ATI Cancer Practice Questions
A nurse is teaching a client who is scheduled for a shave biopsy for suspected cancer. Which of the following client statements indicates understanding of the procedure? A. "A test of my bone marrow will be performed." B. "A lymph node will be removed." C."A needle will be inserted into the mass." D."A small skin sample will be obtained."
D."A small skin sample will be obtained."
A nurse is assessing a lesion on a client who has basal cell carcinoma. The nurse should expect which of the following findings? A. A pearly, shiny nodule B. A pigmented papule C. A rough, scaly tumor D. A weeping vesicle
A. A pearly, shiny nodule Rationale: The most common presentation of basal cell carcinoma is a nodular lesion with well-defined borders that has a pearly or shiny appearance.
A nurse is planning care for a client who has a platelet count of 10,000/mm3. Which of the following interventions should the nurse include in the plan of care? A. Apply prolonged pressure to puncture site after blood sampling. B. Administer epoetin alfa as prescribed. C. Place the client in a private room. D. Have the client use an oral topical anesthetic before meals
A. Apply prolonged pressure to puncture site after blood sampling.
A nurse is instructing a client how to decrease the nausea associated with chemotherapy and radiation Which of the following statements indicates an understanding of the teaching? a. "I will eat smaller meals if I feel nauseated." b. "I will eat foods that are served at room temperature." c. "I will drink more liquids with my meals." d. "I will increase the amount of unsaturated fats in my diet."
B. "I will eat foods that are served at room temperature." **The nurse should instruct the client to eat foods served at room temperature or chilled. Foods served hot may contribute to nausea.
A nurse is caring for a client who is 9 days postoperative following a total laryngectomy. The nurse removes the client's NG tube and initiates oral feedings. Which of the following statements should the nurse make? A. "Tuck your chin when you swallow so you won't choke" B. "It is no longer possible for you to choke on or aspirate food" C. "You should have no trouble swallowing fluids" D. "I will add a thickener to your liquids to prevent aspiration"
B. "It is no longer possible for you to choke on or aspirate food" Rationale: The surgical procedure of total laryngectomy provides complete anatomical separation of the trachea and esophagus. Choking and aspiration of liquids is no longer possible.
A nurse is caring for a client who is receiving radiation therapy to treat lung cancer. Which of the following actions should the nurse take? A. Review laboratory test results for low hemoglobin B. Observe for signs of infection C. Monitor the mouth for signs of xerostomia D. Examine the skin for generalized urticaria
B. Observe for signs of infection Rationale: Radiation therapy to sites containing bone marrow (such as the sternum) can lower WBC count (Leukopenia), thus increasing the client's risk for infection. Screening the client for signs of infection is essential at this time.
A nurse is caring for a client who is receiving chemotherapy and has mucositis. Which of the following actions should the nurse take? A. Use a glycerin soaked swab to clean the client's teeth.‐ B. Encourage increased intake of citrus fruit juices. C. Obtain a culture of the lesions. D. Provide an alcohol based mouthwash for oral hygiene.
C. Obtain a culture of the lesions.
A nurse is caring for a client who is receiving chemotherapy to treat cancer. Which of the following adverse effect should the nurse anticipate from the chemotherapy? A. Gingival hyperplasia B. Hirsutism C. Pancytopenia D. Weight gain
C. Pancytopenia
A client is receiving treatment for stage IV ovarian cancer and asks the nurse to discuss her prognosis. The client plans to have aggressive surgical, radiation and chemotherapy treatments. Which of the following prognoses should the nurse discuss with the client? A. Good, B. Guarded C. Poor D. Very good
C. Poor
A nurse is caring for a client who has malignant melanoma. Which of the following findings should the nurse expect when assessing the lesion? A. Pain B. Pruritus C. Purplish in color D. Purulent drainage
C. Purplish in color Rationale: Dark pigmentation of the lesion is an expected finding of malignant melanoma. Colors are varied and can include red, white, and blue tones.
A nurse is reviewing the laboratory results of a client who was admitted with a history of multiple myeloma. The nurse should expect to find an increase in which of the following laboratory values? A. Absolute neutrophil count (ANC) B. Calcium C. Platelets D. WBCs
B. Calcium Rationale: The nurse should expect the calcium level of a client who has a history of multiple myeloma to increase due to the destruction of bone
A nurse is caring for a client who has cancer. The goal of palliative pain management is to increase which of the following? (Select all that apply.) A. Mental acuity B. Physical mobility C. Time spent at home D. Quality of life E. Bowel function
B. Physical mobility C. Time spent at home D. Quality of life
A nurse is caring for a client who has cancer pain. Which of the following is the most reliable indicator of the client's pain? A. Change in pulse rate B. Facial expression of pain C. Verbal report of pain D. Massaging an area of pain
C. Verbal report of pain
A nurse is caring for a client who has cancer and is 20 weeks pregnant. The client's provider recommends chemotherapy for the client, but the client is uncertain about the recommend treatment. Which of the following statements by the nurse is appropriate?
