1. Nina, an oncology nurse educator is speaking to a womens 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. !ammography is the most reliable method for detecting breast cancer.
b. "reast cancer is the leading killer of women of childbearing age.
c. "reast cancer re#uires a mastectomy.
d. !en can develop breast cancer.
$nswer %. !en can develop breast cancer, although they seldom do. &he most reliable method for
detecting breast cancer is monthly self'e(amination, not mammography. )ung cancer causes more deaths than
breast cancer in women of all ages. $ mastectomy may not be re#uired if the tumor is small, confined, and in an
early stage.
*. Nurse !eredith is instructing a premenopausal woman about breast self'e(amination. &he nurse should tell
the client to do her self'e(amination+
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.
$nswer %. ,remenopausal women should do their self'e(amination immediately after the menstrual
period, when the breasts are least tender and least lumpy. -n the 1st and last days of the cycle, the womans
breasts are still very tender. ,ostmenopausal women because their bodies lack fluctuation of hormone levels,
should select one particular day of the month to do breast self'e(amination.
.. Nurse /ent is teaching a male client to perform monthly testicular self'e(aminations. Which of the
following points would be appropriate to make
a. &esticular cancer is a highly curable type of cancer.
b. &esticular cancer is very difficult to diagnose.
c. &esticular cancer is the number one cause of cancer deaths in males.
d. &esticular cancer is more common in older men.
$nswer $. &esticular cancer is highly curable, particularly when its treated in its early stage. 0elf'
e(amination allows early detection and facilitates the early initiation of treatment. &he highest mortality rates
from cancer among men are in men with lung cancer. &esticular cancer is found more commonly in younger
men.
1. 2hea, has malignant lymphoma. $s part of her chemotherapy, the physician prescribes chlorambucil
3)eukeran4, 15 mg by mouth daily. When caring for the client, the nurse teaches her about adverse reactions to
chlorambucil, such as alopecia. 6ow soon after the first administration of chlorambucil might this reaction
occur
a. 7mmediately
b. 1 week
c. * to . weeks
d. 1 month
$nswer 8. 8hlorambucil'induced alopecia occurs * to . weeks after therapy begins.
9. $ male client is receiving the cell cycle:nonspecific alkylating agent thiotepa 3&hiople(4, ;5 mg weekly for
1 weeks by bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. &he client asks the
nurse how the drug works. 6ow does thiotepa e(ert its therapeutic effects
a. 7t interferes with deo(yribonucleic acid 3%N$4 replication only.
b. 7t interferes with ribonucleic acid 32N$4 transcription only.
c. 7t interferes with %N$ replication and 2N$ transcription.
d. 7t destroys the cell membrane, causing lysis.
$nswer 8. &hiotepa interferes with %N$ replication and 2N$ transcription. 7t doesnt destroy the cell
membrane.
;. &he nurse is instructing the .9 year old client to perform a testicular self'e(amination. &he nurse tells the
client+
a. &o e(amine the testicles while lying down
b. &hat the best time for the e(amination is after a shower
c. &o gently feel the testicle with one finger to feel for a growth
d. &hat testicular self'e(amination should be done at least every ; months
$nswer ". &he testicular'self e(amination is recommended monthly after a warm bath or shower when
the scrotal skin is rela(ed. &he client should stand to e(amine the testicles. <sing both hands, with fingers under
the scrotum and thumbs on top, the client should gently roll the testicles, feeling for any lumps.
=. $ female client with cancer is receiving chemotherapy and develops thrombocytopenia. &he nurse identifies
which intervention as the highest priority in the nursing plan of care
a. !onitoring temperature
b. $mbulation three times daily
c. !onitoring the platelet count
d. !onitoring for pathological fractures
$nswer 8. &hrombocytopenia indicates a decrease in the number of platelets in the circulating blood. $
ma>or concern is monitoring for and preventing bleeding. -ption $ elates to monitoring for infection,
particularly if leukopenia is present. -ptions " and %, although important in the plan of care, are not related
directly to thrombocytopenia.
?. @ian, a community health nurse is instructing a group of female clients about breast self'e(amination. &he
nurse instructs the client to perform the e(amination+
a. $t the onset of menstruation
b. Avery month during ovulation
c. Weekly at the same time of day
d. 1 week after menstruation begins
$nswer %. &he breast self'e(amination should be performed monthly = days after the onset of the
menstrual period. ,erforming the e(amination weekly is not recommended. $t the onset of menstruation and
during ovulation, hormonal changes occur that may alter breast tissue.
B. Nurse 8ecilia is caring for a client who has undergone a vaginal hysterectomy. &he nurse avoids which of
the following in the care of this client
a. Alevating the knee gatch on the bed
b. $ssisting with range'of'motion leg e(ercises
c. 2emoval of antiembolism stockings twice daily
d. 8hecking placement of pneumatic compression boots
$nswer $. &he client is at risk of deep vein thrombosis or thrombophlebitis after this surgery, as for any
other ma>or surgery. Cor this reason, the nurse implements measures that will prevent this complication. 2ange'
of'motion e(ercises, antiembolism stockings, and pneumatic compression boots are helpful. &he nurse should
avoid using the knee gatch in the bed, which inhibits venous return, thus placing the client more at risk for deep
vein thrombosis or thrombophlebitis.
15. !ina, who is suspected of an ovarian tumor is scheduled for a pelvic ultrasound. &he nurse provides
which preprocedure instruction to the client
a. Aat a light breakfast only
b. !aintain an N,- status before the procedure
c. Wear comfortable clothing and shoes for the procedure
d. %rink si( to eight glasses of water without voiding before the test
$nswer %. $ pelvic ultrasound re#uires the ingestion of large volumes of water >ust before the
procedure. $ full bladder is necessary so that it will be visualiDed as such and not mistaken for a possible pelvic
growth. $n abdominal ultrasound may re#uire that the client abstain from food or fluid for several hours before
the procedure. -ption 8 is unrelated to this specific procedure.
11. $ male client is diagnosed as having a bowel tumor and several diagnostic tests are prescribed. &he nurse
understands that which test will confirm the diagnosis of malignancy
a. "iopsy of the tumor
b. $bdominal ultrasound
c. !agnetic resonance imaging
d. 8omputeriDed tomography scan
$nswer $. $ biopsy is done to determine whether a tumor is malignant or benign. !agnetic resonance
imaging, computed tomography scan, and ultrasound will visualiDe the presence of a mass but will not confirm
a diagnosis of malignancy.
1*. $ female client diagnosed with multiple myeloma and the client asks the nurse about the diagnosis. &he
nurse bases the response on which description of this disorder
a. $ltered red blood cell production
b. $ltered production of lymph nodes
c. !alignant e(acerbation in the number of leukocytes
d. !alignant proliferation of plasma cells within the bone
$nswer %. !ultiple myeloma is a "'cell neoplastic condition characteriDed by abnormal malignant
proliferation of plasma cells and the accumulation of mature plasma cells in the bone marrow. -ptions $ and "
are not characteristics of multiple myeloma. -ption 8 describes the leukemic process.
1.. Nurse "ea is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which of the
following would the nurse e(pect to note specifically in this disorder
a. 7ncreased calcium
b. 7ncreased white blood cells
c. %ecreased blood urea nitrogen level
d. %ecreased number of plasma cells in the bone marrow
$nswer $. Cindings indicative of multiple myeloma are an increased number of plasma cells in the bone
marrow, anemia, hypercalcemia caused by the release of calcium from the deteriorating bone tissue, and an
elevated blood urea nitrogen level. $n increased white blood cell count may or may not be present and is not
related specifically to multiple myeloma.
