class NCLEX questions & prep u (med surg) CANCER part 1 & 2

An adult is receiving cancer chemotherapy and demonstrates alteration in her oral mucous membranes. Which of the following should be included in her plan of care? A. Brushing teeth and flossing after every meal and at bedtime B. Using normal saline mouth rinses every 2 hours while awake C. No use of dentures until mucous membranes have healed D. Bland, mechanical, soft diet until mucous membranes have healed

B. Using normal saline mouth rinses every 2 hours while awake

In caring for the client receiving external radiation therapy, the nurse assesses for which of the following side effects? A. Extravasation injury at the IV site used for contrast media injection B. Generalized or local edema C. Infection and bleeding D. Allergic reactions, particularly anaphylaxis

C. Infection and bleeding

The major difference between benign tumors and malignant tumors is that malignant tumors A Grow at a faster rate B. Are often encapsulated C. Invade and metastasize D. Cause death whereas benign tumors do not

C. Invade and metastasize

While caring for a patient who is at the nadir of chemotherapy, the nurse establishes the highest priority for the nursing diagnosis of A. Diarrhea B. Grieving C. Risk for infection D. Imbalanced nutrition: less than body requirements

C. Risk for infection

Which of the following actions is vital for the nurse to perform when assessing a client receiving chemotherapy? A. Checking complete vital signs every 8 hours B. Taking rectal temperatures every 4 hours to check for infection. C. Testing emesis for blood. D. Avoiding fresh fruits and vegetables if absolute white blood count is less than 1000/mm3

C. Testing emesis for blood.

An adult client is receiving radiation therapy. The nurse is teaching the client about signs of radiation-induced thrombocytopenia, which include A. Fatigue B. Shortness of breath C. Elevated temperature D. A tendency to bruise easily

D. A tendency to bruise easily

While doing a health history, a client tells you that her mother, her grandmother, and her sister died of breast cancer. The client wants to know what she can do to keep from getting cancer. What would be your best response? a) "You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is." b) "If you eat right, exercise, and get enough rest, you can always prevent breast cancer." c) "With your family history, there is nothing you can do to prevent getting cancer." d) "Cancer often skips a generation, so don't worry about it."

a) "You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is."

The physician recommends that parents have their daughter vaccinated with HPV vaccine. What is this vaccine for? a) Help prevent breast cancer b) Help prevent leukemia c) Help prevent lung cancer d) Help prevent cervical cancer

d) Help prevent cervical cancer

when teaching a patient testicular self-examination, the nurse instructs the patient to report a finding of a.) an irregular feeling epididymis b.) one testis larger than the other c.) the spermatic cord within the testicle d.) a firm, non-tender nodule on the testis

d.) a firm, non-tender nodule on the testis

A woman loses most of her hair as a result of cancer chemotherapy. The nurse understands that which of the following is true about chemotherapy-induced alopecia? A. New hair will be gray B. Avoid the use of wigs C. The hair loss is temporary D. Pre-chemo hair texture will return

C. The hair loss is temporary

Max Stein, a 79-year-old-male, is returning to your primary care practice for the results of his annual physical. He was without symptoms or complaints, yet he is returning to receive a diagnosis of prostate cancer. What factors contributed to this diagnosis? a) All of the options are correct b) Suspect client history c) Tumor markers d) Risk factors

a) All of the options are correct

The nurse is providing preoperative care to a client who is to undergo a radical prostatectomy for prostate cancer. The client's plan of care includes the nursing diagnosis of "anxiety related to surgery and its outcome." Which of the following would be most appropriate for the nurse to do? a) Ensure privacy when discussing sensitive or embarrassing sexual issues. b) Tell the client that prostate cancer is very curable if caught early. c) Inform the client that risk of recurrence is decreased with this type of surgery. d) Allow the client to assume a passive role in the preparation.

a) Ensure privacy when discussing sensitive or embarrassing sexual issues.

