K. Oncology - Med Surg

A newborn is transferred to the neonatal intensive care unit with a heart rate of 200 beats per min. At delivery the child's weight was 3675 grams. The health care provider orders an initial dose of digoxin 0.03 mg/kg in 3 doses over 24 hours. The syringe is labeled digoxin 100 micrograms/mL. How many mL will the nurse deliver in one dose? Do not round. Type the correct answer to the hundredths place.

0.36 mL 3675g/1000 = 3.675 kg 0.03 mg X 3.675 kg = 0.11025 mg/day 0.11025 mg/3 = 0.03675 mg/single dose 0.03675 mg = 36.75 micrograms 100 mcg/1 mL = 36.75 mcg/X 100X = 36.75 36.75/100 = 0.3675 = 0.36 mL

The nurse instructs a group of clients about dietary habits to reduce the risk of cancer. Which statement, if made by a client to the nurse, indicates further teaching is necessary? 1) "Eating polyunsaturated fats will decrease my chances of developing cancer." 2) "I should increase my intake of foods high in fiber." 3) "I should eat apricots, carrots, leafy vegetables, and citrus fruits." 4) "I should eat turkey on my sandwich rather than bologna."

1) "Eating polyunsaturated fats will decrease my chances of developing cancer."

The nurse reviews testicular self-examination (TSE) with the client. Which client statement indicates that the client needs further instruction? 1) "I always examine my testes after a cool shower." 2) "The testicles are rolled between my thumb and finger." 3) "I know one testicle is lower than the other." 4) "I do the self-examination on the first of every month."

1) "I always examine my testes after a cool shower."

Which statement CORRECTLY indicates the client understand the side effects of the chemotherapy drugs used to treat cancer? 1) "I have a banquet to attend in about 2 weeks. I'll tell them I won't be coming." 2) "My child is bringing a friend to visit in a few weeks." 3) "I promised my niece and nephew I will take them to the movies." 4) "My partner is planning a 2 months cruise for us in three months. I need a vacation."

1) "I have a banquet to attend in about 2 weeks. I'll tell them I won't be coming."

The nurse cares for the child receiving chemotherapy for cancer. Which parental statement indicates that the parents need further instruction? 1) "I will give my child aspirin if my child develops a fever." 2) "My child should drink plenty of liquids." 3) "We have made arrangements for a visiting teacher to come to the house for a while." 4) "We are planning my child's birthday party after chemotherapy is finished."

1) "I will give my child aspirin if my child develops a fever."

The nurse cares for the client diagnosed with cancer of the cervix, the client has an internal radium implant. Which client statement indicates to the nurse that the teaching about the safety measures is effective? 1) "I will not permit my 3 year old granddaughter to visit." 2) "I will not cough and deep breathe because I do not wish to dislodge the applicator." 3) "I am going to ask my partner to stay with me during all the listed visiting hours." 4) "I will get out of bed and ambulate in the hall at least two times a day to prevent the risk of pneumonia."

1) "I will not permit my 3 year old granddaughter to visit."

The nurse assesses the skin of the client who has skin lesions. Which assessment finding should the nurse associate with basal cell carcinoma? 1) A small, crusty nodule on the face. 2) A red, scaly lesion on the back of the hand 3) An irregular, bluish-black lesion on the back 4) A red, scaly raised plaque on the knee with pruritus.

1) A small, crusty nodule on the face.

The nurse understands which of the following is the MOST significant risk factor for developing cancer? 1) Advancing age 2) Smoking tobacco 3) Drinking alcohol 4) Family history of cancer.

1) Advancing age

The client diagnosed with Hodgkin's lymphoma receives radiation therapy. The nurse assesses for side effects from the radiation therapy. Which assessment measure is indicated? 1) Careful observation of skin 2) Assessment of deep tendon reflexes. 3) Measurement of blood pressure and pulse 4) Palpation of lymph nodes

1) Careful observation of skin

The nurse cares for the client days after a mastectomy. The client is encouraged by the health care provider to participate in an exercise program. Which activity should the nurse suggest to facilitate mobility on the affected side? 1) Combing her hair 2) Weeding her rose garden 3) Walking 4) Swimming

1) Combing her hair

The client diagnosed with laryngeal cancer undergoes a total laryngectomy. The client returns from the operating room with a nasogastric tube in place. The nurse identifies the NG tube is in place for which reason? 1) Edema in the surgical area will place the client at risk for aspiration 2) Postoperative incision pain will make eating and drinking regular foods very uncomfortable. 3) The client will have altered body image due to diminished facial motor control, which makes food intake difficult. 4) The client will need high-protein nourishment, which tube feeding provides more effectively than eating regular dietary products.

