1.The nurse is caring for a client who has just had a modified radical mastectomy with immediate reconstruction. She's in her 30's and has two young children.Although she is worried about her future, she seems to be adjusting well to her diagnosis.What should the nurse do to support her coping? A) Tell the client's spouse or partner to be supportive while she recovers B) Encourage the client to proceed with the next phase of treatment C) recommend that the client remain cheerful for the sake of her children D) Refer the client to the American Cancer Society's reach for recovery Program or another support program group ANSWER: D 2.A client with metastatic ovarian Cancer is prescribed cesplatin.Before administering the first dose, the nurse reviews the client's medication history for drugs that may interact with cisplatin.Which drug may cause significant interactions when given concomitantly with cisplatin? A) erythromycin B) tetracycline C) cephalosporin D) aminoglycloside ANSWER: D 3.After being in remission from Hodgkin's disease for 18 months, a client develops a fever of unknown origin.The physician orders a blind liver biopsy to rule out hodgkin's disease and infection.24 hours after the biopsy,the client has a fever,complains of sever abdominal pain and seems increasingly confuseD) The nurse suspects that these findings result from A) Bleeding in the liver caused by liver biopsy B) Perforation in the colon caused by the liver biopsy C) An allergic reaction caused by the contrast media used during the liver biopsy D) Normal postprocedural pain,with a change in the level of consciousness resulting from the preexisting fever ANSWER: B 4.A child is hospitalized for oat cell carcinoma of the lung.To manage severe pain,to manage severe pain,the physician prescribes continuous infusion of morphine. Which formula should the nurse use to check that the morphine dose appropriate for the client? A) 1 milligram per kilogram of body weight B) 5 milligram per kilogram of body weight C) 5 milligram per 70 kg of body weight D) 10 milligram per 70 kg of body weight ANSWER: D 5.A client with stage 11 ovarian cancer undergoes a total abdominal hysterectomy and bilateral salpingoophorectomy with tumor resection.Omentectomy,appendectomy and lymphadenectomy.During the second postoperartive day,which of the following assessment findings would raise the concern in the nurse? A) Abdominal pain B) Hypoactive bowel sounds C) Serous drainage from the incision D) Shallow breathing and increasing lethargy ANSWER: D 6.The nurse is caring for a client receiving the fentanyl for pain management.When applying a new system,thr nurse should A) press the system in place for 30 to 60 seconds B) choose a site on the lower torso C) Shave the application site before use D) Apply the system immediately after removal from the package ANSWER: D 7.A client asks the nurse what PSA is.The nurse should reply that it stands for A) prostate specific antigen B) protein serum antigens which is used to determine protein levels C) pneumococcal strep antigen, which is a bacteria D) Papanicolau specific antigen,which is used to screen for cervical cancer ANSWER: A 8.the nurse is providing breast cancer education at a community facility.The American Cancer society recommends yhay women get mammograms A) yearly after age 40 B) after the birth of the first child and every 2 years after C) after the first monthly period and 2 months thereafter D) every two years between ages 20 t0 40 and annually therafter ANSWER: A 9.A client asks the nurse what PSA is.The nurse should reply that it stands for A) prostate specific antigen which is used for screening prostate cancer B) protein serum antigen which is used to determine protein levels C) pneumococcal strep antigen,which is a bacteria that causes pneumonia D) Papaniculou specific antigen which is used to screen for cervical cancer ANSWER: A 10.A client with colon cancer requires a colostomy because of tumor location. After surgery the client must learn how to irrigate the colostomy ,When irrigating how far into the stoma should insert the stoma should insert the lubricated catheter? A) 0.25" to .5" B) 1" to 1.5" C) 2" to 4" D) 5" to 7" ANSWER: C 11.A client receiving chemotherapy has a nursing diagnosis of Diversional activity deficit related to decreased energy.Which statement indicates an accurate understanding of appropriate ways to deal with the deificit? A) I'll play card games with my friends B) I'll take a long trip to visit my aunt C) I'll bowl, with my friends after discharge D) I'll eat lunch with my friends every day" ANSWER: A 12.A 