Cancer & Oncology Nursing NCLEX Practice Quiz 3
A patient who has been told by the health care provider that the cells in a bowel tumor are poorly differentiated asks the nurse what is meant by "poorly differentiated." Which response should the nurse make? a) "Your tumor cells look more like immature fetal cells than normal bowel cells." b) "The cells in your tumor have mutated from the normal bowel cells." c) "The cells in your tumor do not look very different from normal bowel cells." d) "The tumor cells have DNA that is different from your normal bowel cells."
a) "Your tumor cells look more like immature fetal cells than normal bowel cells." - Correct Answer: A. "Your tumor cells look more like immature fetal cells than normal bowel cells." Option A: An undifferentiated cell has an appearance more like a stem cell or fetal cell and less like the normal cells of the organ or tissue. Option B: All tumor cells are mutations from the normal cells of the tissue. Options C and D: The DNA in cancer cells is always different from normal cells, whether the cancer cells are well differentiated or not.
During the admission assessment of a 35 year old client with advanced ovarian cancer, the nurse recognizes which symptom as typical of the disease? a) Abdominal distention b) Abdominal bleeding c) Diarrhea d) Hypermenorrhea
a) Abdominal distention - Correct Answer: A. Abdominal distention Option A: Clinical manifestations of ovarian cancer include abdominal distention, urinary frequency 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. Options B and D: Abnormal bleeding, often resulting in hypermenorrhea, is associated with uterine and endometrial cancer. Option C: Diarrhea is often related to colon cancer, lymphoma, carcinoid syndrome, and pancreatic cancer.
To provide relief from the cytarabine syndrome, which drug is given? a) Dexamethasone b) Allopurinol c) Alka Seltzer d) Aspirin
a) Dexamethasone - Correct Answer: A. Dexamethasone Option A: Steroids such as dexamethasone may be prescribed to promote relief from cytarabine syndrome. Option B: Allopurinol is given for hyperuricemia that will result from taking some chemotherapeutic agent. Options C and D: Since cytarabine causes platelets to decrease, aspirin and aspirin-containing products are not advised unless prescribed by the physician.
Neoplasm can be classified as either benign or malignant. The following are characteristics of malignant tumor apart from: a) Encapsulated b) Infiltrates surrounding tissues c) Metastasis d) Poorly differentiated cells
a) Encapsulated - Correct Answer: A. Encapsulated Option A: Benign: grows slowly, localized, encapsulated, well-differentiated cells, no metastasis, not harmful to host. Options B, C, and D: Malignant: Grows rapidly, infiltrate surrounding tissues, not encapsulated, poorly differentiated, metastasis present, always harmful.
The home health care nurse is caring for a male client with cancer and the client is complaining of acute pain. The appropriate nursing assessment of the client's pain would include which of the following? a) The client's pain rating b) the nurse's impression of the client's pain c) Nonverbal cues from the client d) Pain relief after appropriate nursing intervention
a) The client's pain rating - Correct Answer: A. The client's pain rating Option A: The client's self-report is a critical component of pain assessment. The nurse should ask the client about the description of the pain and listen carefully to the client's words used to describe the pain. Option B: Nonverbal cues from the client are important but are not the most appropriate pain assessment measure. Option C: The nurse's impression of the client's pain is not appropriate in determining the client's level of pain. Option D: Assessing pain relief is an important measure, but this option is not related to the subject of the question.
The nurse is preparing Cytoxan (cyclophosphamide). Safe handling of the drug should be implemented to protect the nurse from injury. Which of the following actions by the nurse should be corrected? a) The nurse should wear a mask and gloves b) Air bubbles should be expelled on wet cotton c) Review order to check the rate solution, and frequency of the drug d) Vent vials after mixing
a) The nurse should wear a mask and gloves - Correct Answer: A. The nurse should wear a mask and gloves Option A: The nurse should be corrected if she is only wearing a mask and glove because additional protective equipment (gown, goggles, and face shields) should also be worn in handling chemotherapeutic drugs. Option B: Air bubbles are expelled on wet cotton to prevent the spread of the chemotherapeutic agent particles. Option C: Ensures the IV chemotherapy solution is correct and helps avoid medication error. Option D: The vials should be vent after mixing to reduce the internal pressure.
