oncology nclex
Which intervention is appropriate for the nurse caring for a male client in severe pain receiving a continuous I.V. infusion of morphine? a. Assisting with a naloxone challenge test before therapy begins b. Discontinuing the drug immediately if signs of dependence appear c. Changing the administration route to P.O. if the client can tolerate fluids d. Obtaining baseline vital signs before administering the first dose
d. Obtaining baseline vital signs before administering the first dose
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 doesn't guess at prognosis." c. "Client uses any effective method to reduce tension." d. "Client stops seeking information."
a. "Client verbalizes feelings of anxiety."
A male client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis may be appropriate for this client? a. Anticipatory grieving b. Impaired swallowing c. Disturbed body image d. Chronic low self-esteem
a. Anticipatory grieving
What should a male client over age 52 do to help ensure early identification of prostate cancer? a. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly. b. Have a transrectal ultrasound every 5 years. c. Perform monthly testicular self-examinations, especially after age 50. d. Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly.
a. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly.
The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for? a. Actinic b. Asymmetry c. Arcus d. Assessment
b. Asymmetry
For a female client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the plan of care? a. Administering aspirin if the temperature exceeds 102° F (38.8° C) b. Inspecting the skin for petechiae once every shift c. Providing for frequent rest periods d. Placing the client in strict isolation
b. Inspecting the skin for petechiae once every shift
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. Stand as far away from the implant as possible and call for help. b. Pick up the implant with long-handled forceps and place it in a lead-lined container. c. Leave the room and notify the radiation therapy department immediately. d. Put the implant back in place, using forceps and a shield for self-protection, and call for help.
b. Pick up the implant with long-handled forceps and place it in a lead-lined container.
Nurse Amy is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society guidelines, the nurse should recommend that the women: a. perform breast self-examination annually. b. have a mammogram annually. c. have a hormonal receptor assay annually. d. have a physician conduct a clinical examination every 2 years.
b. have a mammogram annually.
A 35 years old client with ovarian cancer is prescribed hydroxyurea (Hydrea), an antimetabolite drug. Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. The mechanism of action of antimetabolites interferes with: a. cell division or mitosis during the M phase of the cell cycle. b. normal cellular processes during the S phase of the cell cycle. c. the chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (cell cycle-nonspecific). d. one or more stages of ribonucleic acid (RNA) synthesis, DNA synthesis, or both (cell cycle-nonspecific).
b. normal cellular processes during the S phase of the cell cycle.
When caring for a male client diagnosed with a brain tumor of the parietal lobe, the nurse expects to assess: a. short-term memory impairment. b. tactile agnosia. c. seizures. d. contralateral homonymous hemianopia.
b. tactile agnosia.
Nurse Brian is developing a plan of care for marrow suppression, the major dose-limiting adverse reaction to floxuridine (FUDR). How long after drug administration does bone marrow suppression become noticeable? a. 24 hours b. 2 to 4 days c. 7 to 14 days d. 21 to 28 days
c. 7 to 14 days
A female client is undergoing tests for multiple myeloma. Diagnostic study findings in multiple myeloma include: a. a decreased serum creatinine level. b. hypocalcemia. c. Bence Jones protein in the urine. d. a low serum protein level.
c. Bence Jones protein in the urine.
A male client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer? a. Persistent nausea b. Rash c. Indigestion d. Chronic ache or pain
c. Indigestion
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. White, cottage cheese-like patches on the tongue b. Yellow tooth discoloration c. Red, open sores on the oral mucosa d. Rust-colored sputum
c. Red, open sores on the oral mucosa
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 visual field deficits b. Related to difficulty swallowing c. Related to impaired balance d. Related to psychomotor seizures
c. Related to impaired balance
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.
c. changes from previous self-examinations.
A male client undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should include which instruction? a. "Keep the stoma uncovered." b. "Keep the stoma dry." c. "Have a family member perform stoma care initially until you get used to the procedure." d. "Keep the stoma moist."
d. "Keep the stoma moist."
A male client has an abnormal result on a Papanicolaou test. After admitting, he 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
d. Alteration in the size, shape, and organization of differentiated cells
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
d. Dry oral mucous membranes and cracked lips
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. Onset of sporadic sexual activity at age 17 b. Spontaneous abortion at age 19 c. Pregnancy complicated with eclampsia at age 27 d. Human papillomavirus infection at age 32
d. Human papillomavirus infection at age 32
A 33-year-old patient has recently been diagnosed with stage II cervical cancer. What should the nurse understand about the patient's cancer? A. It is in situ. B. It has metastasized. C. It has spread locally. D. It has spread extensively.
C. It has spread locally.
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.
c. fatigue.
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.
c. fine needle aspiration.
