Oncology

The client is preparing for discharge from the hospital after radical vulvectomy. The nurse should include which activity as appropriate for the client immediately after discharge? 1.Walking 2.Driving a car 3.Sexual activity 4.Sitting for lengthy periods

1

The community health nurse conducts a health promotion program for community members regarding testicular cancer. The nurse determines that further information needs to be provided if a community member states that which is a sign of testicular cancer? 1.Alopecia 2.Back pain 3.Painless testicular swelling 4.Heavy sensation in the scrotum

1

The nurse has provided teaching for an adult client about screening for colon cancer. Which statement by the client indicates that education was effective? 1."I should have an annual fecal occult blood test." 2."I should have an annual colonoscopy when I become 60." 3."I will have a colonoscopy before the fecal occult blood test." 4."I will not need to have further fecal occult blood tests after a colonoscopy."

1

The nurse is reviewing the laboratory test results for a client with bladder cancer with bone metastasis. The nurse should contact the primary health care provider (PHCP) if which finding is noted? 1.Calcium level of 15 mg/dL (3.75 mmol/L) 2.Potassium level of 3.8 mEq/L (3.8 mmol/L) 3.Platelet count of 200,000 mm3 (200 × 109/L) 4.White blood cell (WBC) count of 6000 mm3 (6 × 109/L)

1

The ambulatory care nurse is providing discharge instructions to a female client who underwent cryosurgery with laser therapy because of a positive Papanicolaou test. Which statement by the client indicates an understanding of the instructions? 1."I should take sitz baths every 4 hours for the next week." 2."I should expect the vaginal discharge to be clear and watery." 3."Very strong pain medications will be needed to relieve any discomfort I may have." 4."If I note any odor to the vaginal discharge, I should call the primary health care provider immediately."

2

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

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

The nurse is caring for a client with leukemia. In assessing the client for signs of leukemia, the nurse determines that what should be monitored? 1.Platelet count 2.Bone marrow biopsy 3.White blood cell count 4.Complete blood cell count

2

The nurse is preparing to care for a client with a diagnosis of metastatic cancer. The nurse notes documentation in the client's chart that the client is experiencing cachexia. Which should the nurse expect to note on assessment of the client? 1.Elevated blood pressure and ascites 2.Sunken eyes and a hollow cheek appearance 3.Periorbital edema and swelling around the ears 4.Generalized edema and the presence of weight gain

2

The nurse has provided instructions to a client receiving external radiation therapy. Which client statement would indicate a need for further instruction regarding self-care related to the radiation therapy? 1."I need to eat a high-protein diet." 2."I need to avoid exposure to sunlight." 3."I need to wash my skin with a mild soap and pat dry." 4."I need to apply pressure on the irritated area by wearing snug clothing to prevent bleeding."

4

A client is admitted to the hospital with suspected bladder cancer. The nurse assesses the client for which early signs and symptoms of the disease? 1.Proteinuria and dysuria 2.Hematuria and absence of pain 3.Painful urination and hematuria 4.Pyuria and palpable abdominal mass

2

The oncology nurse is providing a teaching session for a group of nursing students regarding the risks and causes of bladder cancer. Which statement by a student would indicate a need for further teaching? 1."Bladder cancer most often occurs in women." 2."Using cigarettes and drinking coffee can increase the risk." 3."Bladder cancer generally is seen in clients older than age 40." 4."Environmental health hazards have been implicated as a cause."

1

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

1

The nurse is doing preoperative teaching with a client newly diagnosed with a stage I cervical cancer. Which statement by the client indicates that education was effective? 1."I have carcinoma that is just in the cervix." 2."My carcinoma has extended to the pelvis and the vagina." 3."I have carcinoma that has extended beyond the cervix but has not extended to the pelvic wall." 4."My carcinoma has extended beyond the true pelvis and has involved the bladder or rectal mucosa."

1

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

The nurse is reviewing the record of a client who was admitted to the hospital with a diagnosis of ovarian cancer. A client has received an unsealed radioactive isotope for treatment of thyroid cancer. Which instruction is essential for the nurse to provide the client? 1."Flush the toilet at least 3 times after use." 2."Increase intake of fruits with a core, such as apples and pears." 3."Avoid contact with pregnant women, infants, and children for 3 months." 4."Use disposable eating utensils, plates, and cups for the next 6 months."

