1

30 items set a
NCLEX Review: Oncology Questions Part 1
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 male client with a cerebellar brain tumor is
admitted to an acute care facility. The nurse formulates a
nursing diagnosis of Risk for injury. Which related-to
phrase should the nurse add to complete the nursing
diagnosis statement?
a. Related to visual field deficits
b. Related to difficulty swallowing
c. Related to impaired balance
d. Related to psychomotor seizures
4. A female client with cancer is scheduled for
radiation therapy. The nurse knows that radiation at any
treatment site may cause a certain adverse effect.
Therefore, the nurse should prepare the client to expect:
a. hair loss.
b. stomatitis.
c. fatigue.
d. vomiting.
5. Nurse April is teaching a client who suspects that
she has a lump in her breast. The nurse instructs the
client that a diagnosis of breast cancer is confirmed by:
a. breast self-examination.
b. mammography.
c. fine needle aspiration.
d. chest X-ray.
6. A male client undergoes a laryngectomy to treat
laryngeal cancer. When teaching the client how to care
for the neck stoma, the nurse should include which
instruction?
a. Keep the stoma uncovered.
b. Keep the stoma dry.
c. Have a family member perform stoma care initially
until you get used to the procedure.
d. Keep the stoma moist.
7. A female client is receiving chemotherapy to treat
breast cancer. Which assessment finding indicates a fluid
and electrolyte imbalance induced by chemotherapy?
a. Urine output of 400 ml in 8 hours
b. Serum potassium level of 3.6 mEq/L
c. Blood pressure of 120/64 to 130/72 mm Hg
d. Dry oral mucous membranes and cracked lips
8. Nurse April is teaching a group of women to
perform breast self-examination. The nurse should
explain that the purpose of performing the examination
is to discover:
a. cancerous lumps.
b. areas of thickness or fullness.
c. changes from previous self-examinations.
d. fibrocystic masses.
9. A client, age 41, visits the gynecologist. After
examining her, the physician suspects cervical cancer.
The nurse reviews the 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 27
d. Human papillomavirus infection at age 32
10. A female client is receiving methotrexate
(Mexate), 12 g/m2 I.V., to treat osteogenic carcinoma.
During methotrexate therapy, the nurse expects the client
to receive which other drug to protect normal cells?
a. probenecid (Benemid)
b. cytarabine (ara-C, cytosine arabinoside [Cytosar-U])
c. thioguanine (6-thioguanine, 6-TG)
d. leucovorin (citrovorum factor or folinic acid
[Wellcovorin])
11. The nurse is interviewing a male client about his
past medical history. Which preexisting condition may
lead the nurse to suspect that a client has colorectal
cancer?
a. Duodenal ulcers
b. Hemorrhoids
c. Weight gain
d. Polyps
12. Nurse Amy is speaking to a group of women about
early detection of breast cancer. The average age of the
women in the group is 47. Following the American
Cancer Society guidelines, the nurse should recommend
that the women:
a. perform breast self-examination annually.
b. have a mammogram annually.
c. have a hormonal receptor assay annually.
d. have a physician conduct a clinical examination
every 2 years.
13. A male client with a nagging cough makes an
appointment to see the physician after reading that this
symptom is one of the seven warning signs of cancer.
What is another warning sign of cancer?
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a. Persistent nausea
b. Rash
c. Indigestion
d. Chronic ache or pain
14. For a female client newly diagnosed with
radiation-induced thrombocytopenia, the nurse should
include which intervention in the plan of care?
a. Administering aspirin if the temperature exceeds
102 F (38.8 C)
b. Inspecting the skin for petechiae once every shift
c. Providing for frequent rest periods
d. Placing the client in strict isolation
15. Nurse Lucia is providing breast cancer education at
a community facility. The American Cancer Society
recommends that women get mammograms:
a. yearly after age 40.
b. after the birth of the first child and every 2 years
thereafter.
c. after the first menstrual period and annually
thereafter.
d. every 3 years between ages 20 and 40 and annually
thereafter.
