NCLEX ONCOLOGY
Nurse April is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by: A. breast self-examination. B. mammography. C. fine needle aspiration. D. chest X-ray.
Answer C. Fine needle aspiration and biopsy provide cells for histologic examination to confirm a diagnosis of cancer. A breast self-examination, if done regularly, is the most reliable method for detecting breast lumps early. Mammography is used to detect tumors that are too small to palpate. Chest X-rays can be used to pinpoint rib metastasis.
A female client with cancer is scheduled for radiation therapy. The nurse knows that radiation at any treatment site may cause a certain adverse effect. Therefore, the nurse should prepare the client to expect: A. hair loss. B. stomatitis. C. fatigue. D. vomiting
Answer C. Radiation therapy may cause fatigue, skin toxicities, and anorexia regardless of the treatment site. Hair loss, stomatitis, and vomiting are site-specific, not generalized, adverse effects of radiation therapy.
Nurse April is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover: A. cancerous lumps. B. areas of thickness or fullness. C. changes from previous self-examinations. D. fibrocystic masses.
Answer C. Women are instructed to examine themselves to discover changes that have occurred in the breast. Only a physician can diagnose lumps that are cancerous, areas of thickness or fullness that signal the presence of a malignancy, or masses that are fibrocystic as opposed to malignant.
A female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy? A. Urine output of 400 ml in 8 hours B. Serum potassium level of 3.6 mEq/L C. Blood pressure of 120/64 to 130/72 mm Hg D. Dry oral mucous membranes and cracked lips
Answer D. Chemotherapy commonly causes nausea and vomiting, which may lead to fluid and electrolyte imbalances. Signs of fluid loss include dry oral mucous membranes, cracked lips, decreased urine output (less than 40 ml/hour), abnormally low blood pressure, and a serum potassium level below 3.5 mEq/L.
A female client has an abnormal result on a Papanicolaou test. After admitting, she read his chart while the nurse was out of the room, the client asks what dysplasia means. Which definition should the nurse provide? A. Presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin B.Increase in the number of normal cells in a normal arrangement in a tissue or an organ C. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found D. Alteration in the size, shape, and organization of differentiated cells
Answer D. Dysplasia refers to an alteration in the size, shape, and organization of differentiated cells. The presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin is called anaplasia. An increase in the number of normal cells in a normal arrangement in a tissue or an organ is called hyperplasia. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found is called metaplasia.
Surgical procedure to treat breast cancer involves the removal of the entire breast, pectoralis major muscle and the axillary lymph nodes is: A. Simple mastectomy B. Modified radical mastectomy C. Halstead Surgery D. Radical mastectomy
Answer: B. Modified radical mastectomy Option B: Removal of the entire breast, pectoralis major muscle and the axillary lymph nodes is a surgical procedure called modified radical mastectomy. Option A: Simple mastectomy is the removal of the entire breast but the pectoralis muscles and nipples remain intact. Options C and D: Halstead surgery also called radical mastectomy involves the removal of the entire breast, pectoralis major and minor muscles and neck lymph nodes. It is followed by skin grafting.
A client had undergone radiation therapy (external). The expected side effects include the following apart from: A. Hair loss B. Ulceration of oral mucous membranes C. Constipation D. Headache
Correct Answer: C. Constipation Option C: Diarrhea, not constipation is the side effect of radiation therapy which usually starts during or right after the treatment and may last for several weeks. Options A, B, and D: These are common side effects of radiation therapy.
In staging and grading neoplasm TNM systems is used. TNM stands for: A. Tumor, neoplasm, mode of growth B. Time, node, metastasis C. Tumor, node, metastasis D. Time, neoplasm, mode of growth
Correct Answer: C. Tumor, node, metastasis TNM system is used to describe the amount and spread of cancer in a client's body. TNM stands for tumor (describes the original primary tumor), node (describes whether the cancer has spread to the nearby lymph nodes), and metastasis (describes whether the cancer has spread to other parts of the body).