1

The nurse is taking a history from a client suspected of having testicular cancer. Which data will be most helpful in determining the risk factors for this type of cancer? 1.Age and race 2.Marital status 3.Number of children 4.Number of sexual partners

1

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

1

A client with liver cancer who is receiving chemotherapy tells the nurse that some foods taste bitter. The nurse would try to limit which food that is most likely to cause this bitter taste for the client? 1.Pork 2.Custard 3.Potatoes 4.Cantaloupe

1

The nurse has provided discharge instructions to a client who has had cryosurgery to remove a malignant skin lesion. The nurse determines that the client understands the instructions if the client makes which statements? Select all that apply. 1."I need to avoid baths or showers for 7 to 10 days." 2."I need to clean the site as prescribed to prevent infection." 3."I need to apply ice to the site continuously to prevent swelling." 4."I need to expect some swelling and tenderness in the affected area." 5."I need to apply alcohol-soaked dressings twice a day for 30 minutes each time."

2, 4

A client with laryngeal cancer has undergone laryngectomy and is now receiving external radiation therapy to the head and neck. The nurse should monitor the client for which side and adverse effects of external radiation? Select all that apply. 1.Cystitis 2.Stomatitis 3.Dysgeusia 4.Leukopenia 5.Xerostomia 6.Thrombocytopenia

2, 3, 5

A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication. When implementing the plan, the nurse should make which statement to the client? 1."You can take aspirin as needed for headache." 2."You can drink beverages containing alcohol in moderate amounts each evening." 3."You need to consult with the primary health care provider (PHCP) before receiving immunizations." 4."It is fine to receive a flu vaccine at the local health fair without PHCP approval because the flu is so contagious."

3

Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administering chemotherapy? 1.Measure the client's abdominal girth. 2.Calculate the client's body mass index. 3.Measure the client's current weight and height. 4.Ask the client about his or her weight and height.

3

The nurse conducted discharge teaching for the client diagnosed with melanoma. Which statement by a client indicates that education was effective? 1."It is contagious." 2."Metastasis is rare." 3."It is highly metastatic." 4."It is characterized by local invasion."

3

A client seeks treatment in an ambulatory clinic for a complaint of hoarseness that has lasted for 6 weeks. On the basis of this symptom, the nurse should consider developing a plan of care for which possible medical diagnosis? 1.Thyroid cancer 2.Acute laryngitis 3.Laryngeal cancer 4.Bronchogenic cancer

3

The nurse is creating 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

A client receiving chemotherapy is experiencing mucositis. The nurse should advise the client to use which item as the best substance to rinse the mouth? 1.Alcohol-based mouthwash 2.Hydrogen peroxide mixture 3.Lemon-flavored mouthwash 4.Weak salt and bicarbonate mouth rinse

4

A client with leukemia is receiving busulfan and allopurinol. The nurse should tell the client that the purpose of the allopurinol is to prevent which symptom? 1.Nausea 2.Alopecia 3.Vomiting 4.Hyperuricemia

4

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

4

The nurse is caring for a client with prostate cancer who is being treated with a hormone therapy. What should the nurse monitor for in order to evaluate the effect of this treatment? 1.An increase in testosterone levels 2.An increase in prostaglandin levels 3.An increase the amount of circulating androgens 4.A decline in the amount of circulating androgens

4

A cervical radiation implant is placed in a client who is undergoing treatment of cervical cancer. The nurse should initiate which activity prescription as the most appropriate for this client? 1.Bed rest 2.Out of bed ad lib 3.Out of bed in a chair only 4.Ambulation to the bathroom only

1

A client is admitted to the nursing unit after undergoing radical prostatectomy for cancer. The nurse anticipates that which problem would be of most concern to the client in the immediate postoperative period? 1.Concern about the outcome of surgery 2.Continuous pain because of the effects of cancer 3.Appearance disturbance as a result of the presence of a suprapubic catheter 4.Concern about caring for self at home because of insufficient help after discharge

1

The nurse has admitted a client to the clinical nursing unit after undergoing a right mastectomy. The nurse should plan to place the right arm in which position? 1.Elevated on a pillow 2.Level with the right atrium 3.Dependent to the right atrium 4.Elevated above shoulder level

