.

1. Question
. 1 point(s)
A 32-year-old woman meets with the nurse on her first office visit since
undergoing a left mastectomy. When asked how she is doing, the woman states
her appetite is still not good, she is not getting much sleep because she doesn’t
go to bed until her husband is asleep, and she is really anxious to get back to
work. Which of the following nursing interventions should the nurse explore to
support the client’s current needs?

.
.
 A. Ask open-ended questions about sexuality issues related to her
mastectomy
 B. Suggest that the client learn relaxation techniques to help with
her insomnia
 C. Call the physician to discuss allowing the client to return to work earlier
 D. Perform a nutritional assessment to assess for anorexia

Incorrect

Correct Answer: A. Ask open-ended questions about sexuality issues

related to her mastectomy

 Option A: The content of the client’s comments suggests that she is

avoiding intimacy with her husband by waiting until he is asleep before
going to bed. Addressing sexuality issues is appropriate for a client who has
undergone a mastectomy.
 Option B: Suggesting that she learn relaxation techniques to help her with
her insomnia is appropriate; however, the nurse must first address the
psychosocial and sexual issues that are contributing to her sleeping
difficulties.
 Option C: Rushing her return to work may debilitate her and add to her
exhaustion.
 Option D: A nutritional assessment may be useful, but there is no
indication that she has anorexia.
.
2. Question
. 1 point(s)
One of the most serious blood coagulation complications for individuals with
cancer and for those undergoing cancer treatments is disseminated intravascular
coagulation (DIC). The most common cause of this bleeding disorder is:

.
.
 A. Brain metastasis
 B. Sepsis
 C. Intravenous heparin therapy
 D. Underlying liver disease
 Incorrect

Correct Answer: B. Sepsis

 Option B: Bacterial endotoxins released from gram-negative bacteria

activate the Hageman factor or coagulation factor XII. This factor inhibits
coagulation via the intrinsic pathway of homeostasis, as well as stimulating
fibrinolysis.
 Option D: Liver disease can cause multiple bleeding abnormalities
resulting in chronic, subclinical DIC; however, sepsis is the most common
cause.
.
3. Question
. 1 point(s)
A pneumonectomy is a surgical procedure sometimes indicated for treatment of
non-small-cell lung cancer. A pneumonectomy involves removal of:

.
.
 A. One lobe of a lung
 B. An entire lung field
 C. One or more segments of a lung lobe
 D. A small, wedge-shaped lung surface

Incorrect

Correct Answer: B. An entire lung field

 Option B: A pneumonectomy is the removal of an entire lung field

indicated for the treatment of non-small cell lung cancer that has not
spread outside of the lung tissue. It is performed on patients who will have
adequate lung function in the unaffected lung.
 Option D: A wedge resection refers to the removal of a wedge-shaped
section of lung tissue. It may be used to remove a tumor and a small
amount of normal tissue around it/
 Option A: A lobectomy is the removal of one lobe.
 Option C: Removal of one or more segments of a lung lobe is called a
partial lobectomy.
.
4. Question
. 1 point(s)
A 36-year-old man with lymphoma presents with signs of impending septic shock
9 days after chemotherapy. The nurse would expect which of the following to be
present?

.
.
 A. Low-grade fever, chills, tachycardia
 B. Elevated temperature, oliguria, hypotension
 C. Flushing, decreased oxygen saturation, mild hypotension
 D. High-grade fever, normal blood pressure, increased respirations

Incorrect

Correct Answer: A. Low-grade fever, chills, tachycardia

 Option A: Nine days after chemotherapy, one would expect the client to be
immunocompromised. The clinical signs of shock reflect changes in cardiac
function, vascular resistance, cellular metabolism, and capillary
permeability. Low-grade fever, tachycardia, and flushing may be early signs
of shock.
 Option B: Oliguria and hypotension are late signs of shock. Urine output
can be initially normal or increased.
 Options C and D: The client with impending signs of septic shock may not
have decreased oxygen saturation levels and normal blood pressure.
.
5. Question
. 1 point(s)
Which of the following represents the most appropriate nursing intervention for a
client with pruritus caused by cancer or the treatments?

.
.
 A. Silk sheets
 B. Steroids
 C. Medicated cool baths
 D. Administration of antihistamines

Incorrect

Correct Answer: C. Medicated cool baths

 Option C: Nursing interventions to decrease the discomfort of pruritus

include those that prevent vasodilation, decrease anxiety, and maintain
skin integrity and hydration. Medicated baths with salicylic acid or colloidal
oatmeal can be soothing as a temporary relief.
 Option A: Using silk sheets is not a practical intervention for the
hospitalized client with pruritus.
 Options B and D: The use of antihistamines or topical steroids depends on
the cause of pruritus, and these agents should be used with caution.
.
6. Question
. 1 point(s)
A 56-year-old woman is currently receiving radiation therapy to the chest wall for
recurrent breast cancer. She calls her health care provider to report that she has
pain while swallowing and burning and tightness in her chest. Which of the
 following complications of radiation therapy is A. Radiation enteritislikely
responsible for her symptoms?

