Cancer Practice

16. Which patient is most likely to need long-term nursing care management? 1. 72-yr-old who had a hip replacement after a fall at home 2. 64-yr-old who developed sepsis after a ruptured peptic ulcer 3. 76-yr-old who had a cholecystectomy and bile duct drainage 4. 63-yr-old with bilateral knee osteoarthritis who weighs 350 lb (159 kg)

4. 63-yr-old with bilateral knee osteoarthritis who weighs 350 lb (159 kg)

19. A patient has been assigned the nursing diagnosis of imbalanced nutrition: less than body requirements related to painful oral ulcers. Which nursing action will be most effective in improving oral intake? 1. Offer the patient frequent small snacks between meals. 2. Assist the patient to choose favorite foods from the menu. 3. Provide teaching about the importance of nutritional intake. 4. Apply prescribed anesthetic gel to oral lesions before meals.

4. Apply prescribed anesthetic gel to oral lesions before meals.

7. Which nursing action will be most helpful in decreasing the risk for drug-drug interactions in an older adult? 1. Teach the patient to have all prescriptions filled at the same pharmacy. 2. Make a schedule for the patient as a reminder of when to take each medication. 3. Instruct the patient to avoid taking over-the-counter (OTC) medications or supplements. 4. Ask the patient to bring all medications, supplements, and herbs to each appointment.

4. Ask the patient to bring all medications, supplements, and herbs to each appointment.

3. The nurse is caring for a patient who smokes two packs/day. Which action by the nurse could help reduce the patient's risk of lung cancer? 1. Teach the patient about the seven warning signs of cancer. 2. Plan to monitor the patient's carcinoembryonic antigen (CEA) level. 3. Teach the patient about annual chest x-rays for lung cancer screening. 4. Discuss risks associated with cigarette smoking during each patient encounter.

4. Discuss risks associated with cigarette smoking during each patient encounter.

17. A patient who has ovarian cancer is crying and tells the nurse, "My husband rarely visits. He just doesn't care." The husband indicates to the nurse that he does not know what to say to his wife. Which nursing diagnosis is appropriate for the nurse to add to the plan of care? 1. Compromised family coping related to disruption in lifestyle 2. Impaired home maintenance related to perceived role changes 3. Risk for caregiver role strain related to burdens of caregiving responsibilities 4. Dysfunctional family processes related to effect of illness on family members

4. Dysfunctional family processes related to effect of illness on family members

6. A patient who is diagnosed with cervical cancer classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is accurate? 1. "The cancer involves only the cervix." 2. "The cancer cells look like normal cells." 3. "Further testing is needed to determine the spread of the cancer." 4. "It is difficult to determine the original site of cervical cancer."

1. "The cancer involves only the cervix."

17. An older adult being admitted is assessed at high risk for falls. Which action should the nurse take first? 1. Use a bed alarm system on the patient's bed.

1. Use a bed alarm system on the patient's bed.

11. The nurse cares for an alert, homeless older adult patient who was admitted to the hospital with a chronic foot infection. Which intervention is the most appropriate for the nurse to include in the discharge plan for this patient? 1. Teach the patient how to assess and care for the foot infection. 2. Refer the patient to social services for assessment of resources. 3. Schedule the patient to return to outpatient services for foot care.

2. Refer the patient to social services for assessment of resources.

2. The nurse performs a comprehensive assessment of an older patient who is considering admission to an assisted living facility. Which question is the most important for the nurse to ask? 1. "Have you had any recent infections?" 2. "How frequently do you see a doctor?" 3. "Do you have a history of heart disease?" 4. "Are you able to prepare your own meals?"

4. "Are you able to prepare your own meals?"

32. The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which laboratory result is most important to report to the health care provider? 1. Hematocrit 30% 2. Platelets 95,000/μL 3. Hemoglobin 10 g/L 4. White blood cells (WBC) 2700/μL

4. White blood cells (WBC) 2700/μL

19. The family of an older patient with chronic health problems and increasing weakness is considering placement in a long-term care (LTC) facility. Which action by the nurse will be most helpful in assisting the patient to make this transition? B. Ask the patient's preference for the choice of a LTC facility.