11. Vanessa, a community health nurse conducts a health promotion program regarding testicular cancer to
community members. &he 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. $lopecia
b. "ack pain
c. ,ainless testicular swelling
d. 6eavy sensation in the scrotum
$nswer $. $lopecia is not an assessment finding in testicular cancer. $lopecia may occur, however, as a
result of radiation or chemotherapy. -ptions ", 8, and % are assessment findings in testicular cancer. "ack pain
may indicate metastasis to the retroperitoneal lymph nodes.
19. &he male client is receiving e(ternal radiation to the neck for cancer of the laryn(. &he most likely side
effect to be e(pected is+
a. %yspnea
b. %iarrhea
c. 0ore throat
d. 8onstipation
$nswer 8. 7n general, only the area in the treatment field is affected by the radiation. 0kin reactions,
fatigue, nausea, and anore(ia may occur with radiation to any site, whereas other side effects occur only when
specific areas are involved in treatment. $ client receiving radiation to the laryn( is most likely to e(perience a
sore throat. -ptions " and % may occur with radiation to the gastrointestinal tract. %yspnea may occur with
lung involvement.
1;. Nurse Eoy 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. )imit the time with the client to 1 hour per shift
b. %o not allow pregnant women into the clients room
c. 2emove the dosimeter badge when entering the clients room
d. 7ndividuals younger than 1; years old may be allowed to go in the room as long as they are ; feet away
from the client
$nswer ". &he time that the nurse spends in a room of a client with an internal radiation implant is .5
minutes per ?'hour shift. &he dosimeter badge must be worn when in the clients room. 8hildren younger than
1; years of age and pregnant women are not allowed in the clients room.
1=. $ cervical radiation implant is placed in the client for treatment of cervical cancer. &he nurse initiates what
most appropriate activity order for this client
a. "ed rest
b. -ut of bed ad lib
c. -ut of bed in a chair only
d. $mbulation to the bathroom only
$nswer $. &he client with a cervical radiation implant should be maintained on bed rest in the dorsal
position to prevent movement of the radiation source. &he head of the bed is elevated to a ma(imum of 15 to 19
degrees for comfort. &he nurse avoids turning the client on the side. 7f turning is absolutely necessary, a pillow
is placed between the knees and, with the body in straight alignment, the client is logrolled.
1?. $ female client is hospitaliDed for insertion of an internal cervical radiation implant. While giving care, the
nurse finds the radiation implant in the bed. &he initial action by the nurse is to+
a. 8all the physician
b. 2einsert the implant into the vagina immediately
c. ,ick up the implant with gloved hands and flush it down the toilet
d. ,ick up the implant with long'handled forceps and place it in a lead container.
$nswer %. $ lead container and long'handled forceps should be kept in the clients room at all times
during internal radiation therapy. 7f the implant becomes dislodged, the nurse should pick up the implant with
long'handled forceps and place it in the lead container. -ptions $, ", and 8 are inaccurate interventions.
1B. &he nurse is caring for a female client e(periencing neutropenia as a result of chemotherapy and develops
a plan of care for the client. &he nurse plans to+
a. 2estrict all visitors
b. 2estrict fluid intake
c. &each the client and family about the need for hand hygiene
d. 7nsert an indwelling urinary catheter to prevent skin breakdown
$nswer 8. 7n the neutropenic client, meticulous hand hygiene education is implemented for the client,
family, visitors, and staff. Not all visitors are restricted, but the client is protected from persons with known
infections. Cluids should be encouraged. 7nvasive measures such as an indwelling urinary catheter should be
avoided to prevent infections.
*5. &he home health care nurse is caring for a male client with cancer and the client is complaining of acute
pain. &he appropriate nursing assessment of the clients pain would include which of the following
a. &he clients pain rating
b. Nonverbal cues from the client
c. &he nurses impression of the clients pain
d. ,ain relief after appropriate nursing intervention
$nswer $. &he clients self'report is a critical component of pain assessment. &he nurse should ask the
client about the description of the pain and listen carefully to the clients words used to describe the pain. &he
nurses impression of the clients pain is not appropriate in determining the clients level of pain. Nonverbal
cues from the client are important but are not the most appropriate pain assessment measure. $ssessing pain
relief is an important measure, but this option is not related to the sub>ect of the #uestion.
*1. Nurse !ickey is caring for a client who is postoperative following a pelvic e(enteration and the physician
changes the clients diet from N,- status to clear li#uids. &he nurse makes which priority assessment before
administering the diet
a. "owel sounds
b. $bility to ambulate
c. 7ncision appearance
d. <rine specific gravity
$nswer $. &he client is kept N,- until peristalsis returns, usually in 1 to ; days. When signs of bowel
function return, clear fluids are given to the client. 7f no distention occurs, the diet is advanced as tolerated. &he
most important assessment is to assess bowel sounds before feeding the client. -ptions ", 8, and % are
unrelated to the sub>ect of the #uestion.
**. $ male client is admitted to the hospital with a suspected diagnosis of 6odgkins disease. Which
assessment findings would the nurse e(pect to note specifically in the client
a. Catigue
b. Weakness
c. Weight gain
d. Anlarged lymph nodes
$nswer %. 6odgkins disease is a chronic progressive neoplastic disorder of lymphoid tissue
characteriDed by the painless enlargement of lymph nodes with progression to e(tralymphatic sites, such as the
spleen and liver. Weight loss is most likely to be noted. Catigue and weakness may occur but are not related
significantly to the disease.
*.. %uring the admission assessment of a .9 year old client with advanced ovarian cancer, the nurse
recogniDes which symptom as typical of the disease
a. %iarrhea
b. 6ypermenorrhea
c. $bdominal bleeding
d. $bdominal distention
$nswer %. 8linical manifestations of ovarian cancer include abdominal distention, urinary fre#uency
and urgency, pleural effusion, malnutrition, pain from pressure caused by the growing tumor and the effects of
urinary or bowel obstruction, constipation, ascites with dyspnea, and ultimately general severe pain. $bnormal
bleeding, often resulting in hypermenorrhea, is associated with uterine cancer.
*1. Nurse /ate is reviewing the complications of coloniDation with a client who has microinvasive cervical
cancer. Which complication, if identified by the client, indicates a need for further teaching
a. 7nfection
b. 6emorrhage
c. 8ervical stenosis
d. -varian perforation
$nswer %. 8oniDation procedure involves removal of a cone'shaped area of the cervi(. 8omplications
of the procedure include hemorrhage, infection, and cervical stenosis. -varian perforation is not a complication.
*9. !r. !iller has been diagnosed with bone cancer. Fou know this type of cancer is classified as+
a. sarcoma.
b. lymphoma.
c. carcinoma.
d. melanoma.
$nswer $. &umors that originate from bone,muscle, and other connective tissue are called sarcomas.
*;. 0arah, a hospice nurse visits a client dying of ovarian cancer. %uring the visit, the client e(presses that G7f
7 can >ust live long enough to attend my daughters graduation, 7ll be ready to die.H Which phrase of coping is
this client e(periencing
a. $nger
b. %enial
c. "argaining
d. %epression
$nswer 8. %enial, bargaining, anger, depression, and acceptance are recogniDed stages that a person
facing a life'threatening illness e(periences. "argaining identifies a behavior in which the individual is willing
to do anything to avoid loss or change prognosis or fate. %enial is e(pressed as shock and disbelief and may be
the first response to hearing bad news. %epression may be manifested by hopelessness, weeping openly, or
remaining #uiet or withdrawn. $nger also may be a first response to upsetting news and the predominant theme
is Gwhy meH or the blaming of others.