.
.
 A. Radiation enteritis
 B. Stomatitis
 C. Esophagitis
 D. Hiatal hernia

Correct

Correct Answer: C. Esophagitis

 Option C: Difficulty in swallowing, pain, and tightness in the chest are

signs of esophagitis, which is a common complication of radiation therapy
of the chest wall.
 Option A: Radiation enteritis is a damage to the intestinal lining caused by
radiation therapy. Symptoms include diarrhea, rectal pain, and bleeding or
mucus from the rectum.
 Option B: Stomatitis results from the local effects of radiation to the oral
mucosa. Symptoms include mouth ulcers, red patches, swelling, and oral
dysaesthesia.
 Option D: Hiatal hernia may also cause symptoms of dysphagia and chest
pain but is not related to radiation therapy.
.
7. Question
. 1 point(s)
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 asked what
dysplasia means. Which definition should the nurse provide?

.
.
 A. Alteration in the size, shape, and organization of differentiated
cells
 B. Increase in the number of normal cells in a normal arrangement in a tissue
or an organ
 C. Presence of completely undifferentiated tumor cells that don’t
resemble cells of the tissues of their origin
 D. Replacement of one type of fully differentiated cell by another in tissues
where the second type normally isn’t found

Incorrect

Correct Answer: A. Alteration in the size, shape, and organization of

differentiated cells

 Option A: Dysplasia refers to an alteration in the size, shape, and

organization of differentiated cells.
  Option B: An increase in the number of normal cells in a normal
arrangement in a tissue or an organ is called hyperplasia.
 Option C: The presence of completely undifferentiated tumor cells that
don’t resemble cells of the tissues of their origin is called anaplasia.
 Option D: Replacement of one type of fully differentiated cell by another in
tissues where the second type normally isn’t found is called metaplasia.
.
8. Question
. 1 point(s)
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 stops seeking information.”
 B. “Client uses any effective method to reduce tension.”
 C. “Client doesn’t guess at prognosis.”
 D. “Client verbalizes feelings of anxiety.”

Incorrect

Correct Answer: D. “Client verbalizes feelings of anxiety.”

 Option D: Verbalizing feelings is the client’s first step in coping with the
situational crisis. It also helps the health care team gain insight into the
client’s feelings, helping guide psychosocial care.
 Option A: Seeking information can help a client with cancer gain a sense of
control over the crisis.
 Option B: This is undesirable because some methods of reducing tension,
such as illicit drug or alcohol use, may prevent the client from coming to
terms with the threat of death as well as cause physiological harm.
 Option C: Suppressing speculation may prevent the client from coming to
terms with the crisis and planning accordingly.
.
9. Question
. 1 point(s)
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 psychomotor seizures
 B. Related to impaired balance
 C. Related to visual field deficits
 D. Related to difficulty swallowing
 Incorrect

Correct Answer: B. Related to impaired balance

 Option B: A client with a cerebellar brain tumor may suffer injury from
impaired balance as well as disturbed gait and incoordination.
 Option A: Psychomotor seizures suggest temporal lobe dysfunction.
 Option C: Visual field deficits, difficulty swallowing, and psychomotor
seizures may result from dysfunction of the pituitary gland, pons, occipital
lobe, parietal lobe, or temporal lobe — not from a cerebellar brain tumor.
 Option D: Difficulty swallowing suggests medullary dysfunction.
.
10. Question
. 1 point(s)
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. Fatigue
 B. Vomiting
 C. Hair loss
 D. Stomatitis

Correct

Correct Answer: A. Fatigue

 Option A: Radiation therapy may cause fatigue, skin toxicities, and

anorexia regardless of the treatment site. Fatigue occurs when the
treatment damages and destroys not only the healthy cells but also the
cancer cells.
 Options B, C, and D: Hair loss, stomatitis, and vomiting are site-specific,
not generalized, adverse effects of radiation therapy.
.
11. Question
. 1 point(s)
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
 Incorrect

Correct Answer: C. Fine needle aspiration

 Option C: Fine needle aspiration and biopsy provide cells for histologic
examination to confirm a diagnosis of cancer. During the procedure, a
needle is inserted into the lump and a sample of tissue is taken for
examination.
 Option A: A breast self-examination, if done regularly, is the most reliable
method for detecting breast lumps early.
 Option B: Mammography is used to detect tumors that are too small to
palpate.
 Option D: Chest X-rays can be used to pinpoint rib metastasis.
.
12. Question
. 1 point(s)
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 dry.”
 B. “Keep the stoma moist.”
 C.“Keep the stoma uncovered.”
 D. “Have a family member perform stoma care initially until you get used to
the procedure.”