A nurse is administering daunorubicin (Daunoxome) through a peripheral I.V. line when the client complains of burning at the insertion site. The nurse notes no blood return from the catheter and redness at the I.V. site. The client is most likely experiencing which complication? a) Extravasation b) Flare c) Thrombosis d) Erythema

a) Extravasation

A nurse is preparing a presentation about cervical cancer for a local woman's group. Which of the following would the nurse include as a possible risk factor for the development of cervical cancer? a) Infection with human papilloma virus (HPV) b) Sexual activity beginning at a later age c) Never having been pregnant d) Having a single sexual partner

a) Infection with human papilloma virus (HPV)

Which type of surgery is utilized in an attempt to relieve complications of cancer? a) Palliative b) Reconstructive c) Salvage d) Prophylactic

a) Palliative

After being seen in the oncology clinic, a client with severe bone marrow suppression is admitted to the hospital. The client's cancer therapy consisted of radiation and chemotherapy. When developing the care plan for this client, which nursing diagnosis takes priority? a) Risk for infection b) Anxiety c) Imbalanced nutrition: Less than body requirements d) Risk for injury

a) Risk for infection

Which of the following is the most common type of prostate surgery? a) TURP b) Perineal prostatectomy c) Suprapubic prostatectomy d) Retropubic prostatectomy

a) TURP

A client diagnosed with prostate cancer is to receive brachytherapy. Which of the following would the nurse include when discussing this therapy with the client? a) Use of radioactive seeds implanted into the prostate b) Surgical castration to decrease the level of circulating testosterone c) Use of probes inserted using ultrasound to freeze the tissue d) Need for daily treatments over a 7- to 8-week period

a) Use of radioactive seeds implanted into the prostate

During a follow-up visit, a female client who underwent a mastectomy asks the nurse if she can work in her backyard or at least do some household work. Which suggestion would be most appropriate? a) Wear gloves and protective clothing to avoid any injuries. b) Avoid household chores for at least 6 to 9 months. c) Avoid working in the garden or yard altogether. d) Increase the frequency of follow-up visits if she does works.

a) Wear gloves and protective clothing to avoid any injuries.

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) Papanicolaou-specific antigen, which is used to screen for cervical cancer. c) pneumococcal strep antigen, which is a bacteria that causes pneumonia. d) protein serum antigen, which is used to determine protein levels.

a) prostate-specific antigen, which is used to screen for prostate cancer.

The clinic nurse is caring for a client who has just been diagnosed with a tumor. The client says to the nurse "The doctor says my tumor is benign. What does that mean?" What is the nurse's best response? a) "Benign tumors can spread from one place to another." b) "Benign tumors don't usually cause death." c) "Benign tumors invade surrounding tissue." d) "Benign tumors grow very rapidly."

b) "Benign tumors don't usually cause death."

A client comes to the clinic reporting urinary symptoms. Which statement would most likely alert the nurse to suspect benign prostatic hyperplasia (BPH)? a) "I'm waking up at night to urinate and I've noticed some burning, too." b) "I've had trouble getting started when I urinate, often straining to do so." c) "I've had some pain in my lower abdomen lately and felt a bit sick to my stomach." d) "I've had a fever and noticed I've been running to the bathroom more often."

b) "I've had trouble getting started when I urinate, often straining to do so."

The nurse is teaching a young adult male how to perform testicular self-examination (TSE). The nurse determines that the client has understood the instructions when he states which of the following? a) "I should roll the testis in a circular pattern around the palm of my hand." b) "The best time to do it is once a month after I take my warm morning shower." c) "I'll use my right hand to check the left testicle and the left hand to check the right one." d) "If the top and back of the testicle feels cordlike, I'll call my physician."

b) "The best time to do it is once a month after I take my warm morning shower."

The root cause of cancer is damage to cellular deoxyribonucleic acid (DNA). Such damage results from multiple factors. Which of the following is a carcinogen? a) Environmental factors b) All of the options are carcinogens. c) Viruses d) Dietary substances

b) All of the options are carcinogens.

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 care plan? a) Applying talcum powder to the irradiated areas daily after bathing b) Avoiding using soap on the irradiated areas c) Removing thoracic skin markings after each radiation treatment d) Wearing a lead apron during direct contact with the client

b) Avoiding using soap on the irradiated areas

While administering cisplatin (Platinol-AQ) to a client, the nurse assesses swelling at the insertion site. The first action of the nurse is to a) Aspirate as much of the fluid as possible. b) Discontinue the intravenous medication. c) Administer a neutralizing solution. d) Apply a warm compress.

b) Discontinue the intravenous medication.

