HARTLAND REVIEW CENTER ONCOLOGY DRILLS

1. A hospice nurse visits a client dying of ovarian cancer. During the visit, the client expresses that If I can just live long enough to attend my daughters graduation, Ill be ready to die. Which phase of coping is this client experiencing? A. Isolation B. Bargaining C. Depression D. Acceptance 2. A client diagnosed with cancer asks the question, Why did this have to happen to me? What stage of the process of coping with possible death does the nurse assess the client to be in? A. Denial and isolation B. Anger C. Bargaining D. Depression 3. A client complains of a sore mouth 10 days after receiving chemotherapy. What nursing diagnosis is most appropriate from this assessment data? A. Imbalanced nutrition B. Impaired tissue integrity C. Acute pain D. Risk for infection 4. A nurse is preparing a client with a diagnosis of multiple myeloma for discharge. Which instruction will the nurse reinforce with the client? A. To restrict fluid intake B. To maintain bed rest C. To maintain a high-calorie, low-fiber diet D. To notify the physician if anorexia and nausea occurs and persists 5. A nurse provides discharge instructions to a client who had a mastectomy with axillary lymph node dissection. The nurse tells the client to: A. Avoid the use of sunscreen when outdoors B. Cut the cuticles on a regular basis C. Wear protective gloves when doing the dishes D. Avoid the use of moisturizing cream on the affected arm 6. A nurse is caring for a client with bowel cancer who recently received a course of chemotherapy and has developed stomatitis. The nurse provides instructions to the client regarding the condition and determines the need for further instructions if the client states which of the following? A. I need to eat and drink foods and liquid that are cold. B. I need to avoid foods with spices C. I need to maintain a diet of soft foods D. I need to avoid citrus fruits. 7. A client with leukemia is receiving a course of chemotherapy and the nurse is told that the clients neutrophil count is 600/mm3. Based on this laboratory value, the nurse provides which specific instruction to the client regarding home care? A. Avoid eating any raw fruits or vegetables. B. Avoid taking acetylsalicylic acid (aspirin) or medications containing aspirin C. Avoid straining at bowel movements D. Use an electric shaver for shaving 8. A nurse is providing instructions to the client who received cryosurgery for a localized cervical tumor. The nurse tells the client. A. To call the physician if a watery discharge occurs B. To call the physician if the discharge remains odorous after 2 weeks C. To avoid tub baths 9. A female client suspected of having a diagnosis of leukemia asks the nurse when the diagnosis will be confirmed. In formulating a response, the nurse includes that assessment and definitive diagnosis of leukemia is based on: A. The clients history B. Physical manifestations C. The results of the CBC D. The results of the bone marrow aspiration and biopsy. 10. The nurse notes that which item documented in the medical record of a client with Hodgkins disease is a major symptom of the disease? A. Elevated blood pressure B. Unequal respirations C. Palapable pedal pulses D. Enlarged lymph nodes 11. A nurse is performing a diet history on an older client who lives alone. The nurse notes that the clients typical 24 hour food intake consists of eggs and sausage for breakfast, a fast food lunch of hamburger and French fries, take out friend chicken for dinner, and ice cream in the evening . To decrease the risk of cancer, what would the nurse tell the client? A. You should not eat eggs. B. You should not eat sausage. C. Drinking a lot of alcohol increases the risk of liver cancer. D. A high fate diet increases the risk of colon cancer. 12. A nurse is caring for a client following a modified radical mastectomy. Which assessment finding would indicate that the client is experiencing a complication related to the surgery? A. Blood y drainage in the Jackson Pratt tube B. Pain at the incisional site C. Complaints of numbness near the operative site D. Arm enema on the operative side 13. A nurse is providing instructions to a client following mastectomy who will be discharged to home with the axillary drain in place. Which statement by the client indicates a need for further instructions? A. I must begin full range-of-motion exercises to my upper arm once I get home. B. I should keep my arm elevated when I sit or lie down the prevent swelling. C. I may feel some incisional discormfort until healing occurs. D. I can use lotion on the skin once the incision heals. 14. A nurse is reviewing the record of a client with a diagnosis of cervical cancer. Which risk factor associated with this type of cancer would the nurse expect to note in the clients record? A. Single female, no children, has infrequent sexual intercourse B. Sexual intercourse with a single sex partner C. Sexual intercourse with circumcised males. D. History of human papilloma virus 15. A community health nurse is providing a teaching session regarding the risks of breast cancer. The nurse determines that further information needs to be provided