Breast self-examination (BSE) is one of the ways to detect breast cancer earlier. The nurse is conducting health teaching to female clients in a clinic. During an evaluation, the clients are asked to state what they learned. Which of the following statements made by a client needs further teaching about BSE? a) "BSE is done after menstruation." b) "BSE palpation is done by starting at the center going to the periphery in a circular motion." c) "BSE can be done in a lying position." d) "BSE should start from age 20."
b) "BSE palpation is done by starting at the center going to the periphery in a circular motion." - Correct Answer: B. "BSE palpation is done by starting at the center going to the periphery in a circular motion." Option B: This client needs further teaching as palpation in BSE should start at the periphery going to the center in a circular motion. Option A: BSE is performed 7-10 days after menstruation when the breast are less tender and lumpy. Option C: The breast can be examined in a lying position since this position flattens the breast and makes it easier to examine. Option D: All women age 20 and older must do self-breast exams where breast tumors can be easily detected at this age.
A patient undergoing external radiation has developed dry desquamation of the skin in the treatment area. The nurse knows that teaching about the management of the skin reaction has been effective when the patient says a) "I can use ice packs to relieve itching in the treatment areas." b) "I can buy a steroid cream to use on the itching area." c) "I will expose the treatment area to a sun lamp daily." d) "I will scrub the area with warm water to remove the scales."
b) "I can buy a steroid cream to use on the itching area." - Correct Answer: B. "I can buy a steroid cream to use on the itching area Option B: Steroid (over-the-counter [OTC] hydrocortisone) cream may be used to reduce itching in the area. Options A and C: Extreme heat or cold temperatures may injure the skin. Option D: Treatment areas should be cleaned gently to avoid further injury.
A client taking a chemotherapeutic agent understands the effects of therapy by stating: a) "I should stay in my room all the time." b) "I will avoid eating hot and spicy foods." c) "I should limit my fluid intake to about 500 mL per day." d) "I should notify the physician immediately if a urine color change is observed."
b) "I will avoid eating hot and spicy foods." - Correct Answer: B. "I will avoid eating hot and spicy foods." Option B: The client should prevent hot and spicy food because of the stomatitis side effect. Spicy foods can further irritate the lining of the mouth causing more ulcers. Option A: The client should avoid people with infection but should not isolate himself in his room all the time. Option C: Fluid intake should be increased to help flush out the medication and replace lost fluids caused by the other side effects of chemotherapy such as nausea and vomiting. Option D: Urine color change is normal.
The nurse is teaching a postmenopausal patient with breast cancer about the expected outcomes of her cancer treatment. The nurse evaluates that the teaching has been effective when the patient says a) "After cancer has not recurred for 5 years, it is considered cured." b) "I will need to have follow-up exams for many years after I have treatment before I can be considered cured." c) "Cancer is considered cured if the entire tumor is surgically removed." d) "Cancer is never considered cured, but the tumor can be controlled with surgery, chemotherapy, and radiation."
b) "I will need to have follow-up exams for many years after I have treatment before I can be considered cured." - Correct Answer: B. "I will need to have follow-up examinations for many years after I have treatment before I can be considered cured." Option B: The risk of recurrence varies by the type of cancer; for breast cancer in postmenopausal women, the patient needs at least 20 disease-free years to be considered cured. Options A, C, and D: Some cancers (e.g., leukemia) are cured by nonsurgical therapies such as radiation and chemotherapy.
The classic symptoms that define breast cancer include the following except: a) Solitary, irregular shaped mass b) "Pink peel" skin c) Firm, nontender, nonmobile mass d) Abnormal discharge from the nipple
b) "Pink peel" skin - Correct Answer: B. "Pink peel" skin Options D: Pink peel skin is a symptom of breast cancer but it can also be seen with other conditions such as eczema, contact dermatitis, or scarlet fever. Options A, C, and D: Classic symptoms that define breast cancer include: Firm, nontender, nonmobile mass. Solitary, irregularly shaped mass. Adherence to muscle or skin causing dimpling effect. Involvement of the upper outer quadrant or central nipple portion. Asymmetry of the breasts. "Orange peel" skin. Retraction of nipple. Abnormal discharge from nipple.
On a clinic visit, a client who has a relative with cancer is asking about the warning signs that may relate to cancer. The nurse correctly identifies the warning signs of cancer by responding: a) "A lump located only in the breast may suggest the presence of cancer." b) "Sudden weight loss of unexplained etiology can be a warning sign of cancer." c) "Presence of dry cough is one of the warning signs of cancer." d) "If a sore healing took a month or more to heal, cancer should be suspected."
b) "Sudden weight loss of unexplained etiology can be a warning sign of cancer." - Correct Answer: B. "Sudden weight loss of unexplained etiology can be a warning sign of cancer." Option B: Unexplained sudden weight loss of 10 pounds or more is a warning signal of cancer. This is common among cancers of the esophagus, stomach, and pancreas. Option A: The presence of lump is not limited to the breast only; it can grow elsewhere which is why this option is wrong. Option C: Nagging cough not dry cough and hoarseness of voice is a sign of cancer. Option D: The sore in cancer does not heal.