*=. Nurse Carah is caring for a client following a mastectomy. Which assessment finding indicates that the
client is e(periencing a complication related to the surgery
a. ,ain at the incisional site
b. $rm edema on the operative side
c. 0anguineous drainage in the Eackson',ratt drain
d. 8omplaints of decreased sensation near the operative site
$nswer ". $rm edema on the operative side 3lymphedema4 is a complication following mastectomy and
can occur immediately postoperatively or may occur months or even years after surgery. -ptions $, 8, and %
are e(pected occurrences following mastectomy and do not indicate a complication.
*?. &he nurse is admitting a male client with laryngeal cancer to the nursing unit. &he nurse assesses for
which most common risk factor for this type of cancer
a. $lcohol abuse
b. 8igarette smoking
c. <se of chewing tobacco
d. A(posure to air pollutants
$nswer ". &he most common risk factor associated with laryngeal cancer is cigarette smoking. 6eavy
alcohol use and the combined use of tobacco increase the risk. $nother risk factor is e(posure to environmental
pollutants.
*B. &he 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. &he nurse interprets that the client may be e(periencing+
a. 2upture of the bladder
b. &he development of a vesicovaginal fistula
c. A(treme stress caused by the diagnosis of cancer
d. $ltered perineal sensation as a side effect of radiation therapy
$nswer ". $ vesicovaginal fistula is a genital fistula that occurs between the bladder and vagina. &he
fistula is an abnormal opening between these two body parts and, if this occurs, the client may e(perience
drainage of urine through the vagina. &he clients complaint is not associated with options $, 8, and %.
.5. &he client with leukemia is receiving busulfan 3!yleran4 and allopurinol 3Iyloprim4. &he nurse tells the
client that the purpose if the allopurinol is to prevent+
a. Nausea
b. $lopecia
c. Vomiting
d. 6yperuricemia
$nswer %. $llopurinol decreases uric acid production and reduces uric acid concentrations in serum and
urine. 7n the client receiving chemotherapy, uric acid levels increase as a result of the massive cell destruction
that occurs from the chemotherapy. &his medication prevents or treats hyperuricemia caused by chemotherapy.
$llopurinol is not used to prevent alopecia, nausea, or vomiting.
0ourceJ 2eference+ http+JJncle(reviewers.comJncle('reviewJoncologyJncle('review'oncology'#uestions'part'
*.html
.1. 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
$nswer 8. 7nversion of nipple is one of the manifestations of breast cancer. $ cancerous lesion is non'
mobile.
.*. $ 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
$nswer %. &he client with internal radiation implant should be on bed rest. &his is to prevent
dislodgment of the implant.
... 6ow often should a female who is above 15 years old, go for cancer detection e(amination
a. daily
b. weekly
c. monthly
d. yearly
$nswer %. 8ancer screening for females who are above 15 years of age should be yearly.
.1. &he client is receiving internal radiation therapy. &he nurse should
a. remember to give the badge to the ne(t'shift nurse
b. maintain a .5'minute close contact with the patient in a shift
c. wear gloves, mask and gown when entering the clientKs room
d. instruct relatives no to visit the client during the entire duration of the treatment
$nswer $. %osimeter badge is used to measure amount of e(posure to radiation. 7t should be endorsed
to the ne(t shift.
.9. $ nurse is assessing a client with metastatic breast cancer who reports nocturia, weakness, nausea and
vomiting. &he clientKs serum electrolytes include potassium 1.* mA#J), sodium 1.9 mA#J), calcium =.5 mA#J),
and magnesium *.5 mA#J). "ased 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 clientKs 7V fluids
d. administer $llopurinol
$nswer 8. Nocturia, nausea and vomiting cause dehydration. &herefore, the correct nursing action is to
increase the clientKs 7V fluids.
0ource+ http+JJwww.blogcatalog.comJblogJncle('and'local'board'prc'sample'
e(amJ9ec;.aeeb.B9.B99c?9Ba5cc;b;c55eb
.;. &he nurses assesses that the client with cancer is not ready for teaching when the client asks+
a. G$m 7 going to loose my hairH
b. G0hould 7 get a second opinionH
c. GWill this make me really sickH
d. GWill 7 have to stop e(ercising at the gymH
$nswer ". &his indicates denial of his illness. &he #uestion states he has cancer. $ll of the other
comments indicate an interest in what is going to happen to him.
.=. /nowing that chemotherapy affects the taste buds, the nurse would have the client
a. 7ncrease the amount of spices in the food.
b. $void red meats.
c. !edicate with 8ompaDine before meals.
d. Aat foods that are hot in temperature.
$nswer $. "ecause taste buds are affected, increasing spices will improve flavor.
.?. 7n evaluating the client with cancer what best indicates that nutritional status is ade#uate
a. 8alorie intake
b. Weight is stable
c. $mount of nausea and vomiting
d. 0erum protein levels
$nswer ". 0table weight indicates ade#uate nutritional status.
.B. $n adult client with newly diagnosed cancer says, G7m really afraid of dying. Whos going to take care of
my childrenH What is the best initial response for the nurse to make
a. GWhat makes you think you are going to dieH
b. G6ow old are your childrenH
c. G&his must be a difficult time for you.H
d. G!ost people with your kind of cancer live a long time.H
$nswer 8. &his empathetic response will open communication. L1 is really a GwhyH #uestion which
would put the client on the defensive. L* and L1 do not focus on the clients feelings.
15. $ client with terminal cancer yells at the nurse and says, G7 dont need your help. 7 can bathe myself.H Which
stage of grief is the client most likely e(periencing
a. ,ro>ection
b. %enial
c. $nger
d. %epression
$nswer 8. Felling at the nurse would be typical of anger. ,ro>ection is putting his feelings on the nurse
GFou are angry at me.H %enial would be denying that he was terminally ill or that he had cancer. $ client who is
depressed would be apathetic and probably not have the energy to yell at the nurse.
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N8)AM 2eview+ -ncology Questions ,art 1
1. $ male client has an abnormal result on a ,apanicolaou test. $fter 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. ,resence of completely undifferentiated tumor cells that dont resemble cells of the tissues of their origin
b. 7ncrease in the number of normal cells in a normal arrangement in a tissue or an organ
c. 2eplacement of one type of fully differentiated cell by another in tissues where the second type normally isnt
found
d. $lteration in the siDe, shape, and organiDation of differentiated cells
*. Cor a female client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of $n(iety related
to the threat of death secondary to cancer diagnosis. Which e(pected outcome would be appropriate for this
client
a. G8lient verbaliDes feelings of an(iety.H
b. G8lient doesnt guess at prognosis.H
c. G8lient uses any effective method to reduce tension.H
d. G8lient stops seeking information.H
.. $ male client with a cerebellar brain tumor is admitted to an acute care facility. &he nurse formulates a
nursing diagnosis of 2isk for in>ury. Which Grelated'toH phrase should the nurse add to complete the nursing
diagnosis statement
a. 2elated to visual field deficits
b. 2elated to difficulty swallowing
c. 2elated to impaired balance
d. 2elated to psychomotor seiDures
1. $ female client with cancer is scheduled for radiation therapy. &he nurse knows that radiation at any
treatment site may cause a certain adverse effect. &herefore, the nurse should prepare the client to e(pect+
a. hair loss.
b. stomatitis.
c. fatigue.
d. vomiting.