if an attendee states that which of the following is an associated risk factor for this type of cancer. A. Family history of any first-degree relative with breast cancer. B. Previous history of cancer in one breast C. Menstrual history of late menarche D. History of late menopause 16. A client with breast cancer is scheduled for a total (simple) mastectomy and asks the nurse what this type of surgery involves. The nurse makes which statement to the client? A. It involves the removal of the cancerous mass and some normal tissue to produce clean margins. B. It involves the removal of the breast, the axillary lymph nodes, and the overlying skin. C. It involves resection of breast tissue and some skin from the clavicle to the costal margin and from the midline to the latissimus dorsi. D. It involves the removal of the breast, the overlying skin, the pectoral muscles, and the axillary nodes. 17. A nurse is caring for a client who is scheduled for radiation therapy. Which statement by the client indicates a common concern of clients receiving this therapy? A. Im certain that this will do the trick . B. Will I be radioactive afterwards? C. this is just one of several options I have for treatment D. This treatment is great because it is invisible and very effective. 18. A client is diagnosed with terminal carcinoma of the prostate and the nurse is assisting the client to plan for end-of-life issues. The appropriate nursing intervention is to assist the client to: A. Explore all treatments before death, even if they seem futile B. Gain control over the end-of-life issues through advance directives C. Engage an attorney to make all decisions for the client Direct the insurance company to pay all expenses upon death. 19. A client is admitted to he hospital with severe bone pain associated with multiple myeloma. The nurse anticipates that which of the following will be prescribed for the client? A. Radiation therapy B. Hydration with normal sale intravenously only C. Bed rest D. NPO except for sips of water with medication 20. When teaching the postmenopausal client Breast Self-Exam (BSE) the nurse teaches the client to A. Always begin BSE on the right breast first B. Palpate the breasts before inspection C. Perform BSE on the same day every month D. Call the physician if breasts are not the same size 21. A young male client with Hodgkins disease is going to receive radiation therapy. The nurse includes which psychosocial intervention in the plan of care for the client? A. Checking skin integrity B. Discussing sperm banking with the client C. Vital signs measurement before each treatment D. Measures to prevent infection 22. A nurse has taught a 64-year-old woman at risk for breast cancer how to do breast self-examination (BSE). The nurse determines that the client understands the procedure if the client states which of the following?

