Oncology Practice Test
1. Which of the following positions is the one of choice for palpating tissues during breast self-examination?
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.
2. Select the specific nursing interventions
that will implemented in the care of a child with leukemia who is at risk for
infection.
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. Maintain frequent and thorough handwashing
G. Avoid rectal suppositories, enemas, and the
use of rectal thermometers
3. 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.
4. Which of the following denotes the primary
reason for teaching testicular self-examination of males aged 13 to 14 years
who are at least at Tanner's stage III of development?
A. Testicular cancer is most common in males
aged 15 to 34 years.
B. They will develop a health promotion habit
important in later life.
C. They will become more comfortable with their
own sexuality.
D. They will become more familiar with their own
anatomy.
5. 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."
6. A school-age child is admitted to the
hospital with a diagnosis of acute lymphoblastic leukemia. The nurse formulates
a nursing diagnosis of Risk for infection. Which of the following is the
most effective way for the nurse to reduce the child's risk of infection?
A. Implementing reverse isolation
B. Maintaining standard precautions
C. Requiring staff and visitors to wear masks
D. Practicing thorough hand washing
7. 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
8. 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.
9. A child with leukemia is to be sent home on a
protocol that includes several antineoplastics after an intrathecal
administration of methotrexate. Before discharge the nurse instructs the
child's parents to:
A. Limit contact with peers because they tend to
have communicable diseases
B. Return weekly for bone marrow aspiration to
monitor effectiveness of therapy
C. Schedule routine laboratory screening to
evaluate response to the medication
D. Withhold medications when nausea occurs to prevent
additional episodes of vomiting
10. In addition to systemic chemotherapy, the
nurse is aware that cranial radiation is done on children with leukemia to:
A. Improve the quality of the child's life
B. Reduce the risk of systemic infection
C. Avoid metastasis to the lymphatic system
D. Prevent central nervous system involvement
11. A child with leukemia is complaining of
nausea. A nurse suspects that the nausea is related to the chemotherapy. The
nurse, concerned about the child's nutritional status, most appropriately would
offer which of the following during this episode of nausea?
A. The child's favorite foods
B. Cool, clear liquids
C. Low-protein foods
D. Low-calorie foods
12. The most common symptom associated with
bladder cancer is:
A. Painless hematuria.
B. Decreasing urine output.
C. Burning on urination.
D. Frequent infections.
13. 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
14. A client who is to receive radiation therapy
for cancer says to the nurse, "My family said I will get a radiation
burn." The best response by the nurse would be:
A. "It will be no worse than a
sunburn."
B. "A localized skin reaction usually
occurs."
C. "Have they had experience with this type
of radiation?"
D. "Daily application of an emollient will
prevent the burn."
15. 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.
16. A priority nursing intervention for the care.
of a terminally ill patient diagnosed with metastatic cancer is:
A. maintaining bowel function.
B. alleviating and relieving pain.
C. preventing respiratory arrest.
D. managing chemotherapy.
17. 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, and movable adenopathy in the
cervical area
D. Anorexia and weight loss
18. An adolescent girl who is receiving
chemotherapy for leukemia is admitted for pneumonia. The adolescent's platelet
count is 50,000:
A. A sign over the bed that reads "NO
NEEDLE STICKS AND NOTHING PER RECTUM"
B. Two peripheral I.V. intermittent infusion
devices, one for blood draws and one for infusions
C. Administration of oxygen at a rate of 4
L/minute using a non-humidified nasal cannula
D. Use of a tympanic membrane sensor to measure
the client's temperature at the bedside
19. After teaching a group of parents about
cancer and associated cardinal signs and symptoms, which of the following signs
and symptoms, if stated by the group, would indicate to the nurse that the
group needs more teaching?
A. Unexplained bleeding
B. Persistent localized pain
C. Sudden vision changes
D. Unusual mass or swelling
20. A client who is receiving chemotherapy
expresses concern at the thought of losing her hair. The nurse's best response
would be:
A. "Don't worry about your hair loss. A
good wig can disguise that."
B. "No one knows how long it will take your
hair to grow back. You will have to learn to cope with its loss."
C. "A little hair loss shouldn't concern
you. You have more serious things to worry about."
D. "Your hair loss will be temporary. Would
you like to tell me about your concerns?"
21. The laboratory values of a client with cancer
of the esophagus show a hemoglobin of 7 g/dl, hematocrit of 29%, and RBC count
of 2.5 million/mm3. Considering these data, the most appropriate nursing
diagnosis for the client at this time is:
A. Altered nutrition: less than body
requirements related to dysphagia
B. Ineffective airway clearance related to tumor
growth and metastasis
C. Pain related to pressure of tumor on
surrounding tissues and nerves
D. High risk for injury related to possible
metastasis and subsequent airway obstruction
22. A client with Hodgkin's disease enters a
remission period and remains symptom-free for 6 months, when a relapse occurs.