9. Nurse $pril is teaching a client who suspects that she has a lump in her breast. &he nurse instructs the client
that a diagnosis of breast cancer is confirmed by+
a. breast self'e(amination.
b. mammography.
c. fine needle aspiration.
d. chest M'ray.
;. $ 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. G/eep the stoma uncovered.H
b. G/eep the stoma dry.H
c. G6ave a family member perform stoma care initially until you get used to the procedure.H
d. G/eep the stoma moist.H
=. $ female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid
and electrolyte imbalance induced by chemotherapy
a. <rine output of 155 ml in ? hours
b. 0erum potassium level of ..; mA#J)
c. "lood pressure of 1*5J;1 to 1.5J=* mm 6g
d. %ry oral mucous membranes and cracked lips
?. Nurse $pril is teaching a group of women to perform breast self'e(amination. &he nurse should e(plain that
the purpose of performing the e(amination is to discover+
a. cancerous lumps.
b. areas of thickness or fullness.
c. changes from previous self'e(aminations.
d. fibrocystic masses.
B. $ client, age 11, visits the gynecologist. $fter e(amining her, the physician suspects cervical cancer. &he
nurse reviews the clients history for risk factors for this disease. Which history finding is a risk factor for cervical
cancer
a. -nset of sporadic se(ual activity at age 1=
b. 0pontaneous abortion at age 1B
c. ,regnancy complicated with eclampsia at age *=
d. 6uman papillomavirus infection at age .*
15. $ female client is receiving methotre(ate 3!e(ate4, 1* gJm* 7.V., to treat osteogenic carcinoma. %uring
methotre(ate therapy, the nurse e(pects the client to receive which other drug to protect normal cells
a. probenecid 3"enemid4
b. cytarabine 3ara'8, cytosine arabinoside N8ytosar'<O4
c. thioguanine 3;'thioguanine, ;'&@4
d. leucovorin 3citrovorum factor or folinic acid NWellcovorinO4
11. &he nurse is interviewing a male client about his past medical history. Which pree(isting condition may lead
the nurse to suspect that a client has colorectal cancer
a. %uodenal ulcers
b. 6emorrhoids
c. Weight gain
d. ,olyps
1*. Nurse $my is speaking to a group of women about early detection of breast cancer. &he average age of the
women in the group is 1=. Collowing the $merican 8ancer 0ociety guidelines, the nurse should recommend that
the women+
a. perform breast self'e(amination annually.
b. have a mammogram annually.
c. have a hormonal receptor assay annually.
d. have a physician conduct a clinical e(amination every * years.
1.. $ 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. ,ersistent nausea
b. 2ash
c. 7ndigestion
d. 8hronic ache or pain
11. Cor a female client newly diagnosed with radiation'induced thrombocytopenia, the nurse should include
which intervention in the plan of care
a. $dministering aspirin if the temperature e(ceeds 15*P C 3.?.?P 84
b. 7nspecting the skin for petechiae once every shift
c. ,roviding for fre#uent rest periods
d. ,lacing the client in strict isolation
19. Nurse )ucia is providing breast cancer education at a community facility. &he $merican 8ancer 0ociety
recommends that women get mammograms+
a. yearly after age 15.
b. after the birth of the first child and every * years thereafter.
c. after the first menstrual period and annually thereafter.
d. every . years between ages *5 and 15 and annually thereafter.
1;. Which intervention is appropriate for the nurse caring for a male client in severe pain receiving a continuous
7.V. infusion of morphine
a. $ssisting with a nalo(one challenge test before therapy begins
b. %iscontinuing the drug immediately if signs of dependence appear
c. 8hanging the administration route to ,.-. if the client can tolerate fluids
d. -btaining baseline vital signs before administering the first dose
1=. $ .9 years old client with ovarian cancer is prescribed hydro(yurea 36ydrea4, an antimetabolite drug.
$ntimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the
cell. &he mechanism of action of antimetabolites interferes with+
a. cell division or mitosis during the ! phase of the cell cycle.
b. normal cellular processes during the 0 phase of the cell cycle.
c. the chemical structure of deo(yribonucleic acid 3%N$4 and chemical binding between %N$ molecules 3cell
cycle:nonspecific4.
d. one or more stages of ribonucleic acid 32N$4 synthesis, %N$ synthesis, or both 3cell cycle:nonspecific4.
1?. &he $"8% method offers one way to assess skin lesions for possible skin cancer. What does the $ stand for
a. $ctinic
b. $symmetry
c. $rcus
d. $ssessment
1B. When caring for a male client diagnosed with a brain tumor of the parietal lobe, the nurse e(pects to assess+
a. short'term memory impairment.
b. tactile agnosia.
c. seiDures.
d. contralateral homonymous hemianopia.
*5. $ female client is undergoing tests for multiple myeloma. %iagnostic study findings in multiple myeloma
include+
a. a decreased serum creatinine level.
b. hypocalcemia.
c. "ence Eones protein in the urine.
d. a low serum protein level.
*1. $ .9 years old client has been receiving chemotherapy to treat cancer. Which assessment finding suggests
that the client has developed stomatitis 3inflammation of the mouth4
a. White, cottage cheese:like patches on the tongue
b. Fellow tooth discoloration
c. 2ed, open sores on the oral mucosa
d. 2ust'colored sputum
**. %uring chemotherapy, an oncology client has a nursing diagnosis of impaired oral mucous membrane
related to decreased nutrition and immunosuppression secondary to the cytoto(ic effects of chemotherapy. Which
nursing intervention is most likely to decrease the pain of stomatitis
a. 2ecommending that the client discontinue chemotherapy
b. ,roviding a solution of hydrogen pero(ide and water for use as a mouth rinse
c. !onitoring the clients platelet and leukocyte counts
d. 8hecking regularly for signs and symptoms of stomatitis
*.. What should a male client over age 9* do to help ensure early identification of prostate cancer
a. 6ave a digital rectal e(amination and prostate'specific antigen 3,0$4 test done yearly.
b. 6ave a transrectal ultrasound every 9 years.
c. ,erform monthly testicular self'e(aminations, especially after age 95.
d. 6ave a complete blood count 38"84 and blood urea nitrogen 3"<N4 and creatinine levels checked yearly.
*1. $ male client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue.
0uspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer.
Which nursing diagnosis may be appropriate for this client
a. $nticipatory grieving
b. 7mpaired swallowing
c. %isturbed body image
d. 8hronic low self'esteem
*9. $ male client is in isolation after receiving an internal radioactive implant to treat cancer. &wo hours later,
the nurse discovers the implant in the bed linens. What should the nurse do first
a. 0tand as far away from the implant as possible and call for help.
b. ,ick up the implant with long'handled forceps and place it in a lead'lined container.
c. )eave the room and notify the radiation therapy department immediately.
d. ,ut the implant back in place, using forceps and a shield for self'protection, and call for help.
*;. Eeovina, with advanced breast cancer is prescribed tamo(ifen 3Nolvade(4. When teaching the client about
this drug, the nurse should emphasiDe the importance of reporting which adverse reaction immediately
a. Vision changes
b. 6earing loss
c. 6eadache
d. $nore(ia
*=. $ female 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. )iver
b. 8olon
c. 2eproductive tract
d. White blood cells 3W"8s4
*?. $ .1'year'old female client is re#uesting information about mammograms and breast cancer. 0he isnt
considered at high risk for breast cancer. What should the nurse tell this client
a. 0he should have had a baseline mammogram before age .5.
b. 0he should eat a low'fat diet to further decrease her risk of breast cancer.
c. 0he should perform breast self'e(amination during the first 9 days of each menstrual cycle.
d. When she begins having yearly mammograms, breast self'e(aminations will no longer be necessary.