Which statement by a patient who is scheduled for a needle biopsy of the prostate indicates that the patient understands the purpose of a biopsy? a) "The biopsy will tell the doctor whether cancer has spread to my other organs." b) "The biopsy will help the doctor decide what treatment to use for my enlarged prostate." c) "The biopsy will determine how much longer I have to live." d) "The biopsy will indicate the effect of cancer on my life."
b) "The biopsy will help the doctor decide what treatment to use for my enlarged prostate." - Correct Answer: B. "The biopsy will help the doctor decide what treatment to use for my enlarged prostate." Option B: A biopsy is used to determine whether the prostate enlargement is benign or malignant and determines the type of treatment that will be needed. Options A, C, and D: Biopsy does not give information about metastasis, life expectancy, or the impact of cancer on the patient's life; the three remaining statements indicate a need for patient teaching.
A patient with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. Important nursing intervention for the patient is to a) Have the patient eat large meals when nausea is not present b) Administer prescribed antiemetics 1 hour before the treatments c) Teach about the importance of nutrition during treatment d) Offer dry crackers and carbonated fluids during chemotherapy
b) Administer prescribed antiemetics 1 hour before the treatments - Correct Answer: B. Administer prescribed antiemetics 1 hour before the treatments Option B: Treatment with antiemetics before chemotherapy may help to prevent anticipatory nausea. Option C: Although nausea may lead to poor nutrition, there is no indication that the patient needs instruction about nutrition. Option A: The patient should eat small, frequent meals. Option D: Offering food and beverages during chemotherapy is likely to cause nausea.
Chemotherapeutic agents have different specific classifications. The following medications are antineoplastic antibiotics except: a) Adriamycin (doxorubicin) b) Adrucil (fluorouracil) c) Novantrone (mitoxantrone) d) Blenoxane (bleomycin)
b) Adrucil (fluorouracil) - Correct Answer: B. Adrucil (fluorouracil) Option B: Adrucil (fluorouracil) is an antimetabolite. Antimetabolites work by acting as false metabolites that prevent DNA synthesis. Options A, C, and D: Antineoplastic antibiotics such as doxorubicin, mitoxantrone, and bleomycin are products of Streptomyces. These anticancer drugs block cell growth by interfering with DNA.
Nurse Janet is assigned to the oncology section of the hospital. Which of the following orders should the nurse question if a client is on radiation therapy? a) Bland diet b) Aspirin every 4 hours c) Saline rinses every 2 hours d) Analgesics before meals
b) Aspirin every 4 hours - Correct Answer: B. Aspirin every 4 hours Option B: Radiation therapy makes the platelet count decrease. Thus, nursing responsibilities should be directed at promoting safety by avoiding episodes of hemorrhage or bleeding such as physical trauma and aspirin administration. Options A and C: Bland diet and saline rinses every 2 hours should also be done to manage stomatitis, a complication of radiation therapy. Option D: Analgesics are given before meals to alleviate the pain caused by stomatitis.
The nurse is admitting a male client with laryngeal cancer to the nursing unit. The nurse assesses for which most common risk factor for this type of cancer? a) Alcohol abuse b) Cigarette smoking c) Use of chewing tobacco d) Exposure to air pollutants
b) Cigarette smoking - Correct Answer: B. Cigarette smoking Option B: Cigarette use is the most common risk factor for head and neck cancers such as laryngeal cancer. The smoke that comes from a cigarette contains harmful chemicals such as nicotine, carbon monoxide, ammonia, and hydrogen cyanide that passes through the larynx on its way to the lungs. Options A and C: Combined use of alcohol and tobacco enhances the risk. Option D: Another risk factor is exposure to environmental pollutants (e.g., paint fumes, wood dust, coal dust) but cigarette smoking remains the most common.
While being prepared for a biopsy of a lump in the right breast, the patient asks the nurse what the difference is between a benign tumor and a malignant tumor. The nurse explains that a benign tumor differs from a malignant tumor in that benign tumors a) Do not cause damage to adjacent tissue b) Do not spread to other tissues and organs c) Are simply an overgrowth of normal cells d) Frequently recur in the same site
b) Do not spread to other tissues and organs - Correct Answer: B. Do not spread to other tissues and organs Option B: The major difference between benign and malignant tumors is that malignant tumors invade adjacent tissues and spread to distant tissues and benign tumors never metastasize. Option A: Both types of tumors may cause damage to adjacent tissues. Option C: The cells differ from normal in both benign and malignant tumors. Option D: Benign tumors usually do not recur.