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 faar away as possible and call for help B) Pick up the implant with long handled forceps and place it in 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 ANSWER: B 13.Which intervention Is necessary for the nurse caring for a client in severe pain receiving a continuous infusion of morphine? A) Assisting in a naloxone challenge test before therapy begins B) Discontinuing the drug immediately if signs of dependence occur C) Changing the administration route to p.o. if the client can tolerate fluids D) Obtaining the baseline vital signs before administering the first dose ANSWER: D 14.A client with advance breast cancer is prescribed tamoxifen.When teaching the client about this drug,the urse should emphasize the importance of reporting which adverse reaction immediately? A) Visual changes B) Hearing loss C) Headache D) Anorexia ANSWER: A 15.The nurse is caring for a client with brochogenic carcinomA) Which nursing diagnosis takes highest priority? A) Body image disturbance related to changes in body function B) Ineffective airway clearance related to obstruction by tumor or secretions C) Anxiety related to actual threat to health status aand changes in family dynamics D) Altered nutrition.Less than body requirements related to anorexia and vomiting secondary to chemotherapy ANSWER: B 16.The nurse is instructing the premenopausal woman about breast self-examination A) at the end of her menstrual cycle B) on the same day each month C) on the first day of the menstrual cycle D) immediately after her menstrual period ANSWER: D 17.During a breast examination,which finding most strongly suggests that the client has breast cancer? A) slight asymmetry of the breast B) A fixed nodular mass with dimpling of the overlying skin C) Bloody discharge from the nipples D) Multiple firm round,freely moveable masses that changes with the menstrual cycle ANSWER: B 18.During chemotherapy, an oncology client has a nursing diagnosis of Altered 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 this 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 ANSWER: B 19.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 the client's lump is cancerous? A) Eversion of the right nipple and mobile mass B) Nonmobile mass with irregular edges C) Mobile mass that is soft and easily delineated D) Nonpalpable right axillary node ANSWER: B 20.In assessing postmastectomy client, the nurse determines that the client is in denial.The nurse can best respond by A) accepting the denial B) confronting the denial C) supporting the denial D) interpreting the denial ANSWER: A 21.A client with advanced liver cancer is scheduled for chemotherapy.As part of the chemotherapy regimen, the nurse expects the physician to prescribe A) Fluoxymesterone B) Tamoxifen C) Fluorouracil D) Megestrol ANSWER: C 22.During routine checkup, the nurse assesses a client with acquired immunodeficiency syndrome for signs and symptoms of cancer? A) Squamous cell carcinoma B) Multiple myeloma C) Leukemia D) Kaposi's sarcoma ANSWER: D 23. The nurse has been interviewing a client about his past medical history.Which pre-existing condition may lead the nurse to suspect that a client has colorectal cancer? A) Duodenal ulcers B) Hemorrhoids C) Weight gain D) Polyps ANSWER: D 24.A client age 42 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 by eclampsia at age 27 D) Human papilloma virus infection at age 24 ANSWER: D 25.A client is scheduled for prostatectomy, and the anesthesiologist plans to use the spinal block for surgery.In the operating room , the nurse positions the client according to the anesthesiologists instructions.Why does the client require special type of positioning for this type of anesthesia? A) To prevent confusion B) To prevent seizures C) To prevent spinal fluid leakage D) To prevent cardiac arrhythmias ANSWER: C 26.The American Cancer Society recommends screening test to detect colorectal cancer should the nurse recommend? A) Carcinoembryonic test after age 50 B) Protosigmoidoscopy after age 30 C) Annual digital examination after age 40 D) Barium enema after age 20 ANSWER: C 27.For a 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 does not guess prognosis C) Client uses any effective method to reduce tension D) Client stops seeking information ANSWER: A 28.A client in the final stages of cancer tells his nurse "I wish I could just be allowed to die.I'm tired of fighting this illness.I have lived a good life.I only continue my chemotherapy and radiation treatments because my family wants me to.What is the nurse's best respond? A) Would you