ONCOLOGY 2
D. She should eat a low-fat diet to further decrease her risk of breast cancer
C. 7 to 14 days
A male client undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should include which instruction? A. "Keep the stoma dry." B. "Keep the stoma moist." C."Keep the stoma uncovered." D. "Have a family member perform stoma care initially until you get used to the procedure."
B. "Keep the stoma moist."
A 36-year-old man with lymphoma presents with signs of impending septic shock 9 days after chemotherapy. The nurse would expect which of the following to be present? A. Low-grade fever, chills, tachycardia B. Elevated temperature, oliguria, hypotension C. Flushing, decreased oxygen saturation, mild hypotension D. High-grade fever, normal blood pressure, increased respirations
A. Low-grade fever, chills, tachycardia
Vanessa, a community health nurse conducts a health promotion program regarding testicular cancer to community members. The nurse determines that further information needs to be provided if a community member states that which of the following is a sign of testicular cancer? A. Back pain B. Alopecia C. Heavy sensation in the scrotum D. Painless testicular swelling
B. Alopecia
A pneumonectomy is a surgical procedure sometimes indicated for treatment of non-small-cell lung cancer. A pneumonectomy involves removal of: A. One lobe of a lung B. An entire lung field C. One or more segments of a lung lobe D. A small, wedge-shaped lung surface
B. An entire lung field
A female client is undergoing tests for multiple myeloma. Diagnostic study findings in multiple myeloma include: A. A decreased serum creatinine level B. A low serum protein level C. Hypocalcemia D. Bence Jones protein in the urine
D. Bence Jones protein in the urine
Nurse Lucia is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms: A. After the first menstrual period and annually thereafter B. Yearly after age 40 C. Every 3 years between ages 20 and 40 and annually thereafter D. After the birth of the first child and every 2 years thereafter
B. Yearly after age 40
A male client is diagnosed as having a bowel tumor and several diagnostic tests are prescribed. The nurse understands which test will confirm the diagnosis of malignancy? A. Magnetic resonance imaging B. Computerized tomography scan C. Abdominal ultrasound D. Biopsy of the tumor
D. Biopsy of the tumor
A male client has an abnormal result on a Papanicolaou test. After admitting, he read his chart while the nurse was out of the room, the client asked what dysplasia means. Which definition should the nurse provide? A. Alteration in the size, shape, and organization of differentiated cells B. Increase in the number of normal cells in a normal arrangement in a tissue or an organ C. Presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin D. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found
A. Alteration in the size, shape, and organization of differentiated cells
A 32-year-old woman meets with the nurse on her first office visit since undergoing a left mastectomy. When asked how she is doing, the woman states her appetite is still not good, she is not getting much sleep because she doesn't go to bed until her husband is asleep, and she is really anxious to get back to work. Which of the following nursing interventions should the nurse explore to support the client's current needs? A. Ask open-ended questions about sexuality issues related to her mastectomy B. Suggest that the client learn relaxation techniques to help with her insomnia C. Call the physician to discuss allowing the client to return to work earlier D. Perform a nutritional assessment to assess for anorexia
A. Ask open-ended questions about sexuality issues related to her mastectomy
A female client with cancer is scheduled for radiation therapy. The nurse knows that radiation at any treatment site may cause a certain adverse effect. Therefore, the nurse should prepare the client to expect: A. Fatigue B. Vomiting C. Hair loss D. Stomatitis
A. Fatigue
Nurse Amy is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society guidelines, the nurse should recommend that the women: A. Have a mammogram annually B. Perform breast self-examination annually C. Have a hormonal receptor assay annually D. Have a physician conduct a clinical examination every 2 years
A. Have a mammogram annually
For a female client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the plan of care? A. Inspecting the skin for petechiae once every shift B. Placing the client in strict isolation C. Providing for frequent rest periods D. Administering aspirin if the temperature exceeds 102° F (38.8°C)
A. Inspecting the skin for petechiae once every shift
The nurse is interviewing a male client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer? A. Polyps B. Weight gain C. Hemorrhoids D. Duodenal ulcers
A. Polyps
The nurse is caring for a female client experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. The nurse plans to: A. Teach the client and family about the need for hand hygiene B. Insert an indwelling urinary catheter to prevent skin breakdown C. Restrict fluid intake D. Restrict all visitors
A. Teach the client and family about the need for hand hygiene
Nurse Kent is teaching a male client to perform monthly testicular self-examinations. Which of the following points would be appropriate to make? A. Testicular cancer is a highly curable type of cancer B. Testicular cancer is very difficult to diagnose C. Testicular cancer is the number one cause of cancer deaths in males D. Testicular cancer is more common in older men
A. Testicular cancer is a highly curable type of cancer
Nurse Mary is instructing a premenopausal woman about breast self-examination. The nurse should tell the client to do her self-examination: A. On the 1st day of the menstrual cycle B. On the same day each month C. Immediately after her menstrual period D. At the end of her menstrual cycle
