MOC Exam 4 EAQ Cancer
C
A man is determined to be at risk for breast cancer during a routine health screening by the nurse. The patient does not give any history of radiation exposure or genetic inheritance. Which other factor would have led the nurse to label the patient as high risk? A) History of on and off fever B) History of allergic rashes C) History of taking hormone replacement therapy for changing sex D) History of sudden excessive hair loss resulting in alopecia
A
A nurse is caring for a patient who is in the terminal stage of colon cancer. Two primary health care providers have certified that the patient's prognosis is terminal, with less than six months to live. The manager of a hospice care program reports that the patient is not eligible to receive hospice care. What is the most likely reason the manager has made this determination? A) The patient does not agree to hospice care. B) The patient is not covered under Medicare or Medicaid for hospice care. C) Hospice nurses did not receive training to provide care in terminal stages of cancer. D) The hospice care center does not provide service 24 hours a day, seven days a week.
C
A nurse is caring for a patient with bone cancer. The patient reports intolerable pain in the thigh. Which drug would be most effective for the severe musculoskeletal pain related to cancer? A) Aspirin B) Diclofenac C) Morphine D) Ibuprofen
B
A nurse is caring for a patient with breast cancer. The patient asks the nurse about the genetic basis of the disease. How should the nurse describe the gene that may initiate conversion of normal cells to cancer cells? A) Genome B) Oncogene C) Dominant allele D) Recessive allele
C, D, E
A nurse is educating a patient with breast cancer who is hesitant to undergo radiation therapy. Which statements best explain the advantages of radiation therapy to reassure the patient? Select all that apply. A) It helps to prevent the development of lymphedema. B) It ensures that there are no rashes or other skin changes associated with this surgery. C) It helps to relieve pain caused by local or distant recurrence. D) It helps to prevent local and nodal recurrences after mastectomy. E) It helps to prevent local breast cancer recurrences after a breast-conserving surgery.
A, D, E
A nurse is preparing a teaching plan about pain management for a cancer patient. What information should be included in the teaching plan? Select all that apply. A)Nonpharmacologic pain relief therapies B) Mechanism of action of the pain medications C) Pathophysiology of the development of pain in cancer D) Side effects and complications associated with medications E) Adjustments in drug dosages that may be required over a period of time
A, B, D
A nurse is reviewing the record of a patient with breast cancer to determine the cancer stage according to the TNM system (tumor size, nodal involvement, presence of metastasis). Which parameters are taken into account in TNM staging of cancers? Select all that apply. A) Tumor size B) Metastasis C) Number of tumors D) Lymph node involvement E) Response to hormonal therapy
B, D, E
A nurse is teaching a group of patients who are at high risk of developing cancer due to family history. Which agents should the nurse discuss as being known to be cancer-promoting? Select all that apply. A) Radiation B) Dietary fats C) Chemical agents D) Cigarette smoking E) Alcohol consumption
B, C, E
A nurse is teaching a group of teenagers about breast cancer prevention. What topics should the nurse include in the presentation? Select all that apply. A) Yearly regular mammograms starting at age 60 B) Breast self-examinations C) Identification of an at-risk population D) Breast self-examination before the onset of menstruation monthly E) Importance of clinical breast examination yearly after age 40
B
A nurse planning a community health program on cancer awareness includes the need for testicular self-examination. What target age group would have the highest priority for this educational program? A) 5 to 12 years B) 15 to 35 years C) 30 to 45 years D) Older than 50 years
C
A nurse preparing educational information about lung cancer notes that what is the primary risk factor related to the development of lung cancer? A) Genetics B) Chewing tobacco C) Cigarette smoking D) Occupational exposure
A
A nurse teaching a community group about ways to reduce the risk for colorectal cancer includes decreasing the dietary intake of: A) Beef and pork B) Fish and poultry C) Fresh and dried fruits D) Green leafy vegetables
C, D, E
A patient arrives at the clinic to have a Papanicolaou (Pap) test done. What information should the nurse give to this patient? Select all that apply. A) Get this test done annually until the age of 65 years. B) Get this test done three times a year until the age of 65 years. C) Get this test done once in three years until the age of 65 years. D) This test is not required for women who have undergone hysterectomy. E) After 65 years, this test is not required if two or three consecutive negative Pap tests are received in two years.