The client is diagnosed at stage IV. The therapy option the nurse should expect
to be implemented at this time is:
A. Radiation therapy
B. Combination chemotherapy
C. Radiation with chemotherapy
D. Surgical removal of the affected nodes
23. Which of the following would the nurse
include in the plan of care for a child with leukemia who has an absolute neutrophil
count of 400/mm3?
A. Restrict staff and visitors with active
infections.
B. Place the child in strict isolation.
C. Consult with the physician to administer an
antiemetic.
D. Increase the child’s oral fluid intake.
24. 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
25. A client is admitted with a diagnosis of
cancer of the colon. The nurse knows that malignant tumors of the colon:
A. Are easily detected
B. Are usually localized
C. Occur more frequently in women than in men
D. Account for the majority of intestinal
obstructions
26. After surgical removal of a brain tumor, the
physician writes an order to maintain the child in a flat position. In the
postoperative period a nurse is monitoring the child and notes that the child
is restless, the pulse rate is elevated, and the blood pressure has dropped
significantly from the baseline value. The nurse suspects that the child is in
shock. Which of the following would be the most appropriate nursing action?
A. Place the child in the Trendelenburg's
position.
B. Elevate the head of the bed.
C. Increase the intravenous fluids.
D. Notify the physician.
27. Which one of the following expected outcomes
about nutrition would be appropriate for a client who has had a total
gastrectomy for gastric cancer? The client will:
A. Regain any weight lost within 4 weeks of the
surgical procedure.
B. Eat three full meals a day without
experiencing gastric complications.
C. Learn to self-administer enteral feedings every
4 hours.
D. Maintain adequate nutrition through oral or
parenteral feedings.
28. The client's cancer recurs, and internal
radiation treatment with a radium implant is planned. On hospital admission,
the client says that she is concerned about being radioactive and has been
having nightmares about the treatment. What would be a reasonable explanation
for the nurse to give to the client?
A. "The radioactive material is controlled
and stays with the source; once the material is removed, no radioactivity will
remain."
B. "The radioactivity will gradually
decrease, and you will be discharged when the radioactive material reaches its
half-life."
C. "These nightmares indicate that you're
in the denial phase of accepting the diagnosis."
D. "Careful shielding prevents the area
above your waist from radioactivity."
29. The nurse is conducting an initial nursing
history of a client who is experiencing pain related to bone cancer. The most
important information to gather in this initial assessment is the:
A. Nurse's physical assessment of the client.
B. Amount of pain medication the client is
taking.
C. Client's self-reporting of her pain
experience.
D. Family's response to the client's illness.
30. Which of the following actions would be most
appropriate when caring for a child with leukemia and a platelet count of
20,000/cu mm?
A. Discouraging nose-blowing
B. Instituting strict isolation
C. Medicating for pain every 4 hours
D. Increasing iron foods in the diet
31. Which of these findings is an early sign of bladder
cancer?
A. Painless hematuria
B. Occasional polyuria
C. Nocturia
D. Dysuria
32. What activity orders would be appropriate for
a client with an internal radium implant for cervical cancer?
A. Out of bed as tolerated within the room.
B. Bed rest with bathroom privileges.
C. Bed rest in position of comfort.
D. Bed rest with the head of the bed flat.
33. The nurse, suspecting a fever, checks
tympanic and oral temperatures on a 4-year-old with a diagnosis of leukemia
because:
A. Rectal temperatures are too upsetting for a
4-year-old child
B. Oral temperatures alone are inaccurate in
children with leukemia
C. Rectal temperatures are avoided to reduce the
risk of rectal trauma
D. Tympanic temperatures alone are not accurate
when fever is suspected
34. Which of the following statements by a
25-year-old woman indicates that she understands breast self-examination (BSE)?
A. "I will perform BSE every three
months."
B. "I will wear latex gloves when doing
BSE."
C. "I will do complete BSE on both breasts
seven to 10 days after menses onset."
D. "I will use the palms of my hands to
perform BSE."
35. 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)
36. When caring for children who have received
bone marrow transplants, the nurse is aware that graft-versus-host disease
(GVHD) least often occurs with which of the following?