A client is diagnosed with progressive prostate cancer. Does the nurse expect which drug is given? a) Arimidex (anastrozole) b) Emcyt (estramustine) c) Taxol (paclitaxel) d) Camptosar (irinotecan)
b) Emcyt (estramustine) - Correct Answer: B. Emcyt (estramustine) Option B: Emcyt (estramustine)- is used as a palliative treatment of metastatic and progressive prostate cancer. Option A: Arimidex (anastrozole)- is used in the treatment of advanced breast cancer in post-menopausal women following tamoxifen therapy. Option C: Taxol (paclitaxel) is given as a treatment for ovarian cancer, breast cancer, and AIDS-related to Kaposi's sarcoma. Option D: Camptosar (irinotecan) is indicated in the treatment of metastatic colon or rectal cancer after treatment with 5-FU.
The removal of entire breast, pectoralis major and minor muscles and neck lymph nodes which is followed by skin grafting is a procedure called: a) Radiation therapy b) Halstead surgery c) Modified radical mastectomy d) Simple mastectomy
b) Halstead surgery - Correct Answer: B. Halstead surgery Option B: Halstead surgery also called radical mastectomy involves the removal of the entire breast, pectoralis major and minor muscles, and neck lymph nodes. It is followed by skin grafting. Option A: Radiation therapy uses high doses radiation to kill cancer cells and their ability to grow and divide. Option C: Removal of the entire breast, pectoralis major muscle and the axillary lymph nodes is a surgical procedure called modified radical mastectomy. Option D: Simple mastectomy is the removal of the entire breast but the pectoralis muscles and nipples remain intact.
A client is taking Cyclophosphamide (Cytoxan) for the treatment of lymphoma. The nurse is very cautious in administering the medication because this drug poses the fatal side effect of: a) Sterility b) Hemorrhagic cystitis c) Myeloma d) Alopecia
b) Hemorrhagic cystitis - Correct Answer: B. Hemorrhagic cystitis Option B: Cyclophosphamide when broken down by the body into a substance called acrolein which is excreted into the urine causing irritation in the lining of the bladder (hemorrhagic cystitis). Options A and D: Sterility and alopecia are common side effects of the drug but is only temporary. Option C: Myeloma is an indication for giving this medication.
The client with leukemia is receiving Myleran (busulfan) and Zyloprim (allopurinol). The nurse tells the client that the purpose if the allopurinol is to prevent: a) mouth sores b) Hyperuricemia c) Nausea d) Alopecia
b) Hyperuricemia - Correct Answer: B. Hyperuricemia Option B: Allopurinol decreases uric acid concentrations in serum and urine. In the client receiving chemotherapy, uric acid levels increase as a result of the massive cell destruction that occurs from the chemotherapy. This medication prevents or treats hyperuricemia caused by chemotherapy. Options A, C, and D: Allopurinol is not used to prevent alopecia, nausea, or mouth sores.
The specific classification of the chemotherapeutic agent, Vincristine (Oncovin) is: a) Hormone modulator b) Mitotic inhibitor c) Antineoplastic antibiotic d) Antimetabolite
b) Mitotic inhibitor - Correct Answer: B. Mitotic inhibitor Option B: Vincristine is a mitotic inhibitor that inhibits mitosis or cell division. Other examples of mitotic inhibitors are paclitaxel, docetaxel, and vinblastine. Option A: Hormone modulators work by interfering with the activity of hormones. A good example are the selective estrogen receptor modulators (Tamoxifen, Raloxifene, and Ospemifene). Option C: Antineoplastic antibiotic (e.g., doxorubicin, mitoxantrone, and bleomycin) blocks cell growth by interfering with DNA. Option D: Antimetabolites (such as Sulfanilamides) work by acting as false metabolites that prevent DNA synthesis.
Surgical procedure to treat breast cancer involves the removal of the entire breast, pectoralis major muscle and the axillary lymph nodes is: a) Simple mastectomy b) Modified radical mastectomy c) Halstead Surgery d) Radical mastectomy
b) Modified radical mastectomy - Correct Answer: B. Modified radical mastectomy Option B: Removal of the entire breast, pectoralis major muscle and the axillary lymph nodes is a surgical procedure called modified radical mastectomy. Option A: Simple mastectomy is the removal of the entire breast but the pectoralis muscles and nipples remain intact. Options C and D: Halstead surgery also called radical mastectomy involves the removal of the entire breast, pectoralis major and minor muscles and neck lymph nodes. It is followed by skin grafting.