Incorrect

Correct Answer: B. “Keep the stoma moist.”

 Option B: The nurse should instruct the client to keep the stoma moist,
such as by applying a thin layer of petroleum jelly around the edges,
because a dry stoma may become irritated.
 Option A: Moisture is needed by the stoma to keep the airway moist. The
skin around the stoma is kept clean and dry instead.
 Option C: The nurse should recommend placing a stoma bib over the
stoma to filter and warm air before it enters the stoma.
 Option D: The client should begin performing stoma care without
assistance as soon as possible to gain independence in self-care activities.
.
13. Question
. 1 point(s)
A female client is receiving chemotherapy to treat breast cancer. Which
assessment finding indicates a fluid and electrolyte imbalance induced by
chemotherapy?
.
.
 A. Serum potassium level of 3.6 mEq/L
 B. Blood pressure of 120/64 to 130/72 mm Hg
 C. Dry oral mucous membranes and cracked lips
 D. Urine output of 400 ml in 8 hours

Correct

Correct Answer: C. Dry oral mucous membranes and cracked lips

 Option C: 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.
 Options A, B, and D: These values are within the normal limits.
.
14. Question
. 1 point(s)
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. Fibrocystic masses
 B. Changes from previous self-examinations
 C. Areas of thickness or fullness
 D. Cancerous lumps

Incorrect

Correct Answer: B. Changes from previous self-examinations

 Option B: Women are instructed to examine themselves to discover

changes that have occurred in the breast.
 Options A, C, and D: Only a physician can diagnose lumps that are
cancerous, areas of thickness or fullness that signal the presence of a
malignancy, or masses that are fibrocystic as opposed to malignant.
.
15. Question
. 1 point(s)
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. Pregnancy complicated with eclampsia at age 27
 B. Spontaneous abortion at age 19
 C. Onset of sporadic sexual activity at age 17
 D. Human papillomavirus infection at age 32

Incorrect

Correct Answer: D. Human papillomavirus infection at age 32

 Option D: Like other viral and bacterial venereal infections, human

papillomavirus is a risk factor for cervical cancer. Other risk factors for this
disease include multiple sex partners, multiple pregnancies, long-term use
of oral contraceptives and diethylstilbestrol (DES).
 Options A and B: A spontaneous abortion and pregnancy complicated by
eclampsia aren’t risk factors for cervical cancer.
 Option C: Risk factors for this disease include frequent sexual intercourse
before age 16.
.
16. Question
. 1 point(s)
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. Tabloid (thioguanine)
 B. Cytosar-U (cytarabine)
 C. Wellcovorin (leucovorin or citrovorum factor or folinic acid)
 D. Benemid (probenecid)

Incorrect

Correct Answer: C. Wellcovorin (leucovorin or citrovorum factor or folinic

acid)

 Option C: Leucovorin is administered with methotrexate to protect normal

cells, which methotrexate could destroy if given alone.
 Options A and B: Cytarabine and thioguanine aren’t used to treat
osteogenic carcinoma.
 Option D: Probenecid should be avoided in clients receiving methotrexate
because it reduces renal elimination of methotrexate, increasing the risk of
methotrexate toxicity.
.
17. Question
. 1 point(s)
 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. Polyps
 B. Weight gain
 C. Hemorrhoids
 D. Duodenal ulcers

Incorrect

Correct Answer: A. Polyps

 Option A: Colorectal polyps are common with colon cancer. These polyps
can develop into cancer over time depending on the type of polyps such as
adenomatous polyps and sessile serrated polyps.
 Option B: Weight loss — not gain — is an indication of colorectal cancer.
 Options C and D: Duodenal ulcers and hemorrhoids aren’t preexisting
conditions of colorectal cancer.
.
18. Question
. 1 point(s)
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. Have a mammogram annually
 B. Perform breast self-examination annually
 C. Have a hormonal receptor assay annually
 D. Have a physician conduct a clinical examination every 2 years

Incorrect

Correct Answer: A. Have a mammogram annually

 Option A: The American Cancer Society guidelines state, “Women older

than age 40 should have a mammogram annually and a clinical
examination at least annually [not every 2 years].
 Option B: All women should perform breast self-examination monthly [not
annually].
 Option C: The hormonal receptor assay is done on a known breast tumor
to determine whether the tumor is estrogen- or progesterone-dependent.
 Option D: A physician checkup every 2 years will not detect early signs of
breast cancer.
.
 19. Question
. 1 point(s)
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. Rash
 B. Indigestion
 C. Chronic ache or pain
 D. Persistent nausea

Incorrect

Correct Answer: B. Indigestion

 Option B: Indigestion, or difficulty swallowing, is one of the seven warning

signs of cancer. The other six are a change in bowel or bladder habits, a
sore that does not heal, unusual bleeding or discharge, a thickening or lump
in the breast or elsewhere, an obvious change in a wart or mole, and a
nagging cough or hoarseness.
 Options A and C: Rash and chronic ache or pain seldom indicate cancer.
 Option D: Persistent nausea may signal stomach cancer but isn’t one of
the seven major warning signs.
.
20. Question
. 1 point(s)
For a female client newly diagnosed with radiation-induced thrombocytopenia, the
nurse should include which intervention in the plan of care?