B. Ask the patient's preference for the choice of a LTC facility.

20. The nurse manages the care of older adults in an adult health day care center. Which action can the nurse delegate to unlicensed assistive personnel (UAP)? B. Take blood pressures daily and document in individual patient records.

B. Take blood pressures daily and document in individual patient records.

1. The nurse at the clinic is interviewing a 64-yr-old woman who is 5 feet, 3 inches tall and weighs 125 lb (57 kg). The patient has not seen a health care provider for 20 years. She walks 5 miles most days and has a glass of wine two or three times a week. Which topics will the nurse plan to include in patient teaching about cancer screening and decreasing cancer risk (select all that apply)? a. Pap testing 2. Tobacco use 3. Sunscreen use 4. Mammography 5. Colorectal screening

a. Pap testing 3. Sunscreen use 4. Mammography 5. Colorectal screening

9. An older patient complains of having "no energy" and feeling increasingly weak. The patient has had a 12-lb weight loss over the past year. Which action should the nurse take initially? 1. Ask the patient about daily dietary intake. 2. Schedule regular range-of-motion exercise. 3. Discuss long-term care placement with the patient. 4. Describe normal changes associated with aging to the patient.

1. Ask the patient about daily dietary intake.

. Which nursing actions will the nurse take to assess for possible malnutrition in an older adult patient (select all that apply)? 1. Assess for depression. 2. Review laboratory results. 3. Determine food preferences. 4. Inspect teeth and oral mucosa. 5. Ask about transportation needs.

1. Assess for depression. 2. Review laboratory results. 4. Inspect teeth and oral mucosa. 5. Ask about transportation needs.

42. A patient develops neutropenia after receiving chemotherapy. Which information about ways to prevent infection will the nurse include in the teaching plan (select all that apply)? 1. Cook food thoroughly before eating. 2. Choose low fiber, low residue foods. 3. Avoid public transportation such as buses. 4. Use rectal suppositories if needed for constipation. 5. Talk to the oncologist before having any dental work.

1. Cook food thoroughly before eating. 3. Avoid public transportation such as buses. 5. Talk to the oncologist before having any dental work.

16. A chemotherapy drug that causes alopecia is prescribed for a patient. Which action should the nurse take to support the patient's self-esteem? 1. Encourage the patient to purchase a wig or hat to wear when hair loss begins. 2. Suggest that the patient limit social contacts until regrowth of the hair occurs. 3. Teach the patient to wash hair gently with mild shampoo to minimize hair loss. 4. Inform the patient that hair usually grows back once chemotherapy is complete.

1. Encourage the patient to purchase a wig or hat to wear when hair loss begins.

22. Interleukin-2 (IL-2) is used as adjuvant therapy for a patient with metastatic renal cell carcinoma. Which information should the nurse include when explaining the purpose of this therapy to the patient? 1. IL-2 enhances the body's immunologic response to tumor cells. 2. IL-2 prevents bone marrow depression caused by chemotherapy. 3. IL-2 protects normal cells from harmful effects of chemotherapy. 4. IL-2 stimulates malignant cells in the resting phase to enter mitosis.

1. IL-2 enhances the body's immunologic response to tumor cells.

18. An older adult patient presents with a broken arm and visible scattered bruises healing at different stages. Which action should the nurse take first? 1. Notify an elder protective services agency about possible abuse. 2. Make a referral for a home assessment visit by the home health nurse. 3. Have the family member stay in the waiting area while the patient is assessed.

1. Notify an elder protective services agency about possible abuse.

5. During a routine health examination, a 40-yr-old patient tells the nurse about a family history of colon cancer. Which action should the nurse take next? 1. Obtain more information about the family history. 2. Schedule a sigmoidoscopy to provide baseline data. 3. Teach the patient about the need for a colonoscopy at age 50.