like to talk to a psychologist about your thoughts and feelings? B) Would you like to talk to your minister about the significance of death? C) Would you like to meet with your family and your physician about this matter? D) I know you are tired of fighting this illness but death will come in due time. ANSWER: C 29.A client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warnng signs of cancer.What is another sign of cancer? A) Persistent nausea B) Rash C) Indigestion D) Chronic ache or pain ANSWER: C 30.The nurse is telling the client about breast self examinations. A client asks if she should have an annual mammogram.According to the American Cancer Society,how should the nurse respond? A) All woman over the age of 30 should have an annual mammogram B) All women over the age of 40 should have an annual mammogram C) Any woman over the age of 20 whose mother had breast cancer should have an annual mammogram D) Any woman who feels she is at risk for breast cancer should have an annual mammogram ANSWER: B 34.At a health fair,an oncology nurse ANSWERs questions about risks factors for various type of cancers.One person with a family history of colon cancer asks the nurse to identify risk factors for this type of cancer.The nurse should identify A) smoking B) heavy alcohol consumption C) obesity D) saccharin consumption ANSWER: C 35.A client with suspected lung cancer is scheduled for thoracentesis as part of the diagnostic workup.The nurse reviews the client's history for conditions that might contraindicate this procedure.Which condition is a contraindication for thoracentesis? A) A seizure disorder B) Chronic obstructive pulmonary disease C) Anemia D) Bleeding disorder ANSWER: D 36.The nurse is developing a plan of care for marrow suppression, the major dose limiting adverse reaction to floxuridine.How long after drug administration does bone marrow suppression become noticeable? A) after 24 hours B) 2 to 4 days C) 7 to 14 days D) 21 to 28 days ANSWER: C 37.A 30 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 nurses tell this client? A) She should have had 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 mammogram,breast self examinations will no longer be necessary ANSWER: B 38.The nurse is assessing 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 ANSWER: C 39.The nurse is teaching a male client to perform monthly testicular monthly self examination.Which of the following points would be appropriate to make? A) 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 death in males D) Testicular cancer is more common in older men ANSWER: A 40.A client is undergoing a diagnostic workshop for suspected thyroid cancer. What is the most common form of thyroid cancer in adults? A) Follicular carcinoma B) Medullary carcinoma C) Anaplastic carcinoma D) Papillary carcinoma ANSWER: D 41.The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stands for? A) Active B) Asymmetry C) Arcus D) Assessment ANSWER: B 42.A client 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 3.8 [mEq/L] C) Blood pressure of [120/64 to 130/72 mmHg] D) Dry oral mucous membranes and cracked lips ANSWER: D 43.A client suspected of having colorectal cancer will require which diagnostic study to confirm the diagnosis? A) Stool hematest B) Carcinoembryonic antigen C) Sigmoidoscopy D) Abdominal computed tomography scan ANSWER: C 44. A home care nurse assesses for disease complication in a client with bone cancer complication.The nurse knows that bone cancer may cause which electrolyte imbalance? A) Hyperkalemia B) Hypercalcemia C) Hyponatremia D) Hypermagnesemia ANSWER: C 45.A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of high risk for impaired skin integrity.Which intervention should be part of this client's plan of care? A) Avoiding using soap in the irradiated areas B) Applying talcum powder to the irradiated areas daily after bathing C) Wearing a lead apron during direct contact with the client D) Removing thoracic skin markings ANSWER: A 46.A 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) I have a family member perform stoma care initially unti you get used to the procedure D) Keep the stoma moist ANSWER: D 47. What should a male client over age 50 do to help ensure early identification of prostate cancer? A) Digital rectal examination and prostate specific antigen PSA test done yearly B) Have transurethral USD every 5 years C) Perform monthly testicular self examination D) CBC, BUN, S,Creatinine ANSWER: A 48. A client is undergoing test for multiple myelomA) Diagnostic tests study findings in multiple myeloma include A) a decreased serum