1) Edema in the surgical area will place the client at risk for aspiration

The nurse cares for a patient with stomatits due to chemotherapy. Which of the following actions is most important for the nurse to include in the patient's plan of care? 1) Examine the patient's mouth for blisters, sores, or drainage 2) Encourage the patient to use a commercially prepared mouthwash twice daily. 3) Instruct the patient to use a soft-bristled toothbrush 4) Offer mouth care morning and night.

1) Examine the patient's mouth for blisters, sores, or drainage

The nurse obtains a health history on the client diagnosed with chronic lymphocytic leukemia (CLL). Which sign or symptom would the nurse associate with this diagnosis if it is noted on a client history? 1) Frequent infections 2) Intermittent headaches 3) Mucositis 4) Palpitations

1) Frequent infections

Which of the following nursing interventions is MOST effective in promoting adequate nutrition for patients undergoing radiation and chemotherapy? 1) Include patients when making meal and snack selection. 2) Ensure meals are served hot 3) Offer salty snacks every 2 hours 4) Serve additional portions of food at mealtime.

1) Include patients when making meal and snack selection.

The home nurse cares for a client diagnosed with acute myelogenous leukemia (AML). The client's temperature is 101 degrees F (38.3 degrees C). Which of the following actions should the nurse take FIRST? 1) Notify the physician 2) Offer the client oral fluids 3) Administer an antipyretic 4) Encourage the client to cough and deep breathe.

1) Notify the physician

A 20 year old client has Stage I Hodgkin's lymphoma. Which would the nurse expect to find when assessing this client? 1) Painless enlargement of a single lymph node 2) Unexplained weight gain. 3) Hepatomegaly with tenderness 4) Sudden onset of jaundice

1) Painless enlargement of a single lymph node

Which concern is MOST important for the nurse to consider when planning the care for the client receiving chemotherapy? 1) Preventing individuals with known infections from visiting the client. 2) Minimizing or preventing alopecia by using an ice cap. 3) Maintaining adequate gastrointestinal function to ensure adequate nutrition. 4) Minimizing hemorrhagic cystitis by increasing intravenous (IV) fluids.

1) Preventing individuals with known infections from visiting the client.

The nurse makes a home visit to a client receiving chemotherapy for the treatment of cancer. The nurse instructs the client about ways to avoid injury due to bone marrow suppression. The nurse should intervene if which of the following is observed? 1) The client takes Alka-Seltzer for indigestion 2) The client uses an electric razor to shave. 3) The client blows his nose gently 4) After bumping his leg, the client applies ice for an hour.

1) The client takes Alka-Seltzer for indigestion

The nurse cares for the client diagnosed with breast cancer after a positive breast biopsy. The client refuses to believe the diagnosis and says, "I do not have the C-disease." When planning nursing interventions, which is an INITIAL short-term goal? 1) The client will say the word "cancer" 2) the client will admit having cancer 3) the client will attend a support group for cancer victims 4) the client will sign advance directions

1) The client will say the word "cancer"

The nurse performs postoperative care for a patient after a Whipple procedure for treatment of pancreatic cancer. The nurse is MOST concerned if which of the following is observed? 1) There is clear, colorless, bile-tinged drainage from the NG tube 2) The NG tube is connected to low continuous suction 3) The patient is lying in a semi-Fowler's position 4) The nurse instills air to open the drainage lumen of the NG tube.

1) There is clear, colorless, bile-tinged drainage from the NG tube

Which indicates the CORRECT reason clients diagnosed with acute lymphoid leukemia (ALL) have an enlarged spleen, liver, and lymph nodes? 1) These organs are infiltrated with nonfunctioning white blood cells, causing their enlargement. 2) These organs work overtime in patient diagnosed with leukemia, and therefore grow larger. 3) These organs enlarge when processing the medications given to patients diagnosed with leukemia 4) White blood cells are made in these organs and become trapped which causes the enlargement.