.
.
 A. Inspecting the skin for petechiae once every shift
 B. Placing the client in strict isolation
 C. Providing for frequent rest periods
 D. Administering aspirin if the temperature exceeds 102° F (38.8°C)

Incorrect

Correct Answer: A. Inspecting the skin for petechiae once every shift

 Option A: Because thrombocytopenia impairs blood clotting, the nurse

should inspect the client regularly for signs of bleeding, such as petechiae,
purpura, epistaxis, and bleeding gums.
 Option B: Strict isolation is indicated only for clients who have highly
contagious or virulent infections that are spread by air or physical contact.
  Option C: Frequent rest periods are indicated for clients with anemia, not
thrombocytopenia.
 Option D: The nurse should avoid administering aspirin because it may
increase the risk of bleeding.
.
21. Question
. 1 point(s)
Nurse Lucia is providing breast cancer education at a community facility. The
American Cancer Society recommends that women get mammograms:

.
.
 A. After the first menstrual period and annually thereafter
 B. Yearly after age 40
 C. Every 3 years between ages 20 and 40 and annually thereafter
 D. After the birth of the first child and every 2 years thereafter

Incorrect

Correct Answer: B. Yearly after age 40

 Option B: Breast cancer is a common health problem for women ages 40-
49 years old. The American Cancer Society recommends a mammogram
yearly for women over age 40.
 Options A, C, and D: The other statements are incorrect. It’s
recommended that women between ages 20 and 40 have a professional
breast examination (not a mammogram) every 3 years.
.
22. Question
. 1 point(s)
Which intervention is appropriate for the nurse caring for a male client in severe
pain receiving a continuous I.V. infusion of morphine?

.
.
 A. Discontinuing the drug immediately if signs of dependence appear
 B. Assisting with a naloxone challenge test before therapy begins
 C. Obtaining baseline vital signs before administering the first dose
 D. Changing the administration route to P.O. if the client can tolerate
fluids

Incorrect

Correct Answer: C. Obtaining baseline vital signs before administering

the first dose
  Option C: The nurse should obtain the client’s baseline blood pressure and
pulse and respiratory rates before administering the initial dose and then
continue to monitor vital signs throughout therapy.
 Option A: The nurse shouldn’t discontinue a narcotic agonist abruptly
because withdrawal symptoms may occur.
 Option B: A naloxone challenge test may be administered before using a
narcotic antagonist, not a narcotic agonist.
 Option D: Morphine commonly is used as a continuous infusion in clients
with severe pain regardless of the ability to tolerate fluids.
.
23. Question
. 1 point(s)
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)

Incorrect

Correct Answer: B. Normal cellular processes during the S phase of the

cell cycle

 Option B: Antimetabolites act during the S phase of the cell cycle,

contributing to cell destruction or preventing cell replication. They’re most
effective against rapidly proliferating cancers.
 Option A: Miotic inhibitors interfere with cell division or mitosis during the
M phase of the cell cycle.
 Option C: Alkylating agents affect all rapidly proliferating cells by
interfering with DNA; they may kill dividing cells in all phases of the cell
cycle and may also kill nondividing cells.
 Option D: Antineoplastic antibiotic agents interfere with one or more
stages of the synthesis of RNA, DNA, or both, preventing normal cell growth
and reproduction.
.
24. Question
. 1 point(s)
The ABCD method offers one way to assess skin lesions for possible skin cancer.
What does the A stand for?

.
.
 A. Assessment
 B. Arcus
 C. Actinic
 D. Asymmetry

Correct

Correct Answer: D. Asymmetry

 Option D: When following the ABCD method for assessing skin lesions, the
A stands for “asymmetry,” the B for “border irregularity,” the C for “color
variation,” and the D for “diameter.”
.
25. Question
. 1 point(s)
When caring for a male client diagnosed with a brain tumor of the parietal lobe,
the nurse expects to assess:

.
.
 A. Seizures
 B. Tactile agnosia
 C. Short-term memory impairment
 D. Contralateral homonymous hemianopia

Incorrect

Correct Answer: B. Tactile agnosia

 Option B: Tactile agnosia (inability to identify objects by touch) is a sign of

a parietal lobe tumor.
 Option A: Seizures may result from a tumor of the frontal, temporal, or
occipital lobe.
 Option C: Short-term memory impairment occurs with a frontal lobe tumor.
 Option D: Contralateral homonymous hemianopia suggests an occipital
lobe tumor.
.
26. Question
. 1 point(s)
A female client is undergoing tests for multiple myeloma. Diagnostic study
findings in multiple myeloma include:

