1. A male client has an abnormal result on a Papanicolaou test. After admitting, he read his chart while the nurse was out of the room, the client asks what dysplasia means. Which definition should the nurse provide?
a. Presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin
b. Increase in the number of normal cells in a normal arrangement in a tissue or an organ
c. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found
d. Alteration in the size, shape, and organization of differentiated cells
2. For a female client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client?
a. "Client verbalizes feelings of anxiety."
b. "Client doesn't guess at prognosis."
c. "Client uses any effective method to reduce tension."
d. "Client stops seeking information."
3. A male client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. Which "related-to" phrase should the nurse add to complete the nursing diagnosis statement?
a. Related to visual field deficits
b. Related to difficulty swallowing
c. Related to impaired balance
d. Related to psychomotor seizures
4. A female client with cancer is scheduled for radiation therapy. The nurse knows that radiation at any treatment site may cause a certain adverse effect. Therefore, the nurse should prepare the client to expect:
a. hair loss.
5. Nurse April is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by:
a. breast self-examination.
c. fine needle aspiration.
d. chest X-ray.
6. A male client undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should include which instruction?
a. "Keep the stoma uncovered."
b. "Keep the stoma dry."
c. "Have a family member perform stoma care initially until you get used to the procedure."
d. "Keep the stoma moist."
7. A female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy?
a. Urine output of 400 ml in 8 hours
b. Serum potassium level of 3.6 mEq/L
c. Blood pressure of 120/64 to 130/72 mm Hg
d. Dry oral mucous membranes and cracked lips
8. Nurse April is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover:
a. cancerous lumps.
b. areas of thickness or fullness.
c. changes from previous self-examinations.
d. fibrocystic masses.
9. A client, age 41, visits the gynecologist. After examining her, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer?
a. Onset of sporadic sexual activity at age 17
b. Spontaneous abortion at age 19
c. Pregnancy complicated with eclampsia at age 27
d. Human papillomavirus infection at age 32
10. A female client is receiving methotrexate (Mexate), 12 g/m2 I.V., to treat osteogenic carcinoma. During methotrexate therapy, the nurse expects the client to receive which other drug to protect normal cells?
a. probenecid (Benemid)
b. cytarabine (ara-C, cytosine arabinoside [Cytosar-U])
c. thioguanine (6-thioguanine, 6-TG)
d. leucovorin (citrovorum factor or folinic acid [Wellcovorin])
11. The nurse is interviewing a male client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer?
a. Duodenal ulcers
c. Weight gain
12. Nurse Amy is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society guidelines, the nurse should recommend that the women:
a. perform breast self-examination annually.
b. have a mammogram annually.
c. have a hormonal receptor assay annually.
d. have a physician conduct a clinical examination every 2 years.
13. A male client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer?
a. Persistent nausea
d. Chronic ache or pain
14. For a female client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the plan of care?
a. Administering aspirin if the temperature exceeds 102° F (38.8° C)
b. Inspecting the skin for petechiae once every shift
c. Providing for frequent rest periods
d. Placing the client in strict isolation
15. Nurse Lucia is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms:
a. yearly after age 40.
b. after the birth of the first child and every 2 years thereafter.
c. after the first menstrual period and annually thereafter.
d. every 3 years between ages 20 and 40 and annually thereafter.
16. Which intervention is appropriate for the nurse caring for a male client in severe pain receiving a continuous I.V. infusion of morphine?
a. Assisting with a naloxone challenge test before therapy begins
b. Discontinuing the drug immediately if signs of dependence appear
c. Changing the administration route to P.O. if the client can tolerate fluids
d. Obtaining baseline vital signs before administering the first dose
17. 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).
18. The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for?
19. When caring for a male client diagnosed with a brain tumor of the parietal lobe, the nurse expects to assess:
a. short-term memory impairment.
b. tactile agnosia.
d. contralateral homonymous hemianopia.
20. A female client is undergoing tests for multiple myeloma. Diagnostic study findings in multiple myeloma include:
a. a decreased serum creatinine level.
c. Bence Jones protein in the urine.
d. a low serum protein level.
21. A 35 years old client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis (inflammation of the mouth)?
a. White, cottage cheese-like patches on the tongue
b. Yellow tooth discoloration
c. Red, open sores on the oral mucosa
d. Rust-colored sputum
22. During chemotherapy, an oncology client has a nursing diagnosis of impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis?
a. Recommending that the client discontinue chemotherapy
b. Providing a solution of hydrogen peroxide and water for use as a mouth rinse
c. Monitoring the client's platelet and leukocyte counts
d. Checking regularly for signs and symptoms of stomatitis
23. What should a male client over age 52 do to help ensure early identification of prostate cancer?
a. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly.
b. Have a transrectal ultrasound every 5 years.
c. Perform monthly testicular self-examinations, especially after age 50.
d. Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly.
24. A male client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis may be appropriate for this client?
a. Anticipatory grieving
b. Impaired swallowing
c. Disturbed body image
d. Chronic low self-esteem
25. A male client is in isolation after receiving an internal radioactive implant to treat cancer. Two hours later, the nurse discovers the implant in the bed linens. What should the nurse do first?
a. Stand as far away from the implant as possible and call for help.
b. Pick up the implant with long-handled forceps and place it in a lead-lined container.
c. Leave the room and notify the radiation therapy department immediately.
d. Put the implant back in place, using forceps and a shield for self-protection, and call for help.
26. Jeovina, with advanced breast cancer is prescribed tamoxifen (Nolvadex). When teaching the client about this drug, the nurse should emphasize the importance of reporting which adverse reaction immediately?
a. Vision changes
b. Hearing loss
27. 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?
c. Reproductive tract
d. White blood cells (WBCs)
28. A 34-year-old female client is requesting information about mammograms and breast cancer. She isn't considered at high risk for breast cancer. What should the nurse tell this client?
a. She should have had a baseline mammogram before age 30.
b. She should eat a low-fat diet to further decrease her risk of breast cancer.
c. She should perform breast self-examination during the first 5 days of each menstrual cycle.
d. When she begins having yearly mammograms, breast self-examinations will no longer be necessary.
29. 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
30. 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.