C
A patient expresses concern over her risk factors for developing ovarian cancer since her mother and sister died from the disease. What should the nurse include when teaching about early detection of ovarian cancer? A) Report any pelvic or vaginal bleeding soon B) Use estrogen with progestin for menopause C) Obtain annual bimanual pelvic examinations D) Receive a preventive bilateral oophorectomy
D
A patient has been diagnosed with Burkitt's lymphoma. What does the nurse inform the patient that they most likely have had exposure to? A) Bacteria B) Sun exposure C) Most chemicals D) Epstein-Barr virus
C, D, E
A patient is being treated with chemotherapy for testicular cancer. What side effects should the nurse monitor closely for? Select all that apply. A) Bone pain B) Septic shock C) Nerve damage D) Kidney damage E) Pulmonary toxicity
D
A patient is diagnosed with lung cancer, and the prognosis is very poor. The patient has smoked three packs of cigarettes per day for the last 12 years. The patient's spouse is also a chronic smoker but is healthy. The nurse recognizes that which patient statement indicates that the patient is using rationalization as a defense mechanism? A) "Everyone dies sometime!" B) "I made a mistake, so God gave me a punishment." C) "No, I don't have cancer; there is a mistake in the lab reports." D) "My spouse is a smoker but didn't get cancer; therefore, I don't have cancer."
D
A patient is diagnosed with stage IV malignant cancer. What anatomic extent of the disease does the nurse determine is present? A) Cancer is in situ. B) Tumor growth is localized. C) Spread of cancer cells is limited. D)Cells have undergone metastasis.
A, D, E
A patient is illiterate and has cancer. What factors will the nurse anticipate to be associated with this patient? Select all that apply. A) Higher risk of death B) Lesser hospitalization C) Increased use of cancer screening D) Greater use of emergency department care E) Decreased ability to use medications correctly
B
A patient is in the promotion stage of cancer development. What action can the nurse take to facilitate cancer prevention? A) Teach the patient to exercise daily B) Teach the patient promoting factors to avoid C) Tell the patient to have the cancer surgically removed now D) Teach the patient which vitamins will improve the immune system
C
A patient recently has been diagnosed with stage II cervical cancer. What should the nurse determine regarding the patients diagnosis? A) It is in situ. B) It has metastasized. C) It has spread locally. D) It has spread extensively.
C
A patient reports tenderness and a lump in the breast. The primary health care provider records the size of the tumor to be 7 cm. The pathology report reveals two lymph nodes to be cancerous. Which stage of cancer is described? A) Stage 0 B) Stage 1 C) Stage 2 D) Stage 3
A
A patient with cancer has an elevated serum alpha-fetoprotein level. What does the nurse determine is the reason why this level may be elevated? A) "The protein may be newly formed due to altered expression of protooncogenes." B) "This protein may normally get elevated and should not be associated with cancer." C) "The protein may be newly formed due to altered expression of a tumor-inducing gene." D) "The protein may be newly formed due to altered expression of a tumor-inhibiting gene."
D
A patient with cancer has dysgeusia and tells the student nurse, "I don't want to eat. Everything tastes bitter." Which advice given by the student nurse indicates the need for further teaching? A) "You should add onions to the vegetables." B) "You should use mint juice while cooking fish." C) "You should use lemon juice marinade to the meat." D) "You should increase spices and seasoning in your food."
B, C
A patient with cancer who is receiving methotrexate therapy has developed anemia. The nurse recognizes that which therapies may benefit this patient? Select all that apply. A) Oral iron B) Epoetin alfa C) Oral folic acid D) Blood transfusion E) Parenteral vitamin B 12
A, D
A patient with head and neck cancer is scheduled for radiation therapy. Which instructions will the nurse provide to the patient prior to the first treatment to manage radiation side effects? Select all that apply.A) Drink plenty of fluids. B) Add gravies to the food. C) Gargle with warm salt water. D) Walk for about 30 minutes daily. E) Include fiber-rich foods in the diet.