.
.
 A. A decreased serum creatinine level
 B. A low serum protein level
 C. Hypocalcemia
 D. Bence Jones protein in the urine
 Correct

Correct Answer: D. Bence Jones protein in the urine

 Option D: Bence-Jones protein is an antibody fragment called a light chain

that is not detectable in the urine. A presence of Bence Jones may indicate
excess light chain production of a single type of antibody by the bone
marrow cells.
 Option A: The serum creatinine level may also be increased.
 Option B: Serum protein electrophoresis shows elevated globulin spike.
 Option C: Serum calcium levels are elevated because calcium is lost from
the bone and reabsorbed in the serum.
.
27. Question
. 1 point(s)
A 35-year-old client has been receiving chemotherapy to treat cancer. Which
assessment finding suggests that the client has developed stomatitis
(inflammation of the mouth)?

.
.
 A. Rust-colored sputum
 B. Red, open sores on the oral mucosa
 C. Yellow tooth discoloration
 D. White, cottage cheese–like patches on the tongue

Incorrect

Correct Answer: B. Red, open sores on the oral mucosa

 Option B: The tissue-destructive effects of cancer chemotherapy typically

cause stomatitis, resulting in ulcers on the oral mucosa that appear as red,
open sores.
 Option A: Rust-colored sputum suggests a respiratory disorder, such as
pneumonia.
 Option C: Yellow tooth discoloration may result from antibiotic therapy, not
cancer chemotherapy.
 Option D: White, cottage cheese–like patches on the tongue suggest a
candidal infection, another common adverse effect of chemotherapy.
.
28. Question
. 1 point(s)
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. Monitoring the client’s platelet and leukocyte counts
 B. Checking regularly for signs and symptoms of stomatitis
 C. Recommending that the client discontinue chemotherapy
 D. Providing a solution of hydrogen peroxide and water for use as a
mouth rinse

Correct

Correct Answer: D. Providing a solution of hydrogen peroxide and water

for use as a mouth rinse

 Option D: 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.
 Option A: Monitoring platelet and leukocyte counts may help prevent
bleeding and infection but wouldn’t decrease pain in this highly susceptible
client.
 Option B: Checking for signs and symptoms of stomatitis also wouldn’t
decrease the pain.
 Option C: Stomatitis occurs 7 to 10 days after chemotherapy begins; thus,
stopping chemotherapy wouldn’t be helpful or practical. Instead, the nurse
should stay alert for this potential problem to ensure prompt treatment.
.
29. Question
. 1 point(s)
What should a male client over age 52 do to help ensure early identification of
prostate cancer?

.
.
 A. Have a transrectal ultrasound every 5 years
 B. Perform monthly testicular self-examinations, especially after age 50
 C. Have a digital rectal examination and prostate-specific antigen
(PSA) test done yearly
 D. Have a complete blood count (CBC) and blood urea nitrogen (BUN)
and creatinine levels checked yearly

Incorrect

Correct Answer: C. Have a digital rectal examination and prostate-

specific antigen (PSA) test done yearly

 Option C: The incidence of prostate cancer increases after age 50. The
digital rectal examination, which identifies enlargement or irregularity of
the prostate, and PSA test, a tumor marker for prostate cancer, are
effective diagnostic measures that should be done yearly.
  Options A and D: A transrectal ultrasound, CBC, and BUN and creatinine
levels are usually done after diagnosis to identify the extent of the disease
and potential metastases.
 Option B: Testicular self-examinations won’t identify changes in the
prostate gland due to its location in the body.
.
30. Question
. 1 point(s)
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. Chronic low self-esteem
 B. Disturbed body image
 C. Anticipatory grieving
 D. Impaired swallowing

Correct

Correct Answer: C. Anticipatory grieving

 Option C: Anticipatory grieving is an appropriate nursing diagnosis for this

client because few clients with gallbladder cancer live more than 1 year
after diagnosis.
 Option A: Chronic low self-esteem isn’t an appropriate nursing diagnosis at
this time because the diagnosis has just been made.
 Option B: Although surgery typically is done to remove the gallbladder
and, possibly, a section of the liver, it isn’t disfiguring and doesn’t cause
Disturbed body image.
 Option D: Impaired swallowing isn’t associated with gallbladder cancer.
.
31. Question
. 1 point(s)
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. Leave the room and notify the radiation therapy department immediately
 B. Put the implant back in place, using forceps and a shield for self-protection,
and call for help
 C. Pick up the implant with long-handled forceps and place it in a
lead-lined container
 D. Stand as far away from the implant as possible and call for help
 Correct

