Oncology and Hematology

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

1."Bladder cancer most often occurs in women."

The community health nurse has conducted a teaching session for community members about the risk factors for laryngeal cancer. Which statement by a person attending the session indicates that teaching was effective? 1."Exposure to airborne carcinogens can cause this type of cancer." 2."Alcohol consumption is not associated with this type of cancer." 3."Cigarette smoking does not contribute to the development of this type of cancer." 4."Overuse of the voice is not associated with this type of cancer unless it causes spitting up of blood."

1."Exposure to airborne carcinogens can cause this type of cancer."

The nurse is reviewing the record of a client who was admitted to the hospital with a diagnosis of ovarian cancer. A client has received an unsealed radioactive isotope for treatment of thyroid cancer. Which instruction is essential for the nurse to provide the client? 1."Flush the toilet at least 3 times after use." 2."Increase intake of fruits with a core, such as apples and pears." 3."Avoid contact with pregnant women, infants, and children for 3 months." 4."Use disposable eating utensils, plates, and cups for the next 6 months."

1."Flush the toilet at least 3 times after use."

The nurse is teaching a client who has had a laryngectomy for laryngeal cancer how to use an artificial larynx. Which statement should the nurse include in the teaching? 1."Hold the device alongside the neck." 2."Insert the device into the tracheostomy." 3."Swallow air into the esophagus to make speech." 4."Hold the device over the upper portion of the sternum."

1."Hold the device alongside the neck."

The nurse is doing preoperative teaching with a client newly diagnosed with a stage I cervical cancer. Which statement by the client indicates that education was effective? 1."I have carcinoma that is just in the cervix." 2."My carcinoma has extended to the pelvis and the vagina." 3."I have carcinoma that has extended beyond the cervix but has not extended to the pelvic wall." 4."My carcinoma has extended beyond the true pelvis and has involved the bladder or rectal mucosa."

1."I have carcinoma that is just in the cervix."

The nurse is teaching the client about risk factors for skin cancer. Which statements by the client indicate that teaching was successful? Select all that apply. 1."I have to avoid excessive exposure to sunlight." 2."My dark skin color predisposes me to skin cancer." 3."I am at higher risk for skin cancer because my mother had one." 4."I am at higher risk for skin cancer because I am 20 years old." 5."I am immune to skin cancer because I work as a pest control exterminator."

1."I have to avoid excessive exposure to sunlight." 3."I am at higher risk for skin cancer because my mother had one."

Which are warning signs of head and neck cancer? Select all that apply. 1.Difficulty swallowing 2.Well-fitting dentures 3.Lump in the mouth, neck, or throat 4.Persistent or unexplained oral bleeding 5.Cough and sore throat that resolved 5 days after a viral pharyngitis

1.Difficulty swallowing 3.Lump in the mouth, neck, or throat 4.Persistent or unexplained oral bleeding

A client with bladder cancer has undergone surgical removal of the bladder with creation of an ileal conduit. Which assessment findings indicate that the client is developing complications? Select all that apply. 1.Dusky appearance of the stoma 2.Stoma protrusion from the skin 3.Sharp abdominal pain with rigidity 4.Urine output greater than 30 mL/hour 5.Mucus shreds in the urine collection bag

1.Dusky appearance of the stoma 2.Stoma protrusion from the skin 3.Sharp abdominal pain with rigidity

The nurse has admitted a client to the clinical nursing unit after undergoing a right mastectomy. The nurse should plan to place the right arm in which position? 1.Elevated on a pillow 2.Level with the right atrium 3.Dependent to the right atrium 4.Elevated above shoulder level

1.Elevated on a pillow

A client is receiving intravesical chemotherapy for cancer of the bladder. The nurse should plan to take which action after the completion of each treatment? 1.Encourage increased intake of oral fluids. 2.Provide increased doses of opioid analgesics. 3.Place the client on strict contact isolation for 24 hours. 4.Keep the client on nothing by mouth (NPO) status for 6 hours.

1.Encourage increased intake of oral fluids.

The nurse is creating 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.Encouraging fluids

The nurse is caring for a client with lung cancer and bone metastasis. What signs and symptoms would the nurse recognize as indications of a possible oncological emergency? Select all that apply. 1.Facial edema in the morning 2.Weight loss of 20 lb (9 kg) in 1 month 3.Serum calcium level of 12 mg/dL (3.0 mmol/L) 4.Serum sodium level of 136 mg/dL (136 mmol/L) 5.Serum potassium level of 3.4 mg/dL (3.4 mmol/L) 6.Numbness and tingling of the lower extremities

1.Facial edema in the morning 3.Serum calcium level of 12 mg/dL (3.0 mmol/L) 6.Numbness and tingling of the lower extremities

A woman has just been told by the primary health care provider that she has breast cancer. The woman responds, "Oh, no! Does this mean I'm going to die?" The nurse interprets the woman's initial reaction as which response? 1.Fear 2.Rage 3.Denial 4.Anxiety

1.Fear

The nurse is reviewing the record of a client admitted to the hospital with a diagnosis of Hodgkin's disease. Which assessment findings noted in the client's record are associated with this diagnosis? Select all that apply. 1.Fever 2.Weight loss 3.Night sweats 4.Visual changes 5.Enlarged, painless lymph nodes

1.Fever 2.Weight loss 3.Night sweats 5.Enlarged, painless lymph nodes

The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which 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 bone marrow

1.Increased calcium level

The nurse is preparing a plan of care for a child with sickle cell crisis who will be admitted to the nursing unit. The nurse should include which intervention as a priority in the plan of care for the child? 1.Initiate an intravenous (IV) line for the administration of fluids. 2.Consult with the psychiatric department regarding genetic counseling. 3.Call the blood bank and request preparation of a unit of packed red blood cells. 4.Call the respiratory department to prepare for intubation and mechanical ventilation.

1.Initiate an intravenous (IV) line for the administration of fluids.

The nurse is assessing a dark-skinned client for signs of anemia. The nurse should focus the assessment on which structures? Select all that apply. 1.Lips 2.Tongue 3.Earlobes 4.Conjunctiva 5.Mucous membranes

1.Lips 4.Conjunctiva 5.Mucous membranes

The community nurse is conducting a health promotion program at a local school and is discussing the risk factors associated with cervical cancer. Which are risk factors for cervical cancer? Select all that apply. 1.Smoking 2.Multiple sex partners 3.Human papillomavirus infection 4.Annual gynecological examinations 5.First intercourse before 17 years of age

1.Smoking 2.Multiple sex partners 3.Human papillomavirus infection 5.First intercourse before 17 years of age

Which statement made by a client who will undergo cytoreductive (debulking) surgery for ovarian cancer indicates that teaching by the nurse was effective? 1."The surgery will remove precancerous tissue." 2."The surgery will help to reduce the size of the tumor." 3."The surgery will cure the cancer by removing all gross and microscopic tumor cells." 4."The surgery is focused at improving the appearance of the previously treated body part."