A, D
A patient with lung cancer develops headaches, facial edema, periorbital edema, and distention of the veins in the head, neck, and chest. The nurse expects that what will be included in the patient's treatment plan? Select all that apply. A) Prepare the patient for radiation therapy. B) Administer a narcotic and reassure the patient. C) Administer a diuretic agent and reassure the patient. D) Inform the patient that chemotherapy may be required. E) Inform the patient that the symptoms are due to obstruction of the bronchus.
D
A patient with newly diagnosed ovarian cancer states to the nurse, "I don't understand how the cancer spread so fast." What is the best response by the nurse? A) Ovarian cancer is symptom free. B) The ovaries are highly vascular organs. C) Cell division in ovarian cancer is rapid and uninhibited. D) The pelvic lymphatics and blood vessels are intermingled.
D
After the complete assessment of a patient with lung cancer, the nurse finds that the patient has edema of neck and face. Which complication does the nurse expect in the patient? A) Pleural effusion B) Cardiac tamponade C) Paraneoplastic syndrome D) Superior vena cava syndrome
D
Older adults who belong to minority groups are less likely than their white counterparts to receive screening for which type of cancer? A) Skin B) Lung C) Breast D) Colorectal
B, D, E
The community nurse is teaching preventive cancer measures to a group of people. Which statements indicate effective learning by the participants? Select all that apply. A) "We should sleep for at least four to five hours." B) "We should avoid smoked and salt-cured meats." C) "We should exercise for about 30 minutes in a week." D) "We should add whole grains and fiber foods in our diet." E) "We should be familiar with our family history regarding health."
A
The family of a recently admitted female patient are shocked that their mother has received a diagnosis of lung cancer. They ask the nurse whether it is common for women to have lung cancer. What is the nurse's best response? A) "Lung cancer has the second highest incidence for both men and women." B) "Sadly, it is not that unusual; lung cancer has become the leading cancer for women." C) "It is unusual that your mother would have lung cancer, because fewer women smoke than men." D) "Lung cancer is not as common in women as colorectal cancer, but more women are receiving this diagnosis."
D
The nurse collects a health history from a patient with a suspected malignancy. What finding is considered significant? A) Obesity since childhood B) Annual influenza vaccination C) Varicose veins from an early age D) History of human papillomavirus
C
The nurse is assessing a patient who has been found to have a diffuse infiltrate on a chest x-ray. The patient states, "I am afraid that I have cancer." The nurse will assess the patient for which most common symptom of lung cancer? A) Hoarseness B) Hypercalcemia C) Persistent cough D) Anorexia and weight loss
D
The nurse is assisting a patient with stage IV lung cancer who is upset. Which statement by the nurse would help this patient cope with the diagnosis? A) "Lung cancers are easily treatable." B) "Anyone diagnosed with cancer feels the way you do." C) "Let's discuss this when you have your family with you." D) "This must be very difficult for you. Let me know if I can be of any help."
B
The nurse is caring for a patient who is diagnosed with stage I breast cancer. Which assessment finding corresponds with this diagnosis? A) Metastasis is present. B) The size of the tumor is less than 2 cm. C) The axillary lymph nodes are involved. D) The internal mammary lymph nodes are affected.
A
The nurse is caring for a patient who is receiving radiation therapy for neck cancer. The nurse knows that what is the most frequent side effect of this treatment? A) Dry mouth B) Depression C) Inability to swallow D) Second-degree burns of radiated area.