Correct Answer: C. Pick up the implant with long-handled forceps and

place it in a lead-lined container

 Option C: If a radioactive implant becomes dislodged, the nurse should

pick it up with long-handled forceps and place it in a lead-lined container,
then notify the radiation therapy department immediately. The highest
priority is to minimize radiation exposure for the client and the nurse;
therefore, the nurse must not take any action that delays implant removal.
 Options A, B, and D: Standing as far from the implant as possible, leaving
the room with the implant still exposed, or attempting to put it back in
place can greatly increase the risk of harm to the client and the nurse from
excessive radiation exposure.
.
32. Question
. 1 point(s)
Jenny with an advanced breast cancer is prescribed Nolvadex (tamoxifen). When
teaching the client about this drug, the nurse should emphasize the importance of
reporting which adverse reaction immediately?

.
.
 A. Anorexia
 B. Headache
 C. Hearing loss
 D. Vision changes

Incorrect

Correct Answer: D. Vision changes

 Option D: Tamoxifen, a selective estrogen receptor modulator (SERM)

causes ocular side effects such as dryness, irritation, and cataracts. The
client must report changes in visual acuity immediately because this
adverse effect may be irreversible.
 Options A and B: Although the drug may cause anorexia, headache, and
hot flashes, the client need not report these adverse effects immediately
because they don’t warrant a change in therapy.
 Option C: Tamoxifen isn’t associated with hearing loss.
.
33. Question
. 1 point(s)
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. Colon
 B. Liver
 C. Reproductive tract
 D. White blood cells (WBCs)

Incorrect

Correct Answer: B. Liver

 Option B: The liver is one of the five most common cancer metastasis
sites. The others are the lymph nodes, lung, bone, and brain.
 Options A, C, and D: The colon, reproductive tract, and WBCs are
occasional metastasis sites.
.
34. Question
. 1 point(s)
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. When she begins having yearly mammograms, breast self-examinations
will no longer be necessary
 C. She should perform breast self-examination during the first 5 days of each
menstrual cycle
 D. She should eat a low-fat diet to further decrease her risk of breast
cancer

Incorrect

Correct Answer: D. She should eat a low-fat diet to further decrease her
risk of breast cancer

 Option D: A low-fat diet (one that maintains weight within 20% of

recommended body weight) has been found to decrease a woman’s risk of
breast cancer.
 Option A: A baseline mammogram should be done between ages 30 and
40.
 Option B: The client should continue to perform monthly breast self-
examinations even when receiving yearly mammograms.
 Option C: Monthly breast self-examinations should be done between days
7 and 10 of the menstrual cycle.
.
35. Question
. 1 point(s)
 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

Incorrect

Correct Answer: C. 7 to 14 days

 Bone marrow suppression becomes noticeable 7 to 14 days after floxuridine

administration. Bone marrow recovery occurs in 21 to 28 days.
.
36. Question
. 1 point(s)
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

Incorrect

Correct Answer: D. The client wears a watch and wedding band

 Option D: During an MRI, the client should wear no metal objects, such as
jewelry, because the strong magnetic field can pull on them, causing injury
to the client and (if they fly off) to others.
 Options A and B: The client must lie still during the MRI but can talk to
those performing the test by way of the microphone inside the scanner
tunnel.
 Option C: The client should hear thumping sounds, which are caused by
the sound waves thumping on the magnetic field.
.
37. Question
. 1 point(s)
Nina, an oncology nurse educator, is speaking to a women’s group about breast
cancer. Questions and comments from the audience reveal a misunderstanding of
 some aspects of the disease. Various members of the audience have made all of
the following statements. Which one is accurate?

.
.
 A. Breast cancer requires a mastectomy
 B. Men can develop breast cancer
 C. Breast cancer is the leading killer of women of childbearing age
 D. Mammography is the most reliable method for detecting breast cancer

Incorrect

Correct Answer: B. Men can develop breast cancer

 Option B: Men can develop breast cancer, although they seldom do. It is
common among older men.
 Option A: A mastectomy may not be required if the tumor is small,
confined, and in an early stage.
 Option C: Lung cancer causes more deaths than breast cancer in women
of all ages.
 Option D: The most reliable method for detecting breast cancer is monthly
self-examination, not mammography.
.
38. Question
. 1 point(s)
Nurse Mary is instructing a premenopausal woman about breast self-examination.
The nurse should tell the client to do her self-examination:

.
.
 A. On the 1st day of the menstrual cycle
 B. On the same day each month
 C. Immediately after her menstrual period
 D. At the end of her menstrual cycle

Correct

Correct Answer: C. Immediately after her menstrual period

 Option C: Premenopausal women should do their self-examination

immediately after the menstrual period, when the breasts are least tender
and least lumpy.
 Options A and D: On the 1st and last days of the cycle, the woman’s
breasts are still very tender.
 Option B: Postmenopausal women because their bodies lack fluctuation of
hormone levels, should select one particular day of the month to do breast
self-examination.
.
39. Question
. 1 point(s)
Nurse Kent is teaching a male client to perform monthly testicular self-
examinations. Which of the following points would be appropriate to make?

