1.
A
nurse is evaluating a client's understanding of teaching about changes to
expect following a bone
marrow transplant (BMT). Which statement by the
client indicates the client misunderstood the expected
changes?
1. "You can have weight gain from the side
effects of your steroid immunosuppressant medications."
2. "Sterility can occur from the destruction
of your own stem cells with chemotherapy and radiation."
3. "Cataracts may develop after total body
irradiation."
4. "Changes to the mouth include a white,
patchy
2.
Which
nursing diagnosis should have the highest priority
for a client experiencing superior vena cava
syndrome
secondary to lung cancer?
1. Ineffective breathing pattern
2. Ineffective tissue perfusion
3. Risk for infection
4. Impaired skin integrity
3.
Which
actions should a nurse initiate for a client
who had a left modified radical mastectomy (a total
mastectomy with axillary node dissection and
removal
of the lining over the pectoralis major muscle)?
1. Elevate the left arm above the head.
2. Insert all intravenous (IV) access sites on the
right
side.
3. Have the client view the incision site as soon
as
possible.
4. Initiate strengthening exercises of the left arm
within 24 hours of surgery.
4.
A
client diagnosed with Hodgkin’s lymphoma develops radiation pneumonitis 3
months after radiation
treatment. For which symptoms of radiation
pneumonitis should a nurse observe the client?
1. Tachypnea, hypotension, and fever
2. Cough, fever, and dyspnea
3. Bradypnea, cough, and decreased urine output
4. Cough, tachycardia, and altered mental status
5.
A
nurse assesses that a client, who is receiving radiation for cervical cancer,
continues to have diarrhea.
Which nursing advice is most appropriate for this
client?
1. Take sitz baths twice daily and eat a
low-residue
diet.
2. Drink fluids low in potassium and take frequent
tub baths.
3. Increase your intake of milk products and take
frequent showers.
4. Drink fluids high in sodium and apply
hydrocolloid dressings to reddened areas.
6.
When
caring for a client with epigastric pain and suspected gastric cancer, which
diagnostic test should a
nurse address with the client because it is the
specific
test used to diagnose the cancer?
1. Arthroscopy
2. Bronchoscopy
3. Colonoscopy
4. Esophagogastroduodenoscopy
7.
Which
nursing diagnosis should a nurse plan to document for the client with gastric
cancer experiencing
hematemesis?
1. Impaired oral mucous membrane
2. Decreased cardiac output
3. Impaired gas exchange
4. Fluid volume deficit
8.
Which
vaccine should a nurse recommend for
prevention of liver cancer?
1. Varicella vaccine
2. Hepatitis A vaccine
3. Meningococcal vaccine
4. Hepatitis B vaccine
9.
A
nurse counsels a family member of a cancer client
about the caregiving role. Which self-care activity
would help the family member cope with the
caregiver role?
1. Being open to technologies and ideas that
promote
a loved one’s dependence
2. Trusting that you are doing the right thing and
staying focused on your loved one
3. Grieving over losing personal time for self or
care
of other family members
4. Self-education about a loved one’s condition and
how to communicate effectively with health-care
Providers
10.
A
nurse is caring for a client who is experiencing
pain related to cancer treatment. The client tells
the
nurse, “Methadone (Dolophine®) has always worked
well for me in the past.” Which effects of
methadone
should the nurse consider before obtaining an order
for the medication?
1. Long half-life and high potency
2. Central nervous system toxicity and potential to
cause confusion
3. Frequent allergic reactions and therapeutic
doses
causing liver failure
4.
Coagulation
toxicity and short half-life
11.
A
client with cancer pain may require treatment
with coanalgesics or adjuvant medications to
control
pain. Which adjuvant medication gives the best
response when given with opioids?
1. Promethazine (Phenergan®)
2. Gabapentin (Neurontin®)
3. Diphenhydramine (Benadryl®)
4. Droperidol (Inapsine®)
12.
A
nurse evaluates that a client correctly understands information regarding
breast cancer screening
when the client states:
1. “Women at average risk for breast cancer should
begin having mammography at age 40.”
2. “Women with fibrocystic breast disease should
eliminate chocolate and caffeine from the diet.”
3. “Women should perform monthly breast
selfexamination (BSE).”
4. “Only women with fibrocystic breast disease
should have the addition of breast ultrasound or
MRI.”
13.
A
nurse is evaluating a client’s understanding of
sigmoid colostomy care. The nurse should recognize
the need for additional teaching when the client
makes
which statement?
1. “By utilizing colostomy irrigation I may not
need to
wear a fecal collecting device at all times.”
2. “If I injure the stoma during irrigation, I will
know
because it will be painful.”
3. “I know I need to examine the condition of the
skin
around the stoma every time I change the
appliance.”
