Cellular Regulation NCLEX Questions

26. A nurse is planning an educational program about basal cell carcinoma. Which of the following information should the nurse plan to include? A. Basal cell carcinoma has a low incidence of metastasis B. Basal cell carcinoma has a high mortality rate C. Basal cell carcinoma is aggressive and rapid growing D. Basal cell carcinoma develops from a nevi or mole

A. Basal cell carcinoma has a low incidence of metastasis Rationale: Basal cell carcinoma is a localized lesion that seldom metastasizes

30. A nurse is caring for a client who is 9 days postoperative following a total laryngectomy. The nurse removes the client's NG tube and initiates oral feedings. Which of the following statements should the nurse make? A. "Tuck your chin when you swallow so you won't choke" B. "It is no longer possible for you to choke on or aspirate food" C. "You should have no trouble swallowing fluids" D. "I will add a thickener to your liquids to prevent aspiration"

B. "It is no longer possible for you to choke on or aspirate food" Rationale: The surgical procedure of total laryngectomy provides complete anatomical separation of the trachea and esophagus. Choking and aspiration of liquids is no longer possible.

38. A nurse is teaching a client about the seven warning signs of cancer. Which of the following signs should the nurse include as manifestations of cancer? (Select all that apply) A. A nonhealing sore B. Bloating C. Change in bowel pattern D. Change in moles

A,C,D,E

34. A nurse is reviewing the laboratory results of a client who was admitted with a history of multiple myeloma. The nurse should expect to find an increase in which of the following laboratory values? A. Absolute neutrophil count (ANC) B. Calcium C. Platelets D. WBCs

B. Calcium Rationale: The nurse should expect the calcium level of a client who has a history of multiple myeloma to increase due to the destruction of bone

15. A nurse is caring for a client who has myelosuppression after receiving chemotherapy. The nurse should monitor the client for which of the following adverse effects? A. Anorexia and malnutrition B. Bleeding from the gums C. Diarrhea and dehydration D. Full body alopecia

B. Bleeding from the gums Rationale: Bleeding from the gums is directly related to myelosuppression due to inhibited bone marrow production of blood cells and platelets

17. A nurse is reviewing the laboratory results of a client who has acute leukemia and received an aggressive chemotherapy treatment 10 days ago. Which of the following hematologic laboratory values should the nurse expect? Select all that apply. A. Decreased platelet count B. Increased hemoglobin count C. Decreased leukocyte count D. Increased platelet count E. Decreased erythrocyte count

A,C,E Rationale: The nurse should expect to see a decreased platelet, leukocyte, and erythrocyte count due to bone marrow suppression

24. A nurse is providing teaching to a client about preventing skin cancer. Which of the following client statements indicates a need for further teaching? A. "Eating a high fiber diet will reduce my risk for developing skin cancer" B. "I should check my skin monthly for any changes" C. "I should avoid the use of tanning booths" D. "I should use sunscreen even on cloudy days"

A. "Eating a high fiber diet will reduce my risk for developing skin cancer" Rationale: A high-fiber diet is recommended to reduce the risk of colon cancer

35. A client who has a chronic lymphocytic leukemia is starting chemotherapy treatments and asks if she needs to make any dietary changes. Which of the following statements should the nurse make? A. "You should avoid drinking liquids an hour before the treatments" B. "Eating low-calorie foods helps prevent nausea" C. "Foods that are higher in fat are usually more appealing" D. "Raw fruits and vegetables will be easier for your body to digest"

A. "You should avoid drinking liquids an hour before the treatments" Rationale: Clients should be encouraged to decrease fluid intake just before treatments because fluids may cause nausea and vomiting

11. A nurse is providing discharge teaching for a client who is postoperative following a simple mastectomy. The client is to begin outpatient radiation therapy the next day. Which of the following instructions about maintaining skin integrity should the nurse include? A. Do not apply heat to the area of irradiation B. Do not wash the area of irradiation C. Use an antibiotic ointment to treat skin breakdown D. Lubricate the skin with hypoallergenic lotion

A. Do not apply heat to the area of irradiation Rationale: This instruction will help the client avoid tissue damage. Radiated tissue becomes thinner and might lack tissue receptors that would otherwise alert the client to a potential burn injury. When outdoors in sunlight, the client should wear protective clothing over the area of irradiation.