1

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 primary 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

1,2,5,6

Which are warning signs of head and neck cancer? Select all that apply. 1.Difficulty swallowing 2.Well-fitting dentures 3.Lump in the mouth, neck, or throat 4.Persistent or unexplained oral bleeding 5.Cough and sore throat that resolved 5 days after a viral pharyngitis

1,3,4

The nurse is caring for a client with lung cancer and bone metastasis. What signs and symptoms would the nurse recognize as indications of a possible oncological emergency? Select all that apply. 1.Facial edema in the morning 2.Weight loss of 20 lb (9 kg) in 1 month 3.Serum calcium level of 12 mg/dL (3.0 mmol/L) 4.Serum sodium level of 136 mg/dL (136 mmol/L) 5.Serum potassium level of 3.4 mg/dL (3.4 mmol/L) 6.Numbness and tingling of the lower extremities

1,3,6

A 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 which condition? 1.Rupture of the bladder 2.The development of a vesicovaginal fistula 3.Extreme stress caused by the diagnosis of cancer 4.Altered perineal sensation as a side effect of radiation therapy

2

For the client with stomatitis resulting from chemotherapy, the care plan should include which intervention? 1.Inspect the mouth every week for fungus. 2.Encourage foods with neutral or cool temperatures. 3.Give the client spicy foods to stimulate the sense of taste. 4.Perform frequent oral hygiene using a commercial alcohol-based mouthwash.

2

The community health nurse is preparing an educational session for a group of women and will be discussing the primary prevention strategies and treatment measures for breast cancer. What information should the nurse include in the educational session? 1.Older women are more likely to get mammograms. 2.Treatment decisions are based on a woman's overall health. 3.Women younger than age 65 are more likely to get breast cancer. 4.A woman's age is the main factor used to decide which screening methods to use.

2

The nurse is providing teaching to a client who will undergo chemotherapy for cancer, and alopecia is expected from the chemotherapeutic agent. Which statement made by the client indicates a need for further teaching? 1."Excessive hair brushing should be avoided." 2."I can't believe my hair loss will be permanent." 3."I guess I'll have to stop using my electric hair dryer and curling rod." 4."I will have my hair stylist cut my hair short just before I start my treatments."

2

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

2

A client is having a diagnostic workup for colorectal cancer. Which factors in the client's history place the client at increased risk for this type of cancer? Select all that apply. 1.A high-fiber diet 2.A diet high in fats 3.Minimal alcohol intake 4.A diet high in carbohydrates 5.A history of inflammatory bowel disease 6.A maternal grandfather who had a history of heart disease

2, 4, 5

A client calls the ambulatory care clinic and tells the nurse that she found an area that looks like the peel of an orange when performing breast self-examination (BSE) but found no other changes. What is the nurse's best response to this client? 1."Good job performing your BSE. I am sure that is nothing to be concerned about." 2."Make sure you tell the primary health care provider about your finding at the next regularly scheduled visit." 3."I am glad you called to report this finding. Can you come to the clinic to see your primary health care provider tomorrow?" 4."Do you have a thermometer? You need to take your temperature and call back if you have a fever over 101º F (38.3º C)."

3

The nurse is caring for a client on the oncology unit who has developed stomatitis during chemotherapy for treatment of breast cancer. The nurse should plan which measure to treat this complication? 1.Rinse the mouth with diluted baking soda or saline. 2.Use lemon and glycerin swabs liberally on painful oral lesions. 3.Brush the teeth and use non-waxed dental floss at least twice a day. 4.Place the client on NPO (nothing by mouth) status for 12 hours, and then resume liquids.

1

The nurse is creating 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

The nurse is reviewing a plan of care for a client with cancer of the cervix who is undergoing treatment with a cesium (radiation) implant. Which nursing interventions are most appropriate for this client? Select all that apply. 1.Maintain the client on bed rest. 2.Place the client on a low-fiber diet. 3.Keep the head of the bed flat at all times. 4.Restrict visitors to visiting for 60 minutes per day. 5.Stand at the entrance of the room to communicate with the client when possible.