A male client is in isolation after receiving an internal radioactive implant to treat cancer. Two hours later, the nurse discovers the implant in the bed linens. What should the nurse do first? A Leave the room and notify the radiation therapy department immediately. B Stand as far away from the implant as possible and call for help. C Pick up the implant with long-handled forceps and place it in a lead-lined container. D Put the implant back in place, using forceps and a shield for self-protection, and call for help.
If a radioactive implant becomes dislodged, the nurse should pick it up with long-handled forceps and place it in a lead-lined container, then notify the radiation therapy department immediately. The highest priority is to minimize radiation exposure for the client and the nurse; therefore, the nurse must not take any action that delays implant removal. Standing as far from the implant as possible, leaving the room with the implant still exposed, or attempting to put it back in place can greatly increase the risk of harm to the client and the nurse from excessive radiation exposure.
You are educating a group of young men on preventing testicular cancer. What is a correct statement by a participant regarding a testicular exam? A. "The best time to perform a self exam is after a shower." B. "The testicle should feel hard but firm." C. "The testicle may have minor lumps or swelling due to monthly hormonal changes." D. "I perform a self testicular exam once every 6 months."
The best time to perform a self testicular exam is after a shower when the scrotum is descended and the tissue is soft. This makes it easier to feel for lumps or masses. All the other options are incorrect
Jeovina, with advanced breast cancer is prescribed tamoxifen (Nolvadex). When teaching the client about this drug, the nurse should emphasize the importance of reporting which adverse reaction immediately? A Hearing loss B Anorexia C Headache D Vision changes
The client must report changes in visual acuity immediately because this adverse effect may be irreversible. Tamoxifen isn't associated with hearing loss. Although the drug may cause anorexia, headache, and hot flashes, the client need not report these adverse effects immediately because they don't warrant a change in therapy.
What should a male client over age 52 do to help ensure early identification of prostate cancer? A Have a transrectal ultrasound every 5 years. B Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly. C Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly. D Perform monthly testicular self-examinations, especially after age 50
The incidence of prostate cancer increases after age 50. The digital rectal examination, which identifies enlargement or irregularity of the prostate, and PSA test, a tumor marker for prostate cancer, are effective diagnostic measures that should be done yearly. Testicular self-examinations won't identify changes in the prostate gland due to its location in the body. A transrectal ultrasound, CBC, and BUN and creatinine levels are usually done after diagnosis to identify the extent of the disease and potential metastases
A female client with cancer is being evaluated for possible metastasis. Which of the following is one of the most common metastasis sites for cancer cells? A Reproductive tract B White blood cells (WBCs) C.Liver D. Colon
The liver is one of the five most common cancer metastasis sites. The others are the lymph nodes, lung, bone, and brain. The colon, reproductive tract, and WBCs are occasional metastasis sites.
Which intervention is appropriate for the nurse caring for a male client in severe pain receiving a continuous I.V. infusion of morphine? A. Changing the administration route to P.O. if the client can tolerate fluids B Discontinuing the drug immediately if signs of dependence appear C Assisting with a naloxone challenge test before therapy begins D. Obtaining baseline vital signs before administering the first dose
The nurse should obtain the client's baseline blood pressure and pulse and respiratory rates before administering the initial dose and then continue to monitor vital signs throughout therapy. A naloxone challenge test may be administered before using a narcotic antagonist, not a narcotic agonist. The nurse shouldn't discontinue a narcotic agonist abruptly because withdrawal symptoms may occur. Morphine commonly is used as a continuous infusion in clients with severe pain regardless of the ability to tolerate fluids.
A 35 years old client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis (inflammation of the mouth)? A Yellow tooth discoloration B Rust-colored sputum C White, cottage cheese-like patches on the tongue D Red, open sores on the oral mucosa
The tissue-destructive effects of cancer chemotherapy typically cause stomatitis, resulting in ulcers on the oral mucosa that appear as red, open sores. White, cottage cheese-like patches on the tongue suggest a candidal infection, another common adverse effect of chemotherapy. Yellow tooth discoloration may result from antibiotic therapy, not cancer chemotherapy. Rust-colored sputum suggests a respiratory disorder, such as pneumonia.