A. I will palpate my breasts while standing in front of the mirror B. I will do the exam 14 days after the start of my menstrual cycle. C. I will use the pads of my finger and press deeply to feel lumps. D. I will examine my right breast with my right hand, and vice versa. 23. A school nurse is planning to give a class on testicular self-examination (TSE) at the local high school. The nurse plans to include which of the following information on a written handout to be given to the students? A. Roll the testicle between the thumb and forefinger B. Perform the exam every other month C. Perform the exam after a cold shower D. Expect the exam to be slightly painful 24. The client with cancer has a nursing diagnosis of Risk for Injury Related to Thrombocytopenia Secondary to Side Effects of Chemotherapy. Based on this nursing diagnosis, the nurse would plan to monitor the results of which laboratory study closely? A. Platelet count B. White blood cell (WBC) count C. Erythrocyte sedimentation rate (ESR) D. Antinuclear antibody titer (ANA) 25. The nurse is preparing a client for upcoming radiation therapy for the treatment of cancer. The nurse should teach the client to avoid which action is part of skin care to the radiation site? A. Patting the skin dry B. Wearing loose clothing C. Using mild soap D. Removing skin markings 26. A client with renal cancer is being treated preoperatively with radiation therapy. The nurse determines that the client has an understanding of proper care of the skin over the treatment field if the client states to: A. Avoid skin exposure to direct sunlight B. Use lanolin-based cream on the affected skin on a daily basis C. Remove the lines or ink marks by using a gentle soap of each treatment D. Use hot water to wash the treatment site twice daily. 27. A nurse reads a physicians progress notes and notes that cancer was diagnosed in the client. The staging of the cancer is documented as T3, N2, M1. The nurse analyzes this staging as indicating which of the following? A. The tumor is in situ B. The tumor is 3 cm in size C. Nodal involvement cannot be assessed. D. Distant metastasis was found 28. A client is scheduled for cryosurgery for the treatment of cervical cancer, and the nurse provides instructions to the client regarding the procedure. Which statement by the client indicates a need for additional instructions/ A. I may experience some cramping during the procedure B. I may feel faint during cryosurgery. C. I must receive general anesthesia for this procedure D. I may have watery cervical discharge after the procedure. 29. The nurse is caring for a client with leukemia receiving chemotherapy. the nurse review the laboratory results and notes that the neutrophil count is less than

500/mm3. Based on this laboratory result, the nurse includes which of the following as a necessary component of the plan of care? A. Monitoring oral temperature every 4 hours B. Placing prolonged pressure on venipuncture sites after blood is drawn C. Rotating the blood pressure (BP) cuff to different sites when checking for BP D. Avoiding overinflation of the BP cuff when checking the BP 30. A client is receiving radiation therapy to the brain because of a brain tumor. Which side effect would the nurse most likely expect the client to experience as a result of the radiation therapy? A. Pneumonitis B. Esophagitis C. Nausea and vomiting D. Diarrhea 31. A nurse is performing discharge teaching with a client with multiple myeloma. Which of the following activities will the nurse encourage to prevent the risk of pathological fractures associated with the disease/ A. Use of splints on extremities B. Daily regimen of ambulation C. Daily vital sign measurement D. Aeorbic exercise three times weekly 32. A nurse is caring for a client following mastectomy who is anemic from blood loss during the recent surgery. The nurse interprets that which of the following signs and symptoms exhibited by the client is most likely attribute to the anemia? A. Tachycardia B. Excitability C. Increased respiratory rate D. Muscle cramps 33. A nurse is caring for a client with metastatic lung cancer. the client was medicated 2 hours ago and now complains of a new and sudden sharp pain in the back. The nurse most appropriately interprets this assessment finding as possibly indicating: A. The need for an increase in pain medication B. A low pain threshold C. Further metastasis D. Spinal cord compression 34. A bone marrow aspiration is scheduled for a client suspected of having leukemia. The nurse prepares supplies for the procedure and would plan to brink which of the following skin cleansing agents to the bedside prior to this procedure? A. Soap and water B. Povidone-iodine C. Hydrogen peroxide D. Alcohol swabs 35. A client with leukemia who has a bone marrow aspiration is thrombocytopenic. The nurse gives which of the following instructions to the family as the client is discharged to home? A. Administer acetylsalicylic acid (aspirin) for discomfort B. Watch the puncture site for bleeding for the next several days C. Take the clients temperature daily for a week D. Encourage extra fluid intake for the next 3 days. 36. A nurse is reviewing the record of a client admitted to the hospital for treatment of bladder cancer. Which of the following risk factors related to this type of cancer would the nurse most likely note in this clients record? A. Female African American B. Recorded age of 35 years