This must be a difficult decision for you
A nurse is providing teaching to a client who has a new prescription for tamoxifen to treat breast cancer. The nurse should include the which of the following is an adverse effect of this medication? a. Hot flashes b. Insomnia c. Increased appetite d. Constipation
a. Hot flashes
A nurse is teaching a client about the physical effects of chemotherapy. Following the teaching, the nurse asks the client to describe one physical effect. The nurse is focusing on which of the following elements of the communication process?
feedback
A nurse is caring for a client who is receiving radiation therapy to treat lung cancer. Which of the following actions should the nurse take?
-Tingling feeling in the extremities
A nurse is teaching a client about maintaining a diet that may prevent certain cancers. The nurse should inform the client that the intake of which of the following may be beneficial? (SATA) A. Low saturated fats B. Fiber C. Red meats D. Simple carbohydrates E. Fish
A. Low saturated fats B. Fiber E. Fish
A nurse is caring for a client who has cervical cancer and is scheduled for brachytherapy. Which of the following actions should the nurse take? SATA A. Permit visitors to stay with the client 30 min at a time. B. Place the client on bed rest. C. Insert an indwelling urinary catheter. D. Administer fiber laxatives. E. Dispose soiled linens in hamper outside client's room.
A. Permit visitors to stay with the client 30 min at a time. B. Place the client on bed rest. C. Insert an indwelling urinary catheter.
A nurse is reviewing the health record of a client who has suspected ovarian cancer. Which of the following findings supports this diagnosis? SATA A. Previous treatment for endometriosis B. Family history of colon cancer C. First pregnancy at age 24 D. Report of scant menses E. Use of oral contraceptives for 10 years
A. Previous treatment for endometriosis B. Family history of colon cancer
A nurse is caring for a client who has chronic cancer pain and has a permanent epidural catheter for administration of a fentanyl/bupivacaine solution. The nurse should monitor the client for which of the following findings? (Select all that apply.) A. Respiratory depression B. Hypotension C. Sedation D. Muscle spasticity E. Motor blockage
A. Respiratory depression B. Hypotension C. Sedation E. Motor blockage
A nurse at a provider's office is providing teaching to a client who is taking chemotherapy and losing weight Which of the following should the nurse recommend increasing calorie and protein intake? (Select all that apply.)
-Top fruits with yogurt -Add cream to soups -Use milk instead of water -Dip meats in breadcrumbs before cooking
A nurse is caring for a client who is to start chemotherapy for advanced breast cancer. She tells the nurse she is worried about the adverse effects of the treatment. Which of the following responses should the nurse make? A. "I will have your provider discuss the adverse effects with you before the treatment begins." B. "Someone from the American Cancer Society will be here soon to answer your questions." C. "What is it about the adverse effects that concern you?" D. "I agree. Sometimes the adverse effects can be worse than the disease."
C. "What is it about the adverse effects that concern you?"
A nurse is providing teaching to a client about preventing skin cancer. Which of the following client statements indicates a need for further teaching? A. "Eating a high fiber diet will reduce my risk for developing skin cancer" B. "I should check my skin monthly for any changes" C. "I should avoid the use of tanning booths" D. "I should use sunscreen even on cloudy days"
A. "Eating a high fiber diet will reduce my risk for developing skin cancer" Rationale: A high-fiber diet is recommended to reduce the risk of colon cancer
A nurse is reinforcing teaching to client who has cancer and is receiving external radiation therapy. Which of the following statements made by the client indicates an understanding of the teaching? A. "I need to protect the area from sunlight" B. "I'm going to apply skin lotion to the area every day" C. "I'll massage the area once per day" D. "I'll wash the markings off after each therapy treatment"
A. "I need to protect the area from sunlight"
A nurse is planning an educational program about basal cell carcinoma. Which of the following information should the nurse plan to include? A. Basal cell carcinoma has a low incidence of metastasis B. Basal cell carcinoma has a high mortality rate C. Basal cell carcinoma is aggressive and rapid growing D. Basal cell carcinoma develops from a nevi or mole
A. Basal cell carcinoma has a low incidence of metastasis Rationale: Basal cell carcinoma is a localized lesion that seldom metastasizes
A nurse is caring for a client who has lung cancer and is exhibiting manifestations of syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following Findings should the nurse report to the provider? SATA A. Behavioral changes B. Client report of headache C. Urine output 40 mL/hr D. Client report of nausea E. Increased urine specific gravity
A. Behavioral changes B. Client report of headache D. Client report of nausea
A nurse in a clinic is caring for a client who has suspected uterine cancer. Which of the following assessment techniques should the nurse anticipate the provider will perform? A. Bimanual pelvic examination B. Papanicolaou (Pap) test with cultures C. Digital rectal examination D. Percussion of upper abdominal quadrants for tympany
A. Bimanual pelvic examination
A nurse is caring for a client who is to undergo neurolytic ablation. The nurse should recognize that this treatment is used only when other measures have failed due to the risk of A. irreversible nerve damage. B. increased pain. C. myelosuppression. D. thrombocytopenia
A. irreversible nerve damage.
A nurse is reinforcing postoperative discharge teaching for a client following a panhysterectomy for uterine cancer. Which of the following information should the nurse provide? A. "You will need to continue to use some form of birth control for 6 months" B. "You might experience manifestations of menopause" C. "Do not lift heavier than 15 pounds" D. "Pain or burning on urination is an expected outcome of this surgery"
B. "You might experience manifestations of menopause"
A nurse is teaching a client who is scheduled for nuclear imaging for suspected cancer. Which of the following statements should the nurse give? A. "The presence of a liver enzyme will be identified." B. "you will be given an injection of a radioactive substance." C."An endoscope will be inserted through your mouth." D."The tumor will be aspirated."