A patient expresses concerns about future reproduction after a surgery to correct the cancer of the testes and for whom treatment has proceeded without collecting and storing sperm. Which of the following alternatives should a nurse suggest to the patient? a) Reversal of surgery b) Donor insemination or adoption c) Suggest the use of Viagra d) Undertake herbal alternatives

b) Donor insemination or adoption

A client is ordered continuous bladder irrigation at a rate of 60 gtt/minute. The nurse hangs a 2 L bag of sterile solution with tubing on a three-legged I.V. pole. She then attaches the tubing to the client's three-way urinary catheter, adjusts the flow rate, and leaves the room. Which important procedural step did the nurse fail to follow? a) Counter-balancing the I.V. pole b) Evaluating patency of the drainage lumen c) Attaching the infusion set to an infusion pump d) Collecting a urine specimen before beginning irrigation

b) Evaluating patency of the drainage lumen

A client who has undergone a surgical biopsy of a suspected breast lesion is being prepared for discharge from the ambulatory surgical center. The client is alert and oriented. Which criterion would be of least importance in determining her readiness for discharge? a) Being able to ambulate b) Having a bowel movement c) Tolerating fluids by mouth d) Voiding an adequate amount of urine

b) Having a bowel movement

After a radical prostatectomy for prostate cancer, a client has an indwelling catheter removed. The client then begins to have periods of incontinence. During the postoperative period, which intervention should be implemented first? a) Self-catheterization b) Kegel exercises c) Artificial sphincter use d) Fluid restriction

b) Kegel exercises

Cancer has many characteristics. What is one of the most discouraging characteristics of cancer? a) Carcinogenesis b) Metastasis c) Large size d) Slow growth

b) Metastasis

A nurse is speaking to a local women's group about the various types of cancer affecting the female reproductive tract. The nurse explains that ovarian cancer is the leading cause of death from gynecologic malignancies based on the understanding that this type of cancer does which of the following? a) Spreads more easily than other female reproductive cancers b) Typically manifests with vague symptoms resulting in late diagnosis c) Arises from extremely rare types of cells that are resistant to treatment d) Is closely associated with highly resistant sexually transmitted infections

b) Typically manifests with vague symptoms resulting in late diagnosis

To combat the most common adverse effects of chemotherapy, a nurse should administer an: a) anticoagulant. b) antiemetic. c) antimetabolite. d) antibiotic.

b) antiemetic.

A 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) fine needle aspiration. c) chest X-ray. d) mammography.

b) fine needle aspiration.

A 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) have a physician conduct a clinical examination every 2 years. b) have a mammogram annually. c) have a hormonal receptor assay annually. d) perform breast self-examination annually.

b) have a mammogram annually.

an elderly male has just returned to the nursing care unit following a transurethral resection. he has a three-way indwelling catheter with continuous bladder irrigation. he tells the nurse he has to void. the most appropriate nursing action is to a.) allow him to void around the catheter b.) irrigate the catheter c.) notify the physician d.) remove the catheter

b.) irrigate the catheter

a client who is 8 hours post-transurethral resection prostatectomy (TURP) asks the nurse "why is my urine in the bag clotting like blood?" the nurse's best interpretation of this finding is that a.) after all surgery bleeding is normal b.) it is common for blood clots to be irrigated from the bladder for a day or so c.) the physician is to be called as the client is hemorrhaging d.) the client is tugging on the catheter causing irritation to the bladder mucosa

b.) it is common for blood clots to be irrigated from the bladder for a day or so

A nurse is caring for a client who is receiving chemotherapy and has a platelet count of 30,000/mm3. Which statement by the client indicates a need for additional teaching? a) "I removed all the throw rugs from the house." b) "I use an electric razor to shave." c) "I floss my teeth every morning." d) "I take a stool softener every morning."

c) "I floss my teeth every morning."