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. probenecid (Benemid) b. cytarabine (ara-C, cytosine arabinoside [Cytosar-U]) c. thioguanine (6-thioguanine, 6-TG) d. leucovorin (citrovorum factor or folinic acid [Wellcovorin])
d. leucovorin (citrovorum factor or folinic acid [Wellcovorin])
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. Hemorrhoids c. Weight gain d. Polyps
d. Polyps
The nurse is preparing for a female client for magnetic resonance imaging (MRI) to confirm or rule out a spinal cord lesion. During the MRI scan, which of the following would pose a threat to the client? a. The client lies still. b. The client asks questions. c. The client hears thumping sounds. d. The client wears a watch and wedding band.
d. The client wears a watch and wedding band.
The patient and his family are upset that the patient is going through procedures to diagnose cancer. What nursing actions should the nurse use first to facilitate their coping with this situation (select all that apply)? A. Maintain hope. B. Exhibit a caring attitude. C. Plan realistic long-term goals. D. Give them antianxiety medications. E. Be available to listen to fears and concerns. F. Teach them about all the types of cancer that could be diagnosed.
A. Maintain hope. B. Exhibit a caring attitude. E. Be available to listen to fears and concerns.
The nurse is teaching a wellness class to a group of women at their workplace. The nurse knows that which woman is at highest risk for developing cancer? A. A woman who obtains regular cancer screenings and consumes a high-fiber diet B. A woman who has a body mass index of 35 kg/m2 and smoked cigarettes for 20 years C. A woman who exercises five times every week and does not consume alcoholic beverages D. A woman who limits fat consumption and has regular mammography and Pap screenings
B. A woman who has a body mass index of 35 kg/m2 and smoked cigarettes for 20 years
What can the nurse do to facilitate cancer prevention for the patient in the promotion stage of cancer development? A. Teach the patient to exercise daily. B. Teach the patient promoting factors to avoid. C. Tell the patient to have the cancer surgically removed now. D. Teach the patient which vitamins will improve the immune system. Incorrect
B. Teach the patient promoting factors to avoid.
The patient is receiving an IV vesicant chemotherapy drug. The nurse notices swelling and redness at the site. What should the nurse do first? A. Ask the patient if the site hurts. B. Turn off the chemotherapy infusion. C. Call the ordering health care provider. D. Administer sterile saline to the reddened area.
B. Turn off the chemotherapy infusion.
When caring for the patient with cancer, what does the nurse understand as the response of the immune system to antigens of the malignant cells? A. Metastasis B. Tumor angiogenesis C. Immunologic escape D. Immunologic surveillance
D. Immunologic surveillance
Which nursing diagnosis is most appropriate for a patient experiencing myelosuppression secondary to chemotherapy for cancer treatment? A. Acute pain B. Hypothermia C. Powerlessness D. Risk for infection
D. Risk for infection
The nurse assesses a 76-year-old man with chronic myeloid leukemia receiving nilotinib (Tasigna). It is most important for the nurse to ask which question? A. "Have you had a fever?" B. "Have you lost any weight?" C. "Has diarrhea been a problem?" D. "Have you noticed any hair loss?"
A. "Have you had a fever?"
Previous administrations of chemotherapy agents to a cancer patient have resulted in diarrhea. Which dietary modification should the nurse recommend? A. A bland, low-fiber diet B. A high-protein, high-calorie diet C. A diet high in fresh fruits and vegetables D. A diet emphasizing whole and organic foods
A. A bland, low-fiber diet
The laboratory reports that the cells from the patient's tumor biopsy are Grade II. What should the nurse know about this histologic grading? A. Cells are abnormal and moderately differentiated. B. Cells are very abnormal and poorly differentiated. C. Cells are immature, primitive, and undifferentiated. D. Cells differ slightly from normal cells and are well-differentiated
A. Cells are abnormal and moderately differentiated.
The patient has osteosarcoma of the right leg. The unlicensed assistive personnel (UAP) reports that the patient's vital signs are normal, but the patient says he still has pain in his leg and it is getting worse. What assessment question should the nurse ask the patient to determine treatment measures for this patient's pain? A. "Where is the pain?" B. "Is the pain getting worse?" C. "What does the pain feel like?" D. "Do you use medications to relieve the pain?"
C. "What does the pain feel like?"
A 70-year-old man who has end-stage lung cancer is admitted to the hospital with confusion and oliguria for 2 days. Which finding would the nurse report immediately to the health care provider? A. Weight gain of 2 lb D. Urine specific gravity of 1.015 C. Blood urea nitrogen of 20 mg/dL D. Serum sodium level of 118 mEq/L
D. Serum sodium level of 118 mEq/L
The female patient is having whole brain radiation for brain metastasis. She is concerned about how she will look when she loses her hair. What is the best response by the nurse to this patient? A. "When your hair grows back it will be patchy." B. "Don't use your curling iron and that will slow down the loss." C. "You can get a wig now to match your hair so you will not look different." D. "You should contact "Look Good, Feel Better" to figure out what to do about this.
C. "You can get a wig now to match your hair so you will not look different."
The patient was told that he would have intraperitoneal chemotherapy. He asks the nurse when the IV will be started for the chemotherapy. What should the nurse teach the patient about this type of chemotherapy delivery? A. It is delivered via an Ommaya reservoir and extension catheter. B. It is instilled in the bladder via a urinary catheter and retained for 1 to 3 hours. C. A Silastic catheter will be percutaneously placed into the peritoneal cavity for chemotherapy administration. D. The arteries supplying the tumor are accessed with surgical placement of a catheter connected to an infusion pump.