B. "you will be given an injection of a radioactive substance."
A nurse is caring for a client 24 hr following a liver lobectomy for hepatocellular carcinoma. Which of the following laboratory reports should the nurse monitor? A. Urine specific gravity B. Blood glucose C. Serum amylase D. D dimer
B. Blood glucose
A nurse is an oncology clinic is collecting data from a client who has early stage Hodgkin's lymphoma. Which of the following findings should the nurse expect? A. Bone and joint pain B. Enlarged lymph nodes C. Intermittent hematuria D. Productive cough
B. Enlarged lymph nodes
A nurse is planning care for a client who is being treated with chemotherapy and radiation for metastatic breast cancer who has neutropenia. The nurse should include which of the following restrictions in the client's plan of care? A. All visitors from entering the client's room B. Fresh flowers and potted plants in the room C. Oral fluid intake to between meals only D. Activities that could result in bleeding
B. Fresh flowers and potted plants in the room
A nurse is planning care for a client who is undergoing chemotherapy and is on neutropenic precautions. Which of the following interventions should be included in the plan of care? SATA A. Encourage a high fiber diet. B. Remove plants from the room. C. Have the client wear a mask when leaving the room. D. Have client specific equipment remain in the room. E. Eliminate raw foods from the client's diet
B. Remove plants from the room. C. Have the client wear a mask when leaving the room. D. Have client specific equipment remain in the room. E. Eliminate raw foods from the client's diet
A nurse is caring for an older adult client who has a WBC count of 2, 000 / mm 3 after three rounds of chemotherapy. Which of the following actions should the nurse take? A. Humidify the client's room B. Serve cooked fruit with meals C. Clean dentures in a denture cup D. Replace the water in flower vases with fresh water daily
B. Serve cooked fruits with meals Rationale: The nurse should serve cooked fruits with meals to prevent possible bacterial contamination from raw fruit
A nurse is collecting data from a client. Which of the following findings is the highest risk factor for the client developing bladder cancer? A. A client is a hairdresser B. The client uses tobacco C. The client is over 60 years of age D. The client has frequent UTIs
B. The client uses tobacco
A nurse is caring for a client who is undergoing chemotherapy and reports severe nausea. Which of the following statements should the nurse make? A. "your nausea will lessen with each course of chemotherapy." B. "Hot food is better tolerated due to the aroma." C. "Try eating several small meals throughout the day." D. "Increase your intake of red meat as tolerated."
C. "Try eating several small meals throughout the day."
A nurse is reinforcing discharge teaching to a client who is postoperative following a right mastectomy for breast cancer. The client will be goin home with two Jackson-Pratt drains. Which of the following information should the nurse include in the teaching? A. Cloudy drainage is normal B. Showering is permitted before the drainage tubes are removed C. Avoid wearing deodorant until the drains are removed and the incision heals D. Do not begin exercising until the provider removes the drainage tubes
C. Avoid wearing deodorant until the drains are removed and the incision heals
A nurse is assisting in planning care for a client who is postoperative following a urinary diversion to treat bladder cancer. Which of the following interventions should the nurse include in the plan of care? A. Empty the collection pouch when it is 2/3 full B. Expect urine outflow into pouch to begin 1-2 days following surgery C. Change the collection pouch in the early morning D. Cleanse skin under the collection pouch with hydrogen peroxide
C. Change the collection pouch in the early morning
A nurse is caring for a client who is 1-day postoperative following a total laryngectomy and has begun a soft diet. The client is not eating well and tells the nurse that the hospital food has no taste. Which of the following responses is appropriate for the nurse to make? A. "You should ask your family to bring you some food from home" B. "Clients frequently complain about the taste of hospital food" C. "I would be happy to get you food that you prefer to eat" D. "Because of your surgery, you have an altered ability to smell and taste"
D. "Because of your surgery, you have an altered ability to smell and taste" Rationale: Clients who have lost their larynx commonly complain of poor ability to smell and taste. This is because they now breathe through the tracheal stoma, rather than the mouth and nose, which bypasses the location of the olfactory and gustatory nerve cells
A nurse is teaching a client who is receiving treatment for metastatic colorectal cancer about the adverse effects of bevacizumab. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication? A. Weight gain B. Mild hearing loss C. Temporary loss of smell D. Nosebleeds
D. Nosebleeds Rationale: Nosebleeds are an adverse effect of bevacizumab and should be reported to the provider. The client has an increased risk when taking this medication for severe bleeding from nosebleeds, vaginal bleeding, GI bleeding, intracranial bleeding and pulmonary bleeding, which may be caused by the development of thrombocytopenia and other blood disorders.
A nurse caring for a client who is experiencing severe nausea and vomiting after a course of chemotherapy. The nurse should monitor the client for which of the following clinical manifestations?