A
The nurse is conducting a teaching session within the community regarding cancer prevention and detection. Which type of cancer should the nurse include based on the highest incidence among both men and women? A) Lung cancer B) Thyroid cancer C) Colorectal cancer D) Non-Hodgkin lymphoma
D
The nurse is developing a program for a population with a high incidence of cancer and determines that the male population would benefit. What form of cancer for males should the nurse focus on? A) Lung cancer B) Colon cancer C) Thyroid cancer D) Prostate cancer
B
The nurse is discussing cultural factors that may affect an individual's health. Which of the following statements is true? A) "White Americans are more likely to die from heart disease than African Americans." B) "Persons of lower income and education experience worse health and may die at a younger age than those who are more affluent." C) "People who live in urban areas have higher rates of cancer, heart disease, diabetes, and depression than people living in rural areas." D) "Obesity and chronic illness rates for diabetes, hypertension, and stroke are higher among white people when compared with minority people."
C, D
The nurse is educating a patient about nutritional methods to decrease the risk of cancer. Which foods should the nurse advise the patient to avoid to decrease the risk of cancer? Select all that apply. A) Fresh fruit B) Vegetables C) Smoked ham D) Salt-cured meat E) Poached egg whites
B
The nurse is educating a student nurse about the seven warning signs of cancer. Which warning sign stated by the student nurse indicates the student requires further education? A) Indigestion B) Severe headache C) Unusual bleeding D) Difficult in swallowing
B, D, E
The nurse is educating a teenage patient about risk factors for cancer of the reproductive system. Which patient statements demonstrate understanding of the education? Select all that apply. A) "I will avoid alcohol." B) "I will avoid smoking." C) "I will increase my intake of dietary fiber." D)"I will use condoms for sexual intercourse." E) "I will limit sexual activity in my adolescent years." F) "I will urinate as soon as sexual intercourse is over."
B
The nurse is explaining cancer cell biology to a student nurse. Which statement may be specifically used with regard to contact inhibition? A) "The cell differentiation is unstable." B) "The cells grow on top of one another." C) "The cell loses its potential to perform all the body functions." D) "The cells do not revert back to their previous undifferentiated state."
A
The nurse is preparing a diet plan for a patient with cancer who has malnutrition. Which type of food would be most beneficial to the patient? A) Deviled egg with vegetable salad B) Sausages with ½-cup cottage cheese C) One cup of hot vegetable soup with one spoon of cream D) Milk shake with one scoop of ice cream and one cup of milk
B
The nurse is providing care to a patient with a family history of breast cancer. Which assessment question to determine the patient's genetic risk is most appropriate? A) "Do you conduct self-breast examinations?" B) "Do you know your breast cancer gene (BRAC) status?" C) "Have you ever had a suspicious mammogram of your breast?" D) "Have you ever noted dimpling when conducting a breast exam?"
C
The nurse is reading a pathologic report on a patient who has esophageal cancer. Which letter informs the nurse that the cancer has spread to another part of the body? A) T B) N C) M D) D
A, D, E
The nurse is reviewing statistics regarding the incidence and death rates of cancer. What statement does the nurse recognize has basis in fact? Select all that apply. A) Thyroid cancer is more prevalent in women than in men. B) Colon cancer is the most common type of cancer in men. C) A higher percentage of women than men have lung cancer. D) More men than women die from cancer-related deaths each year. E) African Americans have a higher death rate from cancer than whites.
D
The nurse is reviewing the laboratory reports of a patient diagnosed with cancer and finds that the patient has neutropenia. On examination, the nurse finds that the patient has a body temperature of 100.4° F (38° C). What is the priority nursing intervention in this situation? A) Administering parenteral fluids B) Administering aspirin to the patient C) Administering pamidronate to the patient D) Notifying the primary health care provider
B
The nurse is reviewing the medical record of a patient who has been newly diagnosed with testicular cancer. When considering the goal of curing cancer, the treatment is based on which of these principles? A) Surgery will be the single most effective treatment. B) Therapy will include a combination of treatment modalities. C) The risk for recurrent disease is lowest after treatment completion. D) Chemotherapy most often is tried as the initial treatment for most cancers.