Nurse Kate is reviewing the complications of colonization with a client who has microinvasive cervical cancer. Which complication, if identified by the client, indicates a need for further teaching? a) Hemorrhage b) Ruptured ovarian cyst c) Infection d) Cervical stenosis
b) Ruptured ovarian cyst - Correct Answer: B. Ovarian perforation Option B: Ruptured ovarian cyst is not a complication. This usually occurs after a strenuous exercise and after sexual intercourse. Options A, C, and D: Conization procedure involves the removal of a cone-shaped area of the cervix. Complications of the procedure include hemorrhage, infection, and cervical stenosis.
A client is diagnosed with breast cancer. The tumor size is up to 5 cm with axillary and neck lymph node involvement. The client is in what stage of breast cancer? a) Stage I b) Stage II c) Stage III d) Stage IV
b) Stage II - Correct Answer: B. Stage II Option B: The tumor in stage II measures between 2 cm to 5 cm or the cancer has extended to the nearby lymph nodes. Option A: Stage I - tumor size up to 2 cm. Stage II - tumor size up to 5 cm with axillary and neck lymph node involvement. Option C: Stage III - tumor size is more than 5 cm with axillary and neck lymph node involvement. Option D: Stage IV - metastasis to distant organs (liver, lungs, bone and brain).
The following are teaching guidelines regarding radiation therapy except: a) The therapy is painless b) To promote safety, the client is assisted by therapy personnel while the machine is in operation c) The client may communicate all his concerns or needs or discomforts while the machine is operating d) Safety precautions are necessary only during the time of actual irradiation
b) To promote safety, the client is assisted by therapy personnel while the machine is in operation - Correct Answer: B. To promote safety, the client is assisted by therapy personnel while the machine is in operation Option B: To promote safety to the personnel, the client will remain alone in the treatment room while the machine is in operation. Options A and D: There is no residual radioactivity after radiation therapy. Safety precautions are necessary only during the time of actual irradiation. The client may resume normal activities of daily living afterward. Option C: The client may voice out any concern throughout the treatment because a technologist is just outside the room observing through a window or closed-circuit TV.
A patient with Hodgkin's lymphoma is undergoing external radiation therapy on an outpatient basis. After 2 weeks of treatment, the patient tells the nurse, "I am so tired I can hardly get out of bed in the morning." An appropriate intervention for the nurse to plan with the patient is to a) Consult with a psychiatrist for treatment of depression b) establish a time to take a short walk every day c) Exercise vigorously when fatigue is not as noticeable d) Maintain bed rest until the treatment is completed
b) establish a time to take a short walk every day - Correct Answer: B. Establish a time to take a short walk every day Option B: Walking programs are used to keep the patient active without excessive fatigue. Option A: Fatigue is expected during treatment and is not an indication of depression. Option C: Vigorous exercise when the patient is less tired may lead to increased fatigue. Option D: Bed rest will lead to weakness and other complications of immobility.
A patient who smokes tells the nurse, "I want to have a yearly chest x-ray so that if I get cancer, it will be detected early." Which response by the nurse is most appropriate? a) "Insurance companies do not authorize yearly x-ray just to detect early lung cancer." b) "Annual x-rays will increase your risk for cancer b/c of exposure to radiation." c) "Chest x-rays do not detect cancer until tumors are already at least a half-inch in size." d) "Frequent x-rays damage the lungs and make them more susceptible to cancer."
c) "Chest x-rays do not detect cancer until tumors are already at least a half-inch in size." - Correct Answer: C. "Chest x-rays do not detect cancer until tumors are already at least a half-inch in size." Option C: A tumor must be at least 1 cm large before it is detectable by an x-ray and may already have metastasized by that time. Option A: Insurance companies do not usually authorize x-rays for this purpose, but it would not be appropriate for the nurse to give this as the reason for not doing an x-ray. Options B and D: Radiographs have low doses of radiation, and an annual x-ray alone is not likely to increase lung cancer risk.
Contact of client on radiation therapy should be limited only to how many minutes to promote safety of the therapy personnel? a) 2 minute b) 3 minutes c) 5 minutes d) 10 minutes
c) 5 minutes - Correct Answer: C. 5 minutes Option C: Principles of Radiation protection follows the DTS system. Distance (D), Time (T), and Shielding (S). Distance - at least 3 feet should be maintained when a nurse is not performing any nursing procedures. Time - limit exposure to 5 minutes each time. Shielding - use lead shield during contact with the client.