2."The surgery will help to reduce the size of the tumor."

A client is having a diagnostic workup for colorectal cancer. Which factors in the client's history place the client at increased risk for this type of cancer? Select all that apply. 1.A high-fiber diet 2.A diet high in fats 3.Minimal alcohol intake 4.A diet high in carbohydrates 5.A history of inflammatory bowel disease 6.A maternal grandfather who had a history of heart disease

2.A diet high in fats 4.A diet high in carbohydrates 5.A history of inflammatory bowel disease

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

2.A low-fat diet

The clinic nurse has conducted a health screening clinic to identify clients who are at risk for cervical cancer. The nurse is reviewing the assessment findings in the records of the clients who attended the clinic. Which client is at lowest risk for developing this type of cancer? 1.A multiparity client 2.A single white client 3.A client with a history of chronic cervicitis 4.A client who had early, frequent intercourse with multiple sexual partners

2.A single white client

The nurse is instructing a client with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the client? 1.Administer the iron at mealtimes. 2.Administer the iron through a straw. 3.Mix the iron with cereal to administer. 4.Add the iron to apple juice for easy administration.

2.Administer the iron through a straw.

A 27-year-old client is undergoing evaluation of lumps in her breasts. In determining whether the client could have fibrocystic breast disorder, the nurse should ask her whether the breast lumps seem to become more prominent or troublesome at which time? 1.After menses 2.Before menses 3.During menses 4.At any time, regardless of the menstrual cycle

2.Before menses

The nurse is caring for a client with leukemia. In assessing the client for signs of leukemia, the nurse determines that what should be monitored? 1.Platelet count 2.Bone marrow biopsy 3.White blood cell count 4.Complete blood cell count

2.Bone marrow biopsy

The nurse has conducted a cancer prevention seminar for clients in an ambulatory setting. The nurse determines that teaching was effective if the clients select which food item on the menu? 1.Broiled beef, canned corn, rice 2.Broccoli, baked fish, mashed potato 3.Bacon, scrambled eggs, french fries 4.Bologna, canned asparagus, white bread

2.Broccoli, baked fish, mashed potato

The nurse is admitting a client with laryngeal cancer to the nursing unit. What should the nurse assess for as the 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.Cigarette smoking

When obtaining assessment data from a client with a microcytic normochromic anemia, which should the nurse question the client about? 1.Folic acid intake 2.Dietary intake of iron 3.A history of gastric surgery 4.A history of sickle cell anemia

2.Dietary intake of iron

The community health nurse is creating a poster for an educational session for a group of women and will be discussing the risk factors associated with breast cancer. Which risk factors for breast cancer should the nurse list on the poster? Select all that apply. 1.Multiparity 2.Early menarche 3.Early menopause 4.Family history of breast cancer 5.High-dose radiation exposure to chest 6.Previous cancer of the breast, uterus, or ovaries

2.Early menarche 4.Family history of breast cancer 5.High-dose radiation exposure to chest 6.Previous cancer of the breast, uterus, or ovaries

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 postoperative period 4.Maintaining an intravenous site below the antecubital area on the affected side

2.Elevating the affected arm on a pillow above heart level

The nurse should include which intervention in the care of a client who has undergone a vaginal hysterectomy for the treatment of cancer? Select all that apply. 1.Elevate the knee gatch on the bed. 2.Encourage ambulation as prescribed. 3.Remove antiembolism stockings twice daily. 4.Assist with range-of-motion (ROM) leg exercises. 5.Check placement of pneumatic compression boots

2.Encourage ambulation as prescribed. 3.Remove antiembolism stockings twice daily. 4.Assist with range-of-motion (ROM) leg exercises. 5.Check placement of pneumatic compression boots

For the client with stomatitis resulting from chemotherapy, the care plan should include which intervention? 1.Inspect the mouth every week for fungus. 2.Encourage foods with neutral or cool temperatures. 3.Give the client spicy foods to stimulate the sense of taste. 4.Perform frequent oral hygiene using a commercial alcohol-based mouthwash.

2.Encourage foods with neutral or cool temperatures.

The community health nurse is preparing an educational class on ovarian cancer for a group of women. Which signs and symptoms should the nurse include in the presentation? Select all that apply. 1.Feeling hungry all the time 2.Having urinary urgency or frequency 3.Experiencing pelvic or abdominal swelling 4.Sense of feeling that something is "falling out" 5.Developing a macular-papular rash over the abdomen

2.Having urinary urgency or frequency 3.Experiencing pelvic or abdominal swelling

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

2.Hematuria

A client is admitted to the hospital with suspected bladder cancer. The nurse assesses the client for which early signs and symptoms of the disease? 1.Proteinuria and dysuria 2.Hematuria and absence of pain 3.Painful urination and hematuria 4.Pyuria and palpable abdominal mass

2.Hematuria and absence of pain

The nurse is preparing a list of home care instructions regarding stoma and laryngectomy care for a client with laryngeal cancer who had a laryngectomy. Which instructions should be included in the list? Select all that apply. 1.Restrict fluid intake. 2.Obtain a MedicAlert bracelet. 3.Keep the humidity in the home low. 4.Prevent debris from entering the stoma. 5.Avoid exposure to people with infections. 6.Avoid swimming and use care when showering.

2.Obtain a MedicAlert bracelet. 4.Prevent debris from entering the stoma. 5.Avoid exposure to people with infections. 6.Avoid swimming and use care when showering.

A client is diagnosed as having a bowel tumor. The nurse should monitor the client for which complications of this type of tumor? Select all that apply. 1.Flatulence 2.Peritonitis 3.Hemorrhage 4.Fistula formation 5.Bowel perforation 6.Lactose intolerance

2.Peritonitis 3.Hemorrhage 4.Fistula formation 5.Bowel perforation

A client is diagnosed as having a intestinal tumor. The nurse should monitor the client for which complications of this type of tumor? Select all that apply. 1.Flatulence 2.Peritonitis 3.Hemorrhage 4.Fistula formation 5.Bowel perforation 6.Lactose intolerance

2.Peritonitis 3.Hemorrhage 4.Fistula formation 5.Bowel perforation

The home health care nurse is providing instructions to a client after a vulvectomy. Which instruction should the nurse provide to the client? 1."You can engage in sexual activity in 2 weeks." 2."It is all right to begin to drive a car as long as you do not drive long distances." 3."Resume activities slowly, keeping in mind that walking is a beneficial activity." 4."It is important to rest and sit in a chair with your legs elevated as much as possible."