Metabolic alkalosis
A nurse on an oncology unit is reinforcing discharge teaching for an adolescent client who received a bone marrow transplant for leukemia. Which of the following information should the nurse include? SATA A. "You should take your temperature at least once a day" B. "You may return to school if you feel strong enough" C. "Examine your feet every day" D. "Clean your toothbrush weekly with isopropyl alcohol" E. "Eat plenty of fresh fruits and vegetables"
A. "You should take your temperature at least once a day" C. "Examine your feet every day"
A nurse is assessing a client who reports a nevus that has increased in size and an irregularly shaped lesion that varies in color. These findings are consistent with which of the following medical diagnoses? A. Malignant melanoma B. Basal cell carcinoma C. Squamous cell carcinoma D. Kaposi's sarcoma
A. Malignant melanoma Rationale: These findings are consistent with malignant melanoma, which is associated with changes in preexisting nevi
A nurse is planning care for a client who is scheduled for genetic testing for suspected cancer. Which of the following interventions should the nurse include in the plan of care? A. Obtain a signed informed consent form. B. Withhold all medications prior to the procedure. C. Verify the prescription for a tumor marker assay. D. Ensure the client is placed in a recovery position after testing
A. Obtain a signed informed consent form.
A nurse is reviewing the CBC findings for a female client who is receiving combination chemotherapy for breast cancer. Which of the following findings should the nurse report to the provider? A. WBC 2300/mm B. RBC 5 million/mm C. hemoglobin 12 g/dL D. Platelets 155,000/mm
A. WBC 2300/mm Rationale: The WBC finding is below the expected reference range. Chemotherapy treatment can cause leukopenia; the nurse should report this finding to the provider and implement precautions to protect the client from infection.
A nurse is caring for a client who has breast cancer and is receiving a combination of chemotherapy medications. The client expresses confusion about the therapy. Which of the following explanations should the nurse provide? A. "The risk of renal toxicity is lessened when a combination of chemotherapy medications are used" B. "The chemotherapy medications act at different stages of cell division so more tumors cells are destroyed" C. "The use of more chemotherapy medications will shorten the time you have to be in treatment" D. "The combination of chemotherapy medications will eliminate the potential for bone marrow suppression"
B. "The chemotherapy medications act at different stages of cell division so more tumors cells are destroyed"
A nurse is admitting a child who has leukemia and a critically low platelet count. Which of the following precautions should the nurse initiate? A. Neutropenic B. Bleeding C. Contact D. Droplet
B. Bleeding Rationale: The nurse should initiate bleeding precautions for a child who has a low platelet count. Bleeding precautions involve specific measures to reduce the risk of bleeding, such as using soft-bristled toothbrushes, avoiding IM injections, and preventing constipation.
A nurse in a provider's clinic is assessing a client who has cancer and a prescription for methotrexate PO. Which of the following actions should the nurse take when the client reports bleeding gums? A. Explain to the client that this is an unexpected adverse effect B. Check the value of the client's current platelet count C. Instruct the client to use an electric toothbrush D. Have the client make an appointment to see the dentist
B. Check the value of the client's current platelet count Rationale: The nurse should recognize that the bleeding is likely due to the adverse effect of the chemotherapy and needs to be evaluated further. Bleeding gums is a sign of thrombocytopenia (decreased platelet count) secondary to bone marrow suppression, which can be life-threatening to a client who is receiving chemotherapy.
A nurse is planning care for a client who has terminal cancer and has a prescription for morphine. Which of the following interventions should the nurse include in the plan of care? A. Instruct the client to take diphenoxylate/atropine 5 mg PO twice a day. B. Instruct the client to actively cough to prevent a buildup of secretions in the airway. C. Instruct to client to stop taking the morphine if itching develops. D. Instruct the client to keep room lights dim during waking hours
B. Instruct the client to actively cough to prevent a buildup of secretions in the airway. Morphine acts on the medulla to suppress cough. The nurse should teach the client to actively cough to prevent a buildup of secretions in the airway.
A nurse is assessing a client for suspected cancer. Which of the following findings should the nurse expect? SATA A. Temperature 102° F (38.9° C) for more than 48 hr B. Sore that does not heal C. Difficulty swallowing D. Unusual discharge E. Weight gain 4 lb (1.8 kg) in 2 weeks
B. Sore that does not heal C. Difficulty swallowing D. Unusual discharge
A nurse is providing teaching about colon cancer to a group of women 45 to 65 years of age. Which of the following statements should the nurse include in the teaching? A. "Colonoscopies for individuals with no family history of cancer should begin at age 40." B. "A sigmoidoscopy is recommended every 5 years beginning at age 60." C. "Fecal occult blood tests should be done annually beginning at age 50." D. "An endoscopy provides a definitive diagnosis of colon cancer."