A 25-year-old patient is inquiring about the methods or ways to detect cancer earlier. The nurse least likely identifies this method by stating: a) Yearly physical and blood exam b) Annual digital rectal exam for persons over age 40 c) Annual Pap smear for sexually active women only d) Annual chest x-ray
c) Annual Pap smear for sexually active women only - Correct Answer: C. Annual Pap smear for sexually active women only Option C: Pap smear should be done yearly for sexually active women. All women should have an annual pap smear by age 40 and up whether sexually active or not. Options A, B, and D: Early detection of cancer is promoted by annual oral examination, monthly BSE from age 20, annual chest x-ray, yearly digital rectal examination for persons over age 40, annual Pap smear from age 40 and annual physical and blood examination.
Sarah, a hospice nurse visits a client dying of ovarian cancer. During the visit, the client expresses that "If I can just live long enough to attend my daughter's graduation, I'll be ready to die." Which phrase of coping is this client experiencing? a) Anger b) Denial c) Bargaining d) Depression
c) Bargaining - Correct Answer: C. Bargaining Option C: Denial, bargaining, anger, depression, and acceptance are recognized stages that a person facing a life-threatening illness experience. Bargaining identifies a behavior in which the individual is willing to do anything to avoid loss or change prognosis or fate. Option A: Anger also may be the first response to upsetting news and the predominant theme is "why me?" or the blaming of others. Option B: Denial is expressed as shock and disbelief and may be the first response to hearing bad news. Option D: Depression may be manifested by hopelessness, weeping openly, or remaining quiet or withdrawn
Nurse Melinda is caring for a client who is postoperative following a pelvic exenteration and the physician changes the client's diet from NPO status to clear liquids. The nurse makes which priority assessment before administering the diet? a) Ability to ambulate b) Urine specific gravity c) Bowel sounds d) Incision appearance
c) Bowel sounds - Correct Answer: C. Bowel sounds Option C: The client is kept NPO until peristalsis returns, usually in 4 to 6 days. When signs of bowel function return, clear fluids are given to the client. If no distention occurs, the diet is advanced as tolerated. The most important assessment is to assess bowel sounds before feeding the client. Options A, B, and D: These are unrelated to the subject of the question.
A client had undergone radiation therapy (external). The expected side effects include the following apart from: a) Hair loss b) ulceration of oral mucous membranes c) Constipation d) Headache
c) Constipation - Correct Answer: C. Constipation Option C: Diarrhea, not constipation is the side effect of radiation therapy which usually starts during or right after the treatment and may last for several weeks. Options A, B, and D: These are common side effects of radiation therapy.
During a routine health examination, a 30-year-old patient tells the nurse about a family history of colon cancer. The nurse will plan to a) Schedule a sigmoidoscopy to provide baseline data about the pt. b) Teach the pt. about the need for a colonoscopy at age 50 c) Have the pt. ask the doctor about specific tests for colon cancer d) Ask the pt. to bring in a stool specimen to test for occult blood
c) Have the pt. ask the doctor about specific tests for colon cancer - Correct Answer: C. Have the patient ask the doctor about specific tests for colon cancer Option C: The patient is at increased risk and should talk with the health care provider about needed tests, which will depend on factors such as the exact type of family history and any current symptoms. Option A: The health care provider will take multiple factors into consideration before determining whether a sigmoidoscopy is needed at age 30.Option B: Colonoscopy at age 50 is used to screen for individuals without symptoms or increased risk, but earlier testing may be needed for this patient because of family history. Option D: For fecal occult blood testing, patients use a take-home multiple sample method rather than bring one specimen to the clinic.
External-beam radiation is planned for a patient with endometrial cancer. The nurse teaches the patient that an important measure to prevent complications from the effects of the radiation is to a) Test all stools for the presence of blood b) Inspect the mouth and throat daily for the appearance of thrush c) Perform perianal care with sitz baths and meticulous cleaning d) Maintain a high-residue, high-fat diet
c) Perform perianal care with sitz baths and meticulous cleaning - Correct Answer: C. Perform perianal care with sitz baths and meticulous cleaning Option C: Radiation to the abdomen will affect organs in the radiation path, such as the bowel, and cause frequent diarrhea. Options A and B: Stools are likely to have occult blood from the inflammation associated with radiation, so routine testing of stools for blood is not indicated. Radiation to the abdomen will not cause stomatitis. Option D: A low-residue diet is recommended to avoid irritation of the bowel when patients receive abdominal radiation.
