Oncology NCLEX practice questions copy

28. 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.

a. She should have had a baseline mammogram before age 30. A low-fat diet has been found to decrease a woman's risk of breast cancer. A baseline mammogram should be done between ages 30 and 40. Monthly breast self-examinations should be done between days 7 and 10 of the menstrual cycle.

When developing a plan of care that includes interventions aimed at preventing complications of a low platelet count in a child with leukemia, which of the following is most appropriate? A. Consulting with a physician about the use of a stool softener. B. Placing the child in protective isolation. C. Using heparin instead of saline to flush an intermittent IV access device. D. Eliminating raw vegetables and fruits from the child's diet.

A. Consulting with a physician about the use of a stool softener.

The most common symptom associated with bladder cancer is: A. Painless hematuria. B. Decreasing urine output. C. Burning on urination. D. Frequent infections.

A. Painless hematuria.

Risk factors for the development of breast cancer include: A. Early menopause (before age 40). B. Early onset of menstruation. C. Having had more than two children. D. Breast-feeding.

B. Early onset of menstruation. A family history of breast cancer, early onset of menstruation, delayed onset of menopause, and childlessness all appear to increase a woman's risk of breast cancer.

A 52-year-old female tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client's lump is cancerous? A. Eversion of the right nipple and a mobile mass B. Nonmobile mass with irregular edges C. Mobile mass that is soft and easily delineated D. Nonpalpable right axillary lymph nodes

B. Nonmobile mass with irregular edges

The client undergoing whole-body radiation for Hodgkin's disease may have destruction of bone marrow, making it unable to function normally. As a result of this, the nurse would expect the client to develop: A. Increased blood viscosity B. Increased tendency for fractures C. Decreased number of erythrocytes D. Decreased susceptibility to infections

C. Decreased number of erythrocytes Depression of the bone marrow interferes with hemopoiesis and results in anemia

After a mastectomy for breast cancer, the nurse teaches the client how to avoid the development of lymphedema. Which of the following instructions would be included? A. Applying an elastic bandage to the affected extremity. B. Limiting range-of-motion exercises in the shoulder and elbow. C. Elevating the affected arm on a pillow. D. Taking diuretics as necessary to decrease swelling.

C. Elevating the affected arm on a pillow. The client should be taught to elevate the affected arm on a pillow to promote venous return and lymphatic drainage of the area

The nurse caring for a child with leukemia should place priority on: A. Preventing injury. B. Monitoring the child's platelet count. C. Monitoring the child's temperature. D. Encouraging increased fluid intake.

C. Monitoring the child's temperature.

A nurse is performing an assessment on a 10-year-old child suspected of having Hodgkin's disease. The nurse understands that which data are most characteristic of this disease? A. Painful, enlarged inguinal lymph nodes B. Fever and malaise C. Painless, firm, movable adenopathy in the cervical area D. Anorexia and weight loss

C. Painless, firm, movable adenopathy in the cervical area

A client with carcinoma of the tonsils and enlarged lymph glands in the neck is receiving chemotherapy following surgery. The nurse, recognizing the effects of therapy, should check the client's laboratory reports, especially the: A. Platelet count B. Red blood cell count C. White blood cell count D. Hematocrit and hemoglobin

C. White blood cell count

A client who is newly diagnosed with multiple myeloma asks the physician what treatment will be necessary. The nurse should expect the physician to reply: A. "Human leukocyte interferon therapy." B. "Radiotherapy on an outpatient basis." C. "Surgery to remove the lesion and lymph nodes." D. "Chemotherapy employing a combination of drugs."

D. "Chemotherapy employing a combination of drugs." Multiple myeloma is a diffuse disorder of the bone and no single lesion can be removed.

When teaching a client about the diet following a Whipple procedure performed for cancer of the pancreas, the nurse should include the statement: A. "There are no dietary restrictions; you may eat what you desire." B. "Your diet should be low in calories to prevent taxing your diseased pancreas." C. "Meals should be restricted in protein because of your compromised liver function." D. "Low-fat meals should be eaten because of interference with your fat digestion mechanism."

D. "Low-fat meals should be eaten because of interference with your fat digestion mechanism."

1. Which of the following positions is the one of choice for palpating tissues during breast self-examination? A. Sitting in a chair with a pillow under both shoulders to elevate the chest. B. Standing facing a mirror. C. Flat on the back with a pillow under the head and arms raised over the head. D. Flat on the back with a pillow under the shoulder of the side being examined

D. Flat on the back with a pillow under the shoulder of the side being examined

The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse notes that the platelet count is 20,000 cells/µl. Based on this laboratory result, which intervention will the nurse document in the plan of care? A. Initiate protective isolation precautions. B. Monitor the temperature every 4 hours. C. Monitor closely for signs of infection. D. Use a soft small toothbrush for mouth care.

D. Use a soft small toothbrush for mouth care. If a child is severely thrombocytopenic and has a platelet count less than 20,000 cells/µl, precautions need to be taken because of the increased risk of bleeding. The precautions include limiting activity that could result in head injury, using soft toothbrushes or Toothettes, checking urine and stools for blood, and administering stool softeners to prevent straining with constipation. In addition, suppositories and rectal temperatures are avoided.