.
.
 A. Testicular cancer is a highly curable type of cancer
 B. Testicular cancer is very difficult to diagnose
 C. Testicular cancer is the number one cause of cancer deaths in males
 D. Testicular cancer is more common in older men

Incorrect

Correct Answer: A. Testicular cancer is a highly curable type of cancer

 Option A: Testicular cancer is highly curable, particularly when it’s treated

in its early stage. Stage I of the disease, a radical inguinal orchiectomy
(removal of testicles) is performed first then followed by chemotherapy or
radiation therapy.
 Option B: Self-examination allows early detection and facilitates the early
initiation of treatment.
 Option C: The highest mortality rates from cancer among men are in men
with lung cancer.
 Option D: Testicular cancer is found more commonly in younger men.
.
40. Question
. 1 point(s)
Rhea has malignant lymphoma. As part of her chemotherapy, the physician
prescribes chlorambucil (Leukeran), 10 mg by mouth daily. When caring for the
client, the nurse teaches her about adverse reactions to chlorambucil, such as
alopecia. How soon after the first administration of chlorambucil might this
reaction occur?

.
.
 A. Immediately
 B. 1 week
 C. 2 to 3 weeks
 D. 1 month

Correct

Correct Answer: C. 2 to 3 weeks

 Chlorambucil-induced alopecia occurs 2 to 3 weeks after therapy begins.

The medication causes structural damage to the scalp hairs resulting in
reduced hair growth and complete hair loss (alopecia).
.
 41. Question
. 1 point(s)
A male client is receiving the cell cycle–nonspecific alkylating agent Thioplex
(thiotepa), 60 mg weekly for 4 weeks by bladder instillation as part of a
chemotherapeutic regimen to treat bladder cancer. The client asks the nurse how
the drug works. How does thiotepa exert its therapeutic effects?

.
.
 A. It interferes with deoxyribonucleic acid (DNA) replication only
 B. It interferes with ribonucleic acid (RNA) transcription only
 C. It interferes with DNA replication and RNA transcription
 D. It destroys the cell membrane, causing lysis

Correct

Correct Answer: C. It interferes with DNA replication and RNA

transcription.

 Option C: Thiotepa is an alkylating agent that works by crosslinking DNA

strands by reacting with phosphate groups to stop protein synthesis, RNA,
and DNA.
 Options A, B, and D: Thiotepa interferes with DNA replication and RNA
transcription. It doesn’t destroy the cell membrane.
.
42. Question
. 1 point(s)
Gio, a community health nurse, is instructing a group of female clients about
breast self-examination. The nurse instructs the client to perform the
examination:

.
.
 A. At the onset of menstruation
 B. Every month during ovulation
 C. Weekly at the same time of day
 D. 1 week after menstruation begins

Correct

Correct Answer: D. 1 week after menstruation begins

 Option D: The breast self-examination should be performed monthly 7

days after the onset of the menstrual period when the breasts are less
tender and lumpy.
 Options A and B: At the onset of menstruation and during ovulation,
hormonal changes occur that may alter breast tissue.
 Option C: Performing the examination weekly is not recommended.
.
43. Question
. 1 point(s)
Nurse Cindy is caring for a client who has undergone a vaginal hysterectomy. The
nurse avoids which of the following in the care of this client?

.
.
 A. Removal of antiembolism stockings twice daily
 B. Checking placement of pneumatic compression boots
 C. Elevating the knee gatch on the bed
 D. Assisting with range-of-motion leg exercises

Correct

Correct Answer: C. Elevating the knee gatch on the bed

 Option C: The nurse should avoid using the knee gatch in the bed, which
inhibits venous return, thus placing the client more at risk for deep vein
thrombosis or thrombophlebitis.
 Options A, B, and D: The client is at risk of deep vein thrombosis or
thrombophlebitis after this surgery, as for any other major surgery. For this
reason, the nurse implements measures that will prevent this complication.
Range-of-motion exercises, anti-embolism stockings, and pneumatic
compression boots are helpful.
.
44. Question
. 1 point(s)
Mina, who is suspected of an ovarian tumor is scheduled for a pelvic ultrasound.
The nurse provides which pre-procedure instruction to the client?