3."Resume activities slowly, keeping in mind that walking is a beneficial activity."

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

3."That's important to report even though it might not be serious."

The nurse is caring for a client undergoing external radiation. The client has developed a dry desquamation of the skin in the treatment area, and the nurse is teaching about management of the skin reaction. Which comment made by the client suggests understanding of the instructions? 1."I don't need to stay out of the sun or put on sunscreen." 2."I can use ice packs to relieve itching in the treatment area." 3."When bathing I will use lukewarm water on the affected area." 4."I can lubricate the irritated area with an ointment like bacitracin."

3."When bathing I will use lukewarm water on the affected area."

A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication to treat breast cancer. When implementing the plan, the nurse should make which statement to the client? 1."You can take aspirin as needed for headache." 2."You can drink beverages containing alcohol in moderate amounts each evening." 3."You need to consult with the primary health care provider (PHCP) before receiving immunizations." 4."It is fine to receive a flu vaccine at the local health fair without PHCP approval because the flu is so contagious."

3."You need to consult with the primary health care provider (PHCP) before receiving immunizations."

The nurse is providing information to a client scheduled for a skin biopsy. The client asks the nurse how painful the procedure is. The nurse should make which response to the client? 1."The procedure is painless." 2."A preoperative medication will put you to sleep." 3."An analgesic will be prescribed after the procedure." 4."The local anesthetic may cause a stinging sensation."

4."The local anesthetic may cause a stinging sensation."

The nurse is caring for a client with prostate cancer who is being treated with a hormone therapy. What should the nurse monitor for in order to evaluate the effect of this treatment? 1.An increase in testosterone levels 2.An increase in prostaglandin levels 3.An increase the amount of circulating androgens 4.A decline in the amount of circulating androgens

4.A decline in the amount of circulating androgens

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

4.Abdominal distention

The nurse is caring for a client diagnosed with breast cancer receiving combination chemotherapy. Which nursing intervention is the most appropriate? 1.Give 2 agents from the same medication class. 2.Give 2 agents with like nadirs at the same time. 3.Test the client's knowledge about each agent's nadir. 4.Avoid giving agents with the same nadirs and toxicities at the same time.

4.Avoid giving agents with the same nadirs and toxicities at the same time.

The nurse is preparing to care for a client with chronic kidney disease and anemia. Which describes the relationship between chronic kidney disease and anemia? 1.Lack of angiotensin I may cause anemia. 2.Increased production of aldosterone leads to anemia. 3.Anemia is caused by insufficient production of renin. 4.Decreased production of erythropoietin is causing anemia.

4.Decreased production of erythropoietin is causing anemia.

A client who was diagnosed with toxic shock syndrome (TSS) now exhibits petechiae, oozing from puncture sites, and coolness of the digits of the hands and feet. Clotting times determined for this client are prolonged. The nurse interprets these clinical signs as being most compatible with which condition? 1.Heparin overdose 2.Vitamin K deficiency 3.Factor VIII deficiency 4.Disseminated intravascular coagulopathy (DIC)

4.Disseminated intravascular coagulopathy (DIC)

The nurse is performing an admission assessment of a client with a possible right colon tumor. Which sign or symptom should the nurse anticipate the client may report? 1.Frequent diarrhea 2.Crampy gas pains 3.Flat, ribbon-like stools 4.Dull abdominal pain exacerbated by walking

4.Dull abdominal pain exacerbated by walking

The 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 is a late sign or symptom of this oncological emergency? 1.Headache 2.Dysphagia 3.Constipation 4.Electrocardiographic changes

4.Electrocardiographic changes

A 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.Enlarged lymph nodes

The nurse is providing home care instructions to the client who just had surgery for squamous cell carcinoma. The nurse provides follow-up teaching and explains to the client to watch for which characteristics of this type of skin carcinoma? 1.Irregularly shaped, pigmented papules or plaques 2.Pearly papule with a central crater and rolled, waxy borders 3.Small macules or papules with dry, rough, adherent yellow or brown scale 4.Firm, nodular lesion topped with a crust or with a central area of ulceration

4.Firm, nodular lesion topped with a crust or with a central area of ulceration

A client with leukemia is receiving busulfan and allopurinol. The nurse should tell the client that the purpose of the allopurinol is to prevent which symptom? 1.Nausea 2.Alopecia 3.Vomiting 4.Hyperuricemia

4.Hyperuricemia

The nurse is providing care to a client who has undergone modified right mastectomy for the treatment of breast cancer. Which activity should the nurse incorporate into the plan of care? 1.Keep suction drains fully inflated to provide adequate suction. 2.Perform venipunctures and blood pressures on the operative side only. 3.Inform the client that drains will be removed on the second postoperative day. 4.Maintain head of the bed elevation at 30 degrees with the right arm elevated on a pillow.

4.Maintain head of the bed elevation at 30 degrees with the right arm elevated on a pillow.

The nurse is caring for a client with metastatic breast cancer. The client describes a new and sudden sharp pain in the back. Based on this assessment finding, which is the priority nursing intervention? 1.Document the findings. 2.Administer pain medication. 3.Place a heating pad on the client's back. 4.Notify the primary health care provider (PHCP).

4.Notify the primary health care provider (PHCP).

The client has undergone mastectomy. The nurse determines that the client is making the best adjustment to the loss of the breast if which behavior is observed? 1.Refusing to look at the wound 2.Reading the postoperative care booklet 3.Asking for pain medication when needed 4.Participating in the care of the surgical drain

4.Participating in the care of the surgical drain

The home care nurse visits a client who has just returned home from the hospital after a mastectomy with a suction drain in place. Which observed client behavior requires a need for further teaching? 1.Empties the drain to prevent infection 2.Elevates the arm when lying and sitting 3.Applies lotion to the area after the incision heals 4.Performs full range-of-motion exercises to the upper arm

4.Performs full range-of-motion exercises to the upper arm

The nurse is participating in a health screening clinic and is preparing teaching materials about colorectal cancer. Which risk factor for colorectal cancer should the nurse include? 1.High-fiber, low-fat diet 2.Age older than 30 years 3.Distant relative with colorectal cancer 4.Personal history of ulcerative colitis or gastrointestinal polyps

4.Personal history of ulcerative colitis or gastrointestinal polyps

The nurse is reviewing the medical record for a client who has been diagnosed with Hodgkin's disease. The nurse should check which diagnostic test noted in the client's record to determine the stage of the disease? 1.Blood studies 2.Bone marrow examination 3. Excisional lymph node biopsy 4.Positron emission topography (PET) scan