A. Autologous
B. Allogenic
C. Syngeneic
D. HLA system complex
37. A 4-year-old child is admitted with the
diagnosis of acute lymphocytic leukemia (ALL). Platelets are ordered and an IV
is started. The nurse should:
A. Administer the platelets rapidly
B. Administer the platelets over 2 1/2 hours
C. Check vital signs 3 hours after the
transfusion
D. Flush the line with 5% dextrose and normal
saline
38. 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
39. The alkylating agent cyclophosphamide
(Cytoxan) is ordered for a child with cancer. When the child is receiving this
drug the nurse should assess for:
A. Extent of hydration
B. Increased irritability
C. Unexpected nausea
D. Hyperplasia of gums
40. Radiation therapy is instituted for a client
with Hodgkin's disease. After 1 week, the radiation site becomes red and
irritated. Which of the following statements would indicate that the client
treated the area appropriately at home?
A. "I applied Aloe Vera lotion to the
area."
B. "I applied nothing to the area; I just
kept it dry."
C. "I applied moist cool soaks to the
area."
D. "I applied a hot-water bottle to the
area."
41. The nurse is instructing a premenopausal
woman about breast self-examination. The nurse should tell the client to do her
self-examination:
A. at the end of her menstrual cycle.
B. on the same day each month.
C. on the 1st day of the menstrual cycle.
D. immediately after her menstrual period.
42. After examination and diagnostic testing, the
client is diagnosed with cancer of the cervix in situ. A conization is
scheduled. Which of the following nursing interventions would take priority
during the first 24 postoperative hours?
A. Monitoring vital signs hourly.
B. Maintaining strict bed rest.
C. Monitoring vaginal bleeding.
D. Maintaining electrolyte balance.
43. 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."
44. 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.
45. When evaluating the effectiveness of the
preoperative teaching plan with the parents of children diagnosed with Wilms'
tumor, which of the following would indicate to the nurse that the parents
require further teaching?
A. Frequently palpating the child's abdomen
B. Asking about the child's blood pressure
C. Stating that they will discuss alopecia after
surgery
D. Encouraging the child to discuss fears
46. When obtaining a health history from the
parents of a toddler who is admitted to the hospital with acute lymphocytic
leukemia (ALL), the nurse would be surprised if the parents report that the
first sign they observed was:
A. A loss of appetite
B. Sores in the mouth
C. A paleness of the skin
D. Purplish spots on the skin
47. Which of the following statements indicates
that the client needs further teaching about taking medication to control his
cancer pain?
A. "I should take my medication
around-the-clock to control my pain."
B. "I should skip doses periodically so I
don't get hooked on my drugs."
C. "It is okay to take my pain medication
even if I am not having any pain."
D. "I should contact the oncology nurse if
my pain is not effectively controlled."
48. A priority nursing diagnosis for a client receiving
chemotherapy would be:
A. Excess Fluid Volume.
B. Impaired Physical Mobility.
C. Risk for Infection.
D. Disturbed Body Image.
49. 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.
50. 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.
51. When assessing the status of a child with
leukemia who is receiving vincristine (Oncovin), the nurse would know that the
fluid intake should be increased when the child's:
A. Temperature is 99.8 degrees F
B. Uric acid level is elevated
C. Urine's specific gravity is 1.026
D. Output for the last 24 hours totaled 1700 ml
52. 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).
53. 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.
54. When assessing a four-year-old child with a
brain tumor, which of the following preoperative assessments would the nurse
consider least important?
A. Cranial enlargement
B. Behavior
C. Projective vomiting
D. Headaches
55. When giving nursing care to a child with
leukemia, the nurse notes blood on the pillow case and several bloody tissues.
The nurse should check the child's laboratory report for the:
A. Platelet count
B. Uric acid level
C. Prothrombin time
D. Red blood cell count
56. The most effective way to manage pain for a
patient with terminal cancer is for the nurse to administer pain medication:
A. at eight-hour intervals.
B. on a continuous, around-the-clock schedule.
C. as the pain reaches peak level.
D. when the patient can no longer tolerate the
pain.
57. A child with leukemia presents with
petechiae; gums, lips, and nose that bleed easily; and bruising on various
parts of her body. Which of the following laboratory test results would the
nurse correlate with these findings?
A. Platelet count of 80 x 10³/mm³.
B. Serum calcium level of 5 mg/dL.
C. Fibrinogen level of 75 mg/dL.
D. Partial thromboplastin time (PTT) of 38
seconds.
58. After surgery for cancer, a client is to
receive adjuvant chemotherapy. When teaching the client about the side effects
of chemotherapy, the nurse should emphasize that the occurrence of alopecia is:
A. Usually rare
B. Never permanent
C. Frequently prolonged
D. Sometimes preventable
59. A nurse is monitoring a child for bleeding
following surgery for removal of a brain tumor. The nurse checks the head
dressing for the presence of blood and notes a colorless drainage on the back
of the dressing. Which of the following would be the most appropriate nursing
intervention?