C. Immediately after her menstrual period
Nurse April is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover: A. Fibrocystic masses Nurse April is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover: A. Fibrocystic masses B. Changes from previous self-examinations C. Areas of thickness or fullness D. Cancerous lump C. Areas of thickness or fullness D. Cancerous lump
B. Changes from previous self-examinations
A male client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer? A. Rash B. Indigestion C. Chronic ache or pain D. Persistent nausea
B. Indigestion
A female client with cancer is being evaluated for possible metastasis. Which of the following is one of the most common metastasis sites for cancer cells? A. Colon B. Liver C. Reproductive tract D. White blood cells (WBCs)
B. Liver
Nina, an oncology nurse educator, is speaking to a women's group about breast cancer. Questions and comments from the audience reveal a misunderstanding of some aspects of the disease. Various members of the audience have made all of the following statements. Which one is accurate? A. Breast cancer requires a mastectomy B. Men can develop breast cancer C. Breast cancer is the leading killer of women of childbearing age D. Mammography is the most reliable method for detecting breast cancer
B. Men can develop breast cancer
35 years old client with ovarian cancer is prescribed hydroxyurea (Hydrea), an antimetabolite drug. Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. The mechanism of action of antimetabolites interferes with: A. Cell division or mitosis during the M phase of the cell cycle B. Normal cellular processes during the S phase of the cell cycle C. The chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (cell cycle-nonspecific) D. One or more stages of ribonucleic acid (RNA) synthesis, DNA synthesis, or both (cell cycle-nonspecific)
B. Normal cellular processes during the S phase of the cell cycle
A 35-year-old client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis (inflammation of the mouth)? A. Rust-colored sputum B. Red, open sores on the oral mucosa C. Yellow tooth discoloration D. White, cottage cheese-like patches on the tongue
B. Red, open sores on the oral mucosa
A male client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. Which "related-to" phrase should the nurse add to complete the nursing diagnosis statement? A. Related to psychomotor seizures B. Related to impaired balance C. Related to visual field deficits D. Related to difficulty swallowing
B. Related to impaired balance
One of the most serious blood coagulation complications for individuals with cancer and for those undergoing cancer treatments is disseminated intravascular coagulation (DIC). The most common cause of this bleeding disorder is: A. Brain metastasis B. Sepsis C. Intravenous heparin therapy D. Underlying liver disease
B. Sepsis
When caring for a male client diagnosed with a brain tumor of the parietal lobe, the nurse expects to assess: A. Seizures B. Tactile agnosia C. Short-term memory impairment D. Contralateral homonymous hemianopia
B. Tactile agnosia
Rhea has malignant lymphoma. As part of her chemotherapy, the physician prescribes chlorambucil (Leukeran), 10 mg by mouth daily. When caring for the client, the nurse teaches her about adverse reactions to chlorambucil, such as alopecia. How soon after the first administration of chlorambucil might this reaction occur? A. Immediately B. 1 week C. 2 to 3 weeks D. 1 month
C. 2 to 3 weeks
A male client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis may be appropriate for this client? A. Chronic low self-esteem B. Disturbed body image C. Anticipatory grieving D. Impaired swallowing
C. Anticipatory grieving
A cervical radiation implant is placed in the client for treatment of cervical cancer. The nurse initiates what most appropriate activity order for this client? A. Out of bed ad lib B. Ambulation to the bathroom only C. Bed rest D. Out of bed in a chair only
C. Bed rest
Mina, who is suspected of an ovarian tumor is scheduled for a pelvic ultrasound. The nurse provides which pre-procedure instruction to the client? A. Wear comfortable clothing and shoes for the procedure B. Maintain an NPO status before the procedure C. Drink six to eight glasses of water without voiding before the test D. Eat a light breakfast only
C. Drink six to eight glasses of water without voiding before the test
A female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy? A. Serum potassium level of 3.6 mEq/L B. Blood pressure of 120/64 to 130/72 mm Hg C. Dry oral mucous membranes and cracked lips D. Urine output of 400 ml in 8 hours
C. Dry oral mucous membranes and cracked lips
Nurse Cindy is caring for a client who has undergone a vaginal hysterectomy. The nurse avoids which of the following in the care of this client? A. Removal of antiembolism stockings twice daily B. Checking placement of pneumatic compression boots C. Elevating the knee gatch on the bed D. Assisting with range-of-motion leg exercises
C. Elevating the knee gatch on the bed
A 56-year-old woman is currently receiving radiation therapy to the chest wall for recurrent breast cancer. She calls her health care provider to report that she has pain while swallowing and burning and tightness in her chest. Which of the following complications of radiation therapy is A. Radiation enteritislikely responsible for her symptoms? A. Radiation enteritis B. Stomatitis C. Esophagitis D. Hiatal hernia
C. Esophagitis
Nurse April is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by: A. Breast self-examination B. Mammography C. Fine needle aspiration D. Chest X-ray
C. Fine needle aspiration
What should a male client over age 52 do to help ensure early identification of prostate cancer? A. Have a transrectal ultrasound every 5 years B. Perform monthly testicular self-examinations, especially after age 50 C. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly D. Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly
C. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly
A male client is receiving the cell cycle-nonspecific alkylating agent Thioplex (thiotepa), 60 mg weekly for 4 weeks by bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. The client asks the nurse how the drug works. How does thiotepa exert its therapeutic effects? A. It interferes with deoxyribonucleic acid (DNA) replication only B. It interferes with ribonucleic acid (RNA) transcription only C. It interferes with DNA replication and RNA transcription D. It destroys the cell membrane, causing lysis
C. It interferes with DNA replication and RNA transcription
Which of the following represents the most appropriate nursing intervention for a client with pruritus caused by cancer or the treatments? A. Silk sheets B. Steroids C. Medicated cool baths D. Administration of antihistamines
C. Medicated cool baths
Which intervention is appropriate for the nurse caring for a male client in severe pain receiving a continuous I.V. infusion of morphine? A. Discontinuing the drug immediately if signs of dependence appear B. Assisting with a naloxone challenge test before therapy begins C. Obtaining baseline vital signs before administering the first dose D. Changing the administration route to P.O. if the client can tolerate fluids
C. Obtaining baseline vital signs before administering the first dose
A male client is in isolation after receiving an internal radioactive implant to treat cancer. Two hours later, the nurse discovers the implant in the bed linens. What should the nurse do first? A. Leave the room and notify the radiation therapy department immediately B. Put the implant back in place, using forceps and a shield for self-protection, and call for help C. Pick up the implant with long-handled forceps and place it in a lead-lined container D. Stand as far away from the implant as possible and call for help
C. Pick up the implant with long-handled forceps and place it in a lead-lined container
A female client is receiving methotrexate (Mexate), 12 g/m2 I.V., to treat osteogenic carcinoma. During methotrexate therapy, the nurse expects the client to receive which other drug to protect normal cells? A. Tabloid (thioguanine) B. Cytosar-U (cytarabine) C. Wellcovorin (leucovorin or citrovorum factor or folinic acid) D. Benemid (probenecid)
C. Wellcovorin (leucovorin or citrovorum factor or folinic acid)
For a female client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client? A. "Client stops seeking information." B. "Client uses any effective method to reduce tension." C. "Client doesn't guess at prognosis." D. "Client verbalizes feelings of anxiety."
D. "Client verbalizes feelings of anxiety."
Gio, a community health nurse, is instructing a group of female clients about breast self-examination. The nurse instructs the client to perform the examination: A. At the onset of menstruation B. Every month during ovulation C. Weekly at the same time of day D. 1 week after menstruation begins
D. 1 week after menstruation begins
The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for? A. Assessment B. Arcus C. Actinic D. Asymmetry
D. Asymmetry
Nurse Joy is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which of the following principles? A. Remove the dosimeter badge when entering the client's room B. Individuals younger than 16 years old may be allowed to go in the room as long as they are 6 feet away from the client C. Limit the time with the client to 1 hour per shift D. Do not allow pregnant women into the client's room
D. Do not allow pregnant women into the client's room
A client, age 41, visits the gynecologist. After examining her, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer? A. Pregnancy complicated with eclampsia at age 27 B. Spontaneous abortion at age 19 C. Onset of sporadic sexual activity at age 17 D. Human papillomavirus infection at age 32
D. Human papillomavirus infection at age 32
During chemotherapy, an oncology client has a nursing diagnosis of impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis? A. Monitoring the client's platelet and leukocyte counts B. Checking regularly for signs and symptoms of stomatitis C. Recommending that the client discontinue chemotherapy D. Providing a solution of hydrogen peroxide and water for use as a mouth rinse
D. Providing a solution of hydrogen peroxide and water for use as a mouth rinse
A 34-year-old female client is requesting information about mammograms and breast cancer. She isn't considered at high risk for breast cancer. What should the nurse tell this client? A. She should have had a baseline mammogram before age 30 B. When she begins having yearly mammograms, breast self-examinations will no longer be necessary C. She should perform breast self-examination during the first 5 days of each menstrual cycle D. She should eat a low-fat diet to further decrease her risk of breast cancer
D. She should eat a low-fat diet to further decrease her risk of breast cancer
The male client is receiving external radiation to the neck for cancer of the larynx. The most likely side effect to be expected is: A. Diarrhea B. Dyspnea C. Constipation D. Sore throat
D. Sore throat
The nurse is preparing for a female client for magnetic resonance imaging (MRI) to confirm or rule out a spinal cord lesion. During the MRI scan, which of the following would pose a threat to the client? A. The client lies still B. The client asks questions C. The client hears thumping sounds D. The client wears a watch and wedding band
D. The client wears a watch and wedding band
Jenny with an advanced breast cancer is prescribed Nolvadex (tamoxifen). When teaching the client about this drug, the nurse should emphasize the importance of reporting which adverse reaction immediately? A. Anorexia B. Headache C. Hearing loss D. Vision changes
D. Vision changes