16. Which intervention is appropriate for the nurse
caring for a male client in severe pain receiving a
continuous I.V. infusion of morphine?
a. Assisting with a naloxone challenge test before
therapy begins
b. Discontinuing the drug immediately if signs of
dependence appear
c. Changing the administration route to P.O. if the
client can tolerate fluids
d. Obtaining baseline vital signs before administering
the first dose
17. A 35 years old client with ovarian cancer is
prescribed hydroxyurea (Hydrea), an antimetabolite
drug. Antimetabolites are a diverse group of
antineoplastic agents that interfere with various
metabolic actions of the cell. The mechanism of action
of antimetabolites interferes with:
a. cell division or mitosis during the M phase of the
cell cycle.
b. normal cellular processes during the S phase of the
cell cycle.
c. the chemical structure of deoxyribonucleic acid
(DNA) and chemical binding between DNA molecules
(cell cyclenonspecific).
d. one or more stages of ribonucleic acid (RNA)
synthesis, DNA synthesis, or both (cell cycle
nonspecific).
18. The ABCD method offers one way to assess skin
lesions for possible skin cancer. What does the A stand
for?
a. Actinic
b. Asymmetry
c. Arcus
d. Assessment
19. When caring for a male client diagnosed with a
brain tumor of the parietal lobe, the nurse expects to
assess:
a. short-term memory impairment.
b. tactile agnosia.
c. seizures.
d. contralateral homonymous hemianopia.
20. A female client is undergoing tests for multiple
myeloma. Diagnostic study findings in multiple
myeloma include:
a. a decreased serum creatinine level.
b. hypocalcemia.
c. Bence Jones protein in the urine.
d. a low serum protein level.
21. A 35 years old client has been receiving
chemotherapy to treat cancer. Which assessment finding
suggests that the client has developed stomatitis
(inflammation of the mouth)?
a. White, cottage cheeselike patches on the tongue
b. Yellow tooth discoloration
c. Red, open sores on the oral mucosa
d. Rust-colored sputum
22. During chemotherapy, an oncology client has a
nursing diagnosis of impaired oral mucous membrane
related to decreased nutrition and immunosuppression
secondary to the cytotoxic effects of chemotherapy.
Which nursing intervention is most likely to decrease the
pain of stomatitis?
a. Recommending that the client discontinue
chemotherapy
b. Providing a solution of hydrogen peroxide and water
for use as a mouth rinse
c. Monitoring the clients platelet and leukocyte counts
d. Checking regularly for signs and symptoms of
stomatitis
23. What should a male client over age 52 do to help
ensure early identification of prostate cancer?
a. Have a digital rectal examination and prostate-
specific antigen (PSA) test done yearly.
b. Have a transrectal ultrasound every 5 years.
c. Perform monthly testicular self-examinations,
especially after age 50.
d. Have a complete blood count (CBC) and blood urea
nitrogen (BUN) and creatinine levels checked yearly.
24. A male client complains of sporadic epigastric
pain, yellow skin, nausea, vomiting, weight loss, and
fatigue. Suspecting gallbladder disease, the physician
orders a diagnostic workup, which reveals gallbladder
cancer. Which nursing diagnosis may be appropriate for
this client?
a. Anticipatory grieving
b. Impaired swallowing
c. Disturbed body image
d. Chronic low self-esteem
25. A male client is in isolation after receiving an
internal radioactive implant to treat cancer. Two hours
later, the nurse discovers the implant in the bed linens.
What should the nurse do first?
a. Stand as far away from the implant as possible and
call for help.
b. Pick up the implant with long-handled forceps and
place it in a lead-lined container.
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c. Leave the room and notify the radiation therapy
department immediately.
d. Put the implant back in place, using forceps and a
shield for self-protection, and call for help.