1. Obtain more information about the family history.

37. The nurse assesses a patient with non-Hodgkin's lymphoma who is receiving an infusion of rituximab (Rituxan). Which assessment finding would require the most rapid action by the nurse? 1. Shortness of breath 2. Shivering and chills 3. Muscle aches and pains 4. Temperature of 100.2° F (37.9° C)

1. Shortness of breath

33. When caring for a patient who has pancytopenia, which action by unlicensed assistive personnel (UAP) indicates a need for the nurse to intervene? 1. The UAP assists the patient to use dental floss after eating. 2. The UAP adds baking soda to the patient's saline oral rinses. 3. The UAP puts fluoride toothpaste on the patient's toothbrush. 4. The UAP has the patient rinse after meals with a saline solution.

1. The UAP assists the patient to use dental floss after eating.

12. The home health nurse cares for an older adult patient who lives alone and takes several different prescribed medications for chronic health problems. Which intervention, if implemented by the nurse, would best encourage medication compliance? 1. Use a marked pillbox to set up the patient's medications.

1. Use a marked pillbox to set up the patient's medications.

23. The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient indicates a need for further assessment? 1. "I have frequent muscle aches and pains." 2. "I rarely have the energy to get out of bed." 3. "I experience chills after I inject the interferon." 4. "I take acetaminophen (Tylenol) every 4 hours."

2. "I rarely have the energy to get out of bed."

20. A widowed mother of four school-age children is hospitalized with metastatic ovarian cancer. The patient is crying and tells the nurse that she does not know what will happen to her children when she dies. Which response by the nurse is most appropriate? 1. "Don't you have any friends that will raise the children for you?" 2. "Would you like to talk about options for the care of your children?"

2. "Would you like to talk about options for the care of your children?"

38. A patient who is being treated for stage IV lung cancer tells the nurse about new-onset back pain. Which action should the nurse take first? 1. Give the patient the prescribed PRN opioid. 2. Assess for sensation and strength in the legs. 3. Notify the health care provider about the symptoms. 4. Teach the patient how to use relaxation to reduce pain.

2. Assess for sensation and strength in the legs.

4. The nurse should suggest which food choice when providing dietary teaching for a patient scheduled to receive external-beam radiation for abdominal cancer? 1. Fruit salad c. Creamed broccoli 2. Baked chicken d. Toasted wheat bread

2. Baked chicken

25. The nurse teaches a patient with cancer of the liver about high-protein, high-calorie diet choices. Which snack choice by the patient indicates that the teaching has been effective? 1. Lime sherbet c. Fresh strawberries 2. Blueberry yogurt d. Cream cheese bagel

2. Blueberry yogurt

30. The nurse assesses a patient who is receiving interleukin-2. Which finding should the nurse report immediately to the health care provider? 1. Generalized muscle aches 2. Crackles heard at the lung bases 3. Complaints of nausea and anorexia 4. Oral temperature of 100.6° F (38.1° C)

2. Crackles heard at the lung bases

11. A patient with Hodgkin's lymphoma who is undergoing external radiation therapy tells the nurse, "I am so tired I can hardly get out of bed in the morning." Which intervention should the nurse add to the plan of care? 1. Minimize activity until the treatment is completed. 2. Establish time to take a short walk almost every day. 3. Consult with a psychiatrist for treatment of depression. 4. Arrange for delivery of a hospital bed to the patient's home.

2. Establish time to take a short walk almost every day.

24. A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). The nurse will include which information in the patient's teaching plan? 1. Donor bone marrow is transplanted through a sternal or hip incision. 2. Hospitalization is required for several weeks after the stem cell transplant. 3. The transplant procedure takes place in a sterile operating room to minimize the

2. Hospitalization is required for several weeks after the stem cell transplant.

3. An alert older patient who takes multiple medications for chronic cardiac and pulmonary diseases lives with a daughter who works during the day. During a clinic visit, the patient verbalizes to the nurse that she has a strained relationship with her daughter and does not enjoy being alone all day. Which nursing diagnosis should the nurse assign as the priority for this patient? 1. Social isolation related to fatigue 2. Risk for injury related to drug interactions 3. Caregiver role strain related to family employment schedule

2. Risk for injury related to drug interactions

15. The nurse administers an IV vesicant chemotherapeutic agent to a patient. Which action is most important for the nurse to take? 1. Infuse the medication over a short period of time. 2. Stop the infusion if swelling is observed at the site. 3. Administer the chemotherapy through a small-bore catheter.