*B. Nurse "rian is developing a plan of care for marrow suppression, the ma>or dose'limiting adverse reaction
to flo(uridine 3C<%24. 6ow long after drug administration does bone marrow suppression become noticeable
a. *1 hours
b. * to 1 days
c. = to 11 days
d. *1 to *? days
.5. &he nurse is preparing for a female client for magnetic resonance imaging 3!274 to confirm or rule out a
spinal cord lesion. %uring the !27 scan, which of the following would pose a threat to the client
a. &he client lies still.
b. &he client asks #uestions.
c. &he client hears thumping sounds.
d. &he client wears a watch and wedding band.
N8)AM 2eview+ -ncology Questions ,art 1 $nswers and 2ationale
!ay 15, *515 "y admin )eave a 8omment
View Questions
1.$nswer %. %ysplasia refers to an alteration in the siDe, shape, and organiDation of differentiated cells. &he
presence of completely undifferentiated tumor cells that dont resemble cells of the tissues of their origin is called
anaplasia. $n increase in the number of normal cells in a normal arrangement in a tissue or an organ is called
hyperplasia. 2eplacement of one type of fully differentiated cell by another in tissues where the second type
normally isnt found is called metaplasia.
*.$nswer $. VerbaliDing feelings is the clients first step in coping with the situational crisis. 7t also helps the
health care team gain insight into the clients feelings, helping guide psychosocial care. -ption " is inappropriate
because suppressing speculation may prevent the client from coming to terms with the crisis and planning
accordingly. -ption 8 is undesirable because some methods of reducing tension, such as illicit drug or alcohol
use, may prevent the client from coming to terms with the threat of death as well as cause physiologic harm.
-ption % isnt appropriate because seeking information can help a client with cancer gain a sense of control over
the crisis.
..$nswer 8. $ client with a cerebellar brain tumor may suffer in>ury from impaired balance as well as disturbed
gait and incoordination. Visual field deficits, difficulty swallowing, and psychomotor seiDures may result from
dysfunction of the pituitary gland, pons, occipital lobe, parietal lobe, or temporal lobe Q not from a cerebellar
brain tumor. %ifficulty swallowing suggests medullary dysfunction. ,sychomotor seiDures suggest temporal lobe
dysfunction.
1.$nswer 8. 2adiation therapy may cause fatigue, skin to(icities, and anore(ia regardless of the treatment site.
6air loss, stomatitis, and vomiting are site'specific, not generaliDed, adverse effects of radiation therapy.
9.$nswer 8. Cine needle aspiration and biopsy provide cells for histologic e(amination to confirm a diagnosis of
cancer. $ breast self'e(amination, if done regularly, is the most reliable method for detecting breast lumps early.
!ammography is used to detect tumors that are too small to palpate. 8hest M'rays can be used to pinpoint rib
metastasis.
;.$nswer %. &he nurse should instruct the client to keep the stoma moist, such as by applying a thin layer of
petroleum >elly around the edges, because a dry stoma may become irritated. &he nurse should recommend
placing a stoma bib over the stoma to filter and warm air before it enters the stoma. &he client should begin
performing stoma care without assistance as soon as possible to gain independence in self'care activities.
=.$nswer %. 8hemotherapy commonly causes nausea and vomiting, which may lead to fluid and electrolyte
imbalances. 0igns of fluid loss include dry oral mucous membranes, cracked lips, decreased urine output 3less
than 15 mlJhour4, abnormally low blood pressure, and a serum potassium level below ..9 mA#J).
?.$nswer 8. Women are instructed to e(amine themselves to discover changes that have occurred in the breast.
-nly a physician can diagnose lumps that are cancerous, areas of thickness or fullness that signal the presence of
a malignancy, or masses that are fibrocystic as opposed to malignant.
B.$nswer %. )ike other viral and bacterial venereal infections, human papillomavirus is a risk factor for cervical
cancer. -ther risk factors for this disease include fre#uent se(ual intercourse before age 1;, multiple se( partners,
and multiple pregnancies. $ spontaneous abortion and pregnancy complicated by eclampsia arent risk factors for
cervical cancer.
15.$nswer %. )eucovorin is administered with methotre(ate to protect normal cells, which methotre(ate could
destroy if given alone. ,robenecid should be avoided in clients receiving methotre(ate because it reduces renal
elimination of methotre(ate, increasing the risk of methotre(ate to(icity. 8ytarabine and thioguanine arent used
to treat osteogenic carcinoma.
11.$nswer %. 8olorectal polyps are common with colon cancer. %uodenal ulcers and hemorrhoids arent
pree(isting conditions of colorectal cancer. Weight loss Q not gain Q is an indication of colorectal cancer.
1*.$nswer ". &he $merican 8ancer 0ociety guidelines state, RWomen older than age 15 should have a
mammogram annually and a clinical e(amination at least annually Nnot every * yearsOS all women should perform
breast self'e(amination monthly Nnot annuallyO.R &he hormonal receptor assay is done on a known breast tumor to
determine whether the tumor is estrogen' or progesterone'dependent.
1..$nswer 8. 7ndigestion, or difficulty swallowing, is one of the seven warning signs of cancer. &he other si( are
a change in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, a thickening or lump
in the breast or elsewhere, an obvious change in a wart or mole, and a nagging cough or hoarseness. ,ersistent
nausea may signal stomach cancer but isnt one of the seven ma>or warning signs. 2ash and chronic ache or pain
seldom indicate cancer.
11.$nswer ". "ecause thrombocytopenia impairs blood clotting, the nurse should inspect the client regularly for
signs of bleeding, such as petechiae, purpura, epista(is, and bleeding gums. &he nurse should avoid administering
aspirin because it may increase the risk of bleeding. Cre#uent rest periods are indicated for clients with anemia,
not thrombocytopenia. 0trict isolation is indicated only for clients who have highly contagious or virulent
infections that are spread by air or physical contact.
19.$nswer $. &he $merican 8ancer 0ociety recommends a mammogram yearly for women over age 15. &he
other statements are incorrect. 7ts recommended that women between ages *5 and 15 have a professional breast
e(amination 3not a mammogram4 every . years.
1;.$nswer %. &he nurse should obtain the clients baseline blood pressure and pulse and respiratory rates before
administering the initial dose and then continue to monitor vital signs throughout therapy. $ nalo(one challenge
test may be administered before using a narcotic antagonist, not a narcotic agonist. &he nurse shouldnt
discontinue a narcotic agonist abruptly because withdrawal symptoms may occur. !orphine commonly is used as
a continuous infusion in clients with severe pain regardless of the ability to tolerate fluids.
1=.$nswer ". $ntimetabolites act during the 0 phase of the cell cycle, contributing to cell destruction or
preventing cell replication. &heyre most effective against rapidly proliferating cancers. !iotic inhibitors interfere
with cell division or mitosis during the ! phase of the cell cycle. $lkylating agents affect all rapidly proliferating
cells by interfering with %N$S they may kill dividing cells in all phases of the cell cycle and may also kill
nondividing cells. $ntineoplastic antibiotic agents interfere with one or more stages of the synthesis of 2N$,
%N$, or both, preventing normal cell growth and reproduction.
