F.L.

VARGAS COLLEGE COLLEGE OF HEALTH SCIENCEC NCM 106 PRELIM EXAMINATION Name: _____________________________ Date: ________________________

Instructions. Place the letter of the correct answer beside the number. Use CAPITAL LETTERS. Erasures and superimpositions are not allowed. 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 dont 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 isnt 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 doesnt guess at prognosis. c. Client uses any effective method to reduce tension. d. Client stops seeking information. 3. 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. c. fatigue. b. stomatitis d. vomiting. 4. A female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced bychemotherapy? 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 5. 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. c. changes from previous self-examinations. b. areas of thickness or fullness. d. fibrocystic masses. 6. 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 c. Indigestion b. Rash d. Chronic ache or pain 7. 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. 8. 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. 9. 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 cheeselike patches on the tongue b. Yellow tooth discoloration

c. Red, open sores on the oral mucosa d. Rust-colored sputum

10. 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 clients platelet and leukocyte counts d. Checking regularly for signs and symptoms of stomatitis 11. 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. 12. 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. 13. 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. Liver c. Reproductive tract b. Colon d. White blood cells (WBCs) 14. Nurse Meredith is instructing a premenopausal woman about breast self-examination.
The nurse should tell the client to do her self-examination: c. on the 1st day of the menstrual cycle. d. immediately after her menstrual a. at the end of her menstrual cycle. period. b. on the same day each month. 15.A female client with cancer is receiving chemotherapy and develops thrombocytopenia. The nurse identifies which intervention as the highest priority in the nursing plan of care? a. Monitoring temperature b. Ambulation three times daily c. Monitoring the platelet count d. Monitoring for pathological fractures

16. Gian, a community health nurse is instructing a group of female clients about breast selfexamination. 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

17. 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. Restrict all visitors d. Insert an indwelling urinary catheter to b. Restrict fluid intake prevent skin breakdown c. Teach the client and family about the need for hand hygiene 18. Mr. Miller has been diagnosed with bone cancer. You know this type of cancer is classified as: a. sarcoma. b. lymphoma. c. carcinoma. d. melanoma.

19. The client with leukemia is receiving busulfan (Myleran) and allopurinol (Zyloprim). The
nurse tells the client that the purpose if the allopurinol is to prevent:

a. Nausea b. Alopecia

c. Vomiting d. Hyperuricemia

20. The nurse is instructing the 35 year old client to perform a testicular self-examination. The nurse tells the client: a. To examine the testicles while lying down b. That the best time for the examination is after a shower c. To gently feel the testicle with one finger to feel for a growth d. That testicular self-examination should be done at least every 6 months

21. Oncology nurse education question about a client who seeks care for hoarseness that has lasted for 1 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 foods?"

22. A 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. Liver b. Colon c. Reproductive tract d. White blood cells (WBCs)

23. 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. areas of thickness or fullness. c. changes from previous self-examinations. d. fibrocystic masses

.24. A client in the final stages of terminal 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 response? 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."

25. The nurse is teaching a client proper skin care for external radiation treatments. The nurse knows the client understands when the client states:
I will wash the area daily with betadine solution. I will keep the area covered with an occlusive B. dressing.
A.

I will wear clothing that does not place pressure on the area. D.I will apply my usual dry skin lotion to the area.
C.

26. A nurse is caring for a client wth thrombocytopenia. Which of the followng should be included in the client's plan of care? Check all that apply.
A.Monitor platelet counts B.Assess the patient for melena C.Monitor WBC counts D.Monitor the patient for hematemesis

27. A client who is receiving chemotherapy for lung cancer has a neutrophil count of 600/mm. Which of the following statements should be included in teaching for this client:
A.Avoid using a manual razor to shave

B.Avoid eating raw fruits and vegetables C.Avoid using power tools D.Avoid eating spicy foods

28. A client with cancer undegoing surgery to relieve symptoms. Which type of surgery is the client undergoing ?
A.Palliative B.Reconstructive C.Prophylatic D.Diagnostic

29. The goal of each chemotherapy treatment is to:

A.Eradicate all of the cancer cells B. C.Eradicate the wall of the cancerous tumor D.Eradicate a percentage of the cancer cells

Eradicate all the actively proliferating cells in the body

30. A client receiving chemotherapy states that everything she tries to eat does not taste good. The nurse explains that this is a side effect of chemotherapy and the client can perform which of the following to decrease this symptom.
A.Eat spicy foods to camouflage the taste. B.Frequently perform mouth care. C.Drink sips of water between every mouth of

food. Use commercial mouth wash before each D. meal.