2. Stop the infusion if swelling is observed at the site.

34. The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention? 1. The UAP flushes the toilet once after emptying the patient's bedpan. 2. The UAP stands by the patient's bed for 30 minutes talking with the patient. 3. The UAP places the patient's bedding in the laundry container in the hallway. 4. The UAP gives the patient an alcohol-containing mouthwash to use for oral care.

2. The UAP stands by the patient's bed for 30 minutes talking with the patient.

13. The home health nurse visits an older patient with mild forgetfulness. Which new information is of most concern to the nurse? 1. The patient tells the nurse that a close friend recently died 2. The patient has lost 10 lb (4.5 kg) during the past month.

2. The patient has lost 10 lb (4.5 kg) during the past month.

12. The nurse is caring for a patient with colon cancer who is scheduled for external radiation therapy to the abdomen. Which information obtained by the nurse would indicate a need for patient teaching? 1. The patient has a history of dental caries. 2. The patient swims several days each week. 3. The patient snacks frequently during the day.

2. The patient swims several days each week.

28. A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse would indicate a need for further teaching? 1. The patient ambulates around the room. 2. The patient's visitors bring in fresh peaches. 3. The patient cleans with a warm washcloth after having a stool. 4. The patient uses soap and shampoo to shower every other day.

2. The patient's visitors bring in fresh peaches.

4. Which method should the nurse use to gather the most complete assessment of an older patient? 1. Review the patient's health record for previous assessments. 2. Use a geriatric assessment instrument to evaluate the patient. 3. Ask the patient to write down medical problems and medications. 4. Interview both the patient and the primary caregiver for the patient.

2. Use a geriatric assessment instrument to evaluate the patient.

29. The nurse is caring for a patient diagnosed with stage I colon cancer. When assessing the need for psychological support, which question by the nurse will provide the most information? 1. "How long ago were you diagnosed with this cancer?" 2. "Do you have any concerns about body image changes?" 3. "Can you tell me what has been helpful to you in the past when coping with stressful events?" 4. "Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?"

3. "Can you tell me what has been helpful to you in the past when coping with stressful events?"

13. A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. The nurse teaches the patient about the management of the skin reaction. Which statement, if made by the patient, indicates the teaching was effective? 1. "I can use ice packs to relieve itching." 2. "I will scrub the area with warm water." 3. "I can buy aloe vera gel to use on my skin."

3. "I can buy aloe vera gel to use on my skin."

14. Which statement, if made by an older adult patient, would be of most concern to the nurse? 1. "I prefer to manage my life without much help from other people." 2. "I take three different medications for my heart and joint problems." 3. "I don't go on daily walks anymore since I had pneumonia 3 months ago." 4. "I set up my medications in a marked pillbox so I don't forget to take them."

3. "I don't go on daily walks anymore since I had pneumonia 3 months ago."

8. The nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. Which patient statement indicates that the teaching has been effective? 1. "After cancer has not recurred for 5 years, it is considered cured." 2. "The cancer will be cured if the entire tumor is surgically removed." 3. "I will need follow-up examinations for many years after treatment before I can be considered cured."

3. "I will need follow-up examinations for many years after treatment before I can be considered cured."

1. A patient who is scheduled for a breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is correct? 1. "Benign tumors do not cause damage to other tissues." 2. "Benign tumors are likely to recur in the same location." 3. "Malignant tumors may spread to other tissues or organs." 4. "Malignant cells reproduce more rapidly than normal cells."

3. "Malignant tumors may spread to other tissues or organs."

