Oncological Disorders

A client is diagnosed with multiple myeloma and the client asks the nurse about the diagnosis. The nurse bases the response on which description of this disorder? 1) Altered red blood production. 2) Altered production of lymph nodes. 3) Malignant exacerbation in the umber of leukocytes. 4) Malignant proliferation of plasma cells within the bone.

4.

A gastrectomy is performed on a client with gastric cancer. In the immediate postoperative period, the nurse notes bloody drainage from the nasogastric tube. Which of the following is the appropriate nursing intervention? 1) Notify the physician. 2) Measure abdominal girth. 3) Irrigate the nasogastric tube. 4) Continue to monitor the drainage.

4.

The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which of the following would the nurse expect to note specifically in this disorder? 1) Increased calcium level. 2) Increased white blood cells. 3) Decreased blood urea nitrogen level. 4) Decreased number of plasma cells in the one marrow.

1.

The nurse 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? 1) Bowel sounds. 2) Ability to ambulate. 3) Incision appearance. 4) Urine specific gravity.

1.

The nurse is developing a plan of care for the client with multiple myeloma and includes which priority intervention in the plan? 1) Encouraging fluids. 2) Providing frequent oral care. 3) Coughing and deep breathing. 4) Monitoring the red blood cell count.

1.

A client with carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH) as a complication of the cancer. The nurse anticipates that which of the following may be prescribed? Select all that apply. 1) Radiation 2) Chemotherapy. 3) Increased fluid intake. 4) Serum sodium levels. 5) Decreased oral sodium intake. 6) Medication that is antagonistic to antidiuretic hormone.

1, 2, 4, 6.

The community nurse is conducting a health promotion program at a local school and is discussing the risk factors associated with cervical cancer. which of the following, if identified by the client as a risk factor for cervical cancer, indicates a need for further teaching? 1) Smoking. 2) Multiple sex partners. 3) First intercourse after age 20. 4) Annual gynecological examinations.

3.

The hospice nurse visits a client dying of ovarian cancer. During the visit, the client expresses that "If I can just live long enough to attend my daughter's graduation I'll be ready to die." Which phase of coping is this client experiencing? 1) Anger. 2) Denial. 3) Bargaining. 4) Depression.

3.

The nurse is assessing the stoma of a client following a ureterostomy. Which of the following should the nurse expect to note? 1) A dry stoma. 2) A pale stoma. 3) A dark-colored stoma. 4) A red and moist stoma.

4.

A cervical radiation implant is placed in the client for treatment of cervical cancer. The nurse initiates what most appropriate activity order for the client? 1) Bed rest. 2) Out of bed ad lib. 3) Out of bed in a chair only. 4) Ambulation to the bathroom only.

1.

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

2.

A nurse is monitoring a client for signs and symptoms related to superior vena cava syndrome. Which of the following is an early sign of this oncological emergency? 1) Cyanosis. 2) Arm edema. 3) Periorbital edema. 4) Mental status change.

3.

The client is receiving external radiation to the neck for cancer of the larynx. The most likely side effect to be expected is: 1) Dyspnea. 2) Diarrhea. 3) Sore throat. 4) Constipation.

3.

A nurse manager is teaching the nursing staff about signs and symptoms related to hypercalcemia in a client with metastatic prostate cancer and tells the staff that which of the following is a serious late sign of this oncological emergency? 1) Headache. 2) Dysphagia. 3) Constipation. 4) Electrocardiographic changes.

4.

The oncology nurse specialist provides an educational session to nursing staff regarding the characteristics of Hodgkin's disease. The nurse determines that further teaching is needed if a nursing staff member states that which of the following is a characteristic of the disease? 1) Presence of Reed-Sternberg cells. 2) Occurs most often in the older client. 3) Prognosis depending on the stage of the disease. 4) Involvement of lymph nodes, spleen, and liver.

2.

As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of the greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed when the client states: 1) I should avoid blowing my nose. 2) I may need a platelet transfusion if my platelet count is too low. 3) I'm going to take aspirin for my headache as soon as I get home. 4) I will count the number of pads and tampons I use when menstruating.

3.

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

4.

The client is diagnosed as having a bowel tumor and several diagnostic tests are prescribed. The nurse understands that which test will confirm the diagnosis of malignancy? 1) Biopsy of the tumor. 2) Abdominal ultrasound. 3) Magnetic resonance imaging. 4) Computed tomography scan.

1.

The home health care nurse is caring for a 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? 1) The client's pain rating. 2) Nonverbal cues from the client. 3) the nurse's impression of the client's pain. 4) Pain relief after appropriate nursing intervention.

1.

The nurse is caring for a client who has undergone a vaginal hysterectomy. the nurse avoids which of the following in the care of this client? 1) Elevating the knee gatch on the bed. 2) assisting with range-of-motion exercises. 3) Removal of antiembolism stockings twice daily. 4) Checking placement of pneumatic compression boots.

1.

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

1.

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

1.

What is the purpose of cytoreductive ("debulking") surgery for ovarian cancer? 1) Cancer control by reducing the size of the tumor. 2) Cancer prevention by removal of precancerous tissue. 3) Cancer cure by removing all gross and microscopic tumor cells. 4) Cancer rehabilitation by improving the appearance of a previously treated body part.

1.