4. “I know that my stoma should be odor-free if I
properly apply and made sure the pouch is sealed.”
14.
When
a 4-year-old child arrives on a unit to be admitted for a lymph node biopsy,
the child is crying and
hugging a teddy bear. Which response by the nurse
would be best?
1. “Hello, my name is Chris. Come with me; I am
going to show you to your new room.”
2. “I see that you are crying. Let’s go to the
playroom
where you can meet other children.”
3. “Hi. I know you are feeling scared. I see you
brought your special teddy bear. What’s your bear’s
name?”
4. “Can I hold you and your teddy bear, and then
take
you to the room where you can put teddy to bed?”
15.
A
76-year-old client, hospitalized for cancer
treatment, has an emergency bowel resection for a
bowel obstruction. Four hours postoperatively, the
client is experiencing pain. A nurse has the choice
of
standing postoperative pain orders or standing
orders
for cancer clients (protocol orders) of which all
medications are listed on the client’s medication administration record. Which
medication should the nurse
initially select to treat the client’s
postoperative pain?
1. Meperidine (Demerol®) 75 mg IM
2. Fentanyl (Duragesic®) transdermal patch 50
mcg/hr
3. Morphine sulfate
(Duramorph®) 4 mg IVP q3–4h prn
4. Hydromorphone (Dilaudid®) continuous infusion
15 to 30 mg/hr
16.
Guidelines
fr early detection of cancer include the following except:
B.
Guiac stool examination on yearly basis for adults
over 50 years
17.
If a
client receives a Pap smear report that is Stage I, what should the nurse
advise?
C.
Undergo biopsy
18.
The
client had undergone external radiation treatment. the most common systemic
side effects of the treatment include the following except:
D.
Malaise
19.
Which
of the following medications would be used to relieve nausea and vomiting due
to chemotherapy?
A.
Metaclopramide
20. A 54-year-old client is admitted to the hospital for
breast cancer. During the preoperative period, what is the most important
consideration in the client’s nursing care?
a. Reassure the client that surgery will cure the cancer.
b. Assess the understanding of the procedure and expectation of bodily
appearance after surgery
c. Maintain a cheerful and optimistic behavior
d. Keep visitors to a minimum so that she can have time to reflect on her
condition
21. A chemotherapeutic agent, methotrexate is ordered for a
client. Which of the following statements is true about chemotherapy?
a. It affects only the tumor cells
b. It causes very few side effects
c. It can destroy all cancer cells in one exposure
d. It affects both cancer cells and normal cells.
22. The client is receiving fluorouracil that develops
stomatitis. Nursing interventions for the client include the following except
one:
a. Normal saline, gargle every 2 hours
b. taking hot liquids
c. Soft, bland diet
d. Topical aesthetics before meals
23. A client is receiving cyclophosphamide. Which of the
following statements of the client that understands the effects of the therapy?
a. I will take 2-3 liters of fluid a day
b. My urine will normally be red
c. I have to massage my gums
d. I will normally have watery stools during the therapy
24. which of the following indicates bone marrow depression
in the client receiving chemotherapy?
a. RBC level of 4.8 M / cu.mm
b. WBC level of 8, 000 / cu.mm
c. Platelet’s level of 95,000 / cu.mm
d. none of the above
25. The client with cervical cancer has a cervical cobalt
implant in place. Which of the following nursing intervention should be
included in her care plan?
a. Frequent ambulation
b. Low residue diet
c. Vaginal irrigations every shift
d. Position the bed so that the client faces the door
26. A 32 year old client had modified radical mastectomy due
to stage II breast cancer
a. I understand how you feel, I’d feel the same way too
b. It is okay, you can look at in the mirror when you are at home
c. Your feelings are normal, it is alright to cry
d. I know this is awful. But it is not terrible
27. The client had modified radical mastectomy due to stage
II breast cancer. The following are appropriate nursing intervention except:
a. checks the dressings at the back
b. compress the hemovac after emptying the drainage
c. elevate and abduct the arm on the affected site
d. advise the client not to wear her bra until after the first follow up check
up
28. Which of the following is the priority nursing diagnosis
after mastectomy?
a. Disturbance in self concept
b. Self-care deficit
c. Activity intolerance
d. Alteration in cardiac output
29. Lymphedema is the most common postoperative complication
following axillary lymph node resection. The following actions would minimize
this problem except:
a. Elevate the arm with pillow support
b. Keep the arm abducted
c. Reinforce the arm exercises
d. Take the BP from the arm on the affected side.