7. The nurse teaches a patient who is scheduled for a prostate needle biopsy about the procedure. Which statement, if made by the patient, indicates that teaching was effective? 1. "The biopsy will remove the cancer in my prostate gland." 2. "The biopsy will determine how much longer I have to live." 3. "The biopsy will help decide the treatment for my enlarged prostate." 4. "The biopsy will indicate whether the cancer has spread to other organs."

3. "The biopsy will help decide the treatment for my enlarged prostate."

35. The nurse receives a change-of-shift report on the oncology unit. Which patient should the nurse assess first? 1. A 35-yr-old patient who has wet desquamation associated with abdominal radiation 2. A 42-yr-old patient who is sobbing after receiving a new diagnosis of ovarian cancer 3. A 24-yr-old patient who received neck radiation and has blood oozing from the neck 4. A 56-yr-old patient who developed a new pericardial friction rub after chest radiation

3. A 24-yr-old patient who received neck radiation and has blood oozing from the neck

26. A patient with cancer has a nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste sensation. Which nursing action would address the cause of the patient problem? 1. Add protein powder to foods such as casseroles. 2. Tell the patient to eat foods that are high in nutrition. 3. Avoid giving the patient foods that are strongly disliked. 4. Add spices to enhance the flavor of foods that are served.

3. Avoid giving the patient foods that are strongly disliked.

10. External-beam radiation is planned for a patient with cervical cancer. What instructions should the nurse give to the patient to prevent complications from the effects of the radiation? 1. Test all stools for the presence of blood. 2. Maintain a high-residue, high-fiber diet. 3. Clean the perianal area carefully after every bowel movement. 4. Inspect the mouth and throat daily for the appearance of thrush.

3. Clean the perianal area carefully after every bowel movement.

5. Which intervention should the nurse implement to provide optimal care for an older patient who is hospitalized with pneumonia? 1. Plan for transfer to a long-term care facility. 2. Minimize activity level during hospitalization. 3. Consider the preadmission functional abilities.

3. Consider the preadmission functional abilities.

9. A patient with a large stomach tumor attached to the liver is scheduled for a debulking procedure. Which information should the nurse teach the patient about the outcome of this procedure? 1. Pain will be relieved by cutting sensory nerves in the stomach. 2. Relief of pressure in the stomach will promote better nutrition. 3. Decreasing the tumor size will improve the effects of other therapy. 4. Tumor growth will be controlled by the removal of malignant tissue.

3. Decreasing the tumor size will improve the effects of other therapy.

6. The nurse cares for an older adult patient who lives in a rural area. Which intervention should the nurse plan to implement to meet this patient's needs? 2. Obtain extra medications for the patient to last for 4 to 6 months. 3. Ensure transportation to appointments with the health care provider. 4. Assess the patient for chronic diseases that are unique to rural areas.

3. Ensure transportation to appointments with the health care provider.

41. After change-of-shift report on the oncology unit, which patient should the nurse assess first? 1. Patient who has a platelet count of 82,000/μL after chemotherapy 2. Patient who has xerostomia after receiving head and neck radiation 3. Patient who is neutropenic and has a temperature of 100.5° F (38.1° C) 4. Patient who is worried about getting the prescribed long-acting opioid on time MULTIPLE RESPONSE

3. Patient who is neutropenic and has a temperature of 100.5° F (38.1° C)

10. The nurse is admitting an acutely ill, older patient to the hospital. Which action should the nurse take? 1. Speak slowly and loudly while facing the patient. 2. Obtain a detailed medical history from the patient. 3. Perform the physical assessment before interviewing the patient. 4. Ask a family member to go home and retrieve the patient's cane.