26. Jeovina, with advanced breast cancer is prescribed
tamoxifen (Nolvadex). When teaching the client about
this drug, the nurse should emphasize the importance of
reporting which adverse reaction immediately?
a. Vision changes
b. Hearing loss
c. Headache
d. Anorexia
27. A female client with cancer is being evaluated for
possible metastasis. Which of the following is one of the
most common metastasis sites for cancer cells?
a. Liver
b. Colon
c. Reproductive tract
d. White blood cells (WBCs)
28. A 34-year-old female client is requesting
information about mammograms and breast cancer. She
isnt considered at high risk for breast cancer. What
should the nurse tell this client?
a. She should have had a baseline mammogram before
age 30.
b. She should eat a low-fat diet to further decrease her
risk of breast cancer.
c. She should perform breast self-examination during
the first 5 days of each menstrual cycle.
d. When she begins having yearly mammograms,
breast self-examinations will no longer be necessary.
29. Nurse Brian is developing a plan of care for
marrow suppression, the major dose-limiting adverse
reaction to floxuridine (FUDR). How long after drug
administration does bone marrow suppression become
noticeable?
a. 24 hours
b. 2 to 4 days
c. 7 to 14 days
d. 21 to 28 days
30. The nurse is preparing for a female client for
magnetic resonance imaging (MRI) to confirm or rule
out a spinal cord lesion. During the MRI scan, which of
the following would pose a threat to the client?
a. The client lies still.
b. The client asks questions.
c. The client hears thumping sounds.
d. The client wears a watch and wedding band.





































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Set a 30 items
NCLEX Review: Oncology Questions Part 1 Answers
and Rationale
1.Answer D. Dysplasia refers to an alteration in the size,
shape, and organization of differentiated cells. The
presence of completely undifferentiated tumor cells that
dont resemble cells of the tissues of their origin is called
anaplasia. An increase in the number of normal cells in a
normal arrangement in a tissue or an organ is called
hyperplasia. Replacement of one type of fully
differentiated cell by another in tissues where the second
type normally isnt found is called metaplasia.
2.Answer A. Verbalizing feelings is the clients first step
in coping with the situational crisis. It also helps the
health care team gain insight into the clients feelings,
helping guide psychosocial care. Option B is
inappropriate because suppressing speculation may
prevent the client from coming to terms with the crisis
and planning accordingly. Option C is undesirable
because some methods of reducing tension, such as
illicit drug or alcohol use, may prevent the client from
coming to terms with the threat of death as well as cause
physiologic harm. Option D isnt appropriate because
seeking information can help a client with cancer gain a
sense of control over the crisis.
3.Answer C. A client with a cerebellar brain tumor may
suffer injury from impaired balance as well as disturbed
gait and incoordination. Visual field deficits, difficulty
swallowing, and psychomotor seizures may result from
dysfunction of the pituitary gland, pons, occipital lobe,
parietal lobe, or temporal lobe not from a cerebellar
brain tumor. Difficulty swallowing suggests medullary
dysfunction. Psychomotor seizures suggest temporal
lobe dysfunction.
4.Answer C. Radiation therapy may cause fatigue, skin
toxicities, and anorexia regardless of the treatment site.
Hair loss, stomatitis, and vomiting are site-specific, not
generalized, adverse effects of radiation therapy.
5.Answer C. Fine needle aspiration and biopsy provide
cells for histologic examination to confirm a diagnosis of
cancer. A breast self-examination, if done regularly, is
the most reliable method for detecting breast lumps
early. Mammography is used to detect tumors that are
too small to palpate. Chest X-rays can be used to
pinpoint rib metastasis.
6.Answer D. The nurse should instruct the client to keep
the stoma moist, such as by applying a thin layer of
petroleum jelly around the edges, because a dry stoma
may become irritated. The nurse should recommend
placing a stoma bib over the stoma to filter and warm air
before it enters the stoma. The client should begin
performing stoma care without assistance as soon as
possible to gain independence in self-care activities.
7.Answer D. Chemotherapy commonly causes nausea
and vomiting, which may lead to fluid and electrolyte
imbalances. Signs of fluid loss include dry oral mucous
membranes, cracked lips, decreased urine output (less
than 40 ml/hour), abnormally low blood pressure, and a
serum potassium level below 3.5 mEq/L.
