cellular aberrations 2

Yearly after age 40

21. Nurse Lucia is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms:

The tumor is removed, involving the least possible amount of tissue

21. The client with a benign lung tumor is treated in which of the following ways?

provide pain control

22. In the client with terminal lung cancer, the focus of nursing care is on which of the following nursing interventions?

Teaching and encouraging pursed-lip breathing

Which of the following nursing interventions would be most helpful in making the respiratory effort of a client with etastatic lung cancer more efficient?

Acute lymphoblastic leukemia

Which of the following types of leukemia carries the best prognosis?

. Obtaining baseline vital signs before administering the first dose

22. Which intervention is appropriate for the nurse caring for a male client in severe pain receiving a continuous I.V. infusion of morphine?

Hypercalcemia

10. Nurse Andrei is caring for a client with multiple myeloma. During the review of the laboratory results. The nurse will monitor the client for which of the following conditions?

Fine needle aspiration

11. Nurse April is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by:

Keep the stoma moist."

12. A male client undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should include which instruction?

Sore throat

47. The male client is receiving external radiation to the neck for cancer of the larynx. The most likely side effect to be expected is:

Ask open-ended questions about sexuality issues related to her mastectomy

1. A 32-year-old woman meets with the nurse on her first office visit since undergoing a left mastectomy. When asked how she is doing, the woman states her appetite is still not good, she is not getting much sleep because she doesn't go to bed until her husband is asleep, and she is really anxious to get back to work. Which of the following nursing interventions should the nurse explore to support the client's current needs?

benign prostatic hyperplasia

1. A diagnosis of Hodgkin's disease was made to a 58- year old man and is admitted for the initial cycle of chemotherapy. During the hospitalization, the nurse should watch out for the following complication, except?

Have a mammogram annually

18. Nurse Amy is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society guidelines, the nurse should recommend that the women:

The remaining lobe or lobes over expand to fill the space

18. When a client has a lobectomy, what fills the space where the lobe was?

Indigestion

19. A male client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer?

To remove the tumor and as little surrounding tissue as possible

19. Which of the following is the primary goal for surgical resection of lung cancer?

Fatigue

10. A female client with cancer is scheduled for radiation therapy. The nurse knows that radiation at any treatment site may cause a certain adverse effect. Therefore, the nurse should prepare the client to expect:

Increased vascularity of the breast

12. During a routine physical examination, a firm mass is palpated in the right breast of a 35-year-old woman. Which of the following findings or client history would suggest cancer of the breast as opposed to fibrocystic disease?

Dry oral mucous membranes and cracked lips

13. A female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy?

Changes from previous self-examinations

14. Nurse April 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:

B. Recurrent pleural effusion

14. Warning signs and symptoms of lung cancer include persistent cough, bloody sputum, dyspnea, and which of the other following symptoms?

couging

15. A centrally located tumor would produce which of the following symptoms?

Human papillomavirus infection at age 32

15. A client, age 41, visits the gynecologist. After examining her, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer?

. Wellcovorin (leucovorin or citrovorum factor or folinic acid)

16. A female client is receiving methotrexate (Mexate), 12 g/m2 I.V., to treat osteogenic carcinoma. During methotrexate therapy, the nurse expects the client to receive which other drug to protect normal cells?

early detection

16. Which of the following interventions is the key to increasing the survival rates of clients with lung cancer?

A small, localized area near the surface of the lung

17. A client has been diagnosed with lung cancer and requires a wedge resection. How much of the lung is removed?

. Polyps

17. The nurse is interviewing a male client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer?

It may prevent surgery if the client can't tolerate lung tissue removal

20. If the client with lung cancer also has preexisting pulmonary disease, which of the following statements best describes the extent of a surgery that can be performed?

sepsis

2. One of the most serious blood coagulation complications for individuals with cancer and for those undergoing cancer treatments is disseminated intravascular coagulation (DIC). The most common cause of this bleeding disorder is:

Thrombocytopenia and increased lymphocytes

2. The nurse is reviewing the chart of a client who is newly diagnosed with chronic lymphocytic leukemia. Which of the following laboratory values is expected to be seen?

Inspecting the skin for petechiae once every shift

20. For a female client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the plan of care?

Normal cellular processes during the S phase of the cell cycle

23. A 35 years old 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:

Histologic type of disease, initial WBC count, and client's age at diagnosis

23. What are the three most important prognostic factors in determining long-term survival for children with acute leukemia?

Asymmetry

24. The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for?

Anemia, infection, and bleeding tendencies

24. Which of the following complications are three main consequences of leukemia?

Petechiae

25. A child is seen in the pediatrician's office for complaints of bone and joint pain. Which of the following other assessment findings may suggest leukemia?

Tactile agnosia

25. When caring for a male client diagnosed with a brain tumor of the parietal lobe, the nurse expects to assess:

Bence Jones protein in the urine

26. A female client is undergoing tests for multiple myeloma. Diagnostic study findings in multiple myeloma include:

Headache and vomiting

26. Which of the following assessment findings in a client with leukemia would indicate that cancer has invaded the brain?