C. "Fecal occult blood tests should be done annually beginning at age 50."
A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary? A. An excess amount of doxorubicin can lead to myelosuppression B. Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation C. An excess amount of doxorubicin can lead to cardiomyopathy D. Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat
C. An excess amount of doxorubicin can lead to cardiomyopathy Rationale: Doxorubicin is an antineoplastic antibiotic used in the treatment of various cancers. Irreversible cardiomyopathy with congestive heart failure can result from repeated doses of doxorubicin, and prolonged use can also cause severe heart damage, even years after the client has stopped taking it. The maximum cumulative dose a client should receive is 550mg/m or 450 mg/m with a history of radiation to the mediastinum
A nurse is caring for a client who has multiple types of skin lesions. Which of the following skin lesions are indicative of a malignant melanoma? SATA A. Diffuse vesicles B. Uniformly colored papule C. Area with asymmetric borders D. Rough, scaly patch E. Irregular colored mole
C. Area with asymmetric borders E. Irregular colored mole
A nurse is caring for a client who is 4 days postoperative following a right radical mastectomy. Which of the following activities should the nurse anticipate being the most difficult for this client to perform with her right hand? A. Buttoning her blouse B. Eating her breakfast C. Combing her hair D. Brushing her teeth
C. Combing her hair Rationale: Abduction of the arm is the most difficult, and usually the last, type of movement to be regained by a client following a mastectomy
A nurse is teaching a client about the risk for cancer. Which of the following client statements indicates the need for further teaching? A "I see a dermatologist regularly for the mole on my thigh." B. "I take Milk of Magnesia for occasional constipation." C. "I tan using an indoor tanning lotion instead of laying out in the sun." D. "I used to smoke but switched to chewing tobacco 3 years ago."
D. "I used to smoke but switched to chewing tobacco 3 years ago."
A nurse is planning care for a client who has immunosuppression following chemotherapy. Which of the following interventions should the nurse include in the plan of care? a. Insert an indwelling catheter to monitor sediment in the urine. b. Take the client's temperature once per shift. c. Provide the client with fresh fruit to avoid constipation. d. Limit the number of health care workers entering the room.
D. Limit the number of health care workers entering the room
A nurse is caring for a client who has leukemia and has developed thrombocytopenia. Which of the following actions should the nurse take first? A. Plan for the client to take rest periods throughout the day. B. Encourage the client to cough, turn, and deep breath every 2 hr. C. Assess temperature every 4 hr. D. Monitor platelet counts
D. Monitor platelet counts
A nurse is collecting a health history from a client who has skin cancer. Which of the following findings in the client's history is the highest risk factor for developing skin cancer? A. Age over 60 B. Genetic predisposition C. Light-skinned race D. Overexposure to sunlight
D. Overexposure to sunlight
A nurse is assisting in planning care for a client who has cancer and has developed thrombocytopenia following chemotherapy. Which of the following precautions should the nurse offer to minimize the adverse effects of thrombocytopenia? A. Minimize visitors for manifestation of infection B. Remind the client to use an electric razor C. Encourage frequent rest periods D. Instruct the client to rinse mouth daily with normal saline
B. Remind the client to use an electric razor
A nurse is collecting data from a client who has cancer of the cervix. Which of the following manifestations should the nurse expect? A. Weight gain B. Oliguria C. Back pain D. Vaginal bleeding
D. Vaginal bleeding
After radiation treatment, a client reports dryness, redness, and scaling of his skin occurring within the designated radiation treatment markings. The nurse should instruct the client to take which of the following actions? A. Apply hydrating lotions B. Apply moist heat C. Sit in the sun for 10 min per day D. Wash with plain soap and water
A. Apply hydrating lotions Rationale: The nurse should instruct the client to gently apply hydrating lotions that do not contain metal, alcohol, or perfume
A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching? A. Bottled water is an appropriate choice to increase fluid intake B. The salad bar is a healthy choice when dining out C. Soft-boiled eggs are an appropriate source of protein D. Eating at a buffet is a good choice to increase caloric intake
A. Bottled water is an appropriate choice to increase fluid intake Rationale: Clients who have neutropenia are at risk for foodborne illness. Bottled water prevents client exposure to pathogens that may be found in other water sources.
A nurse is caring for a client who has myelosuppression after receiving chemotherapy. The nurse should monitor the client for which of the following adverse effects? A. Anorexia and malnutrition B. Bleeding from the gums C. Diarrhea and dehydration D. Full body alopecia
B. Bleeding from the gums Rationale: Bleeding from the gums is directly related to myelosuppression due to inhibited bone marrow production of blood cells and platelets
A nurse is planning care for a client who has leukemia and a platelet count of 130,000/mm. Which of the following interventions should the nurse include in the plan of care? A. Check the IV site for bleeding every 8 hr B. Limit IM injections C. Obtain a rectal temperature every 8 hr D. Check the client for proteinuria
B. Limit IM injections Rationale: The nurse should plan to limit IM injections or venipunctures to prevent harm to the client. If venipuncture is necessary, the nurse should hold pressure to the site for 10 min afterward
A nurse is caring for a client who has testicular cancer and is experiencing peripheral neuropathy as an adverse effect of chemotherapy. Which of the following client manifestations is an expected finding of peripheral neuropathy? A. Thinning of the scalp hair B. Tingling of the hands and feet C. Reduced ability to concentrate D. Sores in the mucous membranes
B. Tingling of the hands and feet Several chemotherapeutic agents might cause peripheral neuropathy. One of the major manifestations is numbness and tingling.