4.Positron emission topography (PET) scan

Laboratory studies are performed for a client suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia? 1.Elevated hemoglobin level 2.Decreased reticulocyte count 3.Elevated red blood cell count 4.Red blood cells that are microcytic and hypochromic

4.Red blood cells that are microcytic and hypochromic

The nurse is performing an assessment on a client with a diagnosis of pernicious anemia. Which finding would the nurse expect to note in this client? 1.Dyspnea 2.Dusky mucous membranes 3.Shortness of breath on exertion 4.Red tongue that is smooth and sore

4.Red tongue that is smooth and sore

The nurse is performing an assessment on a client with a diagnosis of anemia that developed as a result of blood loss after a traumatic injury. The nurse should expect to find which sign or symptom in the client as a result of the anemia? 1.Bradycardia 2.Muscle cramps 3.Increased respiratory rate 4.Shortness of breath with activity

4.Shortness of breath with activity

A client enters the hospital emergency department with a nosebleed. On assessment, the client tells the nurse that the nosebleed just suddenly began. The nurse notes no obvious facial injury. Which is the initial nursing action? 1.Insert nasal packing. 2.Prepare a nasal balloon for insertion. 3.Place the client in a semi-Fowler's position, and apply ice packs to the nose. 4.Sit the client down, ask the client to lean forward slightly, and apply pressure to the nose for 5 to 10 minutes.

4.Sit the client down, ask the client to lean forward slightly, and apply pressure to the nose for 5 to 10 minutes.

A 67-year-old man is receiving outpatient radiation treatments for carcinoma of the oropharynx and has developed dysphagia. The nurse develops a teaching plan regarding dysphagia and includes which interventions in the plan? Select all that apply. 1.Teach the man to speak slowly. 2.Teach the man to enunciate clearly. 3.Encourage the man to drink only thin liquids. 4.Teach the man to examine his oral mucosa daily. 5.Encourage the man to use artificial saliva to manage dryness.

4.Teach the man to examine his oral mucosa daily. 5.Encourage the man to use artificial saliva to manage dryness.

The oncology nurse specialist provides an educational session for 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 is a characteristic of the disease? 1.Reed-Sternberg cells are present. 2.The lymph nodes, spleen, and liver are involved. 3.The prognosis depends on the stage of the disease. 4.The disease occurs most often in those older than 75 years of age.

4.The disease occurs most often in those older than 75 years of age.

A client receiving chemotherapy is experiencing mucositis. The nurse should advise the client to use which item 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.Weak salt and bicarbonate mouth rinse

The nurse is creating 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. Encouraging fluids

The nurse is providing dietary teaching for a client with a diagnosis of chronic gastritis. The nurse instructs the client to include which foods rich in vitamin B12 in the diet? Select all that apply. 1.Nuts 2.Corn 3.Liver 4.Apples 5.Lentils 6.Bananas

1. Nuts 3. Liver 5. Lentils

The nurse is caring for the client who is suspected of having lung cancer. The nurse should assess the client for which most frequent early symptom of lung cancer? 1.Cough 2.Hoarseness 3.Hemoptysis 4.Pleuritic pain

1.Cough

The nurse is preparing a client with thrombocytopenia for discharge. Which statement by the client about measures minimizing injury indicates that discharge teaching was effective? Select all that apply. 1."I may continue to use an electric shaver." 2."I will not blow my nose if I get a cold." 3."I should use an enema instead of laxatives for constipation." 4."I definitely will play football with my friends this weekend." 5."I should use a soft-bristled toothbrush to avoid mouth trauma."

1."I may continue to use an electric shaver." 2."I will not blow my nose if I get a cold." 5."I should use a soft-bristled toothbrush to avoid mouth trauma."

The nurse has provided medication instructions to a client with an iron deficiency anemia who will be taking iron supplements. Which statement made by the client indicates an understanding of this medication? 1."I need to increase my fluid intake." 2."I should eliminate fiber foods from my diet." 3."I need to take the medication with water before a meal." 4."I should be sure to chew the tablet thoroughly before swallowing it."

1."I need to increase my fluid intake."

The nurse has provided teaching for an adult client about screening for colon cancer. Which statement by the client indicates that education was effective? 1."I should have an annual fecal occult blood test." 2."I should have an annual colonoscopy when I become 60." 3."I will have a colonoscopy before the fecal occult blood test." 4."I will not need to have further fecal occult blood tests after a colonoscopy."

1."I should have an annual fecal occult blood test."

The nurse has provided discharge instructions to a client who underwent a right mastectomy with axillary lymph node dissection. Which statement made by the client indicates a need for further instruction regarding home care measures? 1."It is all right to use a straight razor to shave under my arms." 2."I must be sure to use thick potholders when I am cooking." 3."I must be sure not to have blood pressures taken or blood drawn from my right arm." 4."I should inform all of my other health care providers that I have had this surgical procedure."

1."It is all right to use a straight razor to shave under my arms."

The nurse has conducted an educational session about risk factors for bladder cancer with clients in the ambulatory care center. Which statements by the clients indicate that teaching was effective? Select all that apply. 1."Quitting smoking will help to reduce my risk." 2."I have to consider natural alternatives to dye my hair." 3."Infections of the bladder cannot cause bladder cancer." 4."Chemicals have to enter the bladder directly in order to cause bladder cancer." 5."I have to consult with my primary health care provider about long-term use of cyclophosphamide medications."

1."Quitting smoking will help to reduce my risk." 2."I have to consider natural alternatives to dye my hair." 5."I have to consult with my primary health care provider about long-term use of cyclophosphamide medications."

The nurse is taking a history from a client suspected of having testicular cancer. Which data will be most helpful in determining the risk factors for this type of cancer? 1.Age and race 2.Marital status 3.Number of children 4.Number of sexual partners

1.Age and race

The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the client identifies which item 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.Age younger than 50 years

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

1.Alopecia

The nurse is performing a skin assessment on a client diagnosed with malignant melanoma. The nurse should expect to note which characteristic of this type of skin lesion? 1.An irregularly shaped lesion 2.A small papule with a dry, rough scale 3.A firm nodular lesion topped with crust 4.A pearly papule with a central crater and a waxy border

1.An irregularly shaped lesion

A client who is receiving chemotherapy for breast cancer develops myelosuppression. Which instructions should the nurse include in the client's discharge teaching plan? Select all that apply. 1.Avoid contact sports. 2.Wash hands frequently. 3.Increase intake of fresh fruits and vegetables. 4.Avoid crowded places such as shopping malls. 5.Treat a sore throat with over-the-counter products. 6.Avoid people who have received live attenuated vaccines.