The female client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing: 1) Rupture of the bladder. 2) The development of a vesicovaginal fistula. 3) Extreme stress caused by the diagnosis of cancer. 4) Altered perineal sensation as a side effect of radiation therapy.

2.

When assessing the laboratory results of the client with bladder cancer and bone metastasis, the nurse notes a calcium level of 12 mg/dL. The nurse recognizes that this is consistent with which oncological emergency? 1) Hyperkalemia. 2) Hypercalcemia. 3) Spinal cord compression. 4) Superior vena cava syndrome.

2.

Hormone therapy is prescribed as the mode of treatment for a client with prostate cancer. The nurse understands that the goal of this form of treatment is to: 1) Increase testosterone levels. 2) Increase prostaglandin levels. 3) Limit the amount of circulating androgens. 4) Increase the amount of circulating androgens.

3.

The nurse is assessing the perineal wound in a client who has returned from the operating room following an abdominal perineal resection and notes serosanguineous drainage from the wound. Which nursing intervention is appropriate? 1) Notify the physician. 2) Clamp the Penrose drain. 3) Change the dressing as prescribed. 4) Remove and replace the perineal packing.

3.

The nurse is reviewing the preoperative orders of a client with a colon tumor who is scheduled for abdominal perineal resection and notes that the physician has prescribed neomycin (Mycifradin) for the client. The nurse determines that this medication has been prescribed primarily: 1) To prevent an immune dysfunction. 2) Because the client has an infection. 3) To decrease the bacteria in the bowel. 4) Because the client is allergic to penicillin.

3.

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

4.

The client is hospitalized for insertion of an internal cervical radiation implant. While giving care, the nurse finds the radiation implant in the bed. The initial action by the nurse is to: 1) Call the physician. 2) Reinsert the implant into the vagina immediately. 3) Pick up the implant with gloved hands and flush it down the toilet. 4) Pick up the implant with long-handled forceps and place it in a lead container.

4.

The nurse is caring for a client with cancer of the prostate following a prostatectomy. The nurse provides discharge instructions to the client and tells the client to: 1) Avoid driving the car for 1 week. 2) Restrict fluid intake to prevent incontinence. 3) Avoid lifting objects heavier than 20 lbs for at least 6 weeks. 4) Notify the physician if small blood clots are noticed during urination.

4.

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

2.

The nurse is assessing the colostomy of a client who has had an abdominal perineal resection for a bowel tumor. Which of the following assessment findings indicates that the colostomy is beginning to function? 1) Absent bowel sounds. 2) The passage of flatus. 3) The client's ability to tolerate food. 4) Bloody drainage from the colostomy.

2.

The nurse is caring for a client experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. The nurse plans to: 1) Restrict all visitors. 2) Restrict fluid intake. 3) Teach the client and family about the need for hand hygiene. 4) Insert an indwelling urinary catheter to prevent skin breakdown.

3.

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

4.

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

2.

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

4.

The client with leukemia is receiving busulfan (Myleran) and allopurinol (Zyloprim) is prescribed for the client. The nurse tells the client that the purpose of the allopurinol is to: 1) Prevent nausea. 2) Prevent alopecia. 3) Prevent vomiting. 4) Prevent hyperuricemia.

4.

The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm? 1) Placing cool compresses on the affected arm. 2) Elevating the affected arm on a pillow above heart level. 3) Avoiding arm exercises in the immediate post-operative period. 4) Maintaining an intravenous site below the antecubital area on the affected side.

2.

The nurse is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which of the following principles? 1) Limit the time with the client to 1 hour per shift. 2) Do not allow pregnant women into the client's room. 3) Remove the dosimeter badge when entering the client's room. 4) Individuals younger than 16 years old may be allowed to go in the room as long as they are 6 feet away from the client.

2.

The nurse is instructing the client to perform a testicular self-examination. The nurse tells the client: 1) To examine the testicles while lying down. 2) That the best time for the examination is after a shower. 3) To gently feel the testicle with one finger to feel for a growth. 4) That testicular self-examination should be done at least every 6 months.

2.

The nurse is caring for a client following intravesical instillation of an alkylating chemotherapeutic agent into the bladder for the treatment of bladder cancer. Following the instillation, the nurse should instruct the client to: 1) Urinate immediately. 2) Maintain strict bed rest. 3) Change position every 15 minutes. 4) Retain the instillation fluid for 30 minutes.

3.

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

1.

The nurse is caring for a client following a mastectomy. Which assessment finding indicates that the client is experiencing a complication related to the surgery? 1) Pain at the incision site. 2) Arm edema on the operative side. 3. Sanguineous drainage in the Jackson-Pratt drain. 4) Complaints of decreased sensation near the operative site.

2.

The community health nurse is instructing a group of female clients about breast self-examination. The nurse instructs the clients to perform the examination: 1) at the onset of menstruation. 2) Every month during menstruation. 3) Weekly at the same time of day. 4) 1 week after menstruation starts.

4.

The nurse is caring for a client following a radical neck dissection and creation of a tracheostomy performed for laryngeal cancer and is providing discharge instruction to the client. Which statement by the client indicates a need for further instructions? 1) I will protect the stoma from water. 2) I need to keep powders and sprays away from the stoma site. 3) I need to use an air conditioner to provide cool air to assist in breathing. 4) I need to apply a thin layer of petrolatum to the skin around the stoma to prevent cracking.

3.