Which action by a nursing assistant (NA) caring for a patient with a temporary radioactive cervical implant indicates that the RN should intervene? a) The NA places the pt's bedding in the laundry container in the hallway b) The NA gives the pt. an alcohol-containing mouthwash for oral care c) The NA stands by the pt's bed for an hour talking with the patient d) The NA flushes the toilet once after emptying the pt's bedpan
c) The NA stands by the pt's bed for an hour talking with the patient - Correct Answer: C. The NA stands by the patient's bed for an hour talking with the patient Option C: Because patients with temporary implants emit radioactivity while the implants are in place, exposure to the patient is limited. Options A and D: Laundry and urine/feces do not have any radioactivity and do not require special precautions. Option B: Cervical radiation will not affect the oral mucosa, and alcohol-based mouthwash is not contraindicated.
When reviewing the chart for a patient with cervical cancer, the nurse notes that the cancer is staged as Tis, N0, M0. The nurse will teach the patient that a) The cancer cells are well-differentiated b) It is difficult to determine the original site of cervical cancer c) The cancer is localized to the cervix d) Further testing is needed to determine the spread of the cancer
c) The cancer is localized to the cervix - Correct Answer: C. The cancer is localized to the cervix Option C: Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time. Option A: Cell differentiation is not indicated by clinical staging. Option B: Because the cancer is in situ, the origin is the cervix. Option D: Further testing is not indicated given that the cancer has not spread.
Which information obtained by the nurse about a patient with colon cancer who is scheduled for external radiation therapy to the abdomen indicates a need for patient teaching? a) The pt. showers with unscented mild soap daily b) The pt. eats frequently during the day c) The pt. swims a mile 5 days a week d) The pt. has a history of dental caries
c) The pt. swims a mile 5 days a week - Correct Answer: C. The patient swims a mile 5 days a week Option C: The patient is instructed to avoid swimming in salt water or chlorinated pools during the treatment period to prevent a skin reaction. Options A and B: The patient does not need to change the habits of eating frequently or showering with a mild soap. Option D: A history of dental caries will not impact the patient who is scheduled for abdominal radiation.
In staging and grading neoplasm TNM systems is used. TNM stands for: a) Tumor, neoplasm, mode of growth b) Time, node, metastasis c) Tumor, node, metastasis d) Time, neoplasm, mode of growth
c) Tumor, node, metastasis - Correct Answer: C. Tumor, node, metastasis TNM system is used to describe the amount and spread of cancer in a client's body. TNM stands for tumor (describes the original primary tumor), node (describes whether the cancer has spread to the nearby lymph nodes), and metastasis (describes whether the cancer has spread to other parts of the body).
A male client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment findings would the nurse expect to note specifically in the client? a) Fatigue b) weakness c) weight gain d) Enlarged lymph nodes
d) enlarged lymph nodes - Correct Answer: D. Enlarged lymph nodes Option D: Hodgkin's disease is a chronic progressive neoplastic disorder of lymphoid tissue characterized by the painless enlargement of lymph nodes with progression to extra lymphatic sites, such as the spleen and liver. Options A and B: Fatigue and weakness may occur but are not related significantly to the disease. Option C: Weight loss is most likely to be noted.
Skin reactions are common in radiation therapy. Nursing responsibilities on promoting skin integrity should be promoted apart from: a) Avoiding the use of ointments, powders, and lotions on the area b) Using soft cotton fabrics for clothing c) Washing the area with a bar of scented soap and water and patting it dry not rubbing it d) Avoiding direct sunshine or cold
c) Washing the area with a bar of scented soap and water and patting it dry not rubbing it - Correct Answer: C. Washing the area with a bar of scented soap and water and patting it dry not rubbing it Option C: A mild unscented soap should only be used on the skin of the client undergoing radiation to decrease the occurrence of skin reactions. Options A, and B: Soap and irritants may cause dryness of the patient's skin. Option D: Since the skin that is receiving radiation therapy may be burned from the treatment, avoiding direct sunlight is helpful to prevent further damage.
Radiation protection is very important to implement when performing nursing procedures. When the nurse is not performing any nursing procedures what distance should be maintained from the client? a) 1 foot b) 2 feet c) 2.5 feet d) 3 feet
d) 3 feet - Correct Answer: D. 3 feet Option D: The distance of at least 3 feet / 0.9 or 1 meter should be maintained when a nurse is not performing any nursing procedures to decrease exposure from the radiation.
Chemotherapy is one of the therapeutic modalities for cancer. This treatment is contraindicated to which of the following conditions? a) Bone marrow depression b) Recent surgery c) Pregnancy d) All of the above
d) All of the above - Bone marrow depression, Recent surgery, Pregnancy - Correct Answer: D. All of the above Chemotherapy is contraindicated in cases of infection (chemotherapeutic agents are immunosuppressive), recent surgery (chemotherapeutic agent may retard the healing process), impaired renal and hepatic function (drugs are nephrotoxic and hepatotoxic), recent radiation therapy (immunosuppressive treatment), pregnancy (drugs can cause congenital defects) and bone marrow depression (chemo. agents may aggravate the condition).