Red, open sores on the oral mucosa

27. A 35-year-old client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis (inflammation of the mouth)?

Providing a solution of hydrogen peroxide and water for use as a mouth rinse

28. 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?

liver function test

29. Joseph who had a history of long-term smoking and alcoholism is diagnosed with oropharyngeal cancer. He is admitted into the chemo unit for the initiation of chemotherapy. Which of the following tests is performed before the infusion of chemotherapeutic agents?

Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly

29. What should a male client over age 52 do to help ensure early identification of prostate cancer?

an entire lung field

3. A pneumonectomy is a surgical procedure sometimes indicated for treatment of non-small-cell lung cancer. A pneumonectomy involves removal of:

neck

3. Maria was recently diagnosed with Hodgkin's lymphoma. Upon the early diagnosis, the nurse will expect which of the following areas is often involved?

Anticipatory grieving

30. A male client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis may be appropriate for this client?

oral poliovirus vaccine (opv)

30. Which of the following immunizations should not be given to a 4-month-old sibling of a client with leukemia?

Pick up the implant with long-handled forceps and place it in a lead-lined container

31. A male 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?

Sulfamethoxazole and trimethoprim (Bactrim)

31.Which of the following medications usually is given to a client with leukemia as prophylaxis against P. carinii pneumonia?

Acute lymphocytic leukemia

32. In which of the following diseases would bone marrow transplantation not be indicated in a newly diagnosed client?

Vision changes

32. Jenny with an advanced breast cancer is prescribed Nolvadex (tamoxifen). When teaching the client about this drug, the nurse should emphasize the importance of reporting which adverse reaction immediately?

Liver

33. A 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?

VZIG should be given within 72 hours of exposure

33. Which of the following treatment measures should be implemented for a child with leukemia who has been exposed to the chickenpox?

She should eat a low-fat diet to further decrease her risk of breast cancer

34. A 34-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?

30 minutes before the initiation of therapy

34. Nausea and vomiting are common adverse effects of radiation and chemotherapy. When should a nurse administer antiemetics?

7 to 14 days

35. Nurse Brian is developing a plan of care for marrow suppression, the major dose-limiting adverse reaction to floxuridine (FUDR). How long after drug administration does bone marrow suppression become noticeable?

Within 5 to 8 weeks

35. Parents of pediatric clients who undergo irradiation involving the central nervous system should be warned about postirradiation somnolence. When does this neurologic syndrome usually occur?

The best time for the examination is after a shower

36. The nurse is instructing the client to perform a testicular self-examination. The nurse tells the client:

The client wears a watch and wedding band

36. The nurse is preparing for a female client for magnetic resonance imaging (MRI) to confirm or rule out a spinal cord lesion. During the MRI scan, which of the following would pose a threat to the client?

Men can develop breast cancer

37. Nina, 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?

. Low-fat and high-fiber diet

37. The community nurse is conducting a health promotion program at a local school and is discussing the risk factors associated with cancer. Which of the following, if identified by the client as a risk factor, indicates a need for further instructions?

Immediately after her menstrual period

38. Nurse Mary is instructing a premenopausal woman about breast self-examination. The nurse should tell the client to do her self-examination:

monitoring the platelet count

38. The client with cancer is receiving chemotherapy and develops thrombocytopenia. The nurse identifies which intervention is the highest priority in the nursing plan of care?

Testicular cancer is a highly curable type of cancer

39. Nurse Kent is teaching a male client to perform monthly testicular self-examinations. Which of the following points would be appropriate to make?

Involvement of lymph node regions or structures on both sides of the diaphragm

4. According to a standard staging classification of Hodgkin's disease, which of the following criteria reflects stage III?

2 to 3 weeks

40. Rhea has malignant lymphoma. As part of her chemotherapy, the physician prescribes chlorambucil (Leukeran), 10 mg by mouth daily. When caring for the client, the nurse teaches her about adverse reactions to chlorambucil, such as alopecia. How soon after the first administration of chlorambucil might this reaction occur?

Increased calcium levels

40. 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?

encouraging fluids

41. The nurse is developing a plan of care for the client with multiple myeloma. The nurse includes which priority intervention in the plan of care?

1 week after menstruation begins

42. Gio, a community health nurse, is instructing a group of female clients about breast self-examination. The nurse instructs the client to perform the examination:

Occurs most often in the older client

42. The oncology nurse specialist provides an educational session to nursing staff regarding the characteristics of Hodgkin's disease. The nurse determines that further education is needed if a nursing staff member states which of the following is characteristic of the disease?

Elevating the knee gatch on the bed

43. Nurse Cindy is caring for a client who has undergone a vaginal hysterectomy. The nurse avoids which of the following in the care of this client?

Assess level of consciousness

43. The nurse is reviewing the laboratory results of a client receiving chemotherapy. The platelet count is 10,000 cells/mm. Based on this laboratory value, the priority nursing assessment is which of the following?