1.Avoid contact sports. 2.Wash hands frequently. 4.Avoid crowded places such as shopping malls. 6.Avoid people who have received live attenuated vaccines.

A cervical radiation implant is placed in a client who is undergoing treatment of cervical cancer. The nurse should initiate which activity prescription as the most appropriate for this 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.Bed rest

The nurse is reviewing the laboratory test results for a client with bladder cancer with bone metastasis. The nurse should contact the primary health care provider (PHCP) if which finding is noted? 1.Calcium level of 15 mg/dL (3.75 mmol/L) 2.Potassium level of 3.8 mEq/L (3.8 mmol/L) 3.Platelet count of 200,000 mm3 (200 × 109/L) 4.White blood cell (WBC) count of 6000 mm3 (6 × 109/L)

1.Calcium level of 15 mg/dL (3.75 mmol/L)

A client is admitted to the nursing unit after undergoing radical prostatectomy for cancer. The nurse anticipates that which problem would be of most concern to the client in the immediate postoperative period? 1.Concern about the outcome of surgery 2.Continuous pain because of the effects of cancer 3.Appearance disturbance as a result of the presence of a suprapubic catheter 4.Concern about caring for self at home because of insufficient help after discharge

1.Concern about the outcome of surgery

The nurse is reviewing a plan of care for a client with cancer of the cervix who is undergoing treatment with a cesium (radiation) implant. Which nursing interventions are most appropriate for this client? Select all that apply. 1.Maintain the client on bed rest. 2.Place the client on a low-fiber diet. 3.Keep the head of the bed flat at all times. 4.Restrict visitors to visiting for 60 minutes per day. 5.Stand at the entrance of the room to communicate with the client when possible.

1.Maintain the client on bed rest. 2.Place the client on a low-fiber diet. 5.Stand at the entrance of the room to communicate with the client when possible.

The nurse in the surgical care center will be assisting the primary health care provider to perform a punch biopsy of a client's skin lesion. Which interventions should be included in the preprocedure plan of care? Select all that apply. 1.Obtain an informed consent. 2.Clean the area of the lesion with water. 3.Prepare to apply direct pressure to the biopsy site after the procedure. 4.Tell the client that a small piece of tissue will be removed for examination. 5.Teach the client about the need to cleanse the site postprocedure with hydrogen peroxide and a topical corticosteroid every 4 hours.

1.Obtain an informed consent. 3.Prepare to apply direct pressure to the biopsy site after the procedure. 4.Tell the client that a small piece of tissue will be removed for examination.

The nurse is preparing to perform an assessment on a child being admitted to the hospital with a diagnosis of sickle cell crisis, vaso-occlusive crisis. Which findings should the nurse expect to note on assessment of the child? Select all that apply. 1.Pallor 2.Fever 3.Joint swelling 4.Blurred vision 5.Abdominal pain

1.Pallor 2.Fever 3.Joint swelling 5.Abdominal pain

The nurse is conducting a history and monitoring laboratory values on a client with multiple myeloma. What assessment findings should the nurse expect to note? Select all that apply. 1.Pathological fracture 2.Urinalysis positive for Bence Jones protein 3.Hemoglobin level of 15.5 g/dL (155 mmol/L) 4.Calcium level of 8.6 mg/dL (2.15 mmol/L) 5.Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

1.Pathological fracture 2.Urinalysis positive for Bence Jones protein 5.Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

The nurse is conducting a history and monitoring laboratory values on a client with multiple myeloma. What assessment findings should the nurse expect to note? Select all that apply. 1.Pathological fracture 2.Urinalysis positive for nitrites 3.Hemoglobin level of 15.5 g/dL (155 mmol/L) 4.Calcium level of 8.6 mg/dL (2.15 mmol/L) 5.Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

1.Pathological fracture 2.Urinalysis positive for nitrites 5.Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

A client with liver cancer who is receiving chemotherapy tells the nurse that some foods taste bitter. The nurse would try to limit which food that is most likely to cause this bitter taste for the client? 1.Pork 2.Custard 3.Potatoes 4.Cantaloupe

1.Pork

The nurse is caring for a client who has undergone a radical neck dissection and creation of a tracheostomy because of laryngeal cancer and is providing discharge instructions to the client. Which should be included in the instructions? Select all that apply. 1.Protect the stoma from water. 2.Use a humidifier if dryness is a problem. 3.Keep powders and sprays away from the stoma site. 4.Use an air conditioner to provide cool air to assist in breathing. 5.Apply a thin layer of non-oil-based ointment to the skin around the stoma to prevent cracking.

1.Protect the stoma from water. 2.Use a humidifier if dryness is a problem. 3.Keep powders and sprays away from the stoma site. 5.Apply a thin layer of non-oil-based ointment to the skin around the stoma to prevent cracking.

A client with carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH) as a complication of the cancer. The nurse anticipates that the primary health care provider will request which prescriptions? Select all that apply. 1.Radiation 2.Chemotherapy 3.Increased fluid intake 4.Decreased oral sodium intake 5.Serum sodium level determination 6.Medication that is antagonistic to antidiuretic hormone

1.Radiation 2.Chemotherapy 5.Serum sodium level determination 6.Medication that is antagonistic to antidiuretic hormone

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

1.Radiation 2.Chemotherapy 5.Serum sodium level determination 6.Medication that is antagonistic to antidiuretic hormone

A client with a medical diagnosis of breast cancer is undergoing chemotherapy. The client complains to the nurse about losing her hair and severe fatigue from the treatment. Which interventions should the nurse implement for this client? Select all that apply. 1.Review side effects of chemotherapy and treatment with the client. 2.Teach the client how to resolve specific concerns of her personal life. 3.Teach the client to pace activities with rest so as to maintain strength. 4.Offer information on available counseling services and support groups. 5.Tell the client about some other clients who have had breast cancer treatment. 6.Inquire how the cancer diagnosis and treatment affect the client's normal routine.

1.Review side effects of chemotherapy and treatment with the client. 3.Teach the client to pace activities with rest so as to maintain strength. 4.Offer information on available counseling services and support groups. 6.Inquire how the cancer diagnosis and treatment affect the client's normal routine.

The nurse is caring for a client on the oncology unit who has developed stomatitis during chemotherapy for treatment of breast cancer. The nurse should plan which measure to treat this complication? 1.Rinse the mouth with diluted baking soda or saline. 2.Use lemon and glycerin swabs liberally on painful oral lesions. 3.Brush the teeth and use non-waxed dental floss at least twice a day. 4.Place the client on NPO (nothing by mouth) status for 12 hours, and then resume liquids.

1.Rinse the mouth with diluted baking soda or saline.