.
.
 A. Wear comfortable clothing and shoes for the procedure
 B. Maintain an NPO status before the procedure
 C. Drink six to eight glasses of water without voiding before the test
 D. Eat a light breakfast only

Correct

Correct Answer: C. Drink six to eight glasses of water without voiding

before the test

 Option C: A pelvic ultrasound requires the ingestion of large volumes of

water just before the procedure. A full bladder is necessary so that it will be
visualized as such and not mistaken for possible pelvic growth.
 Option A: Comfortable shoes and clothing is unrelated to this specific
procedure.
  Option B: An abdominal ultrasound may require that the client abstain
from food or fluid for several hours before the procedure.
 Option D: A patient may eat and drink on the day of the exam regardless
of quantity.
.
45. Question
. 1 point(s)
A male client is diagnosed as having a bowel tumor and several diagnostic tests
are prescribed. The nurse understands which test will confirm the diagnosis of
malignancy?

.
.
 A. Magnetic resonance imaging
 B. Computerized tomography scan
 C. Abdominal ultrasound
 D. Biopsy of the tumor

Incorrect

Correct Answer: D. Biopsy of the tumor

 Option D: A biopsy is done to determine whether a tumor is malignant or

benign through the examination of the sample of tissue taken into a body
part.
 Options A, B, and C: Magnetic resonance imaging, computed tomography
scan, and ultrasound will visualize the presence of a mass but will not
confirm a diagnosis of malignancy.
.
46. Question
. 1 point(s)
Vanessa, a community health nurse conducts a health promotion program
regarding testicular cancer to community members. The nurse determines that
further information needs to be provided if a community member states that
which of the following is a sign of testicular cancer?

.
.
 A. Back pain
 B. Alopecia
 C. Heavy sensation in the scrotum
 D. Painless testicular swelling

Incorrect

Correct Answer: B. Alopecia

  Option B: Alopecia is not an assessment finding in testicular cancer.
Alopecia may occur, however, as a result of radiation or chemotherapy.
 Options A, C, and D: Back pain, heavy sensation in the scrotum, and
painless testicular swelling are assessment findings in testicular cancer.
Back pain may indicate metastasis to the retroperitoneal lymph nodes.
.
47. Question
. 1 point(s)
The male client is receiving external radiation to the neck for cancer of the larynx.
The most likely side effect to be expected is:

.
.
 A. Diarrhea
 B. Dyspnea
 C. Constipation
 D. Sore throat

Correct

Correct Answer: D. Sore throat

 Option D: In general, only the area in the treatment field is affected by the
radiation. Skin reactions, fatigue, nausea, and anorexia may occur with
radiation to any site, whereas other side effects occur only when specific
areas are involved in treatment. A client receiving radiation to the larynx is
most likely to experience a sore throat.
 Options A and C: May occur with radiation to the gastrointestinal tract.
 Option B: Dyspnea may occur with lung involvement.

.
48. Question
. 1 point(s)
Nurse Joy is caring for a client with an internal radiation implant. When caring for
the client, the nurse should observe which of the following principles?

.
.
 A. Remove the dosimeter badge when entering the client’s room
 B. Individuals younger than 16 years old may be allowed to go in the room as
long as they are 6 feet away from the client
 C. Limit the time with the client to 1 hour per shift
 D. Do not allow pregnant women into the client’s room

Correct
 Correct Answer: D. Do not allow pregnant women into the client’s room

 Options B and D: Children younger than 16 years of age and pregnant

women are not allowed in the client’s room to avoid radiation exposure that
may harm the children and the developing baby.
 Option A: The dosimeter badge must be worn when in the client’s room.
 Option C: The time that the nurse spends in a room of a client with an
internal radiation implant is 30 minutes per 8-hour shift.
.
49. Question
. 1 point(s)
A cervical radiation implant is placed in the client for treatment of cervical cancer.
The nurse initiates what most appropriate activity order for this client?

.
.
 A. Out of bed ad lib
 B. Ambulation to the bathroom only
 C. Bed rest
 D. Out of bed in a chair only

Incorrect

Correct Answer: C. Bed rest

 Option C: The client with a cervical radiation implant should be maintained

on bed rest in the dorsal position to prevent movement of the radiation
source. The head of the bed is elevated to a maximum of 10 to 15 degrees
for comfort. The nurse avoids turning the client on the side. If turning is
absolutely necessary, a pillow is placed between the knees and, with the
body in straight alignment, the client is logrolled.
.
50. Question
. 1 point(s)
The nurse is caring for a female client experiencing neutropenia as a result of
chemotherapy and develops a plan of care for the client. The nurse plans to:

.
.
 A. Teach the client and family about the need for hand hygiene
 B. Insert an indwelling urinary catheter to prevent skin breakdown
 C. Restrict fluid intake
 D. Restrict all visitors

Incorrect

Correct Answer: A. Teach the client and family about the need for hand
hygiene
 Option A: In the neutropenic client, meticulous hand hygiene education is
implemented for the client, family, visitors, and staff to avoid transmission-
based infection.
 Option B: Invasive measures such as an indwelling urinary catheter should
be avoided to prevent infections.
 Option C: Fluids should be encouraged.
 Option D: Not all visitors are restricted, but the client is protected from
persons with known infections.