1) These organs are infiltrated with nonfunctioning white blood cells, causing their enlargement.

Which statement indicates to the nurse the client is adapting well to altered body image following surgery for colorectal cancer? 1) "I will just have my partner take care of my ostomy for me." 2) "Do you have a mirror with which I can take a look at the ostomy?" 3) "When did the health care provider say this thing can be fixed and removed?" 4) "I know I will need to have this thing. But I just can't accept it."

2) "Do you have a mirror with which I can take a look at the ostomy?"

A patient is scheduled for a total laryngectomy. He tells the nurse, "I am worried about my operation. I just can't help it." Which of the following responses by the nurse is BEST? 1) "Have you discussed your worries with your doctor?" 2) "I hear your concerns about having the operation." 3) "You have a really fine doctor so there seems to be little need to worry." 4) "Everyone worries about surgery, especially when it is a first-time experience."

2) "I hear your concerns about having the operation."

The nurse teaches stoma care to the client with a total laryngectomy. Which client statement indicates to the nurse an understanding of the instructions? 1) "I am so glad I do not have to wear anything over the stoma." 2) "I will cover the stoma with a gauze pad while I shower." 3) "I will keep my medical emergency card in the car." 4) "I will not put anything around the exterior of the stoma."

2) "I will cover the stoma with a gauze pad while I shower."

The nurse leads adult women in a wellness class. The nurse instructs the class about risk factors for developing breast cancer. The nurse should intervene if one of the women makes which of the following statements? 1) "Women over the age of 40 have a greater chance of developing breast cancer." 2) "Women with a history of benign breast disease have a higher risk of developing breast cancer" 3) "Women who have a mother or sister with breast cancer are at a higher risk of developing breast cancer." 4) "Women who have never had children have a higher risk of developing breast cancer.

2) "Women with a history of benign breast disease have a higher risk of developing breast cancer"

Ondansetron HCL (Zofran) 6 mg PO q 6 hr is ordered for a patient. The nurse knows that the most appropriate time to administer this medication is 1) 1 hr after chemotherapy 2) 30 mins prior to start of chemotherapy 3) 2 hrs after chemotherapy 4) after the patient complains of nausea

2) 30 mins prior to start of chemotherapy

The client diagnosed with terminal cancer says to the nurse, "I'm dying because the health care providers didn't operate soon enough. How could they do this to me?" The nurse recognizes that the client is probably in which stage of the grieving process? 1) Denial 2) Anger 3) Depression 4) Guilt

2) Anger

The nurse knows which of the following is the MOST life-threatening side effect of chemotherapy? 1) Alopecia 2) Bone marrow suppression 3) Vomitting 4) Mucositis

2) Bone marrow suppression

Prior to insertion of a cervical radioactive implant, enemas are prescribed for the patient. The nurse understands enemas are prescribed for which of the following reasons? 1) Make more space for the implant 2) Decrease the chance of the implant becoming dislodged 3) Prevent constipation due to altered activity level during treatment 4) Enhance tissue susceptibility to the effects of radiation.

2) Decrease the chance of the implant becoming dislodged

The nurse assesses a patient with a diagnosis of colorectal cancer. The nurse understands that eating which of the following foods may contribute to the patient developing colon cancer? 1) Broccoli and cabbage 2) Fried red meat 3) Water 4) Oranges and grapefruit

2) Fried red meat

The nurse cares for the client who has been diagnosed with Hodgkin's lymphoma. Which diagnostic test can the nurse expect to be performed? 1) Hemoglobin electrophoresis 2) Lymph node biopsy 3) Chest x-ray 4) Bone marrow biopsy

2) Lymph node biopsy

The client has an absolute neutrophil count of 300/mm3 and is placed on neutropenic precautions. Which nursing intervention should be carried out? 1) Avoiding injections and aspirin products 2) Send the client's flowers home with the family 3) Providing client with foods high in iron and vitamin C 4) Withhold highly-spiced foods and foods high in vitamin K.