A male client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. Which "related-to" phrase should the nurse add to complete the nursing diagnosis statement? A. Related to impaired balance B Related to difficulty swallowing C Related to visual field deficits D. Related to psychomotor seizures
A client with a cerebellar brain tumor may suffer injury from impaired balance as well as disturbed gait and incoordination. Visual field deficits, difficulty swallowing, and psychomotor seizures may result from dysfunction of the pituitary gland, pons, occipital lobe, parietal lobe, or temporal lobe — not from a cerebellar brain tumor. Difficulty swallowing suggests medullary dysfunction. Psychomotor seizures suggest temporal lobe dysfunction.
A 34-year-old female client is requesting information about mammograms and breast cancer. She isn't considered at high risk for breast cancer. What should the nurse tell this client? A She should perform breast self-examination during the first 5 days of each menstrual cycle. B When she begins having yearly mammograms, breast self-examinations will no longer be necessary. C She should eat a low-fat diet to further decrease her risk of breast cancer. D She should have had a baseline mammogram before age 30
A low-fat diet (one that maintains weight within 20% of recommended body weight) has been found to decrease a woman's risk of breast cancer. A baseline mammogram should be done between ages 30 and 40. Monthly breast self-examinations should be done between days 7 and 10 of the menstrual cycle. The client should continue to perform monthly breast self-examinations even when receiving yearly mammograms.
A patient who has been told by the health care provider that the cells in a bowel tumor are poorly differentiated asks the nurse what is meant by "poorly differentiated." Which response should the nurse make? A. "Your tumor cells look more like immature fetal cells than normal bowel cells." B. "The cells in your tumor have mutated from the normal bowel cells." C. "The cells in your tumor do not look very different from normal bowel cells." D. "The tumor cells have DNA that is different from your normal bowel cells."
A. "Your tumor cells look more like immature fetal cells than normal bowel cells." Option A: An undifferentiated cell has an appearance more like a stem cell or fetal cell and less like the normal cells of the organ or tissue. Option B: All tumor cells are mutations from the normal cells of the tissue. Options C and D: The DNA in cancer cells is always different from normal cells, whether the cancer cells are well differentiated or not.
As an oncological nurse, you know what finding is correct regarding breast cancer? A. Masses are usually felt in the upper outer quadrant beneath the nipple or axilla. B. Women who've had a late menarche and early menopause are at risk for breast cancer. C. Nipple retraction is never present. D. The mass is typically painful and red
All options are incorrect expect for "Masses are usually felt in the upper outer quadrant beneath the nipple or axilla."
You are teaching a group of new nurse graduates hired on your oncology unit about oncological disorders. Which statement by a nursing graduate about Hodgkin's Disease require re-education? A. This disease always presents with hallmark signs of bone pain in the ribs, spine, and pelvis. B. Reed Stenberg cells are present in the nodes. C. A positive CT scan of liver and spleen presents. D. A positive biopsy of the lymph nodes with cervical nodes most often affected.
All the options are correct expect for "This disease always presents with hallmark signs of bone pain in the ribs, spine, and pelvis." This is a hallmark of Multiple Myleoma.
While being prepared for a biopsy of a lump in the right breast, the patient asks the nurse what the difference is between a benign tumor and a malignant tumor. The nurse explains that a benign tumor differs from a malignant tumor in that benign tumors A. Do not cause damage to adjacent tissue B. Do not spread to other tissues and organs C. Are simply an overgrowth of normal cells D. Frequently recur in the same site
B. Do not spread to other tissues and organs Option B: The major difference between benign and malignant tumors is that malignant tumors invade adjacent tissues and spread to distant tissues and benign tumors never metastasize. Option A: Both types of tumors may cause damage to adjacent tissues. Option C: The cells differ from normal in both benign and malignant tumors. Option D: Benign tumors usually do not recur.
chemotherapeutic agent known to cause alopecia is prescribed for a patient. To maintain the patient's self-esteem, the nurse plans to A. Suggest that the patient limit social contacts until regrowth of the hair occurs B. Encourage the patient to purchase a wig or hat and wear it once hair loss begins C. Have the patient wash the hair gently with a mild shampoo to minimize hair loss D. Inform the patient that hair loss will not be permanent and that the hair will grow back
B. Encourage the patient to purchase a wig or hat and wear it once hair loss begins
The nurse is interviewing a male client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer? A Duodenal ulcers B Polyps C Hemorrhoids D Weight gain
Colorectal polyps are common with colon cancer. Duodenal ulcers and hemorrhoids aren't preexisting conditions of colorectal cancer. Weight loss — not gain — is an indication of colorectal cancer.