8.Answer C. Women are instructed to examine
themselves to discover changes that have occurred in the
breast. Only a physician can diagnose lumps that are
cancerous, areas of thickness or fullness that signal the
presence of a malignancy, or masses that are fibrocystic
as opposed to malignant.
9.Answer D. Like other viral and bacterial venereal
infections, human papillomavirus is a risk factor for
cervical cancer. Other risk factors for this disease
include frequent sexual intercourse before age 16,
multiple sex partners, and multiple pregnancies. A
spontaneous abortion and pregnancy complicated by
eclampsia arent risk factors for cervical cancer.
10.Answer D. Leucovorin is administered with
methotrexate to protect normal cells, which methotrexate
could destroy if given alone. Probenecid should be
avoided in clients receiving methotrexate because it
reduces renal elimination of methotrexate, increasing the
risk of methotrexate toxicity. Cytarabine and
thioguanine arent used to treat osteogenic carcinoma.
11.Answer D. Colorectal polyps are common with colon
cancer. Duodenal ulcers and hemorrhoids arent
preexisting conditions of colorectal cancer. Weight loss
not gain is an indication of colorectal cancer.
12.Answer B. The American Cancer Society guidelines
state, "Women older than age 40 should have a
mammogram annually and a clinical examination at least
annually [not every 2 years]; all women should perform
breast self-examination monthly [not annually]." The
hormonal receptor assay is done on a known breast
tumor to determine whether the tumor is estrogen- or
progesterone-dependent.
13.Answer C. Indigestion, or difficulty swallowing, is
one of the seven warning signs of cancer. The other six
are a change in bowel or bladder habits, a sore that does
not heal, unusual bleeding or discharge, a thickening or
lump in the breast or elsewhere, an obvious change in a
wart or mole, and a nagging cough or hoarseness.
Persistent nausea may signal stomach cancer but isnt
one of the seven major warning signs. Rash and chronic
ache or pain seldom indicate cancer.
14.Answer B. Because thrombocytopenia impairs blood
clotting, the nurse should inspect the client regularly for
signs of bleeding, such as petechiae, purpura, epistaxis,
and bleeding gums. The nurse should avoid
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administering aspirin because it may increase the risk of
bleeding. Frequent rest periods are indicated for clients
with anemia, not thrombocytopenia. Strict isolation is
indicated only for clients who have highly contagious or
virulent infections that are spread by air or physical
contact.
15.Answer A. The American Cancer Society
recommends a mammogram yearly for women over age
40. The other statements are incorrect. Its recommended
that women between ages 20 and 40 have a professional
breast examination (not a mammogram) every 3 years.
16.Answer D. The nurse should obtain the clients
baseline blood pressure and pulse and respiratory rates
before administering the initial dose and then continue to
monitor vital signs throughout therapy. A naloxone
challenge test may be administered before using a
narcotic antagonist, not a narcotic agonist. The nurse
shouldnt discontinue a narcotic agonist abruptly
because withdrawal symptoms may occur. Morphine
commonly is used as a continuous infusion in clients
with severe pain regardless of the ability to tolerate
fluids.
17.Answer B. Antimetabolites act during the S phase of
the cell cycle, contributing to cell destruction or
preventing cell replication. Theyre most effective
against rapidly proliferating cancers. Miotic inhibitors
interfere with cell division or mitosis during the M phase
of the cell cycle. Alkylating agents affect all rapidly
proliferating cells by interfering with DNA; they may
kill dividing cells in all phases of the cell cycle and may
also kill nondividing cells. Antineoplastic antibiotic
agents interfere with one or more stages of the synthesis
of RNA, DNA, or both, preventing normal cell growth
and reproduction.
18.Answer B. When following the ABCD method for
assessing skin lesions, the A stands for "asymmetry," the
B for "border irregularity," the C for "color variation,"
and the D for "diameter."
19.Answer B. Tactile agnosia (inability to identify
objects by touch) is a sign of a parietal lobe tumor.
Short-term memory impairment occurs with a frontal
lobe tumor. Seizures may result from a tumor of the
frontal, temporal, or occipital lobe. Contralateral
homonymous hemianopia suggests an occipital lobe
tumor.