2) Send the client's flowers home with the family

The nurse plans follow-up home care for the client diagnosed with cancer of the liver. The client appears angry with family members when they discuss any issue related to the client's physical deterioration from the illness. Which is the nurse's BEST interpretation of the client's behavior to the family members? 1) The client's anger is most likely related to medical deterioration from the liver damage. 2) The client is exhibiting both denial and anger, which are characteristic of the grieving process 3) The client needs to avoid dealing with the illness at this time and focus on planning. 4) The client is displaying signs of unresolved conflict with the family that should be explored.

2) The client is exhibiting both denial and anger, which are characteristic of the grieving process

When the client is first diagnosed with cancer of the lung with metastasis to the liver, the client says, "It can't be true." Two weeks later, the client tells the nurse, "I know this is bad." Which additional response is MOST suggestive of the client's difficulty in accepting the diagnosis of cancer? 1) The client repeatedly asks the same questions about treatment options. 2) The client says to the nurse "I give up. It is too overwhelming." 3) The client tells the nurse, "Do whatever will make me better." 4) The client becomes angry and hostile toward the health care provider.

2) The client says to the nurse "I give up. It is too overwhelming."

On the unit there are three clients with brachytherapy. The staff consists of three nurses, one of whom is pregnant. When planning the staff assignments, which decision byt he charge nurse is appropriate? 1) The pregnant nurse can be assigned to one of the clients receiving brachytherapy if the nurse stays 6 feet away from the client. 2) The pregnant nurse is not assigned any of the three clients with brachytherapy. 3) One nurse is assigned to care for all the clients with brachytherapy. 4) Each nurse is assigned to one of the clients with brachytherapy and wears a dosimeter that indicates the amount of radiation received.

2) The pregnant nurse is not assigned any of the three clients with brachytherapy.

After 2 weeks of chemotherapy treatments, a patient's white blood cell count is 2,000/mm3. The nurse knows that this findings is most likely due to which of the following? 1) infection 2) bone marrow depression 3) Weight loss 4) Polycythemia

2) bone marrow depression

Which nursing goal should the nurse recognize as the HIGHEST priority for the client receiving narcotic analgesics for pain from metastitic lung cancer? 1) increased comfort 2) effective airway and respirations 3) reduction in perceived pain 4) effective coping

2) effective airway and respirations

The nurse performs discharge teaching for a patient after a right mastectomy. The nurse determines that teaching is effective if the patient makes which of the following statements? 1) "I should eat a full liquid diet for 3-4 days." 2) "I can take a shower as soon as I get home." 3) "I should empty the drain reservoir twice a day." 4) "I should eat with my left hand until the stitches are removed."

3) "I should empty the drain reservoir twice a day."

The nurse instructs staff members about care of patient diagnosed with cancer of the cervix. The patient has internal radiation in place. The nurse should intervene if a staff member makes which of the following statements? 1) "I should allow the patient to bathe herself." 2) "I should not stand at the foot of the bed." 3) "I should place all linens in a special, lead-lined hamper" 4) "I should wear a dosimeter while I am in the patient's room."

3) "I should place all linens in a special, lead-lined hamper"

The client diagnosed with Hodgkin's lymphoma has the first external radiation treatment. Which statement by the client demonstrates an understanding of the teaching plan? 1) "I will stay inside after the treatments and avoid all sunlight." 2) "I should apply a cream, such as baby oil, before each treatment. 3) "I will wear loose-fitting, cotton clothing that will not irritate the treatment area. 4) "I should use cold applications to the area if needed."

3) "I will wear loose-fitting, cotton clothing that will not irritate the treatment area.

The client has an internal radium implant for uterine cancer. Which client statement indicates an understanding of safety concerns? 1) "I want you to give me a bath in bed this morning." 2) "I need someone to sit by the bed and hold my hand." 3) "It is okay for you to talk with me from the doorway." 4) "I have been lying down a lot. Would you give me a backrub?"

3) "It is okay for you to talk with me from the doorway."

The client diagnosed with cancer asks the nurse, "Why must I take so many drugs?" Which response by the nurse is BEST? 1) "Cancer is so individual, and because no one drug works the same way with every person, more than one drug is usually used." 2) "Cancer cells grow differently than normal cells, so more than one drug is used to ensure an effect." 3) "Like bacteria, cancer cells can resist chemotherapy drugs. By using drugs with different actions, more cells are destroyed before resistance develops." 4) "It's like the 'magic bullet.' If one doesn't work, the other will."