C. Occupation of computer analyzer D. Drinks a pot of coffee every day 37. The nurse is interviewing a client about his medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer? A. Duodenal ulcers B. Hemorrhoids C. Weight gain D. Polyps 38. After cancer chemotherapy, a client develops nausea and vomiting. For this client, the nurse should give the highest priority to which action in the plan of care? A. Serve small portions of bland food. B. Encourage rhythmic breathing exercise. C. Administer metoclopramide (Reglan) and dexamethasone (Decadron) as prescribed. D. Withhold fluids for the first 4 to 6 hours after chemotherapy administration. 39. Which of these findings is an early sign of bladder cancer? A. Painless hematuria B. Occasional polyuria C. Nocturia D. Dysuria 40. A client with a small, well-defined breast nodule asks the nurse about her treatment options. Which treatments would be considered for this client? A. Lumpectomy and radiation B. Partial mastectomy and radiation C. Partial mastectomy and chemotherapy D. Total mastectomy and chemotherapy 41. A client is receiving a radiation implant for the treatment of bladder cancer. Which of the following interventions is appropriate? A. Flush all urine down the toilet. B. Restrict the client's fluid intake. C. Place the client in a semiprivate room. D. Monitor the client for signs and symptoms of cystitis. 42. When caring for a client with an endocervical radiation implant, the nurse notes that the radiation source has become dislodged and is lying on the bed. What should the nurse do first? A. Use long-handled forceps to place the implant in a sealed lead container in the room. B. Put on sterile gloves and remove the radiation source from the room. C. Put on lead-lined gloves and attempt to reinsert the implant. D. Leave the room and notify the physician immediately. 43. During a client's chemotherapy regimen for breast cancer, which is important for the nurse to include in her plan of care? A. Instruct the client to consume plenty of raw fruits and vegetables. B. Take rectal temperatures for greater accuracy. C. Tell the client to avoid crowds and infected individuals. D. Ask friends and relatives not to visit during the course of chemotherapy. 44. A male client should be taught about testicular examinations: A. when sexual activity starts. B. after age 60. C. after age 40. D. before age 20.

45. 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. 46. The nurse is developing a teaching plan for a client who has just been diagnosed with breast cancer. The nurse should include information about which medication? A. acetaminophen (Tylenol) B. dopamine (Intropin) C. tamoxifen (Nolvadex) D. progesterone (Gesterol 50) 47. A client underwent a modified mastectomy and has a pressure dressing encircling her chest. Which postoperative nursing care function should the nurse anticipate to be difficult? A. Promoting intake B. Checking blood pressure C. Promoting turning, coughing, and deep breathing D. Checking dressings 48. The nurse is reviewing the diagnostic data of a client suspected of having gastric cancer. What laboratory finding is the nurse most likely to find? A. Elevated hemoglobin (HB) level and hematocrit (HCT) B. Negative fecal occult blood test C. Subnormal gastric hydrochloric acid level D. Negative carcinoembryonic antigen (CEA) test 49. A client with cancer undergoes a total gastrectomy. Several hours after surgery, the nurse notes that the clients nasogastric (NG) tube has stopped draining. How should the nurse respond? A. Notify the physician. B. Reposition the NG tube. C. Irrigate the NG tube. D. Increase the suction level. 50. A client is receiving chemotherapy for cancer. The nurse reviews the client's laboratory report and notes that he has thrombocytopenia. To which nursing diagnosis should the nurse give the highest priority? A. Activity intolerance B. Impaired tissue integrity C. Impaired oral mucous membrane D. Ineffective tissue perfusion: cerebral, cardiopulmonary, gastrointestinal 51. The nurse is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by: A. a breast self-examination. B. mammography. C. fine-needle aspiration. D. chest X-ray. 52. For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the plan of care? A. Administer aspirin if the temperature exceeds 102 F (38.8 C). B. Inspect the skin for petechiae once every shift. C. Provide for frequent periods of rest. D. Place the client in strict isolation. 53. A client suspected of having colorectal cancer will require which diagnostic study to confirm the diagnosis? A. Stool hematest

