Oncology

A nurse is caring for a postmenopausal client who is concerned that she might have an elevated risk of breast cancer. After conducting a risk assessment, the nurse should identify which of the following factors as increasing the client's breast cancer risk? SATA A. Increased breast density B. BMI of 32 C. Having given birth to 5 children D. Undergoing hormonal replacement therapy for 10 years E. Having 1-2 alcoholic drinks per week

A. Increased breast density B. BMI of 32 D. Undergoing hormonal replacement therapy for 10 years RATIONALE: C- women who are nulliparous have a higher risk of developing breast cancer

A nurse is providing teaching to a client who has stomatitis due to chemotherapy and radiation therapy. Which of the following statements by the client indicates a need for further teaching? A. I will use a soft toothbrush or foam swab for oral care B. I will use lemon and glycerin swabs after meals C. I will remove my dentures except while eating D. I will rinse my mouth frequently with hydrogen peroxide solution

B. I will use lemon and glycerin swabs after meals RATIONALE: D- rinse mouth with hydrogen peroxide, warm saline or baking soda solution every 2-3hr to promote comfort and wound healing

A nurse is collecting a health history from a client. Which of the following findings is the highest risk factor for the client developing bladder cancer? A. The client is a hairdresser B. The client uses tobacco C. The client is over age 60 D. The client has frequent UTIs

B. The client uses tobacco

A nurse is caring for a client who has testicular cancer and is experiencing peripheral neuropathy as an adverse effect of chemotherapy. Which of the following client manifestations is an expected finding of peripheral neuropathy? A. Thinning of the scalp hair B. Tingling of the hands and feet C. Reduced ability to concentrate D. Sores in mucous membranes

B. Tingling of the hands and feet

A nurse is providing postoperative discharge teaching to a client following a panhysterectomy for uterine cancer. Which of the following pieces of information should the nurse include in the teaching? A. You will need to continue to use some form of birth control for 6 months B. You might experience manifestations of menopause C. Do not lift anything heavier than 15lbs D. Pain or burning with urination is an expected outcome of this surgery

B. You might experience manifestations of menopause RATIONALE: A- Pregnancy not possible C- nothing heavier than 5-10lbs D- not expected, report to provider

A nurse is observing a newly licensed nurse provide care for a client who is receiving internal radiation therapy for the treatment of cervical cancer. For which of the following actions by the newly licensed nurse should the charge nurse intervene? A. Leaving soiled linens in a container in the client's room B. Instructing visitors to remain 2m (6 feet) away from the client C. Borrowing a dosimeter film badge from another nurse before entering the client's room D. Removing an extra IV pole from the client's room to be used for another client

C. Borrowing a dosimeter film badge from another nurse before entering the client's room RATIONALE: Nurses who are caring for the client should each have their own personal badge; each film badge will indicate the nurse's cumulative radiation exposure D- only soiled dressings or linens should be given special consideration prior to removal; equipment does not emit radiation

A nurse is caring for a client who is postoperative following a urinary diversion to treat bladder cancer. Which of the following interventions should the nurse include in the plan of care? A. Empty the collection pouch when it is 2/3 full B. Expect urine outflow into the pouch to begin 1-2 days after surgery C. Change the collection pouch in the early morning D. Place an aspirin in the collection pouch to control odor

C. Change the collection pouch in the early morning RATIONALE: because UO is reduced A- 1/3 full B- immediately D- no, can cause ulceration of the stoma

A nurse is providing discharge teaching to a client following an open radical prostatectomy. The client is going home with an indwelling urinary catheter. Which of the following statements by the client indicates an understanding of the teaching? A. I will be able to take a tub bath in 1 week B. I will change the catheter drainage bag once each week C. I will use suppositories to prevent constipation D. I will regain my bladder control once the catheter is removed

B. I will change the catheter drainage bag once each week RATIONALE: A- SHOWER for 2-3 weeks C- stool softeners D- might not return immediately, perform Kegel exercises to help; urinary incontinence can last 1-2 yrs following sx

A nurse is planning a presentation at a community center about risk factors for cancer. Which of the following types of cancer should the nurse include when discussing familial clustering of specific types of cancer? A. Skin B. Prostate C. Bone D. Bladder

B. Prostate RATIONALE: other types of cancers that demonstrate a familial tendency are breast, colorectal, ovarian and prostate A, C, D- typically these cancers do not pose a genetic risk

A nurse is planning care for a client who has cancer and developed thrombocytopenia following chemotherapy. Which of the following precautions should the nurse offer to minimize adverse effects of thrombocytopenia? A. Monitor visitors for manifestations of infection B. Remind the client to use an electric razor C. Encourage frequent rest periods D. Instruct the client to rinse mouth daily with normal saline