3) "Like bacteria, cancer cells can resist chemotherapy drugs. By using drugs with different actions, more cells are destroyed before resistance develops."

The client is scheduled for a bone marrow biopsy. The client asks the nurse, "What can I expect?" Which is the nurse's BEST response? 1) "The test will be performed in the operating room. A small sample of bone marrow will be taken." 2) "We will explain the procedure as we do it. A sample of bone marrow will be taken from your sternum and sent for examination. Your sternum is the breast bone in the center of your chest." 3) "The health care provider will take a sample of bone marrow from you iliac crest, which is your hip bone. It will be uncomfortable when the health care provider actually aspirates the marrow." 4) Don't worry. It's only a little uncomfortable."

3) "The health care provider will take a sample of bone marrow from you iliac crest, which is your hip bone. It will be uncomfortable when the health care provider actually aspirates the marrow."

The client scheduled for a bone marrow biopsy tomorrow morning appears anxious and wants to know what is going to happen. Which is the BEST response by the nurse? 1) "A needle will numb the area, then the health care provider will put a needle into the bone in your skin and draw out bone marrow." 2) "You will be given a local anesthetic in the skin and bone, so after the initial needle you shouldn't feel anything." 3) "You may feel pressure when they take the marrow out, but it only lasts a few seconds." 4) "You will be asleep for the procedure and won't feel anything except a slight discomfort after you wake up."

3) "You may feel pressure when they take the marrow out, but it only lasts a few seconds."

The nurse cares for a patient diagnosed with cancer receiving chemotherapy. The patient shares with the nurse how upset she is that she is losing her hair. Which of the following statements by the nurse is BEST? 1) "I'm sure that your daughter will help you find a wig that you like." 2) "I would not want to lose my hair!" 3) "Your hair will grow back about one month after chemotherapy is complete." 4) "There are many attractive hats and scarves that will look good on you."

3) "Your hair will grow back about one month after chemotherapy is complete."

A client experiences numbness and decreased sensation in both lower extremities during the course of treatment with vinblastine. The nurse instruct the client to take which action? 1) Soak both legs in hot water four times/day 2) Increase walking to three times a week for 30 mins 3) Ambulate carefully with broad-based gait 4) Elevate legs while sitting.

3) Ambulate carefully with broad-based gait

The nurse cares for the client diagnosed with cancer of the cervix. The client undergoes brachytherapy. To minimize the danger of radiation exposure, the nurse should include which intervention in the plan of care? 1) Isolate client and allow no visitors 2) Ensure that visitors stand at least three feet from radiation source 3) Assign a different nurse each day 4) Assign only male nurses.

3) Assign a different nurse each day

The nurse cares for the school-aged client diagnosed with medulloblastoma. The client is scheduled for radiation therapy. Which information should the nurse discuss when providing education to the client's family? 1) The child should refrain from daily tooth flossing 2) Limit calorie intake to 1,000 per day 3) Check skin daily 4) Wear a mask beginning with the first day of treatment.

3) Check skin daily

The client diagnosed with brain cancer asks, "Can I be an organ donor?" On which understanding does the nurse base the response? 1) Any person over the age of 21 years may become an organ donor by written consent. 2) The client would need to check whether the state lived in has adopted the Uniform Anatomical Gift Act for cadaveric organ donation. 3) Contraindications to becoming an organ donor include having any malignancy other than a brain tumor. 4) A person interested in being an organ donor must have an advance directive that includes this information.

3) Contraindications to becoming an organ donor include having any malignancy other than a brain tumor.

The nurse recognizes which of the following signs indicate cancer of the larynx? 1) Increased drooling 2) Blood-streaked sputum 3) Difficulty swallowing 4) Jaundice

3) Difficulty swallowing

Which demonstrates the nurse's CORRECT understanding of neutropenic precautions? 1) Moving the client to a semi-private room 2) Encouraging family members to visit often 3) Having the room dusted and cleaned regularly 4) Encouraging family members to bring in fresh flowers.

