NCLEX Hematological and Oncological Disorders

When caring for client with internal radiation implant, nurse observes which principles? Select all that apply. 1. Limit the time with client to 1 hr per shift 2. Keep pregnant women out of clients room 3. Client needs private room with a private bath 4. Wear lead shield with direct client care 5. Remove dosimeter film badge when enter clients room 6. Allow individuals younger than 16 yo in room as long as they are 6 feet away from client

2. Keep pregnant women out of clients room 3. Client needs private room with a private bath 4. Wear lead shield with direct client care

A client is diagnosed as having a bowel tumor. The nurse should monitor the client for which complications of this type of tumor? Select all that apply. 1. Flatulence 2. Peritonitis 3. Hemorrhage 4. Fistula formation 5. Bowel perforation 6. Lactose intolerance

2. Peritonitis 3. Hemorrhage 4. Fistula formation 5. Bowel perforation

The nurse is instructing a client to perform a testicular self-examination (TSE). The nurse should provide the client with which information about the procedure? 1. To examine while laying down 2. That the best to examine is after a shower 3. To gently feel the testicle with one finger for a growth 4. That TSEs should be done at least every 6 months

2. That the best to examine is after a shower

A client who has been getting radiation therapy for bladder cancer tells the nurse it feels as if she is voiding thru the vaginal. Nurse may interpret that the client is experiencing which condition? 1. Rupture of the bladder 2. The development of vesicovaginal fistula 3. Extreme stress caused by the diagnosis of cancer 4. Altered perineal sensation as a side effect of radiation therapy

2. The development of vesicovaginal fistula

The nurse is assessing the colostomy of a client who has had an abdominal perineal resection for a bowel tumor. Which of the following assessment findings indicates that the colostomy is beginning to function? 1. Absent bowel sounds 2. The passage of flatus 3. The client's ability to tolerate food 4. Bloody drainage from the colostomy

2. The passage of flatus

The nurse is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care? 1. "I change my pouch every week." 2. "I change the appliance in the morning." 3. "I empty the urinary collection bag when it is two-thirds full." 4. "When I'm in the shower I direct the flow of water away from my stoma."

3. "I empty the urinary collection bag when it is two-thirds full."

As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which statement? 1. "I should avoid blowing my nose." 2. "I may need a platelet transfusion if my platelet count is too low." 3. "I'm going to take aspirin for my headache as soon as I get home." 4. "I will count the number of pads and tampons I use when menstruating."

3. "I'm going to take aspirin for my headache as soon as I get home."

The nurse is assessing the perineal wound in a client who has returned from the operating room following an abdominal perineal resection and notes serosanguineous drainage from the wound. Which nursing intervention is appropriate? 1. Notify the physician 2. Clamp the Penrose drain 3. Change the dressing as prescribed 4. Remove and replace the perineal packing

3. Change the dressing as prescribed

A gastrectomy is performed on a client with gastric cancer. In the immediate postoperative period, the nurse notes bloody drainage from the nasogastric tube. The nurse should take which more appropriate action? 1. Measure abdominal girth 2. Irrigate the nasogastric tube 3. Continue to monitor the drainage 4. Notify the health care provider (HCP)

3. Continue to monitor the drainage

The nurse is monitoring a client for signs and symptoms related to superior vena cava syndrome. Which is an early sign of this oncological emergency? 1. Cyanosis 2. Arm edema 3. Periorbital edema 4. Mental status changes

3. Periorbital edema

The nurse should plan to implement which intervention in the care of a client experiencing neutropenia as a result of chemotherapy: 1. Restrict all visitors 2. Restrict fluid intake 3. Teach the client and family about need for hand hygiene 4. Insert an indwelling urinary catheter to prevent skin break down

3. Teach the client and family about need for hand hygiene

The community health nurse is instructing a group of young female clients bout breast self-examination. The nurse should instruct the clients to perform the examination at which time? 1. At the onset of menstruation 2. Every month during ovulation 3. Weekly at the same time of day 4. 1 week after menstruation begins

4. 1 week after menstruation begins

During the admission assessment of a client with advanced ovarian cancer, the nurse recognize which symptoms as typical of the disease? 1. Diarrhea 2. Hypermenorrhea 3. Abnormal bleeding 4. Abdominal distention