In teaching about cancer prevention to a community group, the nurse stresses the promotion of exercise, normal body weight, and a low-fat diet because a) Obesity and lack of exercise cause cancer in susceptible people b) People who exercise and eat healthily will make other lifestyle changes c) Most people are willing to make these changes to avoid cancer d) Dietary fat and obesity promote the growth of many types of cancer
d) Dietary fat and obesity promote growth of many types of cancer - Correct Answer: D. Dietary fat and obesity promote growth of many types of cancer Option D: Obesity and dietary fat promote the growth of malignant cells, and decreasing these risk factors can reduce the chance of cancer development. Option A: Obesity and lack of exercise do not cause cancer, but they promote the growth of altered cells. Option B: Good diet and exercise habits are not a guarantee that other healthy lifestyle changes will then occur. Option C: Many people are not willing to make these changes.
Nausea and vomiting is an expected side effect of chemotherapeutic drug use. Which of the following drugs should be administered to a client on chemotherapy to prevent nausea and vomiting? a) Myeran (busulfan) b) Chemet (succimer) c) Arimidex (anastrozole) d) Metozol (metoclopramide)
d) Metozol (metoclopramide) - Correct Answer: D. Metozol (metoclopramide) Option D: Metoclopramide (Metozol) - an antiemetic is used before chemotherapy to prevent nausea and vomiting. Option A: Busulfan (Myleran) - alkylating agent that works by sticking to one of the DNA strands of the cancer cells. It works also by inhibiting the growth of cancer cells. Option B: Succimer (Chemet) - chelating agent for lead poisoning. Option C: Anastrozole (Arimidex) - hormone regulator that slows or inhibits the growth of certain types of breast cancer cells that requires estrogen to grow.
Cytarabine (Ara-C) is an antimetabolite that can cause a common cytarabine syndrome which includes the following, except: a) Fever b) Myalgia c) Chest pain d) Red-orange urine
d) Red-orange urine - Correct Answer: D. Red-orange urine Option D: Cytarabine syndrome which occurs about 6 to 12 hours after taking cytarabine. It is characterized by fever, myalgia, bone pain, chest pain, rash, conjunctivitis, and malaise. Red-orange urine, a common side effect of medications such as rifampin and phenazopyridine is not included in this syndrome.
A patient with a large stomach tumor that is attached to the liver is scheduled to have a debulking procedure. The nurse explains that the expected outcome of this surgery is a) Control of the tumor growth by removal of malignant tissue b) Promotion of better nutrition by relieving the pressure in the stomach c) Relief of pain by cutting sensory nerves in the stomach d) Reduction of the tumor burden to enhance adjuvant therapy
d) Reduction of the tumor burden to enhance adjuvant therapy - Correct Answer: D. Reduction of the tumor burden to enhance adjuvant therapy Option D: A debulking surgery reduces the size of the tumor and makes radiation and chemotherapy more effective. Option A: Debulking surgeries do not control tumor growth. Option B: The tumor is debulked because it is attached to the liver, a vital organ (not to relieve pressure on the stomach). Option C: Debulking does not sever the sensory nerves, although pain may be lessened by the reduction in pressure on the abdominal organs.
Mr. Miller has been diagnosed with bone cancer. You know this type of cancer is classified as: a) Carcinoma b) Lymphoma c) Melanoma d) Sarcoma
d) Sarcoma - Correct Answer: D. Sarcoma Option D: Tumors that originate from bone, muscle, and other connective tissue are called sarcomas. Option A: Carcinoma is a malignancy that starts at the epithelial lining of an organ, glands, or body structures. Option B: Lymphoma is a cancer that begins in the nodes or glands of the lymphatic system. Option C: Melanoma is a type of skin cancer that originates in cells known as melanocytes.
The 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. The nurse interprets that the client may be experiencing: a) Extreme stress caused by the diagnosis of cancer b) Altered perineal sensation as a side effect of radiation therapy c) Rupture of the bladder d) The development of a vesicovaginal fistual
d) The development of a vesicovaginal fistula - Correct Answer: D. The development of a vesicovaginal fistula Option D: A vesicovaginal fistula is a genital fistula that occurs between the bladder and vagina. The fistula is an abnormal opening between these two body parts and, if this occurs, the client may experience drainage of urine through the vagina. Options A, B, and C: The client's complaint is not associated.