A. Circle the area of drainage and continue to
monitor.
B. Reinforce the dressing.
C. Notify the physician.
D. Document the findings and continue to
monitor.
60. A patient is receiving radiation therapy to
her right breast. The nurse's teaching plan related to skin care should include
which of the following measures?
A. Completely clean the skin each day to remove
ointments and markings
B. Cover broken skin in the treatment area with
a medicated ointment before each radiation treatment
C. Wear a bra at all times to support the
breasts
D. Protect the breast area from direct sunlight
61. A 4-year-old child is admitted to the
hospital for abdominal pain. The mother reports that the child has been pale
and excessively tired and is bruising easily. On physical examination,
lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being
performed on the child because acute lymphocytic leukemia is suspected. The
nurse understands that which diagnostic study will confirm this diagnosis?
A. White blood cell count
B. A lumbar puncture
C. Bone marrow biopsy
D. A platelet count
62. Which of the following would the nurse do
first to rule out neuroblastoma for a child recently admitted who complains
that his feet keep falling asleep?
A. Assess the child's lower extremities
B. Check his chemotherapeutic medications
C. Provide reassurance that everything is okay
D. Elevate the foot of the bed
63. The development of laryngeal cancer is most
clearly linked to which of the following factors?
A. High-fat, low-fiber diet.
B. Alcohol and tobacco use.
C. Low socioeconomic status.
D. Overuse of artificial sweeteners.
64. A pediatric nurse is assigned to care for a
child with a diagnosis of Wilms' tumor. In planning care for the child, the
nurse understands that this tumor is:
A. An abdominal tumor.
B. A renal tumor.
C. A brain tumor.
D. A bone tumor.
65. A client with Hodgkin's disease explains the
monitoring that he will be doing at home between radiation treatments. Which of
the following statements would indicate that he knows how to detect a major
complication?
A. "I'll measure my neck circumference
every day."
B. "I'll take my temperature every
day."
C. "I'll monitor the loss of body hair
every week."
D. "I'll check the circulation in my arms
every day."
66. A female client with Hodgkin's disease is to
start total nodal irradiation. She and her husband have been trying to have a child,
and they are quite concerned when they learn that the radiation therapy
includes the pelvic nodal area. When questioned about this, the nurse should
refer them to the physician because the nurse should be aware that:
A. The ovaries can be surgically moved and
placed in a shielded area
B. Intense radiation to the area always causes
permanent sterilization
C. The radiation used is not radical enough to
destroy ovarian function
D. Ovarian function will be temporarily
destroyed but will return in time
67. A mother is upset because her 8-year-old
daughter developed a right breast mass and she asks the nurse what she should
do. The nurse bases her response on knowing that it is most likely due to which
of the following?
A. The onset of puberty
B. Precocious thelarche
C. Gynecomastia
D. Precocious pseudo puberty
68. A nurse instructs the parents of a child with
leukemia regarding measures related to monitoring for infection. Which
statement if made by a parent indicates a need for further instructions?
A. "I will perform proper hand-washing
techniques."
B. "I will take a rectal temperature
daily."
C. "I will inspect the skin daily for
redness."
D. "I will inspect the mouth daily for
lesions."
69. A 12-year-old child is seen in a clinic, and
a diagnosis of Hodgkin's disease is suspected. Several diagnostic studies are
performed to determine the presence of this disease. When evaluating the
diagnostic results, a nurse would expect to note which of the following, if this
child had Hodgkin's disease?
A. The presence of blast cells in the bone mat-row
B. The presence of Reed-Sternberg cells in the
lymph nodes
C. The presence of Epstein-Barr virus in the
blood
D. Elevated vanillylmandelic acid urinary levels
70. A young woman would like to lower her risk
for developing cancer and is following a low-fat diet. Which type of cancer is
not associated with excess dietary fat intake?
A. Breast cancer.
B. Colon cancer.
C. Prostate cancer.
D. Rectal cancer.
71. A pediatric nurse clinician is discussing the
pathophysiology related to childhood leukemia with a class of nursing students.
Which statement made by a nursing student indicates a lack of understanding of
the pathophysiology of this disease?
A. Normal bone marrow is replaced by blast
cells.
B. Red blood cell production is affected.
C. The platelet count is decreased.
D. The presence of a Reed-Stemberg cell is found
on biopsy.
72. A pediatric nurse specialist provides a
teaching session to the nursing staff regarding osteogenic sarcoma. Which
statement by a member of the nursing staff indicates a need for clarifying the
information presented?
