 hour per shift b) do not allow pregnant women into the client's room c) remove the dosimeter badge when entering the client's room d) 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 57. A cervical radiation implant is placed in the client for the treatment of cervical cancer. The nurse initiates what most appropriate activity order for this client? a) bed rest b) out of bed ad lib c) out of bed in a chair only d) ambulation to the bathroom only 58. The client is hospitalized for insertion of an internal cervical radiation implant. While giving care, the nurse finds the radiation implant in the bed. The initial action by the nurse is to: a) call the physician b) reinsert the implant into the vagina immediately c) pick up the implant with gloved hands and flush it down the toilet d) pick up the implant with long-handled forceps and place it in a lead container 59. The nurse is caring for a client experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. The nurse plants to: a) restrict all visitors b) restrict fluid intake c) teach the client and family about the need for hand hygiene d) insert an indwelling urinary catheter to prevent skin breakdown 60. The nurse is reviewing the laboratory results of a client receiving chemotherapy whose platelet count is 10,000 cells/mm3. based on this laboratory value, the priority nursing assessment is which of the following? a) assess skin turgor b) assess temperature c) assess bowel sounds d) assess level of consciousness 61.The home health care nurse is caring for a client with cancer and the client is complaining of acute pain. The appropriate nursing assessment of the client's pain would include which of the following? a) the client's pain rating b) nonverbal cues from the client c) the nurse's impression of the client's pain d) pain relief after appropriate nursing intervention 62. The nurse is caring for a client who is a pelvic exenteration and the physician changes the client's diet from NPO status to clear liquids. The nurse makes which priority assessment before administering the diet? a) bowel sounds b) ability to ambulate c) incision appearance d) urine specific gravity 63. The client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment finding would the nurse expect to note specifically in the client? a) fatigue b) weakness c) weight gain

d) enlarged lymph nodes 64. During the admission assessment of a client with advanced ovarian cancer, the nurse recognizes which symptom as typical of the disease? a) diarrhea b) hypermenorrhea c) abnormal bleeding d) abdominaldistention 65. The nurse is reviewing the complications of conization with a client who has microinvasive cervical cancer. Which complication, if identified by the client, indicates a need for further teaching? a) infection b) hemorrhage c) cervical stenosis d) ovarian perforation 66.When assessing the laboratory results of the client with bladder cancer and bone metastasis, the nurse notes a calcium level of 12 mg/dl. The nurse recognizes that this is consistent with which oncological emergency? a) hyperkalemia b) hypercalemia c) spinal cord compression d) superior vena cava syndrome 67. The client reports to the nurse that when performing testicular self-examination, he found a lump the size and shape of a pea. The appropriate response to the client is which of the following? a) lumps like that are normal, don't worry b) let me know if it gets bigger next month c) that could be cancer. I'll ask the doctor to examine you d) that's important to report even though it might not be serious 68. The hospice nurse visits a client dying of ovarian cancer. During the visit, the client expresses that "If I can just live long enough to attend my daughter's graduation, I'll be ready to die." Which phase of coping is this client experiencing? a) anger b) denial c) bargaining d) depression 69. The nurse is caring for a client following mastectomy. Which assessment finding indicates that the client is experiencing a complication related to the surgery? a) pain at the incisional site b) armedema on the operative side c) sanguineous drainage in the Jackson-Pratt drain d) complaints of decreased sensation near the operative side 70. The nurse is admitting a client with laryngeal cancer to the nursing unit. The nurse assesses for which most common risk factor for this type of cancer a) alcohol abuse b) cigarette smoking c) use of chewing tobacco d) exposure to air pollutants 1.Which statement reflects useful information to include in a teaching plan for a cancer patient? a) Cancer is a group of diseases. The cancer cells are different from the cells in the tissue of origin in growth and the spreading of abnormal cells. b) Cancer is the third leading cause of death in the United States. Many hospitals have the highest number of patients with this diagnosis. c) Americans who have a diagnosis of cancer die within a year or less. d) When a person is genetically predisposed to a type of cancer, there is nothing that can be done to prevent its occurrence. 2.Helpful sources of information that the nurse may use in beginning to develop a teaching

plan for patients having cancer diagnostic testing include: a)other patients, visitors, or hospital workers who have been associated with someone who has had cancer. b)analysis of what the patient and family already know about prevention, detection, treatment, and outcomes. c)American Cancer Society (ACS), National Cancer Institute, Oncology Nursing Society, VFW, or DAV. d)supermarket tabloids or public books from the local library. 3.Identification of cancer risks is part of every nurses assessment skills. Some of the most common of these signs and symptoms include: a)appearance of recent skin area changes that look markedly unlike surrounding tissues. b)exposure to street repairs by smoothing newly laid concrete. c)coughs and colds that respond quickly to ampicillin and tea with honey. d) frequently forgetting monthly breast self-examination. 4. A patient is receiving another course of chemotherapy as his cancer treatment after some previous radiation treatments. He asks about several cancer words, which he has heard referring to him. Correct interpretation of these words for this patient are that: a)alopecia refers to the darkening of the skin over his cancer area. b)carcinogen refers to some of the materials in his environment such as cigarettes, asbestos, and mercury. c)biotherapy refers to special diet foods and specific vitamins that he will need to take on a regular basis now. d)antineoplastic refers to drugs that increase the spread of his cancer. 5.The nurse includes in the teaching plan that malignant tumors are similar to benign tumors because both: a)contain cells that closely resemble those in the tissue of origin. b)travel quickly to invade and destroy other tissues and organs. c)always grow and multiply very rapidly, competing for space and nutrients and causing severe pain. d)may press on nearby surrounding tissues, such as nerves and blood vessels, causing pain. A patient has a cancer that has been staged as T3 N2 M3. He has a PRN order of morphine, 4 mg, IM q3-4hr. He requests another pain shot about hours after the last one. An appropriate nursing action would be to: 1. inform the patient that this narcotic may be given only every 4 hours to prevent addiction. 2. ignore the call bell for 20 minutes, and then take at least 10 minutes to prepare and administer the injection. 3. give the morphine; evaluate the results of pain relief. Arrange for the physician to evaluate for breakthrough pain. 4. ask the family to assist in helping the patient accept waiting longer to receive an addicting medication such as morphine. A patient is scheduled for a chemotherapy treatment in about 30 minutes. Breakfast trays have arrived and are being served on the unit. The nurses best intervention would be to: 1. encourage the patient to eat all his breakfast to keep up his strength to fight the cancer. Remind the patient that breakfast is about one third of daily intake. 2. listen attentively to any concerns that the patient voices regarding the treatment. Offer to hold his tray until after the treatment. 3. offer to call the family to come and be present after the treatment. Encourage the patient to drink at least all of orange juice and coffee. 4. suggest that the patient request a dose of strong analgesic instead of eating, because this treatment is very painful. ANS: 2