16. A nurse is assessing a client who reports a nevus that has increased in size and an irregularly shaped lesion that varies in color. These findings are consistent with which of the following medical diagnoses? A. Malignant melanoma B. Basal cell carcinoma C. Squamous cell carcinoma D. Kaposi's sarcoma

A. Malignant melanoma Rationale: These findings are consistent with malignant melanoma, which is associated with changes in preexisting nevi

36. A nurse is assessing a client who has a long history of smoking and is suspected of having laryngeal cancer. The nurse should anticipate that the client will report that her earliest manifestation was: A. Dysphagia B. Hoarseness C. Dyspnea D. Weight loss

B. Hoarseness Rationale: Laryngeal cancer, a malignant tumor of the larynx, is most often caused by long exposure to tobacco and alcohol. Hoarseness that does not resolve for several weeks is the earliest manifestation of cancer of the larynx because the tumor impedes the action of the vocal cords during speech. The voice may sound harsh and lower in pitch than normal.

23. A nurse is caring for an older adult client who has a WBC count of 2,000mm after three rounds of chemotherapy. Which of the following actions should the nurse take? A. Humidify the client's room B. Serve cooked fruit with meals C. Clean dentures in a denture cup D. Replace the water in flower vases with fresh water daily

B. Serve cooked fruit with meals Rationale: The nurse should serve cooked fruits with meals to prevent possible bacterial contamination from raw fruit

A nurse is providing teaching to a client who has breast cancer about the adverse effects of chemotherapy. Which of the following clients statements indicates an understanding of the teaching? A. "I will take the antiemetic as soon as the chemotherapy infusion is complete" B. "I will run my toothbrush in the dishwasher every month" C. "I'll call my doctor if I notice any unusual menstrual bleeding" D. "I will avoid crowds to keep from infecting others"

C. "I'll call my doctor if I notice any unusual menstrual bleeding" Rationale: Clients should be taught bleeding precautions and to report bruising or excessive bleeding

33. A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary? A. An excess amount of doxorubicin can lead to myelosuppression B. Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation C. An excess amount of doxorubicin can lead to cardiomyopathy D. Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat

C. An excess amount of doxorubicin can lead to cardiomyopathy Rationale: Doxorubicin is an antineoplastic antibiotic used in the treatment of various cancers. Irreversible cardiomyopathy with congestive heart failure can result from repeated doses of doxorubicin, and prolonged use can also cause severe heart damage, even years after the client has stopped taking it. The maximum cumulative dose a client should receive is 550mg/m o r450 mg/m with a history of radiation to the mediastinum.

28. A nurse is caring for a client who is 1-day postoperative following a total laryngectomy and has begun a soft diet. The client is not eating well and tells the nurse that the hospital food has no taste. Which of the following responses is appropriate for the nurse to make? A. "You should ask your family to bring you some food from home" B. "Clients frequently complain about the taste of hospital food" C. "I would be happy to get you food that you prefer to eat" D. "Because of your surgery, you have an altered ability to smell and taste"

D. "Because of your surgery, you have an altered ability to smell and taste" Rationale: Clients who have lost their larynx commonly complain of poor ability to smell and taste. This is because they now breathe through the tracheal stoma, rather than the mouth and nose, which bypasses the location of the olfactory and gustatory nerve cells

22. A nurse is caring for a client scheduled to receive external radiation to the neck for cancer of the larynx. During a pre-treatment exam, the nurse explains to the client that the most likely side effect would be: A. Infertility B. Diarrhea C. Dyspnea D. Dysphagia

D. Dysphagia Rationale: Radiation therapy does not hurt while it is being given. But the side effects that people may get form radiation therapy can cause pain or discomfort. Only the area of treatment is affected by the radiation, so dysphagia (trouble swallowing) would be an expected side effect. Other possible side effects include hoarseness, xerostomia (dry mouth), loss of taste, and skin redness.

A nurse is teaching a client who is receiving treatment for metastatic colorectal cancer about the adverse effects of bevacizumab. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication? A. Weight gain B. Mild hearing loss C. Temporary loss of smell D. Nosebleeds

D. Nosebleeds Rationale: Nosebleeds are an adverse effect of bevacizumab and should be reported to the provider. The client has an increased risk when taking this medication for severe bleeding from nosebleeds, vaginal bleeding, GI bleeding, intracranial bleeding and pulmonary bleeding, which may be caused by the development of thrombocytopenia and other blood disorders.