A. "The symptoms of the disease in the
early stage are almost always attributed to normal growing pains."
B. "The femur is the most common site of
this sarcoma."
C. "Limping, if a weight-bearing limb is
affected, is a clinical manifestation."
D. "The child does not experience pain at
the primary tumor site."
73. Which of the following client statements
indicates that a 15-year-old with alopecia secondary to chemotherapy requires
more teaching?
A. "My hair will start to regrow in one
year."
B. "I'll wear a cap or bandana in the
sun."
C. "If I need chemo again, my hair won't
fall out as bad."
D. "I think I'll use a scarf so I can look
better."
74. When teaching a client about the signs of
colorectal cancer, the nurse stresses that the most common complaint of persons
with colorectal cancer is:
A. Abdominal pain
B. Rectal bleeding
C. Change in bowel habits
D. Change in caliber of stools
75. 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
76. When collaborating with the physician in the
development of a drug regimen for a client with cancer, the nurse would expect
which of the following medications to be avoided in the treatment of cancer
pain?
A. Meperidine (Demerol).
B. Morphine.
C. Acetaminophen (Tylenol).
D. Hydromorphone (Dilaudid).
77. 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."
78. The nurse should plan care for the client
with cancer based on the fact that an important principle of using medication
to manage cancer pain is to:
A. Avoid giving the client addictive
medications.
B. Provide the medications as soon as the client
requests them.
C. Discontinue the medications periodically to
discourage the development of drug tolerance.
D. Individualize the medication therapy to the
client.
79. For which of the following would the nurse
monitor when caring for a child who is receiving vincristine (Oncovin)?
A. Foot drop
B. Hemorrhagic cystitis
C. Moon face
D. Cardiac abnormalities
80. The client is advised by the physician to
have mammography screening annually. Measures to improve adherence with mammography
screening include:
A. Making sure that the individual barriers to
screening are minimized.
B. Emphasizing that mammography screening can
prevent breast cancer.
C. Emphasizing that mammography screening is a
low-cost approach to cancer prevention.
D. Informing the client that she is at high risk
for breast cancer and needs to follow the physician's recommendation.
81. A client with cancer is receiving a multiple
chemotherapy protocol. Included in the protocol is leucovorin calcium
(Wellcovorin). The nurse recognizes that this drug is administered to:
A. Potentiate the effect of alkylating agents
B. Diminish the toxicity of folic acid
antagonists
C. Limit the occurrence of nausea and vomiting
associated with chemotherapy
D. Interfere with cell division at a different
stage of cell division than the other drugs
82. When assessing a child with leukemia for the
possible side effects of vincristine (Oncovin), the nurse should be aware that
a sign of toxicity is:
A. Diarrhea
B. Alopecia
C. Hemorrhagic cystitis
D. Peripheral neuropathy
83. A 9-year-old child with leukemia is in
remission and has returned to school. The school nurse calls the mother of the
child and tells the mother that a classmate has just been diagnosed with
chickenpox. The mother immediately calls the clinic nurse because the leukemic
child has never had chickenpox. The most appropriate response by the clinic
nurse to the mother is:
A. "Monitor the child for an elevated
temperature, and call the clinic if a temperature occurs."
B. "Keep the child out of school for a
2-week period."
C. "There is no need to be concerned."
D. "Bring the child into the clinic for a
vaccine."
84. Which of the following systems is least
likely associated with the development of complications in the in the long-term
follow-up of childhood cancer survivors?
A. Respiratory
B. Endocrine
C. Reproductive
D. Skeletal
85. A 3-year-old child with leukemia has
completed the induction phase of chemotherapy. To ascertain if a remission has
been achieved, what diagnostic test would be ordered to confirm the absence or
presence of leukemic cells?
A. Bone marrow aspiration
B. Blood culture and smear
C. Acid phosphatase
D. Alkaline phosphatase
86. A client receiving chemotherapy experiences
episodes of severe nausea and has vomited more than 1000 mL of clear fluid in
the past 4 hours. The nurse's most appropriate action would be to:
A. Notify the physician.
B. Maintain the client on a liquid diet.
C. Continue to monitor the client for another 4
hours.
D. Administer antiemetic medication as ordered.
87. A child is to receive intrathecal
methotrexate (Folex) for treatment of meningeal leukemia. For which reason
would intrathecal administration be selected?
A. The child has very poor veins and is unable
to receive drugs I.V.
B. This drug would be destroyed by gastric acid
and so it can't be given by mouth.
C. This drug is poorly transported across the
blood-brain barrier, so it's administered intrathecally.