B. Remind the client to use an electric razor

A nurse is talking with a group of women at a community center about the current recommendations for early detection of breast cancer. The nurse should explain which of the following options? A. Begin monthly breast self-examinations at age 40 B. Have a clinical breast exam each year after age 30 C. Begin annual mammograms at age 40 D. Have breast magnetic imaging every 5 years after age 50

C. Begin annual mammograms at age 40 RATIONALE: A- In early 20s B- ages 20-39, should be every 3 yrs

A nurse is monitoring a client who has cancer and is receiving chemotherapy by peripheral IV infusion. The client reports pain at the insertion site, and the nurse notes fluid leaking around the catheter. Which of the following actions should the nurse take first? A. Take a photograph of the peripheral IV site B. Obtain and record the client's vital signs C. Stop the infusion D. Identify all medications administered through the IV site for the past 24hr

C. Stop the infusion

A nurse is providing discharge teaching to a client who is post-operative following a right mastectomy for breast cancer. The client will be discharged with 2 Jackson-Pratt drains. Which of the following pieces of information should the nurse include in the teaching? A. Empty the drainage tubes once per day B. Showering is permitted before the drainage tubes are removed C. The drainage tubes often are removed at the same time as the stitches D. Do not begin exercising your arm until the provider removes the drainage tubes

C. The drainage tubes often are removed at the same time as the stitches RATIONALE: This is usually within 7-10 days A- twice per day B- take baths until the provider removes the stitches D- nonstrenuous exercise is appropriate before the provider removes the tubes

A nurse is teaching a client who has leukemia and has developed thrombocytopenia. Which of the following instructions should the nurse include in the teaching? A. Limit flossing your teeth to once a week B. Gently blow your nose if needed C. Use an electric razor when shaving D. Wear shoes that have a soft sole

C. Use an electric razor when shaving RATIONALE: A- avoid all together B- avoid all together D- FIRM sole to avoid accidental puncture

A nurse is obtaining a client's health history who has cancer of the cervix. Which of the following manifestations should the nurse expect? A. Weight gain B. Oliguria C. Vaginal bleeding D. Back pain

C. Vaginal bleeding RATIONALE: The most common manifestation of cancer of the cervix is painless vaginal bleeding A- weight LOSS B- dysuria D- pelvic & chest pain

A nurse is admitting a client who has multiple myeloma and a WBC count of 2,200. Which of the following foods should the nurse PROHIBIT the family members from bringing to the client? A. Fried chicken from a fast food restaurant B. A case of canned nutritional supplements C. A factory sealed box of chocolates D. A fresh fruit basket

D. A fresh fruit basket RATIONALE: the skin of these foods might harbor bacteria that can cause infection

A nurse is caring for a client who has lung cancer that has metastasized. Which of the following findings indicates the client is developing superior vena cava syndrome? A. Irregular cardiac rhythm B. Numbness in the hands C. Muscle cramps D. Facial edema

D. Facial edema RATIONALE: SVC syndrome is a medical emergency resulting from a partial occlusion of the SVC, leading to decreased BF through the vein. The earliest manifestations of SVC syndrome are facial & upper extremity edema; death can result if the compression is not corrected

A nurse is caring for a client whose surgeon informed him postoperatively that he has a metastasizing malignant neoplasm in the colon. Which of the following statements by the client should the nurse identify as an indication that the client understands this information? A. I have cancer that has begun to spread B. I have growths in my bowel that the doctor can treat easily C. As long as my tumor doesn't get any bigger, I'll be okay D. There is not much point in having more treatments

A. I have cancer that has begun to spread

A nurse is providing teaching to a client who has cervical cancer and is scheduled to receive brachytherapy in an ambulatory care clinic. Which of the following statements by the client indicates an understanding of the teaching? A. I need to lie still in my bed during my brachytherapy treatment B. I will have an implant placed once a month during my brachytherapy treatment C. I must stay 3ft away from others between brachytherapy treatments D. I should expect some blood in my urine after each brachytherapy treatment

A. I need to lie still in my bed during my brachytherapy treatment RATIONALE: To prevent dislodgment

A nurse is providing teaching to a client with cancer who is receiving external radiation therapy. Which of the following statements by the client indicates an understanding of the teaching? A. I need to protect the area from sunlight B. I'm going to apply a heating pad to the area after each treatment C. I'll massage the area once per day D. I'll wash off the markings after each treatment

A. I need to protect the area from sunlight

A nurse is planning care for a client who is receiving chemotherapy and has a protein deficiency. Which of the following interventions should the nurse include in the plan of care? SATA A. Mix powdered skim milk into liquid milk B. Add raw egg to fruit smoothies C. Add a slice of cheese to hot vegetables D. Add honey to hot tea E. Mix yogurt into fresh fruit