A 61-year-old woman who is 5 feet, 3 inches tall and weighs 125 pounds (57 kg) tells the nurse that she has a glass of wine two or three times a week. The patient works for the post office and has a 5-mile mail-delivery route. This is her first contact with the health care system in 20 years. Which of these topics will the nurse plan to include in patient teaching about cancer? Select all that apply A. Mammography B. Physical activity C. Body weight D. Colorectal screening E. Tobacco use F. Alcohol use G. Pap testing H. Sunscreen use
Correct Answer: A, D, G, and H Options A, D, G, and H: The patient's age, gender, and history indicate a need for teaching about or screening or both for colorectal cancer, mammography, Pap smears, and sunscreen. Options B, C, E, and F: The patient does not use excessive alcohol or tobacco, she is physically active, and her body weight is healthy
During the admission assessment of a 35 year old client with advanced ovarian cancer, the nurse recognizes which symptom as typical of the disease? A. Abdominal distention B. Abdominal bleeding C. Diarrhea D. Hypermenorrhea
Correct Answer: A. Abdominal distention Option A: Clinical manifestations of ovarian cancer include abdominal distention, urinary frequency and urgency, pleural effusion, malnutrition, pain from pressure caused by the growing tumor and the effects of urinary or bowel obstruction, constipation, ascites with dyspnea, and ultimately general severe pain. Options B and D: Abnormal bleeding, often resulting in hypermenorrhea, is associated with uterine and endometrial cancer. Option C: Diarrhea is often related to colon cancer, lymphoma, carcinoid syndrome, and pancreatic cancer.
Neoplasm can be classified as either benign or malignant. The following are characteristics of malignant tumor apart from: A. Encapsulated B. Infiltrates surrounding tissues C. Metastasis D. Poorly differentiated cells
Correct Answer: A. Encapsulated Option A: Benign: grows slowly, localized, encapsulated, well-differentiated cells, no metastasis, not harmful to host. Options B, C, and D: Malignant: Grows rapidly, infiltrate surrounding tissues, not encapsulated, poorly differentiated, metastasis present, always harmful.
A patient receiving head and neck radiation and systemic chemotherapy has ulcerations over the oral mucosa and tongue and thick, ropey saliva. An appropriate intervention for the nurse to teach the patient is to A. Rinse the mouth before and after each meal and at bedtime with a saline solution B. Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth C. Gargle and rinse the mouth several times a day with an antiseptic mouthwash D. Remove food debris from the teeth and oral mucosa with a stiff toothbrush
Correct Answer: A. Rinse the mouth before and after each meal and at bedtime with a saline solution Option A: The patient should rinse the mouth with a saline solution frequently to decrease the pain and to cleanse the wounds. Option B: Hydrogen peroxide may damage tissues. Option C: Antiseptic mouthwashes may irritate the oral mucosa and are not recommended. Option D: A soft toothbrush is used for oral care.
The home health care nurse is caring for a male client with cancer and the client is complaining of acute pain. The appropriate nursing assessment of the client's pain would include which of the following? A. The client's pain rating B. The nurse's impression of the client's pain C. Nonverbal cues from the client D. Pain relief after appropriate nursing intervention
Correct Answer: A. The client's pain rating Option A: The client's self-report is a critical component of pain assessment. The nurse should ask the client about the description of the pain and listen carefully to the client's words used to describe the pain. Option B: Nonverbal cues from the client are important but are not the most appropriate pain assessment measure. Option C: The nurse's impression of the client's pain is not appropriate in determining the client's level of pain. Option D: Assessing pain relief is an important measure, but this option is not related to the subject of the question
Which information noted by the nurse reviewing the laboratory results of a patient who is receiving chemotherapy is most important to report to the health care provider? A. WBC count of 1700/µl B. Platelets of 65,000/µl C. Hemoglobin of 10 g/L D. Serum creatinine level of 1.2 mg/dl
Correct Answer: A. WBC count of 1700/µl Option A: Neutropenia places the patient at risk for severe infection and is an indication that the chemotherapy dose may need to be lower or that white blood cell (WBC) growth factors such as filgrastim (Neupogen) are needed. Options B, C, and D: The other laboratory data do not indicate any immediate life-threatening adverse effects of the chemotherapy.