3) Having the room dusted and cleaned regularly

The nurse is leading a smoking cessation class. Which of the following instructions should the nurse give FIRST? 1) Remove ashtrays and lighters from view 2) Go to places that tempt the client to smoke to test the resolve. 3) Make a list of all the reasons to quit smoking. 4) Drink at least 8 glasses of water per day.

3) Make a list of all the reasons to quit smoking

A young woman receiving chemotherapy for a brain tumor suddenly becomes angry and irritable with the staff. When the nurse tries to administer the patient's medications, the patient throws a tray across the room and curses. Which of the following actions by the nurse is MOST appropriate? 1) Ask another nurse to administer the medication 2) Leave the room, promising to return when the patient gains control 3) Remain with the patient and call for help 4) Restrain the patient and call for help.

3) Remain with the patient and call for help. Explanation 1) passing the buck; the nurse should handle the situation 2) never choose a "leave patient alone" option on the NCLEX exam, always remain with the agitated patient 3) CORRECT - patient's violence is most likely due to increased intracranial pressure; the nurse should stay with the patient to help the patient regain control by talking in a calm, quiet manner, in addition, the nurse should summon help quickly to facilitate medical treatment, the physician must be notified. 4) patient will become more combative if restrained; stay with patient and speak in a calm, quiet manner

The nurse cares for the client diagnosed with multiple myeloma. Which is ESSENTIAL for the nurse to understand in order to plan care for this client? 1) Multiple myelomais is a benign disease in which the large muscle groups deteriorate. 2) Hypocalcemia is often present and is related to severe bone disease. 3) Renal failure or renal insufficiency can occur when plasma cells infiltrate the kidneys 4) Bone destruction often occurs when uric acid invades the bone.

3) Renal failure or renal insufficiency can occur when plasma cells infiltrate the kidneys

The nurse cares for a patient diagnosed with immunosuppression due to chemotherapy. The nurse determines care is appropriate if which of the following is observed? 1) The nurse obtains the patient's vital signs every 8 hours. 2) The patient is placed in a room with a patient admitted with ulcerative colitis. 3) The nursing assistant washes hands prior to changing the patient's bed linens 4) The staff brings in blood pressure equipment to obtain a patient's blood pressure.

3) The nursing assistant washes hands prior to changing the patient's bed linens

A female patient diagnosed with acute myelogenous leukemia (AML) begins menstruating. Which of the following actions should the nurse take FIRST? 1) Instruct the patient to report any increased dizziness and weakness. 2) Contact the physician 3) Weigh the patient's pads and tampons before and after use. 4) Ask the patient if she had heavy periods in the past.

3) Weigh the patient's pads and tampons before and after use.

The nurse care for the client diagnosed with malignant melanoma. Which treatment should the nurse expect will be used? 1) Cryosurgery 2) Intralesional vinblastine 3) Wide excision, full thickness surgical removal 4) Topical application of 5 FU over the entire affected area for 14-21 days.

3) Wide excision, full thickness surgical removal

For which reason is chemotherapy given to clients diagnosed with leukemia? 1) To treat the infections caused by the leukemia 2) To prevent further development of the leukemia 3) to destroy the fastest growing cells in the body 4) To treat the problems caused by the leukemia.

3) to destroy the fastest growing cells in the body

The nurse cares for the client diagnosed with chronic lymphocytic leukemia. The client asks if the disease will worsen very soon. Which is the MOST appropriate response by the nurse? 1) "I really cannot say. You need to discuss this matter with your health care provider." 2) "Oh, don't worry about that right now. Everything will be okay." 3) "Chronic lymphocytic leukemia is a type of leukemia which causes acute symptoms that usually progress rapidly." 4) "Chronic lymphocytic leukemia is a disease of older adults that requires treatment based on progression of disease. Many people in early stages do not require treatment until symptoms worsen."

4) "Chronic lymphocytic leukemia is a disease of older adults that requires treatment based on progression of disease. Many people in early stages do not require treatment until symptoms worsen."

The nurse evaluates teaching provided for the client receiving external radiation. Which client statement does the nurse interpret as the client's understanding of skin care? 1) "I will use cool water without soap as much as possible for my skincare." 2) "I will use lotion to keep my skin in good condition." 3) "I will wear only natural fabrics, such as wool and cotton." 4) "I will use cornstarch instead of powder if I experience itching."