B. Carcinoembryonic antigen (CEA) C. Sigmoidoscopy D. Abdominal computed tomography (CT) scan 54. The nurse walks into the room of a client who has had surgery for testicular cancer. The client says that he'll be undesirable to his wife, and he becomes tearful. He expresses that he has spoiled a happy, satisfying sex life with his wife, and says that he thinks it might be best if he would just die. Based on these signs and symptoms, which nursing diagnosis would be most appropriate for planning purposes? A. Situational low self-esteem B. Unilateral neglect C. Social isolation D. Risk for loneliness 55. A client asks the nurse what PSA is. The nurse should reply that it stands for: A. prostate-specific antigen, used to screen for prostate cancer. B. protein serum antigen, used to determine protein levels. C. pneumococcal strep antigen, a bacteria that causes pneumonia. D. Papanicolaou-specific antigen, used to screen for cervical cancer. 56. What should a male client over age 50 do to help ensure early identification of prostate cancer? A. Have a digital rectal examination and prostatespecific 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. 57. A client has an abnormal result on a Papanicolaou test. After admitting that she read her 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 58. A home care nurse assesses for disease complications in a client with bone cancer. The nurse knows that bone cancer may cause which electrolyte disturbance? A. Hyperkalemia B. Hypercalcemia C. Hyponatremia D. Hypomagnesemia 59. A client is undergoing a diagnostic workup for suspected testicular cancer. When obtaining the client's history, the nurse checks for known risk factors for this type of cancer. Testicular cancer has been linked to: A. testosterone therapy during childhood. B. sexually transmitted disease. C. early onset of puberty. D. cryptorchidism.

60. A client who will have his last chemotherapy cycle in 11 days become neutropenic. The client understands his condition when he states: A. Ill monitor my temperature frequently and go to the nearest emergency departmen if my temperature rises above 100.4 F. B. Ive found that eating fresh fruit and vegetables reduce the side effects of chemotherapy and also give me more energy. C. I find that going out for a quiet dinner and a movie relieves the stress and anxiety of my cancer treatment. D. I love working in my garden; it gives m e a lot of inner peace and tranquility. 61. On discharge, a client who underwent left modified radical mastectomy expresses relief that the cancer has been treated. When discussing this issue with the client, the nurse should stress that she: A. Should continue to perform BSE on her right breast. B. Is lucky that the cancer was caught in time. C. Should schedule a follow up appointment in months. D. Will have irregular menstrual periods. 62. The nurse is teaching a male client to perform monthly testicular self-examination. Which point 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. 63. A client diagnosed with acute myelocytic leukemia (AML) has been receiving chemotherapy. During the last 2 cycles of chemotherapy, the client developed severe thrombocytopenia requiring multiple platelet transfusions. The client is now scheduled to receive a third cycle. How can the nurse best detect early signs of symptoms of thrombocytopenia? a. Perform a cardiovascular assessment every 4 hours. b. Check the clients history for a congenital link to thrombocytopenia c. Monitor daily platelet counts d. Closely observe the clients skin for petechiae and bruising 64. The nurse administers chemotherapeutic drugs to a client with cancer. What adverse effects are the most common? A. Painful mouth sores B. Frequent diarrhea C. Nausea and vomiting D. Constipation 65. The nurse is caring for a client with bronchogenic carcinoma. Which nursing diagnosis takes highest priority? A. Disturbed body image related to changes in body functions B. Ineffective airway clearance related to obstruction by a tumore or secretions C. Anxiety related to actual threat to health status and changes in family dynamics D. Imbalanced nutritiion: Less than body requirements related to anorexia and vomiting secondary to chemotherapy 66. A 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. B. C. D.

Hair loss. Stomatitis. Fatigue. Vomiting.