D. Because the drug is rapidly absorbed if given
I.M., adverse effects may appear more quickly.
88. A child is undergoing remission induction
therapy to treat leukemia. Allopurinol is included in the regimen. The main
reason for administering allopurinol as part of the client's chemotherapy
regimen is to:
A. prevent metabolic breakdown of xanthine to
uric acid.
B. prevent uric acid from precipitating in the
ureters.
C. enhance the production of uric acid to ensure
adequate excretion of urine.
D. ensure that the chemotherapy doesn't
adversely affect the bone marrow.
89. After 2 weeks of radiotherapy, a client with
Hodgkin's disease becomes discouraged, stating, "I'm so tired that I can
barely keep up with my studies." The nurse bases the response on which of
the following statements about fatigue?
A. One of the most common problems associated
with radiotherapy, persisting throughout therapy.
B. A transient problem that typically will
resolve as radiotherapy continues.
C. Further evaluation needed to determine
another possible cause because of no relationship to radiotherapy.
D. An indication that the disease has been
eradicated, making additional radiotherapy unnecessary.
90. Which of the following agents would the nurse
suspect as the probable cause of mood swings in a child with leukemia?
A. Steroids
B. Allopurinol
C. Granulocyte colony-stimulating factor
D. L-asparaginase
91. The mother of a 4-year-old child brings the
child to a clinic and tells a pediatric nurse specialist that the child's
abdomen seems to be swollen. During further assessment of subjective data, the
mother tells the nurse that the child is eating well and that the activity
level of the child is unchanged. The nurse, suspecting the possibility of Wilms'
tumor, would avoid which of the following during the physical assessment?
A. Palpating the abdomen for a mass
B. Assessing the urine for the presence of
hematuria
C. Monitoring the temperature for the presence
of fever
D. Monitoring the blood pressure for the presence
of hypertension
92. A 6-year-old child with leukemia is
hospitalized and is receiving combination chemotherapy. Laboratory results
indicate that the child is neutropenic, and protective isolation procedures are
initiated. The grandmother of the child visits and brings a fresh bouquet of
flowers picked from her garden and asks the nurse for a vase for the flowers.
The nurse responds to the grandmother by telling her:
A. "I have a vase in the utility room, and
I will get it for you."
B. "The flowers from your garden are
beautiful but should not be placed in the child's room at this time."
C. "1 will get the vase and wash it well
before you put the flowers in it."
D. "When you bring the flowers into the
room, place them on the bedside stand as far away from the child as
possible."
93. A home health nurse is visiting a patient
with ovarian cancer. The patient has experienced decreased appetite and a
significant weight loss in the past three weeks. Which of the following actions
should the nurse take first:
A. Recommend multiple small feedings of
high-protein foods
B. Plan to include the majority of calories for
the day at breakfast
C. Apply the standard care plan for altered
nutrition: less than body requirements
D. Collect additional information to determine
potential causes of the weight loss
94. A nurse is caring for a child after surgical
removal of a brain tumor. The nurse assesses the child for which of the
following signs that would indicate that brainstem nvolvement occurred during
the surgical procedure?
A. Elevated temperature
B. Orthostatic hypotension
C. Inability to swallow
D. Altered hearing ability
95. The nurse is
conducting an initial nursing history of a client who is experiencing pain
related to bone cancer. The most important information to gather in this
initial assessment is the:
A.
Nurse's physical assessment of the client.
B.
Amount of pain medication the client is taking.
C.
Client's self-reporting of her pain experience.
D.
Family's response to the client's illness.
96. The nurse walks
into the room of a client who has had surgery for testicular cancer. The client
says that he'll be undesirable to his wife, and he becomes tearful. He
expresses that he has spoiled a happy, satisfying sex life with his wife, and
says that he thinks it might be best if he would just die. Based on these signs
and symptoms, which nursing diagnosis would be most appropriate for planning
purposes?
A.
Situational low self-esteem
B.
Unilateral neglect
C.
Social isolation
D.
Risk for loneliness
97. The nurse cares
for a patient with cancer of the colon who is scheduled for a paracentesis.
During the procedure, 1,500 cc of ascitic fluid is removed by the physician.
Which of the following actions should the nurse take immediately following the
procedure?
A.
Measure the patient's abdominal girth.
B.
Weigh the patient.
C.
Assess the patient's level of pain.
D.
Check the patient's blood pressure.
98. 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.
99. What activity
orders would be appropriate for a client with an internal radium implant for
cervical cancer?
A.
Out of bed as tolerated within the room.
B.
Bed rest with bathroom privileges.
C.
Bed rest in position of comfort.
D.