4. 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. Radiation therapy may cause fatigue, skin toxicities, and anorexia regardless of the treatment site. Hair loss, stomatitis, and vomiting are site-specific, not generalized, adverse effects of radiation therapy.

5. 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. Fine needle aspiration and biopsy provide cells for histologic examination to confirm a diagnosis of cancer.

1. 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 Anaplasia presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin. Hyperplasia an increase in number of normal cells in a normal arrangement Metaplasia replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found

11. 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 Weight loss is an indication of colorectal cancer.

An 8-year-old child, admitted to the hospital for intrathecal methotrexate chemotherapy, is prescribed allopurinol (Zyloprim) and asks the nurse why this medication has to be taken. The nurse's best response would be: A. "Because this pill helps the other medicines get rid of the things making you sick." B. "To protect your body from developing other problems after your treatment has been stopped." C. "To stop your sick white cells from going to other parts of your body where they can cause problems." D. "Because your doctor ordered it. Your doctor would not order anything for you unless it was very important."

A. "Because this pill helps the other medicines get rid of the things making you sick."

Upon admission of a four-year-old child to rule out leukemia, the parents ask the nurse when they will know the diagnosis. The nurse's response is based on the knowledge that the results of which of the following confirms leukemia? A. Bone marrow aspiration B. Complete blood count (CBC) C. Lumbar puncture D. Peripheral blood smear

A. Bone marrow aspiration

Select the nursing interventions that will implemented in the care of a child with leukemia who is at risk for infection. Select All That Apply A. Maintain the child in a private room B. Apply firm pressure to a needlestick area for at least 10 minutes C. Reduce exposure to environmental organisms D. Ensure that anyone entering the child's room wears a mask E. Use strict aseptic technique for all procedures F. Frequent and thorough handwashing G. Avoid rectal suppositories, enemas, and the use of rectal thermometers

A. Maintain the child in a private room D. Ensure that anyone entering the child's room wears a mask E. Use strict aseptic technique for all procedures F. Frequent and thorough handwashing

The laboratory results of a client following chemotherapy for cancer indicate bone marrow depression. The nurse should encourage the client to: A. Use an electric razor when shaving B. Drink citrus juices frequently for nourishment C. Sleep with the head of the bed slightly elevated D. Increase activity levels and ambulate frequently

A. Use an electric razor when shaving Suppression of bone marrow increases bleeding susceptibility associated with decreased platelets.

Which of the following may a parent notice in a child with early retinoblastoma? A. White appearing in the lens B. Protruding eyes C. Blindness D. Inflamed conjunctiva

A. White appearing in the lens

Which of the following is an early sign of laryngeal cancer? A. Difficulty swallowing. B. Persistent mild hoarseness. C. Chronic foul breath. D. Nagging unproductive cough.

B. Persistent mild hoarseness.

Which of the following would the nurse teach the mother of a child with leukemia who has an absolute neutrophil count of 900/mm³? A. The child should wear gloves when in contact with others. B. The child should stay away from crowds of people. C. Anyone in direct contact with the child must wear a gown and mask. D. The child should eat raw fruits and vegetables.

B. The child should stay away from crowds of people.

The nurse understands that that Hodgkin's disease is suspected when a client presents with a painless, swollen lymph node. Hodgkin's disease typically affects people in which age group? A. Children (ages 6 to 12 years). B. Teenagers (ages 13 to 20 years). C. Young adults (ages 21 to 40 years). D. Older adults (ages 41 to 50 years).

C. Young adults (ages 21 to 40 years).

The nurse is developing a teaching plan for a client who has just been diagnosed with breast cancer. The nurse should include information about which medication? A. acetaminophen (Tylenol) B. dopamine (Intropin) C. tamoxifen (Nolvadex) D. progesterone (Gesterol 50)

C. tamoxifen (Nolvadex) Tamoxifen is an estrogen blocker used to treat both premenopausal and postmenopausal breast cancer and to prevent breast cancer in certain women who are at high risk.

12. 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. "Women older than age 40 should have a mammogram annually

14. 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 Thrombocytopenia impairs blood clotting, the nurse should inspect the client regularly for signs of bleeding, such as petechiae, purpura, epistaxis, and bleeding gums. The nurse should avoid administering aspirin because it may increase the risk of bleeding. .

22. 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 To decrease the pain of stomatitis, the nurse should provide a solution of hydrogen peroxide and water for the client to use as a mouth rinse. (Commercially prepared mouthwashes contain alcohol and may cause dryness and irritation of the oral mucosa.) The nurse also may administer viscous lidocaine or systemic analgesics as prescribed.

21. 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

8. 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.

7. 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 Chemotherapy commonly causes nausea and vomiting, which may lead to fluid and electrolyte imbalances. Signs of fluid loss include dry oral mucous membranes, cracked lips, decreased urine output (less than 40 ml/hour), abnormally low blood pressure, and a serum potassium level below 3.5 mEq/L.

9. 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 Other risk factors - frequent sexual intercourse before age 16, multiple sex partners, and multiple pregnancies.