4) "I will use cornstarch instead of powder if I experience itching."

The nurse cares for the client receiving radiation therapy for treatment of lung cancer. The client is upset about the radiation treatments and tells the nurse, "I don't want to be burned." Which is the BEST response by the nurse? 1) "Your treatment may result in third-degree burns." 2) "Burns can be treated with lotions and creams." 3) "The treatment does not leave any effects on the skin." 4) "Side effects include skin reactions, fatigue, nausea, and anorexia."

4) "Side effects include skin reactions, fatigue, nausea, and anorexia."

On the evening before a schedule lung biopsy, a patient says to the nurse, "Do you think I have cancer?" Which of the following responses by the nurse is MOST appropriate? 1) "It is not for me to say; you'll know after tomorrow." 2) "You know that you have been taking a chance smoking cigarettes all these years." 3) "Several tests will have to be done to confirm that diagnosis." 4) "You sound worried about what they might find tomorrow."

4) "You sound worried about what they might find tomorrow."

The nurse performs health screening on a group of people. The nurse identifies which individual is at GREATEST risk for developing skin cancer? 1) A 15 year old male with dark skin works as a lifeguard at the local pool 2) A 30 year old female with light skin works as a cashier at the local store 3) A 47 year old female with dark skin swims daily at a health club 4) A 62 year old male with light skin worked as a roofer for 40 years.

4) A 62 year old male with light skin worked as a roofer for 40 years.

The nurse recognizes which of the following is an early symptom of gastric cancer? 1) Occult blood in the stool 2) Vomiting 3) Iron deficiency anemia 4) Abdominal discomfort relieved with antacids

4) Abdominal discomfort relieved with antacids

The client was recently diagnosed with liver cancer. The nurse knows that the client's prognosis is very poor. The health care provider anticipates that the client only has a few weeks left to live. The client's daughter is due to have a baby in 6 months. This will be the client's first grandchild. As the nurse completes nursing care in the client's home, the client discusses how unhappy he feels about the prospect of dying within the month. The client states, "If I can just make it for 6 months so that I can see my grandchild, then I'll be ready to die. I just want to be here to see my daughter have her baby." Which of Kubler-Ross's five stages of death and dying is the client exhibiting? 1) Denial 2) Acceptance 3) Depression 4) Bargaining

4) Bargaining

The client diagnosed with terminal pancreatic cancer is admitted to the hospice facility. The client's partner has been providing all of the client's daily care while also caring for their two young children. Which admitting information for this couple is appropriate for the nurse to review? 1) Do not allow the children to visit while the client is in hospice care. 2) Encourage the client's partner to provide false assurances to the client and their children. 3) Advise the client's partner to avoid conversation about normal family activities. 4) Communicate news of impending death to the family in a private area.

4) Communicate news of impending death to the family in a private area.

The home care nurse monitors a client diagnosed with cancer of the lung. The client complains about awakening with a severe headache several mornings during the past week. The client also admits to becoming suddenly nauseated, has vomiting, and notices drooling. Which of the following actions by the nurse is BEST? 1) Administer the prescribed antiemetic 2) Reassure the client that this is expected. 3) Assess the status of the client's lungs. 4) Contact the physician.

4) Contact the physician.

The nurse makes staff assignments for the oncology unit. The nurse's main concern is that there is a client on the unit who has an internal radiation source implanted for the treatment of prostate cancer. Which should the nurse plan to protect the staff from radiation exposure? 1) One staff member wears a lead apron when caring for this client. 2) Three staff members share a dosimeter when caring for the client during the shift 3) One staff member assigned for close contact with this client and another staff member assigned to answer the call light for this client. 4) Limiting any staff member's contact with client to not exceed 30 min per 8 hr shift.

4) Limiting any staff member's contact with client to not exceed 30 min per 8 hr shift.

The nurse helps the client diagnosed with cancer make a plan for regaining weight that was lost during antineoplastic therapy. Which food should the nurse suggest to provide the highest protein and calorie intake? 1) Raisins 2) Liver and onions 3) Peanut butter with no preservatives 4) Milkshakes made with whole milk, fruit, and ice cream

4) Milkshakes made with whole milk, fruit, and ice cream

The nurse cares for clients receiving chemotherapy. The nurse recognizes which nursing intervention is of PRIMARY importance for the prevention or early detection of bleeding in these clients? 1) Evaluating white blood cell and differential counts 2) Assessing red blood cell counts 3) Obtaining results of electrolyte counts. 4) Monitoring platelet counts.