1?.$nswer ". When following the $"8% method for assessing skin lesions, the $ stands for Rasymmetry,R the "
for Rborder irregularity,R the 8 for Rcolor variation,R and the % for Rdiameter.R
1B.$nswer ". &actile agnosia 3inability to identify ob>ects by touch4 is a sign of a parietal lobe tumor. 0hort'term
memory impairment occurs with a frontal lobe tumor. 0eiDures may result from a tumor of the frontal, temporal,
or occipital lobe. 8ontralateral homonymous hemianopia suggests an occipital lobe tumor.
*5.$nswer 8. ,resence of "ence Eones protein in the urine almost always confirms the disease, but absence
doesnt rule it out. 0erum calcium levels are elevated because calcium is lost from the bone and reabsorbed in the
serum. 0erum protein electrophoresis shows elevated globulin spike. &he serum creatinine level may also be
increased.
*1.$nswer 8. &he tissue'destructive effects of cancer chemotherapy typically cause stomatitis, resulting in ulcers
on the oral mucosa that appear as red, open sores. White, cottage cheese:like patches on the tongue suggest a
candidal infection, another common adverse effect of chemotherapy. Fellow tooth discoloration may result from
antibiotic therapy, not cancer chemotherapy. 2ust'colored sputum suggests a respiratory disorder, such as
pneumonia.
**.$nswer ". &o decrease the pain of stomatitis, the nurse should provide a solution of hydrogen pero(ide and
water for the client to use as a mouth rinse. 38ommercially prepared mouthwashes contain alcohol and may cause
dryness and irritation of the oral mucosa.4 &he nurse also may administer viscous lidocaine or systemic analgesics
as prescribed. 0tomatitis occurs = to 15 days after chemotherapy beginsS thus, stopping chemotherapy wouldnt be
helpful or practical. 7nstead, the nurse should stay alert for this potential problem to ensure prompt treatment.
!onitoring platelet and leukocyte counts may help prevent bleeding and infection but wouldnt decrease pain in
this highly susceptible client. 8hecking for signs and symptoms of stomatitis also wouldnt decrease the pain.
*..$nswer $. &he incidence of prostate cancer increases after age 95. &he digital rectal e(amination, which
identifies enlargement or irregularity of the prostate, and ,0$ test, a tumor marker for prostate cancer, are
effective diagnostic measures that should be done yearly. &esticular self'e(aminations wont identify changes in
the prostate gland due to its location in the body. $ transrectal ultrasound, 8"8, and "<N and creatinine levels
are usually done after diagnosis to identify the e(tent of the disease and potential metastases
*1.$nswer $. $nticipatory grieving is an appropriate nursing diagnosis for this client because few clients with
gallbladder cancer live more than 1 year after diagnosis. 7mpaired swallowing isnt associated with gallbladder
cancer. $lthough surgery typically is done to remove the gallbladder and, possibly, a section of the liver, it isnt
disfiguring and doesnt cause %isturbed body image. 8hronic low self'esteem isnt an appropriate nursing
diagnosis at this time because the diagnosis has >ust been made.
*9.$nswer ". 7f a radioactive implant becomes dislodged, the nurse should pick it up with long'handled forceps
and place it in a lead'lined container, then notify the radiation therapy department immediately. &he highest
priority is to minimiDe radiation e(posure for the client and the nurseS therefore, the nurse must not take any
action that delays implant removal. 0tanding as far from the implant as possible, leaving the room with the
implant still e(posed, or attempting to put it back in place can greatly increase the risk of harm to the client and
the nurse from e(cessive radiation e(posure.
*;.$nswer $. &he client must report changes in visual acuity immediately because this adverse effect may be
irreversible. &amo(ifen isnt associated with hearing loss. $lthough the drug may cause anore(ia, headache, and
hot flashes, the client need not report these adverse effects immediately because they dont warrant a change in
therapy.
*=.$nswer $. &he liver is one of the five most common cancer metastasis sites. &he others are the lymph nodes,
lung, bone, and brain. &he colon, reproductive tract, and W"8s are occasional metastasis sites.
*?.$nswer ". $ low'fat diet 3one that maintains weight within *5T of recommended body weight4 has been
found to decrease a womans risk of breast cancer. $ baseline mammogram should be done between ages .5 and
15. !onthly breast self'e(aminations should be done between days = and 15 of the menstrual cycle. &he client
should continue to perform monthly breast self'e(aminations even when receiving yearly mammograms.
*B.$nswer 8. "one marrow suppression becomes noticeable = to 11 days after flo(uridine administration. "one
marrow recovery occurs in *1 to *? days.
.5.$nswer %. %uring an !27, the client should wear no metal ob>ects, such as >ewelry, because the strong
magnetic field can pull on them, causing in>ury to the client and 3if they fly off4 to others. &he client must lie still
during the !27 but can talk to those performing the test by way of the microphone inside the scanner tunnel. &he
client should hear thumping sounds, which are caused by the sound waves thumping on the magnetic field.
1. Nina, an oncology nurse educator is speaking to a womens 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. !ammography is the most reliable method for detecting breast cancer.
b. "reast cancer is the leading killer of women of childbearing age.
c. "reast cancer re#uires a mastectomy.
d. !en can develop breast cancer.
*. Nurse !eredith is instructing a premenopausal woman about breast self'e(amination. &he nurse should tell
the client to do her self'e(amination+
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.
.. Nurse /ent is teaching a male client to perform monthly testicular self'e(aminations. Which of the
following points would be appropriate to make
a. &esticular cancer is a highly curable type of cancer.
b. &esticular cancer is very difficult to diagnose.
c. &esticular cancer is the number one cause of cancer deaths in males.
d. &esticular cancer is more common in older men.
1. 2hea, has malignant lymphoma. $s part of her chemotherapy, the physician prescribes chlorambucil
3)eukeran4, 15 mg by mouth daily. When caring for the client, the nurse teaches her about adverse reactions to
chlorambucil, such as alopecia. 6ow soon after the first administration of chlorambucil might this reaction
occur
a. 7mmediately
b. 1 week
c. * to . weeks
d. 1 month
9. $ male client is receiving the cell cycle:nonspecific alkylating agent thiotepa 3&hiople(4, ;5 mg weekly for
1 weeks by bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. &he client asks the
nurse how the drug works. 6ow does thiotepa e(ert its therapeutic effects
a. 7t interferes with deo(yribonucleic acid 3%N$4 replication only.
b. 7t interferes with ribonucleic acid 32N$4 transcription only.
c. 7t interferes with %N$ replication and 2N$ transcription.
d. 7t destroys the cell membrane, causing lysis.