The nurse is monitoring the intravenous (IV) infusion of an antineoplastic medication to treat breast cancer. During the infusion, the client complains of pain at the insertion site. On inspection of the site, the nurse notes redness and swelling and that the infusion of the medication has slowed in rate. The nurse suspects extravasation and should take which actions? Select all that apply. 1.Stop the infusion. 2.Prepare to apply ice or heat to the site. 3.Notify the primary health care provider (PHCP). 4.Restart the IV at a distal part of the same vein. 5.Prepare to administer a prescribed antidote into the site. 6.Increase the flow rate of the solution to flush the skin and subcutaneous tissue.

1.Stop the infusion. 2.Prepare to apply ice or heat to the site. 3.Notify the primary health care provider (PHCP). 5.Prepare to administer a prescribed antidote into the site.

The home health care nurse is visiting a client who has undergone a mastectomy. The nurse determines that the client demonstrates greatest adjustment to the loss of the breast if which behavior is noted? 1.The client looks at the surgical site. 2.The client performs the prescribed arm exercises. 3.The client takes the pain medication as prescribed. 4.The client has read all of the postoperative materials provided by the hospital nurse.

1.The client looks at the surgical site.

The nurse is reviewing the prescriptions for a client admitted to the hospital with a diagnosis of idiopathic autoimmune hemolytic anemia. The nurse prepares the client for treatment of this disorder, understanding that which may be recommended? Select all that apply. 1.Transfusions 2.Splenectomy 3.Radiation therapy 4.Corticosteroid medication 5.Immunosuppressive agents

1.Transfusions 2.Splenectomy 4.Corticosteroid medication 5.Immunosuppressive agents

The client is preparing for discharge from the hospital after radical vulvectomy. The nurse should include which activity as appropriate for the client immediately after discharge? 1.Walking 2.Driving a car 3.Sexual activity 4.Sitting for lengthy periods

1.Walking

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 most appropriate? 1. Clamp the surgical drain 2. Change the dressing as prescribed 3. Notify the surgeon 4. Remove and replace the perineal packing.

2. Change the dressing as prescribed

A 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 which condition? 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. The development of a vesicovaginal fistula

The nurse is counseling a woman about decreasing her risk for cervical cancer. Which statement by the client indicates a need for further counseling? 1."I need to seek prompt treatment for vaginitis." 2."Condoms are needed only if I do not trust a new partner." 3."A partner who is uncircumcised will present an increased risk." 4."I need to keep appointments for Pap tests at the frequency advised by my primary health care provider."

2."Condoms are needed only if I do not trust a new partner."

The nurse is providing teaching to a client who will undergo chemotherapy for cancer, and alopecia is expected from the chemotherapeutic agent. Which statement made by the client indicates a need for further teaching? 1."Excessive hair brushing should be avoided." 2."I can't believe my hair loss will be permanent." 3."I guess I'll have to stop using my electric hair dryer and curling rod." 4."I will have my hair stylist cut my hair short just before I start my treatments."

2."I can't believe my hair loss will be permanent."

The nurse has provided instructions to a client regarding testicular self-examination (TSE). Which client statement indicates the need for further teaching regarding TSE? 1."I know to report any small lumps." 2."I examine myself every 2 months." 3."I examine myself after I take a warm shower." 4."I feel a hard and cord-like thing in back and going up."

2."I examine myself every 2 months."

The nurse has provided discharge instructions to a client who has had cryosurgery to remove a malignant skin lesion. The nurse determines that the client understands the instructions if the client makes which statements? Select all that apply. 1."I need to avoid baths or showers for 7 to 10 days." 2."I need to clean the site as prescribed to prevent infection." 3."I need to apply ice to the site continuously to prevent swelling." 4."I need to expect some swelling and tenderness in the affected area." 5."I need to apply alcohol-soaked dressings twice a day for 30 minutes each time."

2."I need to clean the site as prescribed to prevent infection." 4."I need to expect some swelling and tenderness in the affected area."

The ambulatory care nurse is providing discharge instructions to a female client who underwent cryosurgery with laser therapy because of a positive Papanicolaou test. Which statement by the client indicates an understanding of the instructions? 1."I should take sitz baths every 4 hours for the next week." 2."I should expect the vaginal discharge to be clear and watery." 3."Very strong pain medications will be needed to relieve any discomfort I may have." 4."If I note any odor to the vaginal discharge, I should call the primary health care provider immediately."

2."I should expect the vaginal discharge to be clear and watery."

The nurse is reviewing the preoperative prescriptions for a client with a colon tumor who is scheduled for abdominal perineal resection and notes that the primary health care provider has prescribed neomycin for the client. After discussing a prescription for neomycin with the nursing student who is caring for the client, the nurse determines that the student understands the rationale for administration if which statement is made? 1."The client is allergic to penicillin." 2."It will help to decrease the bacteria in the bowel." 3."It is given to prevent an immune dysfunction postoperatively." 4."It is given because the client has an infection that must be treated prior to surgery."

2."It will help to decrease the bacteria in the bowel."

A client scheduled for a skin biopsy is concerned and asks the nurse how painful the procedure is. Which statement is the appropriate response by the nurse? 1."There is no pain associated with this procedure." 2."The local anesthetic may cause a burning or stinging sensation." 3."A preoperative medication will be given so you will be sleeping and will not feel any pain." 4."There is some pain, but the primary health care provider will prescribe an opioid analgesic after the procedure."

2."The local anesthetic may cause a burning or stinging sensation."

The nurse is caring for a client with leukemia who is receiving intravenous chemotherapy. The nurse reviews the laboratory results and notes that the white blood cell count is 2000 mm3 (2 × 109/L), the platelet count is 150,000 mm3 (150 × 109/L), the clotting time is 10 minutes, and the ammonia level is 20 mcg/dL (12 mcmol/L). Which nursing action would be appropriate? 1.Place the client on bleeding precautions. 2.Place the client on neutropenic precautions. 3.Remove the rectal thermometer from the client's room. 4.Instruct the dietary department to eliminate all proteins from the client's diet.

2.Place the client on neutropenic precautions.

The nurse should be prepared to institute bleeding precautions in the client receiving antineoplastic medication if which result was reported from the laboratory? 1.Clotting time 12 seconds 2.Platelet count 50,000 mm3 (50 × 109/L) 3.Ammonia level 28 mcg/dL (16.8 mcmol/L) 4.White blood cell (WBC) count 4500 mm3 (4.5 × 109/L)

2.Platelet count 50,000 mm3 (50 × 109/L)

The nurse is reviewing the laboratory test results for a client with a diagnosis of leukemia who is receiving chemotherapy. The nurse notes that the client's platelet count is 20,000 mm3 (200 × 109/L). The nurse should prepare to implement which action based on this finding? 1.Remove the fresh flowers from the client's room. 2.Remove the rectal thermometer from the client's room. 3.Instruct family members to wear a mask when entering the client's room. 4.Call the dietary department to report that the client will be on a low-bacteria diet.