31. Which of the following is a charecteristic of benign tumors? A. Invasive growth B. Immature, poorly differentiated tissue C. Presence of metastasis D. Fully differentiated tissue

32. The nurse is monitoring the laboratory results of a client preparing to receive chemotherapy. The
nurse determines that the white blood cell count is normal if which of the following results were present? a) 2000 to 5000 cells/mm3 b) 3000 to 8000 cells/mm3 c) 5000 to 10000 cells/mm3 d) 7000 to 15000 cells/mm3

33. A client is scheduled for a Papanicolaou (Pap) smear at the next scheduled clinic visit. The nurse provides instructions to the client regarding preparation for this test. The nurse tells the client that: a) the test can be performed during menstruation b) fluids are restricted on the day of the test c) the test is painless d) vaginal douching is required 2 hours before the test

34. The nurse teaches skin care to the client receiving external radiation therapy. Which of the following statements, if made by the client, would indicate the need for further instruction? a) I will handle the area gently b) I will avoid the use of deodorants c) I will limit sun exposure to 1 hour daily d) I will wear loose-fitting clothing

35. A community health nurse is preparing a poster for educational session for a group of women and will be discussing the risk factors associated with breast cancer. Select the risk factors for breast cancer that the nurse will list on the poster. Select all that apply. a) family history of breast cancer b) early menarche c) early menopause d) previous cancer of the breast, uterus, or ovaries e) multiparity f) high-dose radiation exposure to chest

36. The nurse inserts an indwelling urinary catheter into a male client. As the catheter moves into the bladder, urine begins to flow into the tubing. Which should the nurse implement next? a) inflate the balloon with water b) insert the catheter 2.5 to 5 cm c) measure the initial urine output d) secure the catheter to the client

37. Which action does the nurse implement to obtain a urine specimen for a urinalysis from a female client with an indwelling urinary catheter? a) detach the tubing of the drainage bag b) use a sterile container for the specimen c) cleanse the perineum from front to back d) aspirate the urine from the drainage port

38. The community health nurse is conducting a breast cancer screening clinic in a local neighborhood and is providing sessions regarding breast self-examination (BSE). A postmenopausal woman arrives at the clinic for information on BSE. Which of the following information should the nurse give the client? a) it is not necessary to do BSE because you are postmenpausal b) you are not at risk for breast cancer because you are in the postmenopausal phase c) you need to perform BSE on the same day of every month d) mammograms performed every 5 years are sufficient in the postmenopausal phase 39. A community health nurse who is conducting a teaching session about the risks of testicular cancer has reviewed a list of instructions regarding testicular self-examination (TSE) with the clients attending the session. Which statement by a client indicates a need for further instructions? a) TSE is performed once a month b) TSE should be performed on the same day of each month c) the scrotum is held in one hand and the testicle is rolled between the thumb and forefinger of the other hand d) it is best to do TSE first thing in the morning before a bath or shower 40. Earliest sign of skin reaction to radiation therapy is: A. desquamation D. pigmentation B. erythema C. atrophy

41. The following are risk factors for cervical cancer EXCEPT:
A. immunosuppressive therapy B. sex at an early age, multiple partners, exposure to socially transmitted disease, male partners sexual habits C. viral agents like the Human Papilloma Virus D. smoking 42. For a patient experiencing pruritus, you recommend which type of bath. A. water B. colloidal (oatmeal C. saline D. sodium bicarbonate

43. The client has a good understanding of the means to reduce the chances of colon cancer when he states: A. I will exercise daily. B. I will include more red meat in my diet. C. I will have an annual chest x-ray. D. I will include more fresh fruits and vegetables in my diet.

44. A client is being evaluated for cancer of the colon. In preparing the client for barium enema, the nurse should: A. Give laxative the night before and a cleansing enema in the morning before the test B. Render an oil retention enema and give laxative the night before C. Instruct the client to swallow 6 radiopaque tablets the evening before the study D. Place the client on CBR a day before the study 45. A client is being admitted to the hospital after receiving a radiation implant for cervical cancer. The
nurse takes which priority action in the care of this client? a) encourages the family to visit b) admits the client to a private room c) places the client on reverse isolation d) encourages the client to take frequent rest periods

46. The nurse is developing a plan of care for a client being admitted to the hospital who is immunosuppressed and will be placed on neutropenic precautions. With regard to neutropenic precautions, which intervention is incorrect? a) admitting the client to a semiprivate room b) placing a precaution sign on the door to the room c) placing a mask on the client if the client leaves the room d) removing a vase with fresh flowers left by a previous client

47. The nurse receives a telephone call from the hospital admission office and is informed that a client is
being admitted who will undergo implantation of a sealed internal radiation source. The nurse asks the admission office clerk if which of the following rooms is selected for the client? a) a single room near the nurse's station b) a single room at the distant end of the hall c) a semiprivate room near the nurse's station d) a semiprivate room between two isolation rooms

48. A client has developed oral mucositis as a result of radiation to the head and neck. The nurse shouls teach the client to incorporate which of the following measures in his or her daily home care routine? a) oral hygiene should be performed in the morning and evening b) high-protein foods, such as peanut butter, should be incorporated in the diet c) a glass of wine per day will not pose any further harm to the oral cavity d) a combination of a weak saline and water solution should be used to rinse the mouth before and after each meal 49. A client with renal cancer is being treated preoperatively with radiation therapy. The nurse evaluates that the client has an understanding of proper care of the skin over the treatment field if the client states to: a) wash the ink marks off the skin b) avoid skin exposure to direct sunlight c) apply perfumed lotion to the affected skin d) wear tight clothing over the skin site to provide support

50. The nurse is caring for a client admitted to the surgical nursing unit following right modified radical
mastectomy. The nurse includes which of the following in the nursing plan of care for this client? a) take blood pressures in the right arm only b) draw serum laboratory samples from the right arm only c) position the client supine with right arm elevated on a pillow d) check the right posterior axilla area when assessing the surgical dressing

PREPARED BY: LIEZEL B. CAUILAN

NOTED BY:

KALTYN C. MANGUPAG DEAN, COHS