Breast self examination (BSE) is one of the ways to detect breast cancer earlier. The nurse is conducting health teaching to female clients in a clinic. During evaluation the clients are asked to state what they learned. Which of the following statements made by a client needs further teaching about BSE? A. "BSE is done after menstruation." B. "BSE palpation is done by starting at the center going to the periphery in a circular motion." C. "BSE can be done in a lying position." D. "BSE should start from age 20."
Correct Answer: B. "BSE palpation is done by starting at the center going to the periphery in a circular motion." Option B: This client needs further teaching as palpation in BSE should start at the periphery going to the center in a circular motion. Option A: BSE is performed 7-10 days after menstruation when the breast are less tender and lumpy. Option C: The breast can be examined in a lying position since this position flattens the breast and makes it easier to examine. Option D: All women age 20 and older must do self-breast exams where breast tumors can be easily detected at this age.
On a clinic visit a client who has a relative with cancer, is asking about the warning signs that may relate to cancer. The nurse correctly identifies the warning signs of cancer by responding: A. "A lump located only in the breast area may suggest the presence of cancer." B. "Sudden weight loss of unexplained etiology can be a warning sign of cancer." C. "Presence of dry cough is one of the warning signs of cancer." D. "If a sore healing took a month or more to heal, cancer should be suspected."
Correct Answer: B. "Sudden weight loss of unexplained etiology can be a warning sign of cancer." Option B: Unexplained sudden weight loss of 10 pounds or more is a warning signal of cancer. This is common among cancers of the esophagus, stomach, and pancreas. Option A: The presence of lump is not limited to the breast only; it can grow elsewhere which is why this option is wrong. Option C: Nagging cough not dry cough and hoarseness of voice is a sign of cancer. Option D: The sore in cancer does not heal.
Nurse Janet is assigned in the oncology section of the hospital. Which of the following orders should the nurse question if a client is on radiation therapy? A. Bland diet B. Aspirin every 4 hours C. Saline rinses every 2 hours D. Analgesics before meals
Correct Answer: B. Aspirin every 4 hours Option B: Radiation therapy makes the platelet count decrease. Thus, nursing responsibilities should be directed at promoting safety by avoiding episodes of hemorrhage or bleeding such as physical trauma and aspirin administration. Options A and C: Bland diet and saline rinses every 2 hours should also be done to manage stomatitis, a complication of radiation therapy. Option D: Analgesics are given before meals to alleviate the pain caused by stomatitis.
The nurse is admitting a male client with laryngeal cancer to the nursing unit. The nurse assesses for which most common risk factor for this type of cancer? A. Alcohol abuse B. Cigarette smoking C. Use of chewing tobacco D. Exposure to air pollutants
Correct Answer: B. Cigarette smoking Option B: Cigarette use is the most common risk factor for head and neck cancers such as laryngeal cancer. The smoke that comes from a cigarette contains harmful chemicals such as nicotine, carbon monoxide, ammonia, and hydrogen cyanide that passes through the larynx on its way to the lungs. Options A and C: Combined use of alcohol and tobacco enhances the risk. Option D: Another risk factor is exposure to environmental pollutants (e.g., paint fumes, wood dust, coal dust) but cigarette smoking remains the most common.