Bed rest with the head of the bed flat.
100.
A client with metastatic melanoma is being treated with Interferon. The
nurse is aware that the teaching about this drug is understood when the client
states:
A.
"I will increase my fluid intake to 2 to 3 liters daily."
B.
"I need to discard any reconstituted solution at the end of the
week."
C.
"I can continue driving my car as before, as long as I have the
stamina."
D.
"I should be able to continue my usual activity while taking this
medication."
101.
The nurse 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.
a breast self-examination.
B.
mammography.
C.
fine-needle aspiration.
D.
chest X-ray.
102.
The nurse is teaching a client diagnosed with basal cell epithelioma.
The most common cause of basal cell epithelioma is:
A.
immunosuppression.
B.
radiation exposure.
C.
exposure to the sun.
D.
burns.
103.
A client who has recently had surgery for prostate cancer expresses to
the nurse feelings of anger toward God, his church, and the clergy. Which
intervention isn't appropriate for this client?
A.
Acknowledging the client's spiritual distress
B.
Inviting the client's clergyman to visit him
C.
Encouraging the client to discuss religious beliefs and practices
D.
Encouraging the client to discuss concerns with the clergy
104.
The nurse 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.
105.
After cancer chemotherapy, a client develops nausea and vomiting. For
this client, the nurse should give the highest priority to which action in the
plan of care?
A.
Serve small portions of bland food.
B.
Encourage rhythmic breathing exercise.
C.
Administer metoclopramide (Reglan) and dexamethasone (Decadron) as
prescribed.
D.
Withhold fluids for the first 4 to 6 hours after chemotherapy
administration.
106.
When caring for a client with a radium implant for cancer of the cervix,
the nurse should:
A.
Spend time with the client to alleviate her anxiety
B.
Wear a lead-lined apron while administering any care
C.
Limit the client's activity so as not to dislodge the radium insert
D.
Use disposable sheets and towels to prevent exposure of laundry
personnel
107.
A client is to receive doxorubicin (Adriamycin) as part of a
chemotherapy protocol. The major life-threatening side effect of Adriamycin
that the nurse should assess the client for is:
A.
Cardiotoxicity
B.
Pancytopenia
C.
Pulmonary fibrosis
D.
Ulcerative stomatitis
108.
The nurse is assessing a client with multiple myeloma. The nurse should
keep in mind that clients with multiple myeloma are at risk for:
A.
chronic liver failure.
B.
acute heart failure.
C.
pathologic bone fractures.
D.
hypoxemia.
109.
A client with a small, well-defined breast nodule asks the nurse about
her treatment options. Which treatments would be considered for this client?
A.
Lumpectomy and radiation
B.
Partial mastectomy and radiation
C.
Partial mastectomy and chemotherapy
D.
Total mastectomy and chemotherapy
110.
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
111.
A 92-year-old client with prostate cancer and multiple metastases is in
respiratory distress and is admitted to a medical unit from a skilled nursing
facility. His advance directive states that he doesn't want to be placed on a
ventilator or receive cardiopulmonary resuscitation. Based on the client's
advance directive, the nursing plan of care should include which intervention?
A.
Check on the client once per shift.
B.
Provide mouth and skin care only if the family requests it.
C.
Turn the client only if he's uncomfortable.
D.
Provide emotional support and pain relief.
112.
A 68-year-old woman is admitted to the general surgical unit for removal
of a breast mass malignancy. In the presurgical assessment of the client, which
of the following choices would be most appropriate for the nurse to ask when
assessing her self-concept?
A.
"Let's talk about what you'd like to do that you haven't
done."
B.
"List for me your accomplishments and achievements in life."
C.
"Tell me how this breast surgery will make you feel about
yourself."
D.
"What does your husband say when he compliments you?"
113.
A client with multiple myeloma is scheduled to have a chest x-ray
examination and a bone scan. For this client, the primary responsibility of the
nursing and radiology staff is to:
A.
Explain the procedure and its purpose
B.
Observe the client for shortness of breath
C.
Provide for rest periods during the procedure
D.
Handle the client with supportive movements
114.
If a client is diagnosed with a gastric ulcer, the nurse would expect
his pain to occur:
A.
below the umbilicus.
B.
at the umbilicus.
C.
in the epigastric area.
D.
after a high-fat meal.
115.
A client is scheduled for a bone scan to determine the presence of
metastases. The nurse is aware that teaching prior to a scheduled bone scan was
effective when the client states that:
A.
"X-rays will be taken to identify where I may have lost calcium
from my bones."
B.
"A portion of my bone marrow will be removed and examined for cell
composition."
C.