C. A Silastic catheter will be percutaneously placed into the peritoneal cavity for chemotherapy administration.
The patient with breast cancer is having teletherapy radiation treatments after her surgery. What should the nurse teach the patient about the care of her skin? A. Use Dial soap to feel clean and fresh. B. Scented lotion can be used on the area. C. Avoid heat and cold to the treatment area. D. Wear the new bra to comfort and support the area.
C. Avoid heat and cold to the treatment area.
The nurse is caring for a patient receiving an initial dose of chemotherapy to treat a rapidly growing metastatic colon cancer. The nurse is aware that this patient is at risk for tumor lysis syndrome (TLS) and will monitor the patient closely for which abnormality associated with this oncologic emergency? A. Hypokalemia B. Hypouricemia C. Hypocalcemia D. Hypophosphatemia
C. Hypocalcemia
The patient is told that the adenoma tumor is not encapsulated but has normally differentiated cells and that surgery will be needed. The patient asks the nurse what this means. What should the nurse tell the patient? A. It will recur. B. It has metastasized. C. It is probably benign. D. It is probably malignant.
C. It is probably benign.
A 64-year-old male patient who is receiving radiation to the head and neck as treatment for an invasive malignant tumor complains of mouth sores and pain. Which intervention should the nurse add to this patient's plan of care? A. Weigh the patient every month to monitor for weight loss. B. Cleanse the mouth every 2 to 4 hours with hydrogen peroxide. C. Provide high-protein and high-calorie, soft foods every 2 hours. D. Apply palifermin (Kepivance) liberally to the affected oral mucosa.
C. Provide high-protein and high-calorie, soft foods every 2 hours.
The nurse is caring for an 18-year-old female patient with acute lymphocytic leukemia who is scheduled to receive hematopoietic stem cell transplantation (HSCT). Which statement, if made by the patient, indicates a correct understanding of the procedure? A. "After the transplant I will feel better and can go home in 5 to 7 days." B. "I understand the transplant procedure has no dangerous side effects." C. "My brother will be a 100% match for the cells used during the transplant." D. "Before the transplant I will have chemotherapy and possibly full body radiation."
D. "Before the transplant I will have chemotherapy and possibly full body radiation."
Which item would be most beneficial when providing oral care to a patient with metastatic cancer who is at risk for oral tissue injury secondary to chemotherapy? A. Firm-bristle toothbrush B. Hydrogen peroxide rinse C. Alcohol-based mouthwash D. 1 tsp salt in 1 L water mouth rinse
D. 1 tsp salt in 1 L water mouth rinse
The patient is receiving biologic and targeted therapy for ovarian cancer. What medication should the nurse expect to administer before therapy to combat the most common side effects of these medications? A. Morphine sulfate B. Ibuprofen (Advil) C. Ondansetron (Zofran) D. Acetaminophen (Tylenol)
D. Acetaminophen (Tylenol)
The nurse is caring for a patient suffering from anorexia secondary to chemotherapy. Which strategy would be most appropriate for the nurse to use to increase the patient's nutritional intake? A. Increase intake of liquids at mealtime to stimulate the appetite. B. Serve three large meals per day plus snacks between each meal. C. Avoid the use of liquid protein supplements to encourage eating at mealtime. D. Add items such as skim milk powder, cheese, honey, or peanut butter to selected foods
D. Add items such as skim milk powder, cheese, honey, or peanut butter to selected foodS
The patient is being treated with brachytherapy for cervical cancer. What factors must the nurse be aware of to protect herself when caring for this patient? A. The medications the patient is taking B. The nutritional supplements that will help the patient C. How much time is needed to provide the patient's care D. The time the nurse spends at what distance from the patient
D. The time the nurse spends at what distance from the patient
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. Liver b. Colon c. Reproductive tract d. White blood cells (WBCs)
a. Liver
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. Vision changes b. Hearing loss c. Headache d. Anorexia
a. Vision changes
Nurse Lucia is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms: a. yearly after age 40. b. after the birth of the first child and every 2 years thereafter. c. after the first menstrual period and annually thereafter. d. every 3 years between ages 20 and 40 and annually thereafter.
a. yearly after age 40.
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. Recommending that the client discontinue chemotherapy b. Providing a solution of hydrogen peroxide and water for use as a mouth rinse c. Monitoring the client's platelet and leukocyte counts d. Checking regularly for signs and symptoms of stomatitis
b. Providing a solution of hydrogen peroxide and water for use as a mouth rinse
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 have had a baseline mammogram before age 30. b. She should eat a low-fat diet to further decrease her risk of breast cancer. c. She should perform breast self-examination during the first 5 days of each menstrual cycle. d. When she begins having yearly mammograms, breast self-examinations will no longer be necessary.
b. She should eat a low-fat diet to further decrease her risk of breast cancer.