3. Perform the physical assessment before interviewing the patient.

39. The nurse is caring for a patient with left-sided lung cancer. Which finding would be most important for the nurse to report to the health care provider? 1. Hematocrit of 32% 2. Pain with deep inspiration 3. Serum sodium of 126 mEq/L 4. Decreased breath sounds on left side

3. Serum sodium of 126 mEq/L

1. When caring for an older patient with hypertension who has been hospitalized after a transient ischemic (TIA), which topic is the most important for the nurse to include in the discharge teaching? 1. Effect of atherosclerosis on blood vessels 2. Mechanism of action of anticoagulant drug therapy 3. Symptoms indicating that the patient should contact the health care provider 4. Impact of the patient's family history on likelihood of developing a serious stroke

3. Symptoms indicating that the patient should contact the health care provider

14. A patient with metastatic cancer of the colon experiences severe vomiting after each administration of chemotherapy. Which action, if taken by the nurse, is appropriate? 1. Have the patient eat large meals when nausea is not present. 2. Offer dry crackers and carbonated fluids during chemotherapy. 3. The Administer prescribed antiemetics 1 hour before the treatments. 4. Give the patient a glass of a citrus fruit beverage during treatments.

3. The Administer prescribed antiemetics 1 hour before the treatments.

21. A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective? 1. The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale). 2. The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness. 3. The patient takes opioids around the clock on a regular schedule and usesadditional doses when breakthrough pain occurs.

3. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.

8. A patient who has just moved to a long-term care facility has a nursing diagnosis of relocation stress syndrome. Which action should the nurse include in the plan of care? 1. Remind the patient that making changes is usually stressful. 2. Discuss the reason for the move to the facility with the patient. 3. Restrict family visits until the patient is accustomed to the facility. 4. Have staff members write notes welcoming the patient to the facility.

4. Have staff members write notes welcoming the patient to the facility.

31. The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer. Which information about the patient alerts the nurse to discuss a possible change in cancer therapy with the health care provider? 1. Frequent loose stools 2. Nausea and vomiting 3. Elevated white blood count (WBC) 4. Increased carcinoembryonic antigen (CEA)

4. Increased carcinoembryonic antigen (CEA)

40. An older adult patient who has colorectal cancer is receiving IV fluids at 175 mL/hr in conjunction with the prescribed chemotherapy. Which finding by the nurse is most important to report to the health care provider? 1. Patient complains of severe fatigue. 2. Patient voids every hour during the day. 3. Patient takes only 50% of meals and refuses snacks. 4. Patient has crackles up to the midline posterior chest.

4. Patient has crackles up to the midline posterior chest.

15. The nurse assesses an older patient who takes diuretics and has a possible urinary tract infection (UTI). Which action should the nurse take first? 1. Palpate over the suprapubic area. 2. Inspect for abdominal distention. 3. Question the patient about hematuria. 4. Request the patient empty the bladder.

4. Request the patient empty the bladder.

18. A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient? 1. Remove food debris from the teeth and oral mucosa with a stiff toothbrush. 2. Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth. 3. Gargle and rinse the mouth several times a day with an antiseptic mouthwash. 4. Rinse the mouth before and after each meal and at bedtime with a saline solution.

4. Rinse the mouth before and after each meal and at bedtime with a saline solution.

27. During the teaching session for a patient who has a new diagnosis of acute leukemia, the patient is restless and looks away without making eye contact. The patient asks the nurse to repeat the information about the complications associated with chemotherapy. Based on this assessment, which nursing diagnosis is appropriate for the patient? 1. Risk for ineffective adherence to treatment related to denial of need for chemotherapy 2. Acute confusion related to infiltration of leukemia cells into the central nervous system 3. Deficient knowledge: chemotherapy related to a lack of interest in learning about treatment 4. Risk for ineffective health maintenance related to possible anxiety about leukemia diagnosis

4. Risk for ineffective health maintenance related to possible anxiety about leukemia diagnosis

36. Which action should the nurse take when caring for a patient who is receiving chemotherapy and complains of problems with concentration? 1. Teach the patient to rest the brain by avoiding new activities. 2. Teach that "chemo-brain" is a short-term effect of chemotherapy. 3. Report patient symptoms immediately to the health care provider. 4. Suggest use of a daily planner and encourage adequate rest and sleep.

4. Suggest use of a daily planner and encourage adequate rest and sleep.

2. The nurse is caring for a patient receiving intravesical bladder chemotherapy. The nurse should monitor for which adverse effect? a. Nausea c. Hematuria b. Alopecia d. Xerostomia

c. Hematuria