A. Mix powdered skim milk into liquid milk C. Add a slice of cheese to hot vegetables E. Mix yogurt into fresh fruit

A nurse is caring for a client who recently had chemotherapy and now has myelosuppression. Which of the following interventions should the nurse initiate? SATA A. Prohibit visitors from bringing fresh flowers and plants into the room B. Encourage frequent visits from family and friends C. Ensure thorough cleaning of the client's room daily D. Replace wound dressings every other day E. Use dedicated equipment such as stethoscopes

A. Prohibit visitors from bringing fresh flowers and plants into the room C. Ensure thorough cleaning of the client's room daily E. Use dedicated equipment such as stethoscopes RATIONALE: D- DAILY

A nurse on an oncology unit is providing discharge teaching to an adolescent female client who received a bone marrow transplant for leukemia. Which of the following pieces of information should the nurse include in the teaching? SATA A. Take your temperature twice each day B. You may return to school if you feel strong enough C. It is important to wear shoes always D. Clean your toothbrush weekly with isopropyl alcohol E. Avoid using tampons

A. Take your temperature twice each day C. It is important to wear shoes always E. Avoid using tampons RATIONALE: D- rinse with weak bleach solution and place in dishwasher

A nurse is performing an admission assessment for a client who has colorectal cancer. Which of the following manifestations should the nurse expect to find? A. Hematuria B. Abdominal cramps C. Weight gain D. Polycythemia

B. Abdominal cramps RATIONALE: A- blood in STOOL, not urine C- weight LOSS D- anemia, not polycythemia

A nurse in an oncology clinic is assessing a client who has early stage Hodgkin's lymphoma. Which of the following findings should the nurse expect? A. Bone & joint pain B. Enlarged lymph nodes C. Intermittent hematuria D. Productive cough

B. Enlarged lymph nodes RATIONALE: A- LATE sign C- bladder CA D- lung CA

A nurse is caring for a client who has breast cancer and is receiving combination chemotherapy medications. The client expresses confusion about the therapy. Which of the following explanations should the nurse provide? A. The risk of renal toxicity is lessened when a combination of chemotherapy medications is used B. The chemotherapy medications act at different stages of cell division so more tumor cells are destroyed C. The use of more chemotherapy medications will shorted the time you have to be in treatment D. The combination of chemotherapy medications will eliminate the potential for bone marrow suppression

B. The chemotherapy medications act at different stages of cell division so more tumor cells are destroyed

A client who is planning care for a client who is postoperative following a radical mastectomy. Which of the following interventions should the nurse include in the plan? A. Rest the arm on the affected side on the bed while the client is sleeping B. Instruct the client to keep the affected arm flexed while ambulating C. Begin exercises with the client 1 day after the procedure D. Maintain the client on bedrest for 2 days after the procedure

C. Begin exercises with the client 1 day after the procedure RATIONALE: to not stress the incision on day 1 A- elevate to promote the return of lymphatic fluid B- avoid to reduce risk of contractures D- ambulate on day 1 post op to increase circulation, ventilation and mobility

A nurse is providing preoperative teaching for a client with colorectal cancer who is scheduled to undergo colostomy placement with a perineal wound. Which of the following statements by the client indicates an understanding of the teaching? A. Not having any more rectal pain will be a relief B. I will need to sit on a rubber donut when I am in the chair C. I can have only liquids for 2 days before the surgery D. The colostomy will start working about 7 days after the surgery

C. I can have only liquids for 2 days before the surgery RATIONALE: This is to decrease bulk and peristalsis

A nurse is providing teaching to a client who is receiving chemotherapy and has developed neutropenia. Which of the following statements indicates that the client needs further instructions? A. I'll keep antibacterial hand gel in my purse B. My partner will have to take care of the cat's litter boxes for a while C. I'm planning a large gathering of friends and family for the holidays D. I will eat canned fruits and vegetables

C. I'm planning a large gathering of friends and family for the holidays RATIONALE: avoid large crowds of people

A nurse is caring for a client who is receiving brachytherapy. Which of the following measures should the nurse include in the client's plan of care? A. Plan to spend extra time with the client to provide emotional support B. Ensure that chemotherapy medications do not extravasate into the client's tissues C. Keep the door to the client's room closed D. Encourage family members and friends to visit for at least 1 hr per day

C. Keep the door to the client's room closed RATIONALE: needs a private room with private bathroom A- LIMIT time spent with client B- brachytherapy doesn't involve chemo meds D- limit to 30min per day and stay 6ft from client

A nurse is caring for a client who is receiving chemotherapy to treat cancer. Which of the following adverse effects should the nurse anticipate from the chemotherapy? A. Gingival hyperplasia B. Hirsutism C. Pancytopenia D. Weight gain