A nurse is reinforcing preoperative teaching for a client who has colorectal cancer and is to undergo placement of a colostomy with a perineal wound. Which of the following statements by the client indicates an understanding of the teaching? A. "It will be a relief to not have any further rectal pain" B. "I will need to sit on a rubber donut when I am out of bed in the chair" C. "I can have only liquids for 2 days before the surgery" D. "The colostomy will start working about 7 days after the surgery"
C. "I can have only liquids for 2 days before the surgery"
A nurse is providing teaching to a client who has breast cancer about the adverse effects of chemotherapy Which of the following client statements indicates an understanding of the teaching? A. "I will take the antiemetic as soon as the chemotherapy infusion is complete" B. "I will run my toothbrush in the dishwasher every month" C. "I'll call my doctor if I notice any unusual menstrual bleeding" D. "I will avoid crowds to keep from infecting others"
C. "I'll call my doctor if I notice any unusual menstrual bleeding" Rationale: Clients should be taught bleeding precautions and to report bruising or excessive bleeding
A nurse is planning care for a client who has an absolute neutrophil count (AANC) less than 1,000/mm. Which of the following interventions should the nurse include in the plan? A. Take the client's rectal temperature each day B. Increase raw produce in the client's diet C. Limit visitors to healthy adults D. Instruct the client to floss his teeth daily
C. Limit visitors to healthy adults Rationale: The expected reference range of absolute neutrophil count is 2500 to 8000/mm. This client has a reduce neutrophil count (neutropenia) and is immunosuppressed. A client who has neutropenia is at an increased risk for infection. The nurse should restrict visitors for a client who has neutropenia to healthy adults to reduce the risk for infection
A nurse is collecting data from a client who has cancer and is receiving chemotherapy by peripheral IV infusion. The client reports pain at the insertion site and the nurse notes fluid leaking around the catheter. Which of the following actions should the nurse take first? A. Take a photograph of the peripheral IV site B. Obtain and record the client's vital signs C. Stop the infusion D. Identify all medications administered through the IV site for the past 24 hrs
C. Stop the infusion
A nurse is teaching a female adult client about screening prevention for cancer. Which of the following statements by the client indicates an understanding of the teaching? A. "I will need to have a mammogram every 2 years beginning at age 45." B. "I should have a colonoscopy every 15 years beginning at age 60." C."I will need to have an annual breast examination every year after 40." D."I should have a fecal occult test done every 3 years."
C."I will need to have an annual breast examination every year after 40."
A hospice nurse is reinforcing teaching about palliative care to the partner of a client who has end stage liver cancer. Which of the following statements by the partner indicates an understanding of teaching? A. "I will do my best to try and get him to eat something" B. "I will lay him flat if his breathing becomes shallow" C. "I will use an electric blanket to keep him warm" D. "I will continue to talk to him even when he's sleeping"
D. "I will continue to talk to him even when he's sleeping"
A nurse is admitting a client who has multiple myeloma and a white blood cell count of 2200. Which of the following foods should the nurse prohibit the family members from bringing to the client? A. Fried chicken from a fast food restaurant B. A case of canned nutritional supplements C. A factory sealed box of chocolates D. A fresh fruit basket
D. A fresh fruit basket
A nurse is preparing a client who is to receive chemotherapy for treatment of ovarian cancer. Which of the following actions should the nurse plan to take? a. Tell the client to expect dark stools following chemotherapy. b. Have the client floss 4 times daily. c. Have the client swish with commercial mouthwash before therapy. d. Administer an antiemetic prior to the procedure.
D. Administer an antiemetic prior to the procedure
A charge nurse is teaching a group of health care workers about hand hygiene to prevent infection. Which of the following information should the charge nurse include in the teaching? A. Keep artificial nails trimmed B. Use alcohol-based hand rubs before administering eye drops for a client C. Wash hands with alcohol-based rubs when caring for a client who has C. diff D. Use chlorhexidine to wash hands if the client is immunosuppressed
D. Use chlorhexidine to wash hands if the client is immunosuppressed Rationale: The CDC recommends health care workers use chlorhexidine for hand washing when providing care to a client who is immunosuppressed
A client who has a chronic lymphocytic leukemia is starting chemotherapy treatments and asks if she needs to make any dietary changes. Which of the following statements should the nurse make? A. "You should avoid drinking liquids an hour before the treatments" B. "Eating low-calorie foods helps prevent nausea" C. "Foods that are higher in fat are usually more appealing" D. "Raw fruits and vegetables will be easier for your body to digest"
A. "You should avoid drinking liquids an hour before the treatments" Rationale: Clients should be encouraged to decrease fluid intake just before treatments because fluids may cause nausea and vomiting
A nurse in is reviewing the health record of a client who had surgery to stage ovarian cancer. The nurse reviews the following diagnostic notation on the pathology report: T2 N3 MX. Which of the following FIndings should the nurse identify as a supporting diagnosis? A. The tumor is 4 cm in size involving the ovary and adjacent tissues. B. No lymph nodes contain cancer cells. C. The tumor is receptive to current medication therapy. D. The cancer has metastasized to other areas in the body.
A. The tumor is 4 cm in size involving the ovary and adjacent tissues.
A client who has chronic lymphocytic leukemia is starting chemotherapy treatments and asks if she needs to make any dietary changes. Which of the following statements should the nurse make? A. You should avoid drinking liquids an hour before the treatments. B. Eating low-calorie foods helps prevent nausea C. Foods that are higher in fat are usually more appealing D. Raw fruits and vegetables will be easier for your body to digest.