1, 2, 5

The nurse is monitoring the intravenous (IV) infusion of an antineoplastic medication to treat breast cancer. During the infusion, the client complains of pain at the insertion site. On inspection of the site, the nurse notes redness and swelling and that the infusion of the medication has slowed in rate. The nurse suspects extravasation and should take which actions? Select all that apply. 1.Stop the infusion. 2.Prepare to apply ice or heat to the site. 3.Notify the primary health care provider (PHCP). 4.Restart the IV at a distal part of the same vein. 5.Prepare to administer a prescribed antidote into the site. 6.Increase the flow rate of the solution to flush the skin and subcutaneous tissue

1, 2, 3, 5

The nurse has conducted an educational session about risk factors for bladder cancer with clients in the ambulatory care center. Which statements by the clients indicate that teaching was effective? Select all that apply. 1."Quitting smoking will help to reduce my risk." 2."I have to consider natural alternatives to dye my hair." 3."Infections of the bladder cannot cause bladder cancer." 4."Chemicals have to enter the bladder directly in order to cause bladder cancer." 5."I have to consult with my primary health care provider about long-term use of cyclophosphamide medications."

1, 2, 5

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 oncologist 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, 2, 5, 6

A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication to treat breast cancer. When implementing the plan, the nurse should make which statement to the client? 1."You can take aspirin as needed for headache." 2."You can drink beverages containing alcohol in moderate amounts each evening." 3."You need to consult with the primary health care provider (PHCP) before receiving immunizations." 4."It is fine to receive a flu vaccine at the local health fair without PHCP approval because the flu is so contagious."

3

The health education nurse provides instructions to a group of clients regarding measures that will assist in preventing skin cancer. Which instructions should the nurse provide? Select all that apply. 1.Sunscreen should be applied every 8 hours. 2.Use sunscreen when participating in outdoor activities. 3.Wear a hat, opaque clothing, and sunglasses when in the sun. 4.Avoid sun exposure in the late afternoon and early evening hours. 5.Examine your body monthly for any lesions that may be suspicious.

2, 3, 5

The community health nurse is creating a poster for an educational session for a group of women and will be discussing the risk factors associated with breast cancer. Which risk factors for breast cancer should the nurse list on the poster? Select all that apply. 1.Multiparity 2.Early menarche 3.Early menopause 4.Family history of breast cancer 5.High-dose radiation exposure to chest 6.Previous cancer of the breast, uterus, or ovaries

2, 4, 5, 6

A client is diagnosed as having a intestinal 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

2,3,4,5

A client is receiving external radiation to the neck for cancer of the larynx. Which is the most likely expected effect? 1.Dyspnea 2.Diarrhea 3.Sore throat 4.Constipation

3

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

Which interventions are the most appropriate for a client who is experiencing thrombocytopenia? Select all that apply. 1.Use a straight-edge razor for shaving. 2.Obtain a rectal temperature every 8 hours. 3.Check secretions for frank or occult blood. 4.Give vitamin K by the intramuscular route. 5.Encourage fluid intake to avoid constipation. 6.Provide oral sponges or a soft toothbrush for oral care.

3,5,6

A client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment finding would the nurse expect to note specifically in the client? 1.Fatigue 2.Weakness 3.Weight gain 4.Enlarged lymph nodes

4

The nurse is participating in a health screening clinic and is preparing teaching materials about colorectal cancer. Which risk factor for colorectal cancer should the nurse include? 1.High-fiber, low-fat diet 2.Age older than 30 years 3.Distant relative with colorectal cancer 4.Personal history of ulcerative colitis or gastrointestinal polyps

4

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 or symptom of this oncological emergency? 1.Headache 2.Dysphagia 3.Constipation 4.Electrocardiographic changes

4

A 67-year-old man is receiving outpatient radiation treatments for carcinoma of the oropharynx and has developed dysphagia. The nurse develops a teaching plan regarding dysphagia and includes which interventions in the plan? Select all that apply. 1.Teach the man to speak slowly. 2.Teach the man to enunciate clearly. 3.Encourage the man to drink only thin liquids. 4.Teach the man to examine his oral mucosa daily. 5.Encourage the man to use artificial saliva to manage dryness.

4, 5

A client is receiving intravesical chemotherapy for cancer of the bladder. The nurse should plan to take which action after the completion of each treatment? 1.Encourage increased intake of oral fluids. 2.Provide increased doses of opioid analgesics. 3.Place the client on strict contact isolation for 24 hours. 4.Keep the client on nothing by mouth (NPO) status for 6 hours.