67. A client with colon cancer requires a permanent colostomy because of the tumor location. After surgery, the client must learn how to irrigate the colostomy. When irrigating, how far into the stoma should the client insert the lubricated catheter? a. 0.25 to 0.5 b. 1 to 1.5 c. 2 to 4 d. 5 to 7 68. The nurse is administering daunorubicin through a peripheral IV line when the client complains of burning at the insertion site. The nurse notes no blood return from the catheter and redness at the IV site. The client is most likely experiencing which complication? a. Erythema b. Flare c. Extravasation d. Thrombosis 69. At a health fair, an oncology nurse answers questions about risk factors for various types of cancer. 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 70. JOVY, a client is undergoing a left modified radical mastectomy for breast cancer. Postoperatively, blood pressure should be obtained from the right arm, and the clients left arm and hand should be elevated as much as possible to prevent which condition? A. lymphedema B. Trousseaus sign C. I.V. infusion infiltration D. Muscle atrophy 71. A 45-year-old client receiving radiation therapy for thyroid cancer complains of mouth and throat pain. While inspecting the mouth and throat, the nurse notices white patches and ulcerations in the oral mucosa. The nurse notifies the radiation oncologist, and teaches the client mouth care. What do these findings suggest? a. Candidiasis b. Xerostomia c. Radiation caries d. Dysphagia 72. The nurse is assessing a client with multiple myeloma. The nurse should keep in mind that clients with multiple myeloma are at risk for: A. Chronic liver failure B. Acute heart failure. C. Pathologic bone fractures D. Hypoxemia 73. To combat the most common advserse effects of chemotherapy, the nurse would administer an: A. antiemetic B. antimetabolite C. antibiotic D. anticoagulant 74. A client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the warning signs of cancer. What is another warning sign of cancer?

A. Persistent nausea B. Rash C. Indigestion D. Chronic ache or pain 75. A client is undergoing tests for multiple myeloma. Diagnostic study findings in multiple myeloma include: a. a decreased serum creatinine level. b. hypocalcemia c. Bence Jones protein in the urine. d. a low serum protein level. 76. Jovelyn, a client, age 42, visits the gynecologist. After examining her, the physician suspects cervical cancer. The nurse reviews the clients 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 17 D. Human papillomavirus infection at age 32. 77. Which intervention is appropriate for the nurse caring for a 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 rout to P.O. if the client can tolerate fluids d. Obtaining baseline vital signs before administering the first dose. 78. 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 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 79. The oncology clinic nurse is reinforcing prevention measures for oropharyngeal infections to a client receiving chemotherapy. Which statement by the client indicates that teaching was successful? a. I clean my teeth gently several times per day. b. I replace my toothbrush every month. c. I lubricate my lips with petroleum jelly. d. I use an alcohol based mouthwash every morning. 80. 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 81. 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 a breast nodule d. fever and erythema of the breast. 82. Which statement by a client undergoing external

radiation therapy indicates the need for further teaching? A. I will wash my skin with mild soap and water only. B. I will not use my heating pad during my treatment. C. I will wear protective clothing when outside. D. I will expose my family members to radiation. 83. A client in the terminal stage of cancer is receiving a continuous infusion of morphine (Duramorph) 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 hours b. Respiratory rate of 8 breaths/minute c. Irregular heart rate of 82 beats/minute d. Pupils constricted and equal 84. After receiving chemotherapy for lung cancer, a clients platelet count falls to 98,000/ul. What term should the nurse use to describe this low platelet count? a. Anemia b. Leucopenia c. Thrombocytopenia d. Neutropenia 85. John has been diagnosed with leukemia and his white blood cell and platelet counts are critically low. He is febrile and complaining of a headached and constipation. Which of the following is the most appropriate nursing interventions for this client? A. Administer meperidine (Demerol) IM every 4 hours for headache B. Monitor temperature and neurological status at least every 4 hours. C. Administer a glycerin suppository D. Administer aspirin every 4 hours to control the fever 86. Ador is a 22-year-old college student admitted for chemotherapy treatment of acute lymphoblastic leukemia (ALL). In addition to combination chemotherapy with intravenous drugs, Ador will also receive intrathecal methotrexate. Ador is engaged and was planning on being married when he graduated college. He and his fiancee ask you about the reproductive consequences of chemotherapy. Which of the following is the most appropriate statement concerning the reproductive effects of chemotherapy? A. Ador should consider sperm banking prior to beginning therapy B. Ador will be impotent as a result of therapy C. Contraception is no longer necessary D. Ador will be permanently sterile as a result of therapy 87. The nurse provides client teaching about ways to minimize which of the following, which is the leading cause of death in adult clients with leukemia? A. Anemia B. Lymphatic obstruction C. Infection D. Hemorrhage 88. Because cancer chemotherapy destroys rapidly dividing cells, many of thedrugs in this class produce: A. Impaired renal function B. Neurotoxicities C. Bone marrow depression D. Cardiac disorders 89. Martha is a 21-year-old secretary with acute lymphocytic leukemia. Her WBC is 700/mm3, hemoglobin 7.0 g/dL, hematocrit 20%, and platelet count 20,000. Collaborative management of Marthas disease is aimed chiefly at: A. Increasing serum iron levels B. Increasing lymphocytes