creatinine level B) Hypocalcemia C) Bench Jones protein in the urine D) Low serum proteinlevel ANSWER: C 49.The spouse of a client with gastric cancer expresses concern that the couple's children may develop this type of cancer when they're older. When reviewing the risk factors for gastric cancer with the client and family, the nurse explains certain blood type increases the risk by 10%. The nurse is referring to A) Type A B) Type B C) Type AD D) Type O ANSWER: A 50.At a public health fair, a nurse discusses the dangers of sun exposure.Prolonged sun exposure has been blamed for which form of cancer? A) Malignant melanoma B) Squamous cell carcinoma C) Basal cell epithelioma D) All of the above ANSWER: D 51.At a public health fair ,the nurse teaches a group of women about breast cancer awareness.Possible signs of breast cancer include A) Fever B) Breast changes during menstruation C) Nipple discharge and breast nodule D) Fever and erythema of the breast ANSWER: C 52.A client who reports increasing difficulty of swallowing,weight loss and fatigue is diagnosed with esophageal cancer.Because the client has difficulty swallowing,the nurse should assign highest priority to A) helping the client cope with body image changes B) ensuring adequate nutrition C) maintaining a patent airway D) preventing injury ANSWER: C 53.To treat cervical cancer , a client has had an applicator of radioactive material place in the vaginA) Which observation by the nurse indicates a radiation hazard? A) The client is maintained on strict bed rest B) The head of the bed is at a 30 degree angle C) The client receives a complete bed bath each morning D) The nurse checks the apllicator's position every 4 hours ANSWER: C 54.Before a cancer client receiving total parenteral nutrition, resumes a normal diet,the nurse teaches him about dietary sources of minerals.Which food are good sources of Zinc? A) Fruits and yellow vegetables B) Yeast and legumes C) Fruits and green vegetables D) Whole grains and meats ANSWER: D 55.A client with vaginal cancer asks the nurse " What is usual treatment for this type of cancer? Which treatment should the nurse name? A) Surgery B) Chemotherapy C) radiation D) Immunotherapy ANSWER: C 56.A client is scheduled to receive methtrexate .625 milligram per kilogram p.o. daily to treat malignant lymphomA) Before administering the drug the nurse receives the client medication history.Which of the following drugs might interact with methotrexate? A) digoxin B) theophylline C) probenecid D) famotidine ANSWER: C 57.A client has a routine papaniculou smear test during a yearly gynecological examination.The result reveals a class V finding.What should the nurse tell about this finding? A) its normal and requires no action B) it calls for a repeat Pap test in 3 months C) It calls for a repeat Pap test in 6 weeks D) it calls for a biopsy as soon as possible ANSWER: D 58.A client receives minor surgery for basal cell tumor.The anesthesiologist administers the anesthetic ketamine hydrochloride 60 g IV.After ketamine administration,the nurse should monitor the client for A) muscle rigidity and spasm B) extrapyramidal reactions C) hiccups D) respiratory depression ANSWER: A 59.A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows TIS, NO, MO. What does this classification mean? A) No evidence of primary tumor, no abnormal lymph nodes and no evidence of distant metastasis B) Carcinoma in situ, no abnormal regional lymph nodes and no evidence of distant metastasis. C) Can't assess tumor or regional lymph nodes and no evidence of metastasis D) Can't assess tumor or regional lymph nodes and ascending degrees of distant metastasis ANSWER: B 60.A client in the terminal stage of cancer is receiving a continuous infusion of morphine for pain management.Which assessment finding suggests that the client is experiencing an adverse effect of this drug? A) Voiding of 350 ml of concentrated urine in 8 hrs B) Respiratory rate of [8 hrs/minute] C) Irregular heart rate of [82 beats/minute] D) Pupils constricted and equal ANSWER: B 61.A client with cerebellar brain tumor is admitted to an acute facility. The nurse formulates a nursing diagnosis of risk for injury. Which is "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 ANSWER: C 62.The nurse is teaching the client who suspects that she has a lump in her breast.The nurse instructs the client that diagnosis of breast cancer is confirmed by A) Breast self examination B) Fine needle aspiration C) Chest X ray D) Mammography ANSWER: B 63.The nurse is speaking to a group of women about early detection of breast cancer. The average