1

The community health nurse has conducted a teaching session for community members about the risk factors for laryngeal cancer. Which statement by a person attending the session indicates that teaching was effective? 1."Exposure to airborne carcinogens can cause this type of cancer." 2."Alcohol consumption is not associated with this type of cancer." 3."Cigarette smoking does not contribute to the development of this type of cancer." 4."Overuse of the voice is not associated with this type of cancer unless it causes spitting up of blood."

1

The home health care nurse is visiting a client who has undergone a mastectomy. The nurse determines that the client demonstrates greatest adjustment to the loss of the breast if which behavior is noted? 1.The client looks at the surgical site. 2.The client performs the prescribed arm exercises. 3.The client takes the pain medication as prescribed. 4.The client has read all of the postoperative materials provided by the hospital nurse.

1

The nurse is caring for the client who is suspected of having lung cancer. The nurse should assess the client for which most frequent early symptom of lung cancer? 1.Cough 2.Hoarseness 3.Hemoptysis 4.Pleuritic pain

1

The nurse is caring for a client with lung cancer and bone metastasis. What signs and symptoms would the nurse recognize as indications of a possible oncological emergency? Select all that apply. 1.Facial edema in the morning 2.Weight loss of 20 lb (9 kg) in 1 month 3.Serum calcium level of 12 mg/dL (3.0 mmol/L) 4.Serum sodium level of 136 mg/dL (136 mmol/L) 5.Serum potassium level of 3.4 mg/dL (3.4 mmol/L) 6.Numbness and tingling of the lower extremities

1, 3, 6

The oncology nurse specialist provides an educational session for nursing staff regarding the characteristics of Hodgkin's disease. The nurse determines that further teaching is needed if a nursing staff member states that which is a characteristic of the disease? 1.Reed-Sternberg cells are present. 2.The lymph nodes, spleen, and liver are involved. 3.The prognosis depends on the stage of the disease. 4.The disease occurs most often in those older than 75 years of age.

4

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 (155 mmol/L) 4.Calcium level of 8.6 mg/dL (2.15 mmol/L) 5.Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

1,2,5

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 Bence Jones protein 3.Hemoglobin level of 15.5 g/dL (155 mmol/L) 4.Calcium level of 8.6 mg/dL (2.15 mmol/L) 5.Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

1,2,5

A client with bladder cancer has undergone surgical removal of the bladder with creation of an ileal conduit. Which assessment findings indicate that the client is developing complications? Select all that apply. 1.Dusky appearance of the stoma 2.Stoma protrusion from the skin 3.Sharp abdominal pain with rigidity 4.Urine output greater than 30 mL/hour 5.Mucus shreds in the urine collection bag

1,2,3

The community nurse is conducting a health promotion program, and the topic of the discussion relates to the risk factors for gastric cancer. Which item, if identified as a risk factor by a client, indicates a need for further discussion? 1.Smoking 2.A low-fat diet 3.Foods containing nitrates 4.A diet of smoked, highly salted, and spiced foods

2

The nurse is admitting a client with laryngeal cancer to the nursing unit. What should the nurse assess for as the most common risk factor for this type of cancer? 1.Alcohol abuse 2.Cigarette smoking 3.Use of chewing tobacco 4.Exposure to air pollutants

2

The nurse is counseling a woman about decreasing her risk for cervical cancer. Which statement by the client indicates a need for further counseling? 1."I need to seek prompt treatment for vaginitis." 2."Condoms are needed only if I do not trust a new partner." 3."A partner who is uncircumcised will present an increased risk." 4."I need to keep appointments for Pap tests at the frequency advised by my primary health care provider."

2

The nurse is providing discharge instructions to a client who has undergone treatment of cervical cancer with a radiation (cesium) implant. Which instruction should the nurse provide to the client? 1.Avoid douching for at least 1 year. 2.Use a vaginal dilator 3 times a week. 3.Sexual activity can be resumed in about 2 months. 4.Bed rest is recommended for at least 1 week after discharge.