;. &he nurse is instructing the .9 year old client to perform a testicular self'e(amination. &he nurse tells the
client+
a. &o e(amine the testicles while lying down
b. &hat the best time for the e(amination is after a shower
c. &o gently feel the testicle with one finger to feel for a growth
d. &hat testicular self'e(amination should be done at least every ; months
=. $ female client with cancer is receiving chemotherapy and develops thrombocytopenia. &he nurse identifies
which intervention as the highest priority in the nursing plan of care
a. !onitoring temperature
b. $mbulation three times daily
c. !onitoring the platelet count
d. !onitoring for pathological fractures
?. @ian, a community health nurse is instructing a group of female clients about breast self'e(amination. &he
nurse instructs the client to perform the e(amination+
a. $t the onset of menstruation
b. Avery month during ovulation
c. Weekly at the same time of day
d. 1 week after menstruation begins
B. Nurse 8ecilia is caring for a client who has undergone a vaginal hysterectomy. &he nurse avoids which of
the following in the care of this client
a. Alevating the knee gatch on the bed
b. $ssisting with range'of'motion leg e(ercises
c. 2emoval of antiembolism stockings twice daily
d. 8hecking placement of pneumatic compression boots
15. !ina, who is suspected of an ovarian tumor is scheduled for a pelvic ultrasound. &he nurse provides
which preprocedure instruction to the client
a. Aat a light breakfast only
b. !aintain an N,- status before the procedure
c. Wear comfortable clothing and shoes for the procedure
d. %rink si( to eight glasses of water without voiding before the test
11. $ male client is diagnosed as having a bowel tumor and several diagnostic tests are prescribed. &he nurse
understands that which test will confirm the diagnosis of malignancy
a. "iopsy of the tumor
b. $bdominal ultrasound
c. !agnetic resonance imaging
d. 8omputeriDed tomography scan
1*. $ female client diagnosed with multiple myeloma and the client asks the nurse about the diagnosis. &he
nurse bases the response on which description of this disorder
a. $ltered red blood cell production
b. $ltered production of lymph nodes
c. !alignant e(acerbation in the number of leukocytes
d. !alignant proliferation of plasma cells within the bone
1.. Nurse "ea is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which of the
following would the nurse e(pect to note specifically in this disorder
a. 7ncreased calcium
b. 7ncreased white blood cells
c. %ecreased blood urea nitrogen level
d. %ecreased number of plasma cells in the bone marrow
11. Vanessa, a community health nurse conducts a health promotion program regarding testicular cancer to
community members. &he 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. $lopecia
b. "ack pain
c. ,ainless testicular swelling
d. 6eavy sensation in the scrotum
19. &he male client is receiving e(ternal radiation to the neck for cancer of the laryn(. &he most likely side
effect to be e(pected is+
a. %yspnea
b. %iarrhea
c. 0ore throat
d. 8onstipation
1;. Nurse Eoy 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. )imit the time with the client to 1 hour per shift
b. %o not allow pregnant women into the clients room
c. 2emove the dosimeter badge when entering the clients room
d. 7ndividuals younger than 1; years old may be allowed to go in the room as long as they are ; feet away
from the client
1=. $ cervical radiation implant is placed in the client for treatment of cervical cancer. &he nurse initiates what
most appropriate activity order for this client
a. "ed rest
b. -ut of bed ad lib
c. -ut of bed in a chair only
d. $mbulation to the bathroom only
1?. $ female client is hospitaliDed for insertion of an internal cervical radiation implant. While giving care, the
nurse finds the radiation implant in the bed. &he initial action by the nurse is to+
a. 8all the physician
b. 2einsert the implant into the vagina immediately
c. ,ick up the implant with gloved hands and flush it down the toilet
d. ,ick up the implant with long'handled forceps and place it in a lead container.
1B. &he nurse is caring for a female client e(periencing neutropenia as a result of chemotherapy and develops
a plan of care for the client. &he nurse plans to+
a. 2estrict all visitors
b. 2estrict fluid intake
c. &each the client and family about the need for hand hygiene
d. 7nsert an indwelling urinary catheter to prevent skin breakdown
*5. &he home health care nurse is caring for a male client with cancer and the client is complaining of acute
pain. &he appropriate nursing assessment of the clients pain would include which of the following
a. &he clients pain rating
b. Nonverbal cues from the client
c. &he nurses impression of the clients pain
d. ,ain relief after appropriate nursing intervention
*1. Nurse !ickey is caring for a client who is postoperative following a pelvic e(enteration and the physician
changes the clients diet from N,- status to clear li#uids. &he nurse makes which priority assessment before
administering the diet
a. "owel sounds
b. $bility to ambulate
c. 7ncision appearance
d. <rine specific gravity
**. $ male client is admitted to the hospital with a suspected diagnosis of 6odgkins disease. Which
assessment findings would the nurse e(pect to note specifically in the client
a. Catigue
b. Weakness
c. Weight gain
d. Anlarged lymph nodes
*.. %uring the admission assessment of a .9 year old client with advanced ovarian cancer, the nurse
recogniDes which symptom as typical of the disease
a. %iarrhea
b. 6ypermenorrhea
c. $bdominal bleeding
d. $bdominal distention
*1. Nurse /ate is reviewing the complications of coloniDation with a client who has microinvasive cervical
cancer. Which complication, if identified by the client, indicates a need for further teaching
a. 7nfection
b. 6emorrhage
c. 8ervical stenosis
d. -varian perforation
*9. !r. !iller has been diagnosed with bone cancer. Fou know this type of cancer is classified as+
a. sarcoma.
b. lymphoma.
c. carcinoma.
d. melanoma.
*;. 0arah, a hospice nurse visits a client dying of ovarian cancer. %uring the visit, the client e(presses that G7f
7 can >ust live long enough to attend my daughters graduation, 7ll be ready to die.H Which phrase of coping is
this client e(periencing
a. $nger
b. %enial
c. "argaining
d. %epression
*=. Nurse Carah is caring for a client following a mastectomy. Which assessment finding indicates that the
client is e(periencing a complication related to the surgery
a. ,ain at the incisional site
b. $rm edema on the operative side
c. 0anguineous drainage in the Eackson',ratt drain
d. 8omplaints of decreased sensation near the operative site
*?. &he nurse is admitting a male client with laryngeal cancer to the nursing unit. &he nurse assesses for
which most common risk factor for this type of cancer
a. $lcohol abuse
b. 8igarette smoking
c. <se of chewing tobacco
d. A(posure to air pollutants
*B. &he 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. &he nurse interprets that the client may be e(periencing+
a. 2upture of the bladder
b. &he development of a vesicovaginal fistula
c. A(treme stress caused by the diagnosis of cancer
d. $ltered perineal sensation as a side effect of radiation therapy
.5. &he client with leukemia is receiving busulfan 3!yleran4 and allopurinol 3Iyloprim4. &he nurse tells the
client that the purpose if the allopurinol is to prevent+
a. Nausea
b. $lopecia
c. Vomiting
d. 6yperuricemia
1. $nswer %. !en can develop breast cancer, although they seldom do. &he most reliable method for
detecting breast cancer is monthly self'e(amination, not mammography. )ung cancer causes more deaths than
breast cancer in women of all ages. $ mastectomy may not be re#uired if the tumor is small, confined, and in an
early stage.
*. $nswer %. ,remenopausal women should do their self'e(amination immediately after the menstrual period,
when the breasts are least tender and least lumpy. -n the 1st and last days of the cycle, the womans breasts are
still very tender. ,ostmenopausal women because their bodies lack fluctuation of hormone levels, should select
one particular day of the month to do breast self'e(amination.
.. $nswer $. &esticular cancer is highly curable, particularly when its treated in its early stage. 0elf'
e(amination allows early detection and facilitates the early initiation of treatment. &he highest mortality rates
from cancer among men are in men with lung cancer. &esticular cancer is found more commonly in younger
men.
1. $nswer 8. 8hlorambucil'induced alopecia occurs * to . weeks after therapy begins.
9. $nswer 8. &hiotepa interferes with %N$ replication and 2N$ transcription. 7t doesnt destroy the cell
membrane.
;. $nswer ". &he testicular'self e(amination is recommended monthly after a warm bath or shower when the
scrotal skin is rela(ed. &he client should stand to e(amine the testicles. <sing both hands, with fingers under the
scrotum and thumbs on top, the client should gently roll the testicles, feeling for any lumps.