During a breast examination, which finding most strongly suggests that a client has breast cancer? a) Bloody discharge from the nipple b) Slight asymmetry of the breasts c) A fixed nodular mass with dimpling of the overlying skin d) Multiple firm, round, freely movable masses that change with the menstrual cycle

c) A fixed nodular mass with dimpling of the overlying skin

What should a male client older than age 50 do to help ensure early identification of prostate cancer? a) Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly. b) Have a transrectal ultrasound every 5 years. c) Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly. d) Perform monthly testicular self-examinations, especially after age 50.

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

Your patient is receiving carmustine, a chemotherapy agent. A significant side effect of this medication is thrombocytopenia. What symptom would the nurse assess for in a patient at risk for thrombocytopenia? a) Increased weight b) Hot flashes c) Nose bleed d) Interrupted sleep pattern

c) Nose bleed

A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis? a) Yellow tooth discoloration b) Rust-colored sputum c) Red, open sores on the oral mucosa d) White, cottage cheese-like patches on the tongue

c) Red, open sores on the oral mucosa

A nurse is caring for a client who has just had a modified radical mastectomy with immediate reconstruction. She's in her 30s and has two young children. Although she's worried about her future, she seems to be adjusting well to her diagnosis. What should the nurse do to support her coping? a) Tell the client's spouse or partner to be supportive while she recovers. b) Encourage the client to proceed with the next phase of treatment. c) Refer the client to the American Cancer Society's Reach for Recovery program or another support program. d) Recommend that the client remain cheerful for the sake of her children.

c) Refer the client to the American Cancer Society's Reach for Recovery program or another support program.

After having transurethral resection of the prostate (TURP), a client returns to the unit with a three-way indwelling urinary catheter and continuous closed bladder irrigation. Which finding suggests that the client's catheter is occluded? a) The urine in the drainage bag appears red to pink. b) About 1,000 ml of irrigant have been instilled; 1,200 ml of drainage have been returned. c) The client reports bladder spasms and the urge to void. d) The normal saline irrigant is infusing at a rate of 50 drops/minute.

c) The client reports bladder spasms and the urge to void.

A 36-year-old man is receiving three different chemotherapeutic agents for Hodgkin's disease. The nurse explains to the client that the three drugs are given over an extended period because: a) The three drugs can be given at lower doses. b) The first two drugs are toxic to cancer cells, and the third drug promotes cell growth. c) The three drugs have a synergistic effect and act on the cancer cells with different mechanisms. d) The second and third drugs increase the effectiveness of the first drug.

c) The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.

A client complains of having tender and painful breasts, often feeling multiple lumps within her breast tissue. The nurse would need to gather additional information about which of the following? a) Client's workplace in relation to the surroundings b) Bathing frequency and living surroundings c) Timing of symptoms in relation to the menstrual cycle d) Alcohol and caffeine consumption

c) Timing of symptoms in relation to the menstrual cycle

Your client is receiving radiation therapy. The client asks you about oral hygiene. What advice regarding oral hygiene should you offer? a) Gargle after each meal. b) Floss before going to bed. c) Use a soft toothbrush and avoid an electronic toothbrush. d) Treat cavities immediately.

c) Use a soft toothbrush and avoid an electronic toothbrush.

The nurse is evaluating the client's risk for cancer and recommends changes when the client states she a) drinks 1 glass of wine at dinner each night b) uses the treadmill for 30 minutes on 5 days each week c) eats red meat such as steaks or hamburgers every day d) works as a secretary at a medical radiation treatment center

c) eats red meat such as steaks or hamburgers every day

Palliation refers to a) hair loss. b) the spread of cancer cells from the primary tumor to distant sites. c) relief of symptoms associated with cancer. d) the lowest point of white blood cell depression after therapy that has toxic effects on the bone marrow

c) relief of symptoms associated with cancer.