Drink six to eight glasses of water without voiding before the test

44. Mina, who is suspected of an ovarian tumor is scheduled for a pelvic ultrasound. The nurse provides which pre-procedure instruction to the client?

Biopsy of the tumor

45. A male client is diagnosed as having a bowel tumor and several diagnostic tests are prescribed. The nurse understands which test will confirm the diagnosis of malignancy?

Apply sunscreen with a sun protection factor (SPF) of 30 or more before sun exposure

45. A nurse is providing education in a community setting about general measures to avoid excessive sun exposure. Which of the following recommendations is appropriate

Alopecia

46. Vanessa, a 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?

B. Fever

47. The nurse is teaching a 17-year old client and the client's family about what to expect with high-dose chemotherapy and the effects of neutropenia. What should the nurse teach as the most reliable early indicator of infection in a neutropenic client?

"Chemotherapy affects all rapidly dividing cells."

48. A 58-year-old man is going to have chemotherapy for lung cancer. He asks the nurse how the chemotherapeutic drugs will work. The most accurate explanation the nurse can give is which of the following?

Do not allow pregnant women into the client's room

48. Nurse Joy is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which of the following principles?

Bed rest

49. A cervical radiation implant is placed in the client for treatment of cervical cancer. The nurse initiates what most appropriate activity order for this client?

Faster growing cells are more susceptible to chemotherapy

5. Angela, a clinical instructor is conducting a lecture about chemotherapy. Which of the following statements is correct about the rate of cell growth in relation to chemotherapy?

Medicated cool baths

5. Which of the following represents the most appropriate nursing intervention for a client with pruritus caused by cancer or the treatments?

Teach the client and family about the need for hand hygiene

50. The nurse is caring for a female client experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. The nurse plans to:

"Try eating sashimi in one of the famous Japanese restaurants around the city"

6. A 40-year-old male diagnosed with acute lymphocytic leukemia finished his first cycle of chemotherapy. Which of the following statements by the nurse is wrong?

C. Breath sounds

7. A client with leukemia has neutropenia. Which of the following functions must be frequently assessed?

Client verbalizes feelings of anxiety."

8. For a female client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client

A 60-year-old African-American man

8. Which of the following clients is most at risk for developing multiple myeloma?

Related to impaired balance

9. A male client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. Which "related-to" phrase should the nurse add to complete the nursing diagnosis statement?

. Immunoglobulins

9. Which of the following substances has abnormal values early in the course of multiple myeloma (MM)?

low-grade fever, chills, tachycardia

A 36-year-old man with lymphoma presents with signs of impending septic shock 9 days after chemotherapy. The nurse would expect which of the following to be present?

Esophagitis

A 56-year-old woman is currently receiving radiation therapy to the chest wall for recurrent breast cancer. She calls her health care provider to report that she has pain while swallowing and burning and tightness in her chest. Which of the following complications of radiation therapy is A. Radiation enteritislikely responsible for her symptoms?

Malignant proliferation of plasma cells and tumors within the bone

A client is diagnosed with multiple myeloma. The client asks the nurse about the diagnosis. The nurse bases the response on which of the following descriptions of this disorder?

A. Metabolic alkalosis

A client with stomach cancer is admitted to the oncology unit after vomiting for 3 days. Physical assessment findings include irregular pulse, muscle twitching, and complaints of prickling sensations in the fingers and hands. Laboratory results include a potassium level of 2.9 mEq/L, a pH of 7.46, and a bicarbonate level of 29 mEq/L. The client is experiencing:

Alteration in the size, shape, and organization of differentiated cells

A male client has an abnormal result on a Papanicolaou test. After admitting, he read his chart while the nurse was out of the room, the client asked what dysplasia means. Which definition should the nurse provide?

It interferes with DNA replication and RNA transcription

A male client is receiving the cell cycle-nonspecific alkylating agent Thioplex (thiotepa), 60 mg weekly for 4 weeks by bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. The client asks the nurse how the drug works. How does thiotepa exert its therapeutic effects?

Ovarian cancer

Giving instructions for breast self-examination is particularly important for clients with which of the following medical problems?

Arm edema on the operative side

Nurse Donald is caring for a client following a modified radical mastectomy. Which assessment finding would indicate that the client is experiencing a complication related to this surgery?

Squamous cell

The client with which of the following types of lung cancer has the best prognosis?

B. If unable to aspirate blood, reposition the client and encourage the client to cough. C. Contact the health care provider about verifying placement if the status is questionable. D. Inspect the insertion site for swelling, erythema, or drainage. E. Verify patency of the line by the presence of a blood return at regular intervals.

When caring for a client with a central venous line, which of the following nursing actions should be implemented in the plan of care for chemotherapy administration? Select all that apply.

To assess for central nervous system infiltration

Which of the following is the reason to perform a spinal tap on a client newly diagnosed with leukemia?