18. A nurse is admitting a child who has leukemia. Which of the following clients should the nurse place in the same room with this child? A. A child who has nephrotic syndrome B. A child recovering from a ruptured appendix C. A child who has rheumatic fever D. A child who has cystic fibrosis

A. A child who has nephrotic syndrome Rationale: A child who has leukemia is at risk for infection. Nephrotic syndrome is not an infectious disorder and poses no risk to the child who has leukemia

25. A nurse is teaching a client about the side effects of chemotherapy medication. Which of the following nursing statements should the nurse include in the teaching? A. "Most clients do not experience nausea" B. "Hair loss is common and includes your eyebrows and eyelashes" C. "Most clients start to gain weight during their treatment" D. "Clients lose their hair, but it usually grows back nice and thick"

B. "Hair loss is common and includes your eyebrows and eyelashes" Rationale: This nursing statement is correct, because alopecia occurs as a whole-body hair loss for most clients administered chemotherapy

A nurse is admitting a child who has leukemia and a critically low platelet count. Which of the following precautions should the nurse initiate? A. Neutropenic B. Bleeding C. Contact D. Droplet

B. Bleeding Rationale: The nurse should initiate bleeding precautions for a child who has a low platelet count. Bleeding precautions involve specific measures to reduce the risk of bleeding, such as using soft-bristled toothbrushes, avoiding IM injections, and preventing constipation.

13. A nurse is planning care for a client who has leukemia and a platelet count of 130,000/mm. Which of the following interventions should the nurse include in the plan of care? A. Check the IV site for bleeding every 8 hr B. Limit IM injections C. Obtain a rectal temperature every 8 hr D. Check the client for proteinuria

B. Limit IM injections Rationale: The nurse should plan to limit IM injections or venipunctures to prevent harm to the client. If venipuncture is necessary, the nurse should hold pressure to the site for 10 min afterward

10. A nurse is preparing a client for a radiation treatment who is postoperative following a mastectomy. The nurse should inform the client to expect which of the following adverse effects from the treatment? A. Alopecia B. Diarrhea C. Fatigue D. Anorexia

C. Fatigue Rationale: The nurse should inform the client to expect fatigue with her radiation treatment. Fatigue occurs regardless of the radiation target site.

31. A nurse is planning care for a client who has an absolute neutrophil count (AANC) less than 1,000/mm. Which of the following interventions should the nurse include in the plan? A. Take the client's rectal temperature each day B. Increase raw produce in the client's diet C. Limit visitors to healthy adults D. Instruct the client to floss his teeth daily

C. Limit visitors to healthy adults Rationale: The expected reference range of absolute neutrophil count is 2500 to 8000/mm. This client has a reduce neutrophil count (neutropenia) and is immunosuppressed. A client who has neutropenia is at an increased risk for infection. The nurse should restrict visitors for a client who has neutropenia to healthy adults to reduce the risk for infection

19. A nurse is caring for a client who has malignant melanoma. Which of the following findings should the nurse expect when assessing the lesion? A. Pain B. Pruritus C. Purplish in color D. Purulent drainage

C. Purplish in color Rationale: Dark pigmentation of the lesion is an expected finding of malignant melanoma. Colors are varied and can include red, white, and blue tones.

9. A nurse is assessing a client at a dermatology clinic. Which of the following findings places the client at risk for developing malignant melanoma? A. Female gender B. Age 19 to 30 years C. Dark hair D. History of chronic skin irritation

D. History of chronic skin irritation Rationale: Clients who have a history of chronic inflammatory skin irritation are at increased risk for skin cancer. Other risk factors include exposure to chronic sunlight, chemical pollution, and immunosuppression

14. A charge nurse is teaching a group of health care workers about hand hygiene to prevent infection. Which of the following information should the charge nurse include in the teaching? A. Keep artificial nails trimmed B. Use alcohol-based hand rubs before administering eye drops for a client C. Wash hands with alcohol-based rubs when caring for a client who has C. diff D. Use chlorhexidine to wash hands if the client is immunosuppressed

D. Use chlorhexidine to wash hands if the client is immunosuppressed Rationale: The CDC recommends health care workers use chlorhexidine for hand washing when providing care to a client who is immunosuppressed

A nurse is caring for a client who is receiving radiation therapy to treat lung cancer. Which of the following actions should the nurse take? A. Review laboratory test results for low hemoglobin B. Observe for signs of infection C. Monitor the mouth for signs of xerostomia D. Examine the skin for generalized urticaria

B. Observe for signs of infection Rationale: Radiation therapy to sites containing bone marrow (such as the sternum) can lower WBC count (Leukopenia), thus increasing the client's risk for infection. Screening the client for signs of infection is essential at this time.