=. $nswer 8. &hrombocytopenia indicates a decrease in the number of platelets in the circulating blood. $
ma>or concern is monitoring for and preventing bleeding. -ption $ elates to monitoring for infection,
particularly if leukopenia is present. -ptions " and %, although important in the plan of care, are not related
directly to thrombocytopenia.
?. $nswer %. &he breast self'e(amination should be performed monthly = days after the onset of the
menstrual period. ,erforming the e(amination weekly is not recommended. $t the onset of menstruation and
during ovulation, hormonal changes occur that may alter breast tissue.
B. $nswer $. &he client is at risk of deep vein thrombosis or thrombophlebitis after this surgery, as for any
other ma>or surgery. Cor this reason, the nurse implements measures that will prevent this complication. 2ange'
of'motion e(ercises, antiembolism stockings, and pneumatic compression boots are helpful. &he nurse should
avoid using the knee gatch in the bed, which inhibits venous return, thus placing the client more at risk for deep
vein thrombosis or thrombophlebitis.
15. $nswer %. $ pelvic ultrasound re#uires the ingestion of large volumes of water >ust before the procedure.
$ full bladder is necessary so that it will be visualiDed as such and not mistaken for a possible pelvic growth. $n
abdominal ultrasound may re#uire that the client abstain from food or fluid for several hours before the
procedure. -ption 8 is unrelated to this specific procedure.
11. $nswer $. $ biopsy is done to determine whether a tumor is malignant or benign. !agnetic resonance
imaging, computed tomography scan, and ultrasound will visualiDe the presence of a mass but will not confirm
a diagnosis of malignancy.
1*. $nswer %. !ultiple myeloma is a "'cell neoplastic condition characteriDed by abnormal malignant
proliferation of plasma cells and the accumulation of mature plasma cells in the bone marrow. -ptions $ and "
are not characteristics of multiple myeloma. -ption 8 describes the leukemic process.
1.. $nswer $. Cindings indicative of multiple myeloma are an increased number of plasma cells in the bone
marrow, anemia, hypercalcemia caused by the release of calcium from the deteriorating bone tissue, and an
elevated blood urea nitrogen level. $n increased white blood cell count may or may not be present and is not
related specifically to multiple myeloma.
11. $nswer $. $lopecia is not an assessment finding in testicular cancer. $lopecia may occur, however, as a
result of radiation or chemotherapy. -ptions ", 8, and % are assessment findings in testicular cancer. "ack pain
may indicate metastasis to the retroperitoneal lymph nodes.
19. $nswer 8. 7n general, only the area in the treatment field is affected by the radiation. 0kin reactions,
fatigue, nausea, and anore(ia may occur with radiation to any site, whereas other side effects occur only when
specific areas are involved in treatment. $ client receiving radiation to the laryn( is most likely to e(perience a
sore throat. -ptions " and % may occur with radiation to the gastrointestinal tract. %yspnea may occur with
lung involvement.
1;. $nswer ". &he time that the nurse spends in a room of a client with an internal radiation implant is .5
minutes per ?'hour shift. &he dosimeter badge must be worn when in the clients room. 8hildren younger than
1; years of age and pregnant women are not allowed in the clients room.
1=. $nswer $. &he client with a cervical radiation implant should be maintained on bed rest in the dorsal
position to prevent movement of the radiation source. &he head of the bed is elevated to a ma(imum of 15 to 19
degrees for comfort. &he nurse avoids turning the client on the side. 7f turning is absolutely necessary, a pillow
is placed between the knees and, with the body in straight alignment, the client is logrolled.
1?. $nswer %. $ lead container and long'handled forceps should be kept in the clients room at all times
during internal radiation therapy. 7f the implant becomes dislodged, the nurse should pick up the implant with
long'handled forceps and place it in the lead container. -ptions $, ", and 8 are inaccurate interventions.
1B. $nswer 8. 7n the neutropenic client, meticulous hand hygiene education is implemented for the client,
family, visitors, and staff. Not all visitors are restricted, but the client is protected from persons with known
infections. Cluids should be encouraged. 7nvasive measures such as an indwelling urinary catheter should be
avoided to prevent infections.
*5. $nswer $. &he clients self'report is a critical component of pain assessment. &he nurse should ask the
client about the description of the pain and listen carefully to the clients words used to describe the pain. &he
nurses impression of the clients pain is not appropriate in determining the clients level of pain. Nonverbal
cues from the client are important but are not the most appropriate pain assessment measure. $ssessing pain
relief is an important measure, but this option is not related to the sub>ect of the #uestion.
*1. $nswer $. &he client is kept N,- until peristalsis returns, usually in 1 to ; days. When signs of bowel
function return, clear fluids are given to the client. 7f no distention occurs, the diet is advanced as tolerated. &he
most important assessment is to assess bowel sounds before feeding the client. -ptions ", 8, and % are
unrelated to the sub>ect of the #uestion.
**. $nswer %. 6odgkins disease is a chronic progressive neoplastic disorder of lymphoid tissue characteriDed
by the painless enlargement of lymph nodes with progression to e(tralymphatic sites, such as the spleen and
liver. Weight loss is most likely to be noted. Catigue and weakness may occur but are not related significantly to
the disease.
*.. $nswer %. 8linical manifestations of ovarian cancer include abdominal distention, urinary fre#uency and
urgency, pleural effusion, malnutrition, pain from pressure caused by the growing tumor and the effects of
urinary or bowel obstruction, constipation, ascites with dyspnea, and ultimately general severe pain. $bnormal
bleeding, often resulting in hypermenorrhea, is associated with uterine cancer.
*1. $nswer %. 8oniDation procedure involves removal of a cone'shaped area of the cervi(. 8omplications of
the procedure include hemorrhage, infection, and cervical stenosis. -varian perforation is not a complication.
*9. $nswer $. &umors that originate from bone,muscle, and other connective tissue are called sarcomas.
*;. $nswer 8. %enial, bargaining, anger, depression, and acceptance are recogniDed stages that a person
facing a life'threatening illness e(periences. "argaining identifies a behavior in which the individual is willing
to do anything to avoid loss or change prognosis or fate. %enial is e(pressed as shock and disbelief and may be
the first response to hearing bad news. %epression may be manifested by hopelessness, weeping openly, or
remaining #uiet or withdrawn. $nger also may be a first response to upsetting news and the predominant theme
is Gwhy meH or the blaming of others.
*=. $nswer ". $rm edema on the operative side 3lymphedema4 is a complication following mastectomy and
can occur immediately postoperatively or may occur months or even years after surgery. -ptions $, 8, and %
are e(pected occurrences following mastectomy and do not indicate a complication.
*?. $nswer ". &he most common risk factor associated with laryngeal cancer is cigarette smoking. 6eavy
alcohol use and the combined use of tobacco increase the risk. $nother risk factor is e(posure to environmental
pollutants.
*B. $nswer ". $ vesicovaginal fistula is a genital fistula that occurs between the bladder and vagina. &he
fistula is an abnormal opening between these two body parts and, if this occurs, the client may e(perience
drainage of urine through the vagina. &he clients complaint is not associated with options $, 8, and %.
.5. $nswer %. $llopurinol decreases uric acid production and reduces uric acid concentrations in serum and
urine. 7n the client receiving chemotherapy, uric acid levels increase as a result of the massive cell destruction
that occurs from the chemotherapy. &his medication prevents or treats hyperuricemia caused by chemotherapy.
$llopurinol is not used to prevent alopecia, nausea, or vomiting.