C. Pancytopenia

A nurse is teaching a client how to perform a breast self examination (BSE). The nurse should identify which of the following findings as an indication of breast cancer? A. Lumps that are mobile and tender on palpation prior to a menstrual period B. Multiple round masses that are tender and found in both breasts C. Bilaterally darkened areolas D. A nontender, hard lump that is palpated in a breast

D. A nontender, hard lump that is palpated in a breast

A nurse is collecting a health history from a female client who is undergoing screening for breast cancer. Which of the following factors increases the client's risk of developing breast cancer? A. Obesity B. Oral contraceptive use C. Alcohol use D. Age over 50 y/o

D. Age over 50 y/o RATIONALE: Age is the #1 determining factor for CA risk A- only moderately increases risk B- only moderately increases risk C- dose dependent risk

A client who has stage II breast cancer asks the nurse about sites of metastasis for this cancer. Which of the following responses should the nurse provide? A. It's too soon to worry about something that might not happen B. Breast cancer tends to metastasize to the stomach C. Metastasis is unlikely since we detected your cancer early D. Breast cancer tends to metastasize to the bones

D. Breast cancer tends to metastasize to the bones RATIONALE: Also lungs, brain and liver

A nurse is providing teaching to a client who has cancer and is undergoing external radiation treatment. Which of the following statements by the client indicates an understanding of the teaching? A. I should use petroleum based lotions on the areas being radiated B. I will dry the areas being radiated by rubbing in a circular pattern C. I will apply sunscreen to the areas being radiated when I spend time in the sun D. I should use my hand, instead of a washcloth to wash the areas being radiated

D. I should use my hand, instead of a washcloth to wash the areas being radiated RATIONALE: A- no powders, lotions, ointments or creams should be used on the areas being radiated B- gently pat areas dry, do not rub C- do not apply to areas being radiated; instead, the client should protect these areas by wearing clothing, staying in the shade when in intense sun, or avoiding sun exposure

A hospice nurse is providing education about palliative care to the partner of a client who has end-stage liver cancer. Which of the following statements by the partner indicates an understanding of the teaching? A. I will do my best to try and get him to eat something B. I will lay him flat if his breathing becomes shallow C. I will use an electric blanket to keep him warm D. I will continue to talk to him, even when he's sleeping

D. I will continue to talk to him, even when he's sleeping RATIONALE: regarding the dying process A- should not be forced to eat/drink B- head elevated C- NON-electric

A nurse is preparing a plan of care for a client who is postoperative following a modified radical mastectomy. Which of the following invasive devices should the nurse expect the client to have? A. Chest tube B. Indwelling urinary catheter C. Nasogastric tube D. Jackson-Pratt drain

D. Jackson-Pratt drain

A nurse is caring for a client who is receiving radiation therapy for breast cancer and reports a metallic taste in the mouth. Which of the following dietary recommendations should the nurse share with the client? A. Eat with metal utensils B. Limit coffee C. Avoid citrus foods D. Offer mints

D. Offer mints RATIONALE: B- add coffee to sweet beverages or milk, as the coffee overcomes the sweetness of the beverage C- encourage citrus foods to overcome metallic taste

A nurse is collecting a client's health history. Which of the following findings is the highest risk factor for the client developing skin cancer? A. Age over 60 B. Genetic predisposition C. Light-skinned race D. Overexposure to sunlight

D. Overexposure to sunlight

A nurse is caring for a client who will receive brachytherapy to treat uterine cancer. The nurse should ensure the client understands that she will receive which of the following interventions? A. Chemotherapy via centra venous access device B. Radiation to the tumor from an external device C. Precise delivery of high-dose radiation after tumor imaging D. Radioactive infusions or insertions into or near the tumor

D. Radioactive infusions or insertions into or near the tumor

A nurse is caring for a client who is receiving radiation therapy for mouth cancer and reports a dry mouth. Which of the following dietary recommendations should the nurse provide? A. Offer graham crackers as a snack B. Avoid foods containing citrus C. Rinse the mouth with an alcohol-based mouthwash before eating D. Use gravies or sauces to soften food

D. Use gravies or sauces to soften food RATIONALE: this will make them easier to eat A- Avoid eating dry, coarse foods because it can make the mouth feel more dry & unpleasant B- SHOULD consume citrus to stimulate saliva C- Alcohol FREE before eating

A nurse is planning a presentation for a group of older adults at a community center about risk factors for cancer. Which of the following factors increases the risk of developing cancer after age 60? A. High-protein diet B. Insufficient calcium intake C. Declining muscle mass D. Weakened immune response

D. Weakened immune response