4) Monitoring platelet counts.

The nurse teaches a class on basal cell carcinoma to young adults working in the agriculture industry. One of the goals of the class is to teach methods to prevent skin cancer. Which item should be included as a carcinogenic agent to which these young adults might be exposed? 1) Fertilizers 2) Dust particles 3) Diesel fuel 4) Pesticides

4) Pesticides

The nurse cares for the client diagnosed with cervical cancer. The client receives external radiation. Which nursing diagnosis is the highest priority for the nurse to include in the plan of care for this client? 1) Altered oral mucous membrane 2) Pain 3) Self-care deficit 4) Risk for impaired skin integrity

4) Risk for impaired skin integrity

The nurse performs a home care visit for a client receiving chemotherapy for treatment of cancer. The client's white blood cell count is 3,500mm3. Which of the following observations, if made by the nurse, requires an intervention? 1) The client cleans the toothbrush daily by washing it in the dishwasher. 2) The client eats peeled fruits and cooked vegetables 3) The client takes and records the oral temperature each day 4) The client pulls weeds in the garden every day.

4) The client pulls weeds in the garden every day.

The client newly diagnosed with cancer tells the nurse, "I know I don't have a tumor. There must be some mistake." What is the significance of this client's denial? 1) The denial prevents the client from receiving the required treatment. 2) The denial causes the client's anxiety to increase. 3) The denial is maladaptive for the client 4) The denial may be helpful as a temporary protection.

4) The denial may be helpful as a temporary protection.

The nurse cares for a patient diagnosed with cancer of the lung receiving chemotherapy. The nurse notes that the patient's platelet count is 60,000/mm3. Which of the following actions by the nurse if most appropriate? 1) The nurse administers an IM injection with a 21-gauge needle. 2) The nurse obtains the patient's temperature rectally 3) The nurse observes teh IV site every 8 hours for bleeding. 4) The nurse checks the bristles on the patient's toothbrush.

4) The nurse checks the bristles on the patient's toothbrush.

The nurse teaches the client diagnosed with multiple meyloma how to manage the disease process. Which rationale does the nurse give for the need to increase fluid intake to 3 L per day? 1) To increase calcium loss from the bone 2) To increase the serum calcium level 3) To decrease the risk of diarrhea 4) To decrease the risk of protein accumulation in the renal tubes.

4) To decrease the risk of protein accumulation in the renal tubes.

The home care nurse visits a client undergoing external radiation for treatment of lung cancer. It is MOST important for the nurse to include which of the following interventions in the client's plan of care? 1) Use a washcloth to gently cleanse the irradiated area. 2) Apply cream to the irradiated area daily 3) Apply sunscreen to the irradiated area is exposed to the sun. 4) Use a patting motion to dry the irradiated area.

4) Use a patting motion to dry the irradiated area.

Which would the nurse include when teaching the client how to prevent skin cancer? 1) Use a tanning booth rather than go out into the sun 2) Limit tanning to the hours between 1000 and 1500 3) Use sunscreen with a SPF of less than 15 4) Wear a hat and opaque clothing when out in the sun.

4) Wear a hat and opaque clothing when out in the sun.

The client has a family history of pancreatic cancer and wants to know how to recognize the disease in the early stages. The nurse should instruct the client about which signs of pancreatic cancer? 1) Intolerance to fatty food sand frequent belching 2) Cramp-like abdominal pain and nausea 3) Polyphagia and bloody diarrhea 4) Weight loss and jaundice

4) Weight loss and jaundice

The nurse cared for the client diagnosed with acute myelogenous leukemia. Which laboratory result would the nurse expect? 1) Hematocrit (Hct) 55% 2) Hemoglobin (Hgb) 16g/dL 3) Platelets 500,000/mm3 4) White blood cells (WBC) 11,000/mm3 with myeloblasts

4) White blood cells (WBC) 11,000/mm3 with myeloblasts