D
The nurse is reviewing the role of the immune system in cancer development. Which of these statements explains the primary protective role of the immune system related to malignant cells? A) Immune cells bind with free antigen released by malignant cells. B) Immune cells produce blocking factors that immobilize cancer cells. C) The immune system produces antibodies that attack the cancer cells. D) The immune system provides surveillance for cells with tumor-associated antigens (TAAs).
A
The nursing instructor is evaluating a student nurse's teaching plan about preventive measures for head and neck cancer in patients. Which statement of the student nurse does the nursing instructor correct? A) "Chewing tobacco is better than smoking." B) "If you smoke, stop. If you don't, don't start." C) "Alcohol in moderation, but no alcohol is best." D) "Brush three times daily and floss at least once."
A, B, E
The patient and family are upset that the patient is going through procedures to diagnose cancer. What nursing actions should the nurse use first to facilitate their coping with this situation? Select all that apply. A) Maintain hope B) Exhibit a caring attitude C) Plan realistic long-term goals D) Give them antianxiety medications E) Be available to listen to fears and concerns F) each them about all the types of cancer that could be diagnosed
C
The registered nurse is teaching a student nurse about cancer cell proliferation. Which statement given by the student nurse indicates a need for further teaching? A) "The cancer cells respond differently to the intracellular signals." B) "The rate of proliferation of cancer cells is the same as normal cells." C) "The rate of proliferation of cancer cells is more rapid than normal cells." D) "There is an indiscriminate and continuous proliferation of cancer cells."
C
When discussing cancer diagnoses with a patient, which should the nurse identify as the only definitive method? A) Genetic markers B) Radiographic studies C) Pathologic evaluation D) Endoscopic examination
B
When studying the incidence of skin cancers in a population, a nurse finds that a greater number of skin cancer cases have been reported in white patients than in African American patients. What could be the most likely cause of such an occurrence? A) Whites usually have less exposure to the sun than African Americans. B) Whites have less melanin content in their skin than African Americans. C) Whites usually have more exposure to the sun than African Americans. D) Whites have greater melanin content in their skin than African Americans.
A, C, E
When teaching a patient with testicular cancer about possible treatment options and their corresponding effects on sexual function, which should the nurse discuss with the patient? Select all that apply. A) Testicular cancer treatment involves high risk of infertility. B) Testicular cancer treatment can actually enhance fertility. C) Consider cryopreservation of sperm in a sperm bank before treatment. D) Sexual function will be as normal as before the treatment for all patients. E) Retroperitoneal lymph node dissection can result in ejaculatory dysfunction.
A
When teaching the patient about reducing the risks of lung cancer, what is the most important topic for the nurse to address? A) Smoking cessation B) Drinking more fluids C) Eating more grains D)Using steam inhalation
A, B, C
Which are treatment goals of cancer? Select all that apply. A) Cure B) Control C) Palliation D) Prevention E) Early detection F) Clinical staging
C
Which data collected by the nurse indicates the patient has a complete carcinogen risk factor for the development of cancer? A) Type I obesity B) Diet high in fat C) Cigarette smoking D) Alcohol consumption
C
Which question should the nurse include in the health history interview to determine if a patient is at risk for cancer due to a chemical carcinogen? A) "What foods are in your diet?" B) "Have you received the hepatitis B vaccination?" C) "Are you exposed to benzene through your occupation?" D) "Do you use sunscreen when exposed to sunlight for large periods of time?"
D
Which question should the nurse include in the health history interview to determine if a patient is at risk for cancer due to an exposure to radiation, a carcinogen? A) "What foods are in your diet?" B) "Have you received the hepatitis B vaccination?" C) "Are you exposed to benzene through your occupation?" D) "Do you use sunscreen when exposed to sunlight for large periods of time?"
B, D, E
Which statements should the nurse include when conducting a teaching session regarding gender differences related to cancer? Select all that apply. A) "Women are more likely to develop liver cancer than are men." B) "The mortality rate of lung cancer is higher in men than in women." C) "More women than men die from cancer-related deaths every year." D) "The cancer with the highest incidence among men is prostate cancer." E) "Head and neck cancers occur more frequently in men than in women."