age of the woman in the group is 47. Following the American Cancer Society guidelines, the nurse should recommend that the women A) Perform breast selfexamination annually B) Have a mammogram annually C) Have a hormonal receptor assay annually D) Have a physician conduct a clinical examination every 2 years ANSWER: B 64.A client complains of on and off epigastric pain.yellow skin,nausea ,vomiting and weight loss and fatigue.Suspecting gallbladder disease,the physician orders a diagnostic work up,which reveals gallbladder cancer?Which nursing diagnosismay be appropriate for this client? A) Anticipatory grieving B) Impaired swallowing C) Body image disturbance D) Chronic low self-esteem ANSWER: A 65.A client with prostatic cancer is being evaluated for possible metastasis.Which of the following is the most common site of metastatic sites for cancer? A) Liver B) Colon C) Reproductive tract D) White blood cells ANSWER: A 66.A client is receiving methotrexate 12 g IV to treat osteogenic osteogenic carcinomA) During metrotrexate therapy,the nurse expects the client to receive which other drug to protect normal cells? A) probeneid B) cytarabine C) cytoguanine D) leucovorin ANSWER: D 67.When caring for a client with a brain tumor of the parietal lobe, the nurse is expected to assess A) Short term memory impairment B) tactile agnosia C) seizures D) contralateral homonymous hemianopsia ANSWER: B 68.Which nursing intervention is most appropriate for a client with multiple myeloma? A) Monitoring respiratory status B) Balancing rest and activity C) restricting fluid intake D) Preventing bone injury ANSWER: D 69.A few minutes after beginning a blood transfusion,the nurse notes that the client has chills,dyspnea and urticariA) The nurse reports this to the physician immediatelybecause the client probably is experiencing which problem? A) A hemolytic reaction to mismatched blood B) A hemolytic reaction to mismatched blood C) A hemolytic reaction caused by an antigen reaction D) A hemolytic reaction caused by bacterial contamination of donor blood ANSWER: C 70. A woman with uterine cancer asks the nurse which is type of cancer is the most common cause of death in women? A) Breast cancer B) Lung cancer C) Brain cancer D) Colon and rectal cancer ANSWER: B 71.A client seeks care for hoarshness that lasted for one month.To elicit the most appropriate information about this problem,the nurse should ask which question? A) Do you smoke cigarettes,cigars or a pipe? B) Have you strained your voice recently? C) Do you eat a lot of red meat" D) Do you eat spicy food" ANSWER: A 72. After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? A) Serving small portions of bland food B) Encouraging rhythmic breathing exercises C) Administering metochlopromide and dexamethasone as prescribed D) Witholding fluids for the first 4-6 hours after chemotherapy administration ANSWER: C 73.A nurse is working with a dying client and his family.Which communication technique is most important to use? A) Reflection B) Interpretation C) Clarification D) Active listening ANSWER: D 74. A client is admiited to an acute care facility with esophageal cancer.The incidenc of esophageal cancer is highest in A) Black males B) Adults ages 20 to 30 C) Women over the age 60 D) Whites under age 10 ANSWER: A 75.A client is receiving the cell cycle nonspecific alkylating agent thiotepa 60 mg weekly for 4 weeks by bladder instillation as part of the chemotherapeutic regiment to treat bladder cancer.The client ask the nurse how the drug works.How does theopeta exerts its therapeutic effects? A) It interferes with deoxyribonucleic acid replication only B) It interferes with ribonucleic acid transcription only C) It interferes with DNA replication and RNA transcription D) It destroys cell membrane causing lysis ANSWER: C 76.Several days prior to admission, patient found lump in the left breast near the nipple. What should be done A) Inform physician immediately B) Squeeze nipple to see discharge C) Check area if there is skin dimpling D) Put a heating pa d on area to reduce inflammation ANSWER: A 77.Which finding is an early indicator of cancer? A) painless hematuria B) occasional polyuria C) nocturia D) Dysuria ANSWER: A 78.Most common type of cancer in women A) Breast cancer B) Lung cancer C) Brain cancer D) Colon and rectal cancer ANSWER: A 79.A client with supraglottic cancer undergoes a partial laryngectomy.Postoperatively a cuff tracheostomy tube is in place.When removing secretions that pull above the cuff,the nurse should instruct the client to A) cough as the cuff is being deflated B) take a deep breath