20. A nurse is caring for a client who is receiving cisplatin to treat bladder cancer. After several treatments, the client reports fatigue. Which of the following actions should the nurse take? A. Check the results of the client's most recent CBC B. Assess the client for a hypersensitivity reaction C. Evaluate the client for hypercalcemia D. Examine the client for hepatomegaly

A. Check the results of the client's most recent CBC Rationale: The client might have anemia as a result of myelosuppression (bone marrow suppression) from the chemotherapy. If so, she might require treatment for the anemia (transfusion, medication) and the provider might have to delay further chemotherapy until her blood counts are higher.

A nurse is providing teaching to a client who has a superficial lesion and has had a biopsy indicates malignant melanoma. The nurse should include which of the following options as the treatment of choice? A. Cryosurgery B. Chemotherapy C. Radiation therapy D. Surgical excision

D. surgical excision Rationale: Surgical excision is the treatment of choice for superficial lesions of malignant melanoma

37. A nurse is reviewing the CBC findings for a female client who is receiving combination chemotherapy for breast cancer. Which of the following findings should the nurse report to the provider? A. WBC 2300/mm B. RBC 5 million/mm C. hemoglobin 12 g/dL D. Platelets 155,000/mm

A. WBC 2300/mm Rationale: The WBC finding is below the expected reference range. Chemotherapy treatment can cause leukopenia; the nurse should report this finding to the provider and implement precautions to protect the client from infection.

29. After radiation treatment, a client reports dryness, redness, and scaling of his skin occurring within the designated radiation treatment markings. The nurse should instruct the client to take which of the following actions? A. Apply hydrating lotions B. Apply moist heat C. Sit in the sun for 10 min per day D. Wash with plain soap and water

A. Apply hydrating lotions Rationale: The nurse should instruct the client to gently apply hydrating lotions that do not contain metal, alcohol, or perfume

12. A nurse is reviewing the provider's history and physical form for a client who has advanced multiple myeloma. Which of the following findings should the nurse expect? A. Ecchymoses B. Hypocalcemia C. Hypotension D. Polycythemia

A. Ecchymoses Rationale: A client who has multiple myeloma has an overgrowth of plasma cells in the bone marrow, which leads to a reduction in other types of blood cells. As the platelets are affected, the client is prone to bleeding and bruising.

A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy-induced nausea. For which of the following adverse effects should the nurse monitor? A. Headache B. Dependent edema C. Polyuria D. Photosensitivity

A. Headache Rationale: Headache is a common adverse effect of ondansetron. Analgesic relief is often required.

A nurse is teaching a client about the adverse effects of cisplatin. Which of the following adverse effects should the nurse include in the teaching? A. Tinnitus B. Constipation C. Hyperkalemia D. Weight gain

A. Tinnitus Rationale: Tinnitus, hearing loss, diarrhea, and hypokalemia are adverse effects of cisplatin. Weight gain is an adverse effect of docetaxel due to fluid retention.

A nurse in a provider's clinic is assessing a client who has cancer and a prescription for methotrexate PO. Which of the following actions should the nurse take when the client reports bleeding gums? A. Explain to the client that this is an unexpected adverse effect B. Check the value of the client's current platelet count C. Instruct the client to use an electric toothbrush D. Have the client make an appointment to see the dentist

B. Check the value of the client's current platelet count Rationale: The nurse should recognize that the bleeding is likely due to the adverse effect of the chemotherapy and needs to be evaluated further. Bleeding gums is a sign of thrombocytopenia (decreased platelet count) secondary to bone marrow suppression, which can be life-threatening to a client who is receiving chemotherapy.

21. A nurse is assessing a lesion on a client who has basal cell carcinoma. The nurse should expect which of the following findings? A. A pearly, shin nodule B. A pigmented papule C. A rough, scaly tumor D. A weeping vesicle

A. A pearly, shin nodule Rationale: The most common presentation of basal cell carcinoma is a nodular lesion with well- defined borders that has a pearly or shiny appearance.

32. A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching? A. Bottled water is an appropriate choice to increase fluid intake B. The salad bar is a healthy choice when dining out C. Soft-boiled eggs are an appropriate source of protein D. Eating at a buffet is a good choice to increase caloric intake

A. Bottled water is an appropriate choice to increase fluid intake Rationale: Clients who have neutropenia are at risk for foodborne illness. Bottled water prevents client exposure to pathogens that may be found in other water sources.

27. A nurse is caring for a client who is 4 days postoperative following a right radical mastectomy. Which of the following activities should the nurse anticipate being the most difficult for this client to perform with her right hand? A. Buttoning her blouse B. Eating her breakfast C. Combing her hair D. Brushing her teeth

C. Combing her hair Rationale: Abduction of the arm is the most difficult, and usually the last, type of movement to be regained by a client following a mastectomy