30. A 76 yr. old client is admitted to a surgical unit
following a right colectomy for a small tumor. The client has Lactated Ringers solution
infusing intravenously at 125 mL/hr, O2 per nasal cannula at 3L, and a right abdominal
dressing. A nurse analyzes the clients assessment information and identifies to
the nursing dx. : Risk for infection (pneumonia) due to age related functional
changes in the respiratory system. Which age related assessment most likely
prompted the nurse to establish the nursing dx.?
a. Decreased residual volume
b. Increased vital capacity
c. Increased PaO2
d. Decreased cough reflex
31. A 72yr. old male with a terminal cancer is receiving
palliative care services in his home. He comments to the nurse, “I am such a
feeble old man. My life is such a waste, and I hate having my wife see me like
this. I just wish I could die now.” The nurse’s best interpretation of these
comments is that the client is:
a. Ashamed and ready to die
b. expressing anxiety due to the diagnosis of terminal cancer.
c. experiencing Havighurst’s developmental tasks of later maturity
d. experiencing Erikson’s developmental state of integrity versus despair
32. A clients plan of care includes a nursing dx., of
anticipatory grieving / death anxiety r/t anticipated loss of physiologic well-
being. A nurse evaluated that the client has achieved one desired outcome
pertinent to the diagnosis when the client:
a. dies with family members present
b. continues normal life activities within abilities and verbalizes taking 1
day at a time
c. verbalizes experiencing negative death images and unpleasant thoughts
d. states worry about causing grief and suffering in others.
33. A female client is being treated with radioactive iodine
(RAI) therapy for an enlarged thyroid gland. The client asks if there are any precautions
that are needed during RAI therapy. Which is the nurse’s best response?
a. “No precautions are necessary. You have radiation in the form of a capsule
that will target and destroy the thyroid tissue only.”
b. “Though a pregnancy test has confirmed that you are not pregnant, use
contraceptives or abstain from sexual intercourse to avoid conceiving during
treatment.”
c. “Because maximum effects may not be seen for 6 months, you will need to
continue taking the thyroid medication and propranolol until the effects of
radiation become apparent,.”
d. “Although RAI is usually effective, a few individuals will need life – long thyroid
hormone replacement due to post treatment hypothyroidism.”
34. A nurse is admitting a client with gastric cancer to an
oncology unit for treatment. The nurse knows that the cancer has metastasized
to the peritoneal cavity when which item of assessment data is collected?
a. The client is reporting nausea
b. A nurse observes Grey Turner’s Sign
c. The client is reporting rapid weight loss
d. A nurse observes ascites
35. A nurse suspects that a client a client, admitted with
upper right – sided abdominal pain, may have liver cancer when which serum
laboratory test result is noted to be elevated?
a. Creatinine 2
b. Serum fetoprotein (AFP) levels
c. Serum phosphorous levels
d. CA – 125
36. A client tells a nurse that she has been diagnosed with
a 2 cm. cancerous tumor in the liver. The client wants to know what type of
treatment should be anticipated. The nurse’s response should reflect the
knowledge that:
a. Chemotherapy is the first line treatment for liver cancer
b. because of the vascularity of the liver, it is not possible to excise the
cancerous tumor using an open surgical approach
c. liver transplantation is not an option for clients with liver cancer
d. A radiofrequency ablation has been successful in treating tumors of that
size.
37. A registered nurse is caring for a client following a
liver biopsy with the assistance of a student nurse. The RN evaluated that he
students understands the post procedure care when the student nurse:
a. plans to monitor VS every hour
b. promotes ambulation 1 hour after the procedure
c. positions the client on the right side
d. encourages the client to cough and deep breathe immediately following the
procedure
38. A client is being admitted to a postsurgical unit
following anorectal surgery. A nurse reviews the following postoperative orders
from the surgeon. Which order should the nurse question?
a. Administer morphine sulfate per intravenous bolus before the first
defecation
b. Administer sitz bath after each defecation
c. Begin high fiber diet as soon as client can tolerate oral intake.
d. Position client in supine position with the head of the bed elevated to 30
degrees
39. A nurse is caring a client who had a surgery for colon
cancer, which included the creation of a temporary colostomy. The client is 24
hours post surgery. During an assessment of the client, A nurse notes no stool
in the colostomy bag. A review of the client’s medical records indicates that,
since surgery, there has not been stool in the bag. Considering this
information, the nurse should:
a. Call the doctor immediately to report this finding
b. Reposition the client to the left side
c. Document the findings
d. Administer pain medications
40. A client who had a sigmoid colectomy for colon cancer is
instructed to a follow up clinic visit to take 325 mg of aspirin (Ectorin) per
day. A nurse explains to the client that the aspirin will?
a. Decrease the surgical pain
b. Promote healing of the surgical incision
c. Prevent the return of cancer in the colon
d. Prevent metastasis of the cancer to other areas of the body