as the nurse deflates the cuff C) hold the breath as the cuff is being reinflated D) exhale deeply as the nurse reinflates the cuff ANSWER: A 80.A client is being diagnosed with metastatic adenocarcinoma of the stomach A) it initiates DNA synthesis B) it initiates RNA synthesis C) its cellcycle specific D) It inhibits protein synthesis ANSWER: A 81.On a visit to the gynecologist, a client complains of urinary frequency, pelvic discomfort and weight loss. After a complete physical examination, blood studies, and a pelvic examination with a Papanicolou test, the physician diagnosis stage 1V ovarian cancer. The nurse expects to prepare the client for which initial treatment/ A) Radioactive therapy B) Major surgery C) Chemotherapy D) None(at this stage, ovarian cancer isn't treatable ANSWER: B 82.For a client newly diagnosed with radiation induced thrombocytopenia,the nurse should include which intervention in the plan of care A) Adminstering aspirin as the temperature rises to 38.8 B) Inspecting the skin for petechiae once every shift C) Providing for frequent rest periods D) Placing the client in strict isolation ANSWER: B 83.A client asks the nurse "Does everyone who gets cancer die of it?" The nurse best response is based on the understanding that A) About five million people in the U.S. survive cancer for five or more years. B) All one million people diagnosed in the U.S. annually will eventually die of their disease C) Cancer is the leading cause of adult death in the U.S. D) It destroys hope to discuss dying with a client with cancer. ANSWER: A 84.The client state," I heard that all men get prostate cancer sometimes in their lives." In teaching the client about cancer incidence, the best response is based on the understanding that A) Lung cancer is the most frequently diagnosed cancer in men B) Prostate cancer is the most frequently diagnosed cancer in men C) Prostate cancer is the most prevalent in Caucasian men D) There is no way to screen for prostate cancer, so it is the most common cause of cancer death in men. ANSWER: B 85.When planning the discharge of a client with cancer, which of the following should the nurse include as a priority? A) Encouragement to drink no alcoholic beverages B) Information on all local hospices C) Plans for visiting nurse D) Information on stress reduction techniques ANSWER: D 86.While assessing a client's skin, the nurse should report which of the following findings as a possible skin cancer? A) Red, swollen plaques B) A bull's eye rash C) A blue-black appearing mole D) Spider angiomas ANSWER: C 87.The nurse is collecting a health history on a client admitted for colon cancer. Which of the following questions would be a priority to ask this client? A) Have you noticed any blood in the stool?" B) Have you been experiencing nausea?" C) Do you have any back pain?" D) Have you noticed your abdomen has swollen? ANSWER: A 88.A nurse is educating a group of clients on cancer screening practices. Which of the following instructions should the nurse include as a recommended screening pattern? A) Annual Pap and pelvic examination should begin at age 40 B) Annual cancer check-ups for all persons over age 40 C) Annual mammography should begin at age 30 D) Annual fecal occult blood test and colonoscopy at age 40 ANSWER: B 89.The client with cancer states," My pain is a 10! On a 0 to 10 scale ( 10 being worst possible pain). Which of the following is the appropriate nursing intervention? A) Instruct the client that no more narcotic analgesia can be given at this time in order to prevent addiction. B) Ask the client if the pain is really that bad, since narcotic analgesia will be given as a last resort for severe pain. C) Assure that a strong opioid, nonopioid, and adjuvant are ordered and administer per order D) Administer another dose of meperidine ( Demerol) as prescribed ANSWER: C 90.In planning the care of a client experiencing fatigue related to chemotherapy, which of the following is the most appropriate nursing intervention? A) Prioritize and administer nursing care throughout the day B) Accomplish all the nursing cares early in the day so the client can rest remainder of the day C) Perform all nursing cares during the evening shift when the client is the most rested D) Limit the number of visitors, promoting a maximum opportunity for sleep ANSWER: A 91.The nurse is caring for a client who underwent a bone marrow transplant 10 days ago. The nurse should monitor the client for which of the following clinical manifestations that indicates a potentially life- threatening situation? A) Mucositis B) Confusion C) Depression