The removal of entire breast, pectoralis major and minor muscles and neck lymph nodes which is followed by skin grafting is a procedure called: A. Radiation therapy B. Halstead surgery C. Modified radical mastectomy D. Simple mastectomy
Correct Answer: B. Halstead surgery Option B: Halstead surgery also called radical mastectomy involves the removal of the entire breast, pectoralis major and minor muscles, and neck lymph nodes. It is followed by skin grafting. Option A: Radiation therapy uses high doses radiation to kill cancer cells and their ability to grow and divide. Option C: Removal of the entire breast, pectoralis major muscle and the axillary lymph nodes is a surgical procedure called modified radical mastectomy. Option D: Simple mastectomy is the removal of the entire breast but the pectoralis muscles and nipples remain intact
The client with leukemia is receiving Myleran (busulfan) and Zyloprim (allopurinol). The nurse tells the client that the purpose if the allopurinol is to prevent: A. Mouth sores B. Hyperuricemia C. Nausea D. Alopecia
Correct Answer: B. Hyperuricemia Option B: Allopurinol decreases uric acid concentrations in serum and urine. In the client receiving chemotherapy, uric acid levels increase as a result of the massive cell destruction that occurs from the chemotherapy. This medication prevents or treats hyperuricemia caused by chemotherapy. Options A, C, and D: Allopurinol is not used to prevent alopecia, nausea, or mouth sores.
Nurse Kate is reviewing the complications of colonization with a client who has microinvasive cervical cancer. Which complication, if identified by the client, indicates a need for further teaching? A. Hemorrhage B. Ruptured ovarian cyst C. Infection D. Cervical stenosis
Correct Answer: B. Ruptured ovarian cyst Option B: Ruptured ovarian cyst is not a complication. This usually occurs after a strenuous exercise and after sexual intercourse. Options A, C, and D: Conization procedure involves the removal of a cone-shaped area of the cervix. Complications of the procedure include hemorrhage, infection, and cervical stenosis.
A 25-year-old patient is inquiring about the methods or ways to detect cancer earlier. The nurse least likely identifies this method by stating: A. Yearly physical and blood examination B. Annual digital rectal examination for persons over age 40 C. Annual Pap smear for sexually active women only D. Annual chest x-ray
Correct Answer: C. Annual Pap smear for sexually active women only Option C: Pap smear should be done yearly for sexually active women. All women should have an annual pap smear by age 40 and up whether sexually active or not. Options A, B, and D: Early detection of cancer is promoted by annual oral examination, monthly BSE from age 20, annual chest x-ray, yearly digital rectal examination for persons over age 40, annual Pap smear from age 40 and annual physical and blood examination.
Nurse Melinda is caring for a client who is postoperative following a pelvic exenteration and the physician changes the client's diet from NPO status to clear liquids. The nurse makes which priority assessment before administering the diet? A. Ability to ambulate B. Urine specific gravity C. Bowel sounds D. Incision appearance
Correct Answer: C. Bowel sounds Option C: The client is kept NPO until peristalsis returns, usually in 4 to 6 days. When signs of bowel function return, clear fluids are given to the client. If no distention occurs, the diet is advanced as tolerated. The most important assessment is to assess bowel sounds before feeding the client. Options A, B, and D: These are unrelated to the subject of the question.
When assessing a patient's needs for psychologic support after the patient has been diagnosed with stage I cancer of the colon, which question by the nurse will provide the most information? A. "How do you feel about having a possibly terminal illness?" B. "How long ago were you diagnosed with this cancer?" C. "Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?" D. "Can you tell me what has been helpful to you in the past when coping with stressful events
Correct Answer: D. "Can you tell me what has been helpful to you in the past when coping with stressful events?" Option D: Information about how the patient has coped with past stressful situations helps the nurse determine usual coping mechanisms and their effectiveness. Option A: The patient with stage I cancer is not considered to have a terminal illness at this time, and this question is likely to worry the patient unnecessarily. Option B: The length of time since the diagnosis will not provide much information about the patient's need for support. Option C: The patient's knowledge of typical stages in adjustment to a critical diagnosis does not provide insight into patient's needs for assistance.