2

The nurse is reviewing the laboratory test results for a client with a diagnosis of leukemia who is receiving chemotherapy. The nurse notes that the client's platelet count is 20,000 mm3 (200 × 109/L). The nurse should prepare to implement which action based on this finding? 1.Remove the fresh flowers from the client's room. 2.Remove the rectal thermometer from the client's room. 3.Instruct family members to wear a mask when entering the client's room. 4.Call the dietary department to report that the client will be on a low-bacteria diet.

2

The nurse is reviewing the laboratory test results for a client receiving chemotherapy. The nurse notes that the white blood cell count is extremely low and places the client on neutropenic precautions. Which interventions are components of these types of precautions? Select all that apply. 1.Allowing only fresh fruits in the client's room 2.Removing fresh-cut flowers from the client's room 3.Encouraging the client to eat any types of fresh vegetables 4.Instructing family members on the proper technique for hand washing 5.Instructing family members to wear a mask when entering the client's room

2, 4, 5

The nurse is teaching a group of adults about the warning signs of cancer. Which signs and symptoms should the nurse mention to the group? Select all that apply. 1.Areas of alopecia 2.Sores that do not heal 3.Nagging cough or hoarseness 4.Indigestion or difficulty swallowing 5.Change in bowel or bladder habits 6.Absence or decreased frequency of menses

2,3,4,5

The nurse in the primary health care provider's office is performing a postoperative assessment of a client who underwent mastectomy of her right breast 2 weeks ago. The client tells the nurse that she is very concerned because she has numbness in the area of the surgery and along the inner side of the arm from the armpit to the elbow. The nurse should provide which information to the client about her complaint? 1.These sensations are signs of a complication. 2.These sensations probably will be permanent. 3.These sensations dissipate over several months and usually resolve after 1 year. 4.It is nothing to worry about because most women who have this type of surgery experience this problem.

3

The nurse is caring for a chemotherapy client with a low platelet aggregation level. Which likely caused this decreased platelet production? 1.Anemia 2.Thrombocytopenia 3.Bone marrow suppression 4.Low hemoglobin and hematocrit (H&H) counts

3

The nurse is caring for a client with cancer of the prostate who has undergone a prostatectomy. Which action should the nurse include in discharge instructions? 1.Avoid driving the car for a few days. 2.Restrict fluid intake to prevent incontinence. 3.Avoid lifting objects heavier than 20 lb (9 kg) for at least 6 weeks. 4.Notify the primary health care provider if small blood clots are noticed during urination.

3

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

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 or symptom of this oncological emergency? 1.Headache 2.Dysphagia 3.Constipation 4.Electrocardiographic changes

4

The nurse teaches skin care to a client receiving external radiation therapy. Which client statement indicates the need for further instruction? 1."I will handle the area gently." 2."I will wear loose-fitting clothing." 3."I will avoid the use of deodorants." 4."I will limit sun exposure to 1 hour daily."

4

A client who is receiving chemotherapy for breast cancer develops myelosuppression. Which instructions should the nurse include in the client's discharge teaching plan? Select all that apply. 1.Avoid contact sports. 2.Wash hands frequently. 3.Increase intake of fresh fruits and vegetables. 4.Avoid crowded places such as shopping malls. 5.Treat a sore throat with over-the-counter products. 6.Avoid people who have received live attenuated vaccines.

1,2,4,6

The client reports to the nurse that while performing testicular self-examination, he found a lump the size and shape of a pea. Which statement is the most appropriate response to the client? 1."Lumps like that are normal. Don't worry." 2."Let me know if it gets bigger next month." 3."That's important to report even though it might not be serious." 4."That could be cancer. I'll ask the primary health care provider to examine you."

3

The clinic nurse prepares instructions for a client diagnosed with leukemia who developed stomatitis after the administration of a course of antineoplastic medications. The nurse should provide the client with which instruction? 1.Avoid foods and fluids for the next 12 to 24 hours. 2.Swab the mouth with lemon and glycerin 4 times a day. 3.Rinse the mouth with a diluted solution of baking soda or saline. 4.Brush the teeth with a stiff-bristled toothbrush, and use dental floss 3 times a day.