4. Abdominal distention

The nurse manager is teaching the nursing staff about signs and symptoms related to hypercalcemia in a client with metastatic prostate cancer and tells the staff that which is a late sign of this oncological emergency? 1. Headache 2. Dysphagia 3. Constipation 4. Electrocardiographic changes

4. Electrocardiographic changes

A client is admitted to the hospital with suspected diagnosis of Hodgkins disease. Which assessment finding is the nurse to note specifically in the client? 1. Fatigue 2. Weakness 3. Weight gain 4. Enlarge lymph nodes

4. Enlarge lymph nodes

While giving care to a client with a internal cervical radiation implant, the nurse finds the implant in the bed. The nurse should take which initial action? 1. Call the health care provider (HCP) 2. Reinsert the implant into the vagina 3. Pick up implant with gloved hands and flush down toilet 4. Pick up the implant with long-handled forceps and place into a lead container

4. Pick up the implant with long-handled forceps and place into a lead container

A client with carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH) as a complication of the cancer. The nurse anticipates that the health care provider will request which prescriptions? Select all that apply. 1. Radiation 2. Chemotherapy 3. Increased fluid intake 4. Decreased oral sodium intake 5. Serum sodium level determination 6. Medication that is antagonistic to antidiuretic hormone

1. Radiation 2. Chemotherapy 5. Serum sodium level determination 6. Medication that is antagonistic to antidiuretic hormone

The home health care nurse is caring for a client with cancer, who is complaining of acute pain. The most appropriate determination of the clients pain should include which assessment? 1. The client's pain rating 2. Nonverbal cues from the client 3. The nurse's impression of the client's pain 4. Pain relief after appropriate nursing intervention

1. The client's pain rating

The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm? 1. Placing cool compresses on the affected arm 2. Elevating the affected arm on a pillow above heart level 3. Avoiding arm exercises in the immediate postoperative period 4. Maintaining an intravenous site below the antecubital area on the affected side

2. Elevating the affected arm on a pillow above heart level

The nurse is reviewing the history of a client with bladder cancer. The nurse expects to note documentation of which most common symptom of this type of cancer? 1. Dysuria 2. Hematuria 3. Urgency on urination 4. Frequency of urination

2. Hematuria

A nurse is teaching a client about the risk factors associated with colorectal cancer the nurse determines that further teaching related to colorectal cancer is necessary if the client identifies which of the following as an associated risk factor? 1. Age younger than 50 2. History of colorectal polyps 3. Family history of colorectal cancer 4. Chronic inflammatory bowel disease

1. Age younger than 50

Nurse is caring for a client who is postoperative following a pelvic exenteration, the HCP changes the clients diet from NPO to clear liquids. The nurse should check which priority item before admin the diet? 1. Bowel sounds 2. Ability to ambulate 3. Incision appearance 4. Urine specific gravity

1. Bowel sounds

The nurse is developing a plan of care for the client with multiple myeloma and includes which priority intervention in the plan? 1. Encouraging fluids 2. Providing frequent oral care 3. Coughing and deep breathing 4. Monitoring the red blood cell count

1. Encouraging fluids

The nurse is caring for client with lung cancer and bone metastasize. What signs and symptoms would the nurse recognize as indications of a possible oncological emergency? Select all that apply. 1. Facial edema in morning 2. Serum calcium level of 12mg/dL 3. Weight loss 20 lbs in one month 4. Serum sodium level of 136 mg/dL 5. Serum potassium level of 3.4mg/dL 6. Numbness and tingling of the lower extremities

1. Facial edema in morning 2. Serum calcium level of 12mg/dL 6. Numbness and tingling of the lower extremities

The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would the nurse expect to note specifically in this disorder? 1. Increased calcium level 2. Increased white blood cells 3. Decreased blood urea nitrogen level 4. Decreased number of plasma cells in the bone marrow

1. Increased calcium level

The nurse is conducting a history and monitoring laboratory values on a client with multiple myeloma. What assessment findings should the nurse expect to note? Select all that apply. 1. Pathological fracture 2. Urinalysis positive for nitrites 3. Hemoglobin level of 15.5 g/dL 4. Calcium level of 8.6 mg/dL 5. Serum creatinine level of 2.0 mg/dL

1. Pathological fracture 2. Urinalysis positive for nitrites 5. Serum creatinine level of 2.0 mg/dL