Chemotherapy is one of the therapeutic modalities for cancer. This treatment is contraindicated to which of the following conditions? A. Bone marrow depression B. Recent surgery C. Pregnancy D. All of the above
Correct Answer: D. All of the above Chemotherapy is contraindicated in cases of infection (chemotherapeutic agents are immunosuppressive), recent surgery (chemotherapeutic agent may retard the healing process), impaired renal and hepatic function (drugs are nephrotoxic and hepatotoxic), recent radiation therapy (immunosuppressive treatment), pregnancy (drugs can cause congenital defects) and bone marrow depression (chemo. agents may aggravate the condition).
male client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment findings would the nurse expect to note specifically in the client? A. Fatigue B. Weakness C. Weight gain D. Enlarged lymph nodes
Correct Answer: D. Enlarged lymph nodes Option D: Hodgkin's disease is a chronic progressive neoplastic disorder of lymphoid tissue characterized by the painless enlargement of lymph nodes with progression to extra lymphatic sites, such as the spleen and liver. Options A and B: Fatigue and weakness may occur but are not related significantly to the disease. Option C: Weight loss is most likely to be noted.
Mr. Miller has been diagnosed with bone cancer. You know this type of cancer is classified as: A. Carcinoma B. Lymphoma C. Melanoma D. Sarcoma
Correct Answer: D. Sarcoma Option D: Tumors that originate from bone, muscle, and other connective tissue are called sarcomas. Option A: Carcinoma is a malignancy that starts at the epithelial lining of an organ, glands, or body structures. Option B: Lymphoma is a cancer that begins in the nodes or glands of the lymphatic system. Option C: Melanoma is a type of skin cancer that originates in cells known as melanocytes.
A with tumor lysis syndrome (TLS) is taking Zyloprim (allopurinol). Which laboratory value should the nurse monitor to determine the effectiveness of the medication? A. Blood urea nitrogen (BUN) B. Serum phosphate C. Serum potassium D. Uric acid level
Correct Answer: D. Uric acid level Option D: Allopurinol is used to decrease uric acid levels so a monitoring of serum uric acid is essential. Options A, B, and C: UN, potassium, and phosphate levels are also increased in TLS but are not affected by allopurinol therapy.
Which patient is at highest risk for cervical cancer? A. A 21 year old who reports first sexual partner at the age of 14 and that she has had at least 10 sex partners. B. A 60 year old with a history of syphillis and cigarette smoking. C. A 32 year old in a monogamous relationship who declined the HPV vaccine. D. None of the patients are at risk for cervical cancer.
Due to the patient's young age of a first sexual encounter (any age before 17 is significant) and multiple sex partners, drastically increases a person risk of cervical cancer.
A female client is receiving methotrexate (Mexate), 12 g/m2 I.V., to treat osteogenic carcinoma. During methotrexate therapy, the nurse expects the client to receive which other drug to protect normal cells? A cytarabine (ara-C, cytosine arabinoside [Cytosar-U] B leucovorin (citrovorum factor or folinic acid [Wellcovorin]) C thioguanine (6-thioguanine, 6-TG) D probenecid (Benemid)
Leucovorin is administered with methotrexate to protect normal cells, which methotrexate could destroy if given alone. Probenecid should be avoided in clients receiving methotrexate because it reduces renal elimination of methotrexate, increasing the risk of methotrexate toxicity. Cytarabine and thioguanine aren't used to treat osteogenic carcinoma.
A client, age 41, visits the gynecologist. After examining her, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer? A Pregnancy complicated with eclampsia at age 27 B Spontaneous abortion at age 19 C. Onset of sporadic sexual activity at age 17 D. Human papillomavirus infection at age 32
Like other viral and bacterial venereal infections, human papillomavirus is a risk factor for cervical cancer. Other risk factors for this disease include frequent sexual intercourse before age 16, multiple sex partners, and multiple pregnancies. A spontaneous abortion and pregnancy complicated by eclampsia aren't risk factors for cervical cancer.