2.Remove the rectal thermometer from the client's room.

The nurse is reviewing the laboratory test results for a client receiving chemotherapy. The nurse notes that the white blood cell count is extremely low and places the client on neutropenic precautions. Which interventions are components of these types of precautions? Select all that apply. 1.Allowing only fresh fruits in the client's room 2.Removing fresh-cut flowers from the client's room 3.Encouraging the client to eat any types of fresh vegetables 4.Instructing family members on the proper technique for hand washing 5.Instructing family members to wear a mask when entering the client's room

2.Removing fresh-cut flowers from the client's room 4.Instructing family members on the proper technique for hand washing 5.Instructing family members to wear a mask when entering the client's room

The nurse is teaching a group of adults about the warning signs of cancer. Which signs and symptoms should the nurse mention to the group? Select all that apply. 1.Areas of alopecia 2.Sores that do not heal 3.Nagging cough or hoarseness 4.Indigestion or difficulty swallowing 5.Change in bowel or bladder habits 6.Absence or decreased frequency of menses

2.Sores that do not heal 3.Nagging cough or hoarseness 4.Indigestion or difficulty swallowing 5.Change in bowel or bladder habits

A client with laryngeal cancer has undergone laryngectomy and is now receiving external radiation therapy to the head and neck. The nurse should monitor the client for which side and adverse effects of external radiation? Select all that apply. 1.Cystitis 2.Stomatitis 3.Dysgeusia 4.Leukopenia 5.Xerostomia 6.Thrombocytopenia

2.Stomatitis 3.Dysgeusia 5.Xerostomia

The nurse is preparing to care for a client with a diagnosis of metastatic cancer. The nurse notes documentation in the client's chart that the client is experiencing cachexia. Which should the nurse expect to note on assessment of the client? 1.Elevated blood pressure and ascites 2.Sunken eyes and a hollow cheek appearance 3.Periorbital edema and swelling around the ears 4.Generalized edema and the presence of weight gain

2.Sunken eyes and a hollow cheek appearance

A 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 which condition? 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.The development of a vesicovaginal fistula

A client has undergone abdominal perineal resection for a bowel tumor. The nurse interprets that the client's colostomy is beginning to function if which sign is noted? 1.Absent bowel sounds 2.The passage of flatus 3.Blood drainage from the colostomy 4.The client's ability to tolerate food

2.The passage of flatus

The community health nurse is preparing an educational session for a group of women and will be discussing the primary prevention strategies and treatment measures for breast cancer. What information should the nurse include in the educational session? 1.Older women are more likely to get mammograms. 2.Treatment decisions are based on a woman's overall health. 3.Women younger than age 65 are more likely to get breast cancer. 4.A woman's age is the main factor used to decide which screening methods to use.

2.Treatment decisions are based on a woman's overall health.

The nurse is providing discharge instructions to a client who has undergone treatment of cervical cancer with a radiation (cesium) implant. Which instruction should the nurse provide to the client? 1.Avoid douching for at least 1 year. 2.Use a vaginal dilator 3 times a week. 3.Sexual activity can be resumed in about 2 months. 4.Bed rest is recommended for at least 1 week after discharge.

2.Use a vaginal dilator 3 times a week.

The health education nurse provides instructions to a group of clients regarding measures that will assist in preventing skin cancer. Which instructions should the nurse provide? Select all that apply. 1.Sunscreen should be applied every 8 hours. 2.Use sunscreen when participating in outdoor activities. 3.Wear a hat, opaque clothing, and sunglasses when in the sun. 4.Avoid sun exposure in the late afternoon and early evening hours. 5.Examine your body monthly for any lesions that may be suspicious.

2.Use sunscreen when participating in outdoor activities. 3.Wear a hat, opaque clothing, and sunglasses when in the sun. 5.Examine your body monthly for any lesions that may be suspicious.

The nurse conducted discharge teaching for the client diagnosed with melanoma. Which statement by a client indicates that education was effective? 1."It is contagious." 2."Metastasis is rare." 3."It is highly metastatic." 4."It is characterized by local invasion."

3."It is highly metastatic."

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

3. Periorbital edema

The nurse in the ambulatory care unit is providing home care instructions to a client after cryotherapy for the treatment of malignant skin lesions. Which statement would be most appropriate for the nurse to include in the home care instructions for this client? 1."Apply ice to the site to prevent swelling." 2."Clean the site with alcohol 3 times daily." 3."Apply a warm, damp washcloth if discomfort occurs." 4."Avoid showering or taking baths until seen by the primary health care provider in 1 week."

3."Apply a warm, damp washcloth if discomfort occurs."

A client calls the ambulatory care clinic and tells the nurse that she found an area that looks like the peel of an orange when performing breast self-examination (BSE) but found no other changes. What is the nurse's best response to this client? 1."Good job performing your BSE. I am sure that is nothing to be concerned about." 2."Make sure you tell the primary health care provider about your finding at the next regularly scheduled visit." 3."I am glad you called to report this finding. Can you come to the clinic to see your primary health care provider tomorrow?" 4."Do you have a thermometer? You need to take your temperature and call back if you have a fever over 101º F (38.3º C)."

3."I am glad you called to report this finding. Can you come to the clinic to see your primary health care provider tomorrow?"

The nurse is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care? 1."I change my pouch every week." 2."I change the appliance in the morning." 3."I empty the urinary collection bag when it is two-thirds full." 4."When I'm in the shower I direct the flow of water away from my stoma."

3."I empty the urinary collection bag when it is two-thirds full."

The nurse is providing instructions to the client who is receiving external radiation therapy. Which statement, if made by the client, indicates the need for further instruction? 1."I will dry affected areas with patting motions." 2."I will wear soft clothing over the affected site." 3."I will use a washcloth to wash the affected area." 4."I need to make sure I carry my purse on the unaffected side."

3."I will use a washcloth to wash the affected area."

As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which statement? 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."I'm going to take aspirin for my headache as soon as I get home."

A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication. When implementing the plan, the nurse should make which statement to the client? 1."You can take aspirin as needed for headache." 2."You can drink beverages containing alcohol in moderate amounts each evening." 3."You need to consult with the primary health care provider (PHCP) before receiving immunizations." 4."It is fine to receive a flu vaccine at the local health fair without PHCP approval because the flu is so contagious."

3."You need to consult with the primary health care provider (PHCP) before receiving immunizations."