A. You should avoid drinking liquids an hour before the treatments
A nurse is caring for a client scheduled to receive external radiation to the neck for cancer of the larynx. During a pre-treatment exam, the nurse explains to the client that the most likely side effect would be: A. Infertility B. Diarrhea C. Dyspnea D. Dysphagia
D. Dysphagia Rationale: Radiation therapy does not hurt while it is being given. But the side effects that people may get form radiation therapy can cause pain or discomfort. Only the area of treatment is affected by the radiation, so dysphagia (trouble swallowing) would be an expected side effect. Other possible side effects include hoarseness, xerostomia (dry mouth), loss of taste, and skin redness.
A nurse is planning care for a client who has cancer and is to undergo cryoanalgesia. Which of the following interventions should be included in the plan of care? A. Monitor oxygen saturation during the procedure. B. Instruct client to apply heat to the insertion site. C. Assess for irritated oral mucous membranes following the procedure D. Evaluate bladder control after the procedure.
D. Evaluate bladder control after the procedure.
A nurse is caring for a client who has a lung cancer that has metastasized. Which of the following findings indicates the client is developing superior vena cava syndrome? A. Irregular cardiac rhythm B. Numbness in the hands C. Muscle cramps D. Facial edema
D. Facial edema
A nurse is teaching a client who is receiving radiation therapy about skin care. Which of the following instructions should the nurse include?
Walk outside in the early mornings
A nurse is teaching a client about risk factors for skin cancer. Which of the following statements by the client indicates an understanding of the teaching? a. "Because I'm dark-complected, I won't have to worry about skin cancer." b. "I should apply sunscreen prior to going outside, even in the winter months." c. "I used to lie in the sun all the time, but now I know the tanning bed is a better option." d. "My father was treated for melanoma, but skin cancer isn't related to genetics."
b. "I should apply sunscreen prior to going outside, even in the winter months."
A nurse is caring for a client who has cancer and is scheduled for immediate chemotherapy. The client tells the nurse that she wants to try nontraditional treatments first. Which of the following responses should the nurse make? a. "Using nontraditional treatments is not a good idea. I'd rather you avoid that route." b. "A lot of people think nontraditional treatments will work, and they find out too late that they made the wrong choice." c. "Your provider is very knowledgeable. If he prescribes chemotherapy, it's the best treatment for you." d. "Tell me more about your concerns about taking chemotherapy."
d. "Tell me more about your concerns about taking chemotherapy."
A nurse is planning care for a client who has malnutrition due to cancer. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A. Advise the client to keep a food diary. B. Encourage the client to brush teeth before and after meals. C. Assess the laboratory report of ferritin. D. Monitor for changes in mental status. E. Instruct the client to drink fluids between meals.
A. Advise the client to keep a food diary. B. Encourage the client to brush teeth before and after meals. C. Assess the laboratory report of ferritin. E. Instruct the client to drink fluids between meals.
A nurse is assessing a client who has a long history of smoking and is suspected of having laryngeal cancer. The nurse should anticipate that the client will report that her earliest manifestation was: A. Dysphagia B. Hoarseness C. Dyspnea D. Weight loss
B. Hoarseness Rationale: Laryngeal cancer, a malignant tumor of the larynx, is most often caused by long exposure to tobacco and alcohol. Hoarseness that does not resolve for several weeks is the earliest manifestation of cancer of the larynx because the tumor impedes the action of the vocal ords during speech. The voice may sound harsh and lower in pitch than normal.
A nurse is teaching a client about the seven warning signs of cancer. Which of the following signs should the nurse include as manifestations of cancer? (Select all that apply) A. A nonhealing sore B. Bloating C. Change in bowel pattern D. Change in moles E. Nagging cough
A. A nonhealing sore C. Change in bowel pattern D. Change in moles E. Nagging cough
A nurse is caring for a client who is receiving cisplatin to treat bladder cancer. After several treatments, the client reports fatigue. Which of the following actions should the nurse take? A. Check the results of the client's most recent CBC B. Assess the client for a hypersensitivity reaction C. Evaluate the client for hypercalcemia D. Examine the client for hepatomegaly
A. Check the results of the client's most recent CBC Rationale: The client might have anemia as a result of myelosuppression (bone marrow suppression) from the chemotherapy. If so, she might require treatment for the anemia (transfusion, medication) and the provider might have to delay further chemotherapy until her blood counts are higher.
A nurse is reviewing the laboratory results of a client who has acute leukemia and received an aggressive chemotherapy treatment 10 days ago. Which of the following hematologic laboratory values should the nurse expect? (Select all that apply.) A) Decreased platelet count B) Increased hemoglobin count C) Decreased leukocyte count D) Increased platelet count E) Decreased erythrocyte count
A. Decreased platelet count C. Decreased leukocyte count E. Decreased erythrocyte count
A nurse is providing discharge teaching for a client who is postoperative following a simple mastectomy. The client is to begin outpatient radiation therapy the next day. Which of the following instructions about maintaining skin integrity should the nurse include? A. Do not apply heat to the area of irradiation B. Do not wash the area of irradiation C. Use an antibiotic ointment to treat skin breakdown D. Lubricate the skin with hypoallergenic lotion
A. Do not apply heat to the area of irradiation Rationale: This instruction will help the client avoid tissue damage. Radiated tissue becomes thinner and might lack tissue receptors that would otherwise alert the client to a potential burn injury. When outdoors in sunlight, the client should wear protective clothing over the area of irradiation.