C. Preventing electrolyte imbalance D. Preventing infection 90. Which of the following would not be included in the care plan of a client to prevent stomatitis during chemotherapy? A. Use lemon and glycerin swabs q 4 hours. B. Use toothettes instead of a toothbrush C. Assess client for subjective complaints of oral discomfort D. Start q4 hour mouth care when chemotherapy starts 91. A client diagnosed with metastatic cancer is scheduled for surgery to treat obstruction caused by the primary tumor. The nurse understands that this type of surgery is: A. Radical B. Palliative C. Diagnostic D. Prophylactic 92. The nurse would instruct the client about which of the following as part of a teaching plan for skin care during radiation therapy? A. Protect the radiated skin with sun tan lotion B. Be sure not to scrub or rub off the markings C. Redraw the markings after showering D. Apply lotion to the affected area prior to each treatment 93. An IV infusing a plant alkaloid (Vinblastine) infiltrates. As you prioritize your response, which action will you do last? A. Notify the physician B. Aspirate IV C. Remove IV D. Stop IV 94. As many as 75% of clients with cancer being treated with either chemotherapy or radiation therapy experience diarrhea. The nurse will teach the client at risk for diarrhea to: A. Increase the fiber in the diet with nuts and raw vegetables B. Decrease the total amount of fluids taken each day C. Eat a low residue diet with foods such as peeled apples, baked fish, and potatoes. D. Have a glass of wine or beer with meals. 95. A client who has been diagnosed with metastatic cancer asks the nurse to go over the doctors explanation about metastasis again. Which of the following statements does the nurse incorporate when responding to the client? A. Metastasis is a random process. B. Gravity is a factor in metastasis of some tumors. C. Blood is the most common means of metastasis D. The brain is the most common site of metastasis.

96. Which of the following would not be necessary to assess when monitoring for myelosuppresion (bone marrow depression) in a client receiving chemotherapy for cancer? A. BUN and creatinine levels B. Shortness of breath with activity C. Sore throat D. Petechiae 97. The nurse would look for the results of which of the following diagnostic tests to verify whether a client has actually been diagnosed with Hodgkins disease? A. Abdominal CT scan B. Complete blood count (CBC) C. Chest X-ray D. Lymph node biopsy 98. A client is receving chemotherapy for cancer. The nurse assigned to the cleint assesses for which of the following early signs of thrombocytopenia/ A. Confusion B. Hyperthermia C. Petechiae D. Dyspnea 99. A client asks you to discuss further the physicians explanation of Hodgkins disease. You begin your discussion of this malignant disorder by saying that it primarily involves the: A. Hematopoietic system. B. Biliary system C. Lymphoid system D. Bone marrow 100. Anna is being treated for acute leukemia. Her CBC results show a WBC of 1,000/mm3, hemoglobin of 8.0 g/dL, hematocrit of 22%, and a platelet count of 40,000. Considering these laboratory results, which of the following interventions should be avoided? A. Monitoring Annas temperature every 4 hours B. Checking of Annas stools, urine, and emesis for occult blood C. Administering aspirin to Anna for her complaints of headache D. Preventing contact with visitors or personnel with colds

-Sir Glenn Cabero BSN, RN, USRN, MAN (39units)