The nurse is caring for a client with cancer of the prostate who has undergone a prostatectomy. Which action should the nurse include in discharge instructions? 1.Avoid driving the car for a few days. 2.Restrict fluid intake to prevent incontinence. 3.Avoid lifting objects heavier than 20 lb (9 kg) for at least 6 weeks. 4.Notify the primary health care provider if small blood clots are noticed during urination.

3.Avoid lifting objects heavier than 20 lb (9 kg) for at least 6 weeks.

The nurse is caring for a chemotherapy client with a low platelet aggregation level. Which likely caused this decreased platelet production? 1.Anemia 2.Thrombocytopenia 3.Bone marrow suppression 4.Low hemoglobin and hematocrit (H&H) counts

3.Bone marrow suppression

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

3.Change position every 15 minutes.

Which interventions are the most appropriate for a client who is experiencing thrombocytopenia? Select all that apply. 1.Use a straight-edge razor for shaving. 2.Obtain a rectal temperature every 8 hours. 3.Check secretions for frank or occult blood. 4.Give vitamin K by the intramuscular route. 5.Encourage fluid intake to avoid constipation. 6.Provide oral sponges or a soft toothbrush for oral care.

3.Check secretions for frank or occult blood. 5.Encourage fluid intake to avoid constipation. 6.Provide oral sponges or a soft toothbrush for oral care.

The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy? 1.Anemia 2.Decreased platelets 3.Increased uric acid level 4.Decreased leukocyte count

3.Increased uric acid level

A community health nurse is providing an educational session on cancer of the cervix for women living in the community. The nurse informs the community residents that which is an early sign of this type of cancer? 1.Abdominal pain 2.Constant and profuse bleeding 3.Irregular vaginal bleeding or spotting 4.Dark and foul-smelling vaginal drainage

3.Irregular vaginal bleeding or spotting

A client seeks treatment in an ambulatory clinic for a complaint of hoarseness that has lasted for 6 weeks. On the basis of this symptom, the nurse should consider developing a plan of care for which possible medical diagnosis? 1.Thyroid cancer 2.Acute laryngitis 3.Laryngeal cancer 4.Bronchogenic cancer

3.Laryngeal cancer

Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administering chemotherapy? 1.Measure the client's abdominal girth. 2.Calculate the client's body mass index. 3.Measure the client's current weight and height. 4.Ask the client about his or her weight and height.

3.Measure the client's current weight and height.

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

3.Periorbital edema

The nurse monitoring an oncological client assesses for which early sign of vena cava syndrome? 1.Cyanosis 2.Arm edema 3.Periorbital edema 4.Mental status changes

3.Periorbital edema

The clinic nurse prepares instructions for a client diagnosed with leukemia who developed stomatitis after the administration of a course of antineoplastic medications. The nurse should provide the client with which instruction? 1.Avoid foods and fluids for the next 12 to 24 hours. 2.Swab the mouth with lemon and glycerin 4 times a day. 3.Rinse the mouth with a diluted solution of baking soda or saline. 4.Brush the teeth with a stiff-bristled toothbrush, and use dental floss 3 times a day.

3.Rinse the mouth with a diluted solution of baking soda or saline.

A client is receiving external radiation to the neck for cancer of the larynx. Which is the most likely expected effect? 1.Dyspnea 2.Diarrhea 3.Sore throat 4.Constipation

3.Sore throat

The nurse in the primary health care provider's office is performing a postoperative assessment of a client who underwent mastectomy of her right breast 2 weeks ago. The client tells the nurse that she is very concerned because she has numbness in the area of the surgery and along the inner side of the arm from the armpit to the elbow. The nurse should provide which information to the client about her complaint? 1.These sensations are signs of a complication. 2.These sensations probably will be permanent. 3.These sensations dissipate over several months and usually resolve after 1 year. 4.It is nothing to worry about because most women who have this type of surgery experience this problem.

3.These sensations dissipate over several months and usually resolve after 1 year.

The nurse has instructed the client in the correct technique for breast self-examination (BSE). For a portion of the examination, the client will lie down. The nurse should teach the client to put the pillow in which location for self-examination of the right breast? 1.Under the left scapula 2.Under the left shoulder 3.Under the right shoulder 4.Under the small of the back

3.Under the right shoulder

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

4. Abdominal distention

The 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 is a late sign or symptom of this oncological emergency? 1. Headache 2. Dysphagia 3. Constipation 4. Electrocardiographic changes

4. Electrocardiographic changes

A 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. Enlarged lymph nodes

The nurse is monitoring a client with chronic lymphocytic leukemia (CLL). Which sign should the nurse specifically monitor for and report to the primary health care provider? 1.Anemia 2.Bleeding 3.Pancytopenia 4.Lymphadenopathy

4. Lymphadenopathy

A client has been hospitalized for removal of a cervical radiation implant used to treat cancer. The implant is removed, and the nurse provides home care instructions to the client. Which statement made by the client indicates a need for further instruction? 1."Cream may be used to relieve dryness or itching." 2."Some vaginal bleeding is expected for 1 to 3 months." 3."Sexual intercourse may be resumed after 7 to 10 days." 4."Foul-smelling vaginal discharge is a sign of an infection."

4."Foul-smelling vaginal discharge is a sign of an infection."

The nurse has provided instructions to a client receiving external radiation therapy. Which client statement would indicate a need for further instruction regarding self-care related to the radiation therapy? 1."I need to eat a high-protein diet." 2."I need to avoid exposure to sunlight." 3."I need to wash my skin with a mild soap and pat dry." 4."I need to apply pressure on the irritated area by wearing snug clothing to prevent bleeding."

4."I need to apply pressure on the irritated area by wearing snug clothing to prevent bleeding."

The nurse teaches skin care to a client receiving external radiation therapy. Which client statement indicates the need for further instruction? 1."I will handle the area gently." 2."I will wear loose-fitting clothing." 3."I will avoid the use of deodorants." 4."I will limit sun exposure to 1 hour daily."

4."I will limit sun exposure to 1 hour daily."

The nurse is reviewing the discharge instructions for the client who had a skin biopsy. Which statement, if made by the client, would indicate a need for further instruction? 1."I will keep the dressing dry." 2."I will watch for any drainage from the wound." 3."I will use the antibiotic ointment as prescribed." 4."I will return tomorrow to have the sutures removed."

4."I will return tomorrow to have the sutures removed."

The nurse has provided instructions to the mother of a child with sickle cell disease regarding measures that will prevent a sickle cell crisis. Which client statement indicates an understanding of these measures? 1."My child needs to avoid any exercise." 2."My child needs to avoid increasing any fluid intake." 3."My child needs to avoid going outdoors in warm weather." 4."My child needs to avoid situations that may lead to an infection."

4."My child needs to avoid situations that may lead to an infection."