Testicular cancer risk is highest for adolescents and men younger than age 35. To specifically address testicular cancer risk, a nurse should modify client teaching for male clients to include: a) risk factors. b) physician visits. c) testicular self-examination. d) family history.

c) testicular self-examination.

a 46 year old woman is admitted to the hospital for a panhysterectomy. which nursing strategy should be included in the nursing care plan to meet her body image perception change? a.) allowing her time to work out her feelings on her own b.) discouraging her fears about weight gain c.) helping her verbalize her fears about her femininity d.) insisting that she look at the scar

c.) helping her verbalize her fears about her femininity

A client has had a right modified radical mastectomy and axillary lymph node dissection. The nurse is teaching the client about measures to reduce the risk of complications. The client demonstrates understanding of the instructions when she states which of the following? a) "Anytime I need blood drawn, they should get the sample from my right arm." b) "I can lift with my right arm objects that weigh as much as 15 pounds." c) "I should tell my manucurist that it is okay to trim the cuticles on my right hand." d) "I need to use an electric shaver when shaving my right armpit."

d) "I need to use an electric shaver when shaving my right armpit."

A client who will have his last chemotherapy cycle in 11 days becomes neutropenic. The client understands his condition when he states: a) "I love working in my garden; it gives me a lot of inner peace and tranquility." b) "I find that going out for a quiet dinner and a movie relieves the stress and anxiety of my cancer treatment." c) "I've found that eating fresh fruit and vegetables reduces the side effects of chemotherapy and also gives me more energy." d) "I'll monitor my temperature frequently and go to the nearest emergency department if my temperature rises above 100.4° F."

d) "I'll monitor my temperature frequently and go to the nearest emergency department if my temperature rises above 100.4° F."

A patient with a diagnosis of prostate cancer is receiving radiation therapy, a treatment that has resulted in stomatitis. To best manage this patient's stomatitis, the nurse should: a) Provide a hypertonic solution for the patient to gargle. b) Arrange for a low-residue diet for the patient and provide small, frequent meals. c) Encourage the patient's family to bring in mouthwash for the patient. d) Encourage the patient to use an oral swab rather than a regular toothbrush.

d) Encourage the patient to use an oral swab rather than a regular toothbrush.

Which of the following would a nurse include in a teaching plan for a client with benign prostatic hyperplasia who is not yet a candidate for surgery? a) Using appropriate coping to allay anxiety b) Performing deep breathing exercises periodically c) Doing leg exercises at least daily d) Maintaining optimal bladder emptying

d) Maintaining optimal bladder emptying

A client tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client's lump is cancerous? a) Nonpalpable right axillary lymph nodes b) Eversion of the right nipple and mobile mass c) Mobile mass that is soft and easily delineated d) Nonmobile mass with irregular edges

d) Nonmobile mass with irregular edges

You are admitting a client to your unit. While assessing the client. you find out that the client has had hoarseness of approximately 4 months duration. Why would you report this to the attending physician? a) The client may have chronic laryngitis. b) The client is a smoker and has denied it. c) Persistent hoarseness means the client talks to much. d) Persistent hoarseness is a warning sign of cancer.

d) Persistent hoarseness is a warning sign of cancer.

The client has received chemotherapy and 1 week later is at home experiencing nausea and vomiting. The first action of the nurse is to recommend a) Practicing relaxation techniques b) Obtaining acupressure treatments c) Using imagery techniques d) Taking prescribed ondansetron (Zofran)

d) Taking prescribed ondansetron (Zofran)

A decrease in circulating white blood cells is a) neutropenia. b) granulocytopenia. c) thrombocytopenia. d) leukopenia.

d) leukopenia.

According to the TNM classification system, T0 means there is a) distant metastasis. b) no regional lymph node metastasis. c) no distant metastasis. d) no evidence of primary tumor.

d) no evidence of primary tumor.

a group of women have gathered at the local library for a series of seminar's about women's health issues. in discussing cancer of the cervix, which of the following would be accurate? a.) this cancer is very rapid growing, so early detection is difficult to achieve b.) a cervical biopsy is the screening test of choice for early detection of cervical cancer c.) all women have an equal chance of developing cervical cancer because there are no risk factors d.) an early Pap smear may detect cervical dysplasia, a frequent precursor of cervical cancer

d.) an early Pap smear may detect cervical dysplasia, a frequent precursor of cervical cancer

a patient with lung mass found on chest x-ray is undergoing further testing. the nurse explains that a diagnosis of lung cancer can be confirmed by a.) CT scans b.) lung tomograms c.) pulmonary angiography d.) biopsy positive for malignant cells

d.) biopsy positive for malignant cells