A nurse is reviewing the provider's history and physical form for a client who has advanced multiple myeloma. Which of the following findings should the nurse expect? A. Ecchymoses B. Hypocalcemia C. Hypotension D. Polycythemia
A. Ecchymoses Rationale: A client who has multiple myeloma has an overgrowth of plasma cells in the bone marrow, which leads to a reduction in other types of blood cells. As the platelets are affected, the client is prone to bleeding and bruising.
A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy induced nausea. For which of the following adverse effects should the nurse monitor? A. Headache B. Dependent edema C. Polyuria D. Photosensitivity
A. Headache Rationale: Headache is a common adverse effect of ondansetron. Analgesic relief is often required.
A nurse is teaching a client about the adverse effects of cisplatin. Which of the following adverse effects should the nurse include in the teaching? A. Tinnitus B. Constipation C. Hyperkalemia D. Weight gain
A. Tinnitus Rationale: Tinnitus, hearing loss, diarrhea, and hypokalemia are adverse effects of cisplatin. Weight gain is an adverse effect of docetaxel due to fluid retention.
A nurse is teaching a client about the side effects of chemotherapy medication. Which of the following nursing statements should the nurse include in the teaching? A. "Most clients do not experience nausea" B. "Hair loss is common and includes your eyebrows and eyelashes" C. "Most clients start to gain weight during their treatment" D. "Clients lose their hair, but it usually grows back nice and thick"
B. "Hair loss is common and includes your eyebrows and eyelashes" Rationale: This nursing statement is correct, because alopecia occurs as a whole-body hair loss for most clients administered chemotherapy
A nurse is reinforcing discharge teaching to a client following open radical prostatectomy. The client is going home with an indwelling urinary catheter. Which of the following statements by the client indicates an understanding of the teaching? A. "I will be able to take a tub bath in 1 week" B. "I will take acetaminophen if I have any pain" C. "I will use suppositories to prevent constipation" D. "I will regain my bladder control once the catheter is removed"
B. "I will take acetaminophen if I have any pain"
A nurse is preparing a client for a radiation treatment who is postoperative following a mastectomy. The nurse should inform the client to expect which of the following adverse effects from the treatment? A. Alopecia B. Diarrhea C. Fatigue D. Anorexia
C. Fatigue Rationale: The nurse should inform the client to expect fatigue with her radiation treatment. Fatigue occurs regardless of the radiation target site
A nurse is assessing a client at a dermatology clinic. Which of the following findings places the client at risk for developing malignant melanoma? A. Female gender B. Age 19 to 30 years C. Dark hair D. History of chronic skin irritation
D. History of chronic skin irritation Rationale: Clients who have a history of chronic inflammatory skin irritation are at increased risk for skin cancer. Other risk factors include exposure to chronic sunlight, chemical pollution, and immunosuppression
A nurse is caring for a client who is participating in a research study for an experimental chemotherapy medication. After three treatments, the experimental medication is discontinued due to evidence of rapidly advancing kidney failure. The nurse should understand discontinuing this medication demonstrates which of the following ethical principles? a. Veracity b. Autonomy c. Fidelity d. Nonmaleficence
D. Non maleficence response feedback: Nonmaleficence, as a principle in research, is the obligation to do no harm to the client. Intentionally exposing clients to serious or permanent harm is unacceptable. Should such a situation emerge during the conduct of a study, the study should be terminated immediately
A nurse is collecting data from a female client who is undergoing screening for breast cancer. Which of the following factors places the client at a high increased risk for developing breast cancer? A. Obesity B. Oral contraceptive use C. Alcohol use D. Over 50 years of age
D. Over 50 years of age
A nurse is providing teaching to a client who has a superficial lesion and has had a biopsy indicates malignant melanoma. The nurse should include which of the following options as the treatment of choice? A. Cryosurgery B. Chemotherapy C. Radiation therapy D. Surgical excision
D. Surgical excision Rationale: Surgical excision is the treatment of choice for superficial lesions of malignant melanoma
A nurse is caring for a client who is receiving cisplatin for treatment of ovarian cancer. The client's most recent complete blood count (CBC) is shown below. It is important for the nurse to consider which of the following for the client? WBC 1400 RBC 4.3 Hgb 12.1 Hct 36.5% Platelets 170 Albumin 4.5 a. The client has an increased risk for bleeding. b. The client should receive a diet with increased protein. c. The client has an increased risk for infection. d. The client should receive an erythropoiesis stimulating agent.
c. The client has an increased risk for infection.
A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following scenarios should the nurse document as the explanation for this situation? a. The client has not been taking the medication properly. b. The client is experiencing episodes of confusion. c. The client has become addicted to the medication. d. The client developed a tolerance to the medication.
d. The client developed a tolerance to the medication.