"A radioactive chemical will be injected into my vein that will
destroy cancer cells present in my bones."
D.
"A substance of low radioactivity will be injected into my vein,
and my body inspected by an instrument to detect where it is deposited."
116.
A client is receiving a radiation implant for the treatment of bladder
cancer. Which of the following interventions is appropriate?
A.
Flush all urine down the toilet.
B.
Restrict the client's fluid intake.
C.
Place the client in a semiprivate room.
D.
Monitor the client for signs and symptoms of cystitis.
117.
A client asks why malignant melanoma is considered so serious. The nurse
would respond with which of the following reasons?
A.
It usually metastasizes only to the kidneys.
B.
It can spread through the lymphatic system and the bloodstream.
C.
It usually develops where the client can't see it: the legs in males and
the back in females.
D.
It's the most common skin cancer.
118.
The nurse is assessing a 65-year-old woman who has been diagnosed with
terminal breast cancer. Objective data that may indicate anxiety in the client
includes:
A.
decreased independence in activities of daily living (ADLs).
B.
increased distraction.
C.
increased independence in ADLs.
D.
increased urinary frequency.
119.
The nurse is reviewing the laboratory report of a client who underwent a
bone marrow biopsy. The finding that would most strongly support a diagnosis of
acute leukemia is the existence of a large number of immature:
A.
lymphocytes.
B.
thrombocytes.
C.
reticulocytes.
D.
leukocytes.
120.
A client who has cervical cancer is scheduled to undergo internal
radiation. In teaching the client about the procedure, the nurse would be most
accurate in telling the client:
A.
she'll be in a private room with unrestricted activities.
B.
a bowel-cleansing procedure will precede radioactive implantation.
C.
she'll be expected to use a bedpan for urination.
D.
the preferred positioning in bed will be semi-Fowler's.
121.
The nurse is interviewing a client about his 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
122.
A client undergoes a circular skin punch to confirm a diagnosis of skin
cancer. Immediately following the procedure, the nurse should observe the site
for:
A.
infection.
B.
dehiscence.
C.
hemorrhage.
D.
swelling.
123.
The nurse plans to teach a client who is receiving radiation therapy how
to care for his skin at home. The nurse's instructions should include:
A.
"Apply a heating pad to the area to relieve pain."
B.
"You may use deodorant soap if you wish to cleanse the area."
C.
"Put baby oil on the area after each treatment to keep it from
getting dry."
D.
"Keep the area covered when you go outdoors."
124.
A nurse is caring for a client with a diagnosis of cancer who is
immunosuppressed. A nurse would consider implementing neutropenic precautions
if the client's white blood cell count was:
A.
2000 cells/µL.
B.
5800 cells/µL.
C.
8400 cells/µL.
D.
11,500 cells/µL.
125.
For a client newly diagnosed with radiation-induced thrombocytopenia,
the nurse should include which intervention in the plan of care?
A.
Administer aspirin if the temperature exceeds 102
B.
Assess the client regularly for signs of bleeding.
C.
Frequent rest periods.
D.
Strict isolation.
126.
A male client should be taught about testicular examinations:
A.
when sexual activity starts.
B.
after age 60.
C.
after age 40.
D.
before age 20.
127.
During chemotherapy for lymphocytic leukemia, a client develops
abdominal pain, fever, and "horse barn" smelling diarrhea. It would
be most important for the nurse to advise the physician to order:
A.
an enzyme-linked immunosuppressant assay (ELISA) test.
B.
an electrolyte panel and hemogram.
C.
a stool for Clostridium difficile test.
D.
a flat plate X-ray of the abdomen.
128.
A 21-year-old male has been seen in the clinic for a thickening in his
right testicle. The physician ordered a human chorionic gonadotropin (HCG)
level. The nurse's explanation to the client should include the fact that:
A.
the test will evaluate prostatic function.
B.
the test was ordered to identify the site of a possible infection.
C.
the test was ordered because clients who have testicular cancer have
elevated levels of HCG.
D.
the test was ordered to evaluate the testosterone level.
129.
The nurse is caring for a client with multiple myeloma. A sign that a
client with multiple myeloma isn't coping well with his prognosis is that he:
A.
becomes tearful when discussing his condition.
B.
asks questions about his prognosis.
C.
shows concern about his family during his treatment.
D.
avoids any conversation concerning his health.
130.
A client with cancer undergoes a total gastrectomy. Several hours after
surgery, the nurse notes that the client's nasogastric (NG) tube has stopped
draining. How should the nurse respond?
A.
Notify the physician.
B.
Reposition the NG tube.
C.
Irrigate the NG tube.
D.
Increase the suction level.
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