D) Mild temperature elevation ANSWER: D 92.Six days after receiving chemotherapy, the client report that ,"My mouth feels like it's on fire!" which of the following is the priority nursing action? A) Encourage rinsing the mouth several times per day with an over the counter mouthwash B) Administer analgesics as ordered C) Assess the oral mucosa for signs of infection and tissue breakdown D) Instruct the client to eat small, frequent meals of soft food such as applesauce ANSWER: C 93.The nurse finds the client vomiting on the second day after chemotherapy. Antiemetics and IV fluids have been administered as ordereD) The nurse should include which of the following as an appropriate intervention for this client? A) Offer music therapy to decrease nausea B) Encourage the client to remain in an upright position for two hours after eating C) Obtain an order for a tube feeding to assure adequate nutrition D) Discuss decreasing the next dose of chemotherapy with the physician. ANSWER: C 94.In preparing a client on oral narcotic analgesics for discharge after a mastectomy, the nurse should include the following in postoperative teaching. A) Use oral narcotics sparingly to avoid constipation B) Bowel training program C) High-protein, low-carbohydrate diet plan D) Upper extremity weight-training program ANSWER: B 95.While caring for the client with superior vena cava syndrome, the nurse should include which of the following intervention/ A) Restrict visitors, since the client will be anxious B) Withhold chemotherapy until the syndrome resolves C) Instruct the client in Valsalva's maneuver D) Elevate the head of the bed ANSWER: D 96.The nurse is caring for a client with small cell lung cancer. Which of the following observations would be a priority that the nurse should report immediately? A) Weight loss B) Serum sodium less than 130mEq/L C) Headache D) Urinary output greater than 60 ml/hour ANSWER: B 97.The nurse is caring for a client who received chemotherapy for leukemia 24 hours ago and is now complaining of flank pain. The client's urinary output has decreased to less than 30 ml/hour. The nurse evaluates which of the following conditions as the most likely cause of the client's clinical manifestations? A) Syndrome of inappropriate antidiuretic hormone (SIADH) B) Tumor lysis syndrome C) Superior vena cava syndrome D) Hypercalcium ANSWER: B 98.The nurse should instruct a client that which of the following is the most effective prevention against bladder cancer? A) Drink 8 to 10 glasses of fluid per day B) Void at least five times per day C) Stop smoking D) Take herbal supplements ANSWER: C 99.Which of the following should the nurse include in the preoperative care plan of a client with head and neck cancer? A) Instruct the client and family in communicating with a picture board B) Assess the client's favorite foods to assure these are provided postoperatively C) Plan for a volunteer to take the client outside for cigarette breaks D) Provide frequent oral care, including rinsing with mouthwash. ANSWER: A 100.A client who has been treated for lung cancer returns to the clinic and during the nursing assessment reports recent problems with balance and memory. Based on the nurse's understanding of lung cancer, the appropriate action would be. A) reassure the client that these are just common signs of aging B) recommend that the client obtain gingko from the health food store C) perform a more through assessment D) call for an ambulance, since this is an oncology emergency ANSWER: C 101.The nurse is caring for a client following lobectomy lung cancer. Which of the following should the nurse include in the pain of care for this client? A) position the client on the operative side only B) avoid administering narcotic pain medication C) maintain strict bed rest D) instruct the client on the importance of coughing and deep breathing ANSWER: D 102.The spouse of a client with early-stage prostate cancer asks the nurse, "why isn't the physician treating my husband's cancer?" The nurse's best response should be based on which of the following? A) watchful waiting is often appropriate for men over age 70 B) the client must really have stage IV cancer, which is not curable C) all prostate cancer should be treated, and this client should get another opinion D) The client is being treated with hormonal manipulation, which isn't perceived as treatment by clients. ANSWER: A 103.While performing a nursing assessment, a female client informs the nurse of vague abdominal discomfort, bloating, and unexplained indigestion and flatulence for the last few months. What should