3

The nurse has instructed the client in the correct technique for breast self-examination (BSE). For a portion of the examination, the client will lie down. The nurse should teach the client to put the pillow in which location for self-examination of the right breast? 1.Under the left scapula 2.Under the left shoulder 3.Under the right shoulder 4.Under the small of the back

3

The nurse in the ambulatory care unit is providing home care instructions to a client after cryotherapy for the treatment of malignant skin lesions. Which statement would be most appropriate for the nurse to include in the home care instructions for this client? 1."Apply ice to the site to prevent swelling." 2."Clean the site with alcohol 3 times daily." 3."Apply a warm, damp washcloth if discomfort occurs." 4."Avoid showering or taking baths until seen by the primary health care provider in 1 week."

3

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

The client has undergone mastectomy. The nurse determines that the client is making the best adjustment to the loss of the breast if which behavior is observed? 1.Refusing to look at the wound 2.Reading the postoperative care booklet 3.Asking for pain medication when needed 4.Participating in the care of the surgical drain

4

The home care nurse visits a client who has just returned home from the hospital after a mastectomy with a suction drain in place. Which observed client behavior requires a need for further teaching? 1.Empties the drain to prevent infection 2.Elevates the arm when lying and sitting 3.Applies lotion to the area after the incision heals 4.Performs full range-of-motion exercises to the upper arm

4

The nurse is providing home care instructions to the client who just had surgery for squamous cell carcinoma. The nurse provides follow-up teaching and explains to the client to watch for which characteristics of this type of skin carcinoma? 1.Irregularly shaped, pigmented papules or plaques 2.Pearly papule with a central crater and rolled, waxy borders 3.Small macules or papules with dry, rough, adherent yellow or brown scale 4.Firm, nodular lesion topped with a crust or with a central area of ulceration

4

The nurse is providing information to a client scheduled for a skin biopsy. The client asks the nurse how painful the procedure is. The nurse should make which response to the client? 1."The procedure is painless." 2."A preoperative medication will put you to sleep." 3."An analgesic will be prescribed after the procedure." 4."The local anesthetic may cause a stinging sensation."

4

The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy? 1.Anemia 2.Decreased platelets 3.Increased uric acid level 4.Decreased leukocyte count

3

A client with a medical diagnosis of breast cancer is undergoing chemotherapy. The client complains to the nurse about losing her hair and severe fatigue from the treatment. Which interventions should the nurse implement for this client? Select all that apply. 1.Review side effects of chemotherapy and treatment with the client. 2.Teach the client how to resolve specific concerns of her personal life. 3.Teach the client to pace activities with rest so as to maintain strength. 4.Offer information on available counseling services and support groups. 5.Tell the client about some other clients who have had breast cancer treatment. 6.Inquire how the cancer diagnosis and treatment affect the client's normal routine.

1,3,4,6

The nurse is reviewing the preoperative prescriptions for a client with a colon tumor who is scheduled for abdominal perineal resection and notes that the primary health care provider has prescribed neomycin for the client. After discussing a prescription for neomycin with the nursing student who is caring for the client, the nurse determines that the student understands the rationale for administration if which statement is made? 1."The client is allergic to penicillin." 2."It will help to decrease the bacteria in the bowel." 3."It is given to prevent an immune dysfunction postoperatively." 4."It is given because the client has an infection that must be treated prior to surgery."

2

The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy? 1.Anemia 2.Decreased platelets 3.Increased uric acid level 4.Decreased leukocyte count

3

The community nurse is conducting a health promotion program at a local school and is discussing the risk factors associated with cervical cancer. Which are risk factors for cervical cancer? Select all that apply. 1.Smoking 2.Multiple sex partners 3.Human papillomavirus infection 4.Annual gynecological examinations 5.First intercourse before 17 years of age

1,2,3,5

The nurse should include which intervention in the care of a client who has undergone a vaginal hysterectomy for the treatment of cancer? Select all that apply. 1.Elevate the knee gatch on the bed. 2.Encourage ambulation as prescribed. 3.Remove antiembolism stockings twice daily. 4.Assist with range-of-motion (ROM) leg exercises. 5.Check placement of pneumatic compression boots.

2,3,4,5

The nurse is providing instructions to the client who is receiving external radiation therapy. Which statement, if made by the client, indicates the need for further instruction? 1."I will dry affected areas with patting motions." 2."I will wear soft clothing over the affected site." 3."I will use a washcloth to wash the affected area." 4."I need to make sure I carry my purse on the unaffected side."

3