A client is diagnosed with breast cancer. The tumor size is up to 5 cm with axillary and neck lymph node involvement. The client is in what stage of breast cancer? A. Stage I B. Stage II C. Stage III D. Stage IV
Option B: The tumor in stage II measures between 2 cm to 5 cm or the cancer has extended to the nearby lymph nodes. Option A: Stage I - tumor size up to 2 cm. Stage II - tumor size 2 up to 5 cm with axillary and neck lymph node involvement. Option C: Stage III - tumor size is more than 5 cm with axillary and neck lymph node involvement. Option D: Stage IV - metastasis to distant organs (liver, lungs, bone and brain
A female client is undergoing tests for multiple myeloma. Diagnostic study findings in multiple myeloma include: A. Bence Jones protein in the urine. B. a low serum protein level. C. hypocalcemia D. a decreased serum creatinine level
Presence of Bence Jones protein in the urine almost always confirms the disease, but absence doesn't rule it out. Serum calcium levels are elevated because calcium is lost from the bone and reabsorbed in the serum. Serum protein electrophoresis shows elevated globulin spike. The serum creatinine level may also be increased.
A 28 year old female patient asks you when it is best to perform a self breast exam. Your response is the following: A. It is best to perform a self breast exam 7 to 10 days after menses. B. It is best to perform a self breast exam every 6 months on the 1st day of bleeding. C. It is best to perform a self breast exam on the same time every month of the day. D. It is best to perform a self breast exam on the day after ovulation
Self breast exams should be performed 7 to 10 day after the start of menses (the patient's period...this is the first day of bleeding). Breast tissue is soft at this time due to hormone levels.
When caring for a male client diagnosed with a brain tumor of the parietal lobe, the nurse expects to assess:When caring for a male client diagnosed with a brain tumor of the parietal lobe, the nurse expects to assess: A contralateral homonymous hemianopia. B seizures C. tactile agnosia. D short-term memory impairment
Tactile agnosia (inability to identify objects by touch) is a sign of a parietal lobe tumor. Short-term memory impairment occurs with a frontal lobe tumor. Seizures may result from a tumor of the frontal, temporal, or occipital lobe. Contralateral homonymous hemianopia suggests an occipital lobe tumor.
Nurse Lucia is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms: A after the first menstrual period and annually thereafter B after the birth of the first child and every 2 years thereafter. C yearly after age 40. D every 3 years between ages 20 and 40 and annually thereafter.
The American Cancer Society recommends a mammogram yearly for women over age 40. The other statements are incorrect. It's recommended that women between ages 20 and 40 have a professional breast examination (not a mammogram) every 3 years.
During chemotherapy, an oncology client has a nursing diagnosis of impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis? A Monitoring the client's platelet and leukocyte counts B Recommending that the client discontinue chemotherapy C Checking regularly for signs and symptoms of stomatitis D Providing a solution of hydrogen peroxide and water for use as a mouth rinse
To decrease the pain of stomatitis, the nurse should provide a solution of hydrogen peroxide and water for the client to use as a mouth rinse. (Commercially prepared mouthwashes contain alcohol and may cause dryness and irritation of the oral mucosa.) The nurse also may administer viscous lidocaine or systemic analgesics as prescribed. Stomatitis occurs 7 to 10 days after chemotherapy begins; thus, stopping chemotherapy wouldn't be helpful or practical. Instead, the nurse should stay alert for this potential problem to ensure prompt treatment. Monitoring platelet and leukocyte counts may help prevent bleeding and infection but wouldn't decrease pain in this highly susceptible client. Checking for signs and symptoms of stomatitis also wouldn't decrease the pain.
For a female client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client? A. "Client verbalizes feelings of anxiety." B. "Client uses any effective method to reduce tension." C "Client stops seeking information." D "Client doesn't guess at prognosis.
Verbalizing feelings is the client's first step in coping with the situational crisis. It also helps the health care team gain insight into the client's feelings, helping guide psychosocial care. Option "Client doesn't guess at prognosis." is inappropriate because suppressing speculation may prevent the client from coming to terms with the crisis and planning accordingly. "Client uses any effective method to reduce tension." is undesirable because some methods of reducing tension, such as illicit drug or alcohol use, may prevent the client from coming to terms with the threat of death as well as cause physiologic harm. "Client stops seeking information." isn't appropriate because seeking information can help a client with cancer gain a sense of control over the crisis.
The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for? A Assessment B Asymmetry C Arcus D Actinic
When following the ABCD method for assessing skin lesions, the A stands for "asymmetry," the B for "border irregularity," the C for "color variation," and the D for "diameter."