the nurse ask in order to elicit the most important information for completing the assessment? A) "Do you often eat spicy food?" B) "tell me about your family's medical history." C) "Have you had weigh loss recently?" D) "Are you experiencing unusual menstrual bleeding?" ANSWER: B 104.The nurse is teaching a class on breast self-examination. Which of the following should the nurse include in the class? A) use only deep pressure when palpating the breast B) include both inspection and palpation of the breast in the exam C) use fingertips while palpating the breast D) perform beast palpation exam in front of a mirror ANSWER: B 105.A client state, "I'm worried about being burned by radiation therapy." The most appropriate response is based on the nurse's understanding that A) Applying hand lotion to the area being radiated will reduce the chance of burns. B) Darker-skinned person's burn more easily during radiation therapy. C) Burns are very rare with today's technology. D) Washing the radiated area with strong soap will reduce the chance of burns. ANSWER: C 106.When planning care for a client being treated for cervical cancer, it would be a priority for the nurse to include which of the following in the plan of care? A) instruction on birth control methods B) Vigorous fluid hydration C) Assessment of sexual function D) Daily weights ANSWER: C 107.The registered nurse is making out the nursing tasks for the day. Which of the following nursing tasks may be delegated to a licensed practical nurse? A) administer 3percent saline solution IV to a client with severe syndrome of inappropriate antidiuretic hormone [SIADH] B) Assess for an electrolyte imbalance in a client with tumor lysis syndrome C) Administer prescribed anticonvulsant to prevent seizure in a client who has a central nervous system tumor D) Monitor the serum calcium level in a client who has hypecalcemia ANSWER: C 108.the nurse is teaching a class on breast cancer. Which of the following should the nurse include as risk factors? A) Menopause at and early age and excessive caffeine use B) Slender build and first birth before the age of 20 years. C) Menarche at an early age and nulliparous D) Asian descent and lower socioeconomic status ANSWER: C 109.Which of the following findings on a female breast exam should the nurse repost as suspicious of breast cancer? A) Multiple, bilateral, round, lumpy tissue that is tender. B) A soft, mobile, single lobular nodule that is nontender C) A poorly defined, firm lump that is nontender and fixed to the skin D) A single soft lump that is will defined and tender ANSWER: C 110.The nurse is admitting a client with vaginal cancer. Which of the following questions should the nurse to elicit the most likely causative factor/ A) "Did you experience your first menses before the age of 11 years?" B) "Did your mother take diethylstilbestrol (DES) during pregnancy?" C) "Have you ever taken tamoxifen?" D) "Do you have a history of a sexually transmitted disease?" ANSWER: B 111.The nurse should instruct a female client that the best time to perform a breast self-examination is which of the following? A) the onset of menstruation B) the last day of the menstrual period C) Every month during ovulation D) Weekly at the same time of day ANSWER: B 112.Which of the following instructions should the nurse give a male client on how to perform a testicular self-examination (TSE)? A) Examine the testicle while lying down B) Gently feel the testicle with one finger to feel for a growth C) The best time to examine the testicle is after a shower D) A testicular exam should be done once every six months. ANSWER: C 113.The physician orders cystosocopy and random biopsies of the bladder for a client who reports painless hematuria Test results reveal carcinoma in situ several bladder regions. To treat bladder cancer, the client will have a series of intravesical installations of bacillus Calmette-Guerin (BCG) administered, 1 week apart. When teaching the client about BCG, the nurse should mention that this drug commonly causes A) Renal calculi B) Hematuria C) delayed ejaculation D) Impotence ANSWER: B 114. An oncology nurse educator is speaking in a woman'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) Mammography is the most reliable method for detecting breast cancer. B) Breast cancer is the leading killer of women of child bearing age C) Breast cancer requires a mastectomy D) Men can develop cancer ANSWER: D 115.The nurse 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) Area of thickness or fullness C) Changes from previous examination D) Fibrocystic mass ANSWER: C