20.Answer C. Presence of Bence Jones protein in the
urine almost always confirms the disease, but absence
doesnt rule it out. Serum calcium levels are elevated
because calcium is lost from the bone and reabsorbed in
the serum. Serum protein electrophoresis shows elevated
globulin spike. The serum creatinine level may also be
increased.
21.Answer C. The tissue-destructive effects of cancer
chemotherapy typically cause stomatitis, resulting in
ulcers on the oral mucosa that appear as red, open sores.
White, cottage cheeselike patches on the tongue
suggest a candidal infection, another common adverse
effect of chemotherapy. Yellow tooth discoloration may
result from antibiotic therapy, not cancer chemotherapy.
Rust-colored sputum suggests a respiratory disorder,
such as pneumonia.
22.Answer B. To decrease the pain of stomatitis, the
nurse should provide a solution of hydrogen peroxide
and water for the client to use as a mouth rinse.
(Commercially prepared mouthwashes contain alcohol
and may cause dryness and irritation of the oral mucosa.)
The nurse also may administer viscous lidocaine or
systemic analgesics as prescribed. Stomatitis occurs 7 to
10 days after chemotherapy begins; thus, stopping
chemotherapy wouldnt be helpful or practical. Instead,
the nurse should stay alert for this potential problem to
ensure prompt treatment. Monitoring platelet and
leukocyte counts may help prevent bleeding and
infection but wouldnt decrease pain in this highly
susceptible client. Checking for signs and symptoms of
stomatitis also wouldnt decrease the pain.
23.Answer A. The incidence of prostate cancer increases
after age 50. The digital rectal examination, which
identifies enlargement or irregularity of the prostate, and
PSA test, a tumor marker for prostate cancer, are
effective diagnostic measures that should be done yearly.
Testicular self-examinations wont identify changes in
the prostate gland due to its location in the body. A
transrectal ultrasound, CBC, and BUN and creatinine
levels are usually done after diagnosis to identify the
extent of the disease and potential metastases
24.Answer A. Anticipatory grieving is an appropriate
nursing diagnosis for this client because few clients with
gallbladder cancer live more than 1 year after diagnosis.
Impaired swallowing isnt associated with gallbladder
cancer. Although surgery typically is done to remove the
gallbladder and, possibly, a section of the liver, it isnt
disfiguring and doesnt cause Disturbed body image.
Chronic low self-esteem isnt an appropriate nursing
diagnosis at this time because the diagnosis has just been
made.
25.Answer B. If a radioactive implant becomes
dislodged, the nurse should pick it up with long-handled
forceps and place it in a lead-lined container, then notify
the radiation therapy department immediately. The
highest priority is to minimize radiation exposure for the
client and the nurse; therefore, the nurse must not take
any action that delays implant removal. Standing as far
from the implant as possible, leaving the room with the
implant still exposed, or attempting to put it back in
place can greatly increase the risk of harm to the client
and the nurse from excessive radiation exposure.
26.Answer A. The client must report changes in visual
acuity immediately because this adverse effect may be
irreversible. Tamoxifen isnt associated with hearing
loss. Although the drug may cause anorexia, headache,
and hot flashes, the client need not report these adverse
effects immediately because they dont warrant a change
in therapy.
27.Answer A. The liver is one of the five most common
cancer metastasis sites. The others are the lymph nodes,
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lung, bone, and brain. The colon, reproductive tract, and
WBCs are occasional metastasis sites.
28.Answer B. A low-fat diet (one that maintains weight
within 20% of recommended body weight) has been
found to decrease a womans risk of breast cancer. A
baseline mammogram should be done between ages 30
and 40. Monthly breast self-examinations should be
done between days 7 and 10 of the menstrual cycle. The
client should continue to perform monthly breast self-
examinations even when receiving yearly mammograms.
29.Answer C. Bone marrow suppression becomes
noticeable 7 to 14 days after floxuridine administration.
Bone marrow recovery occurs in 21 to 28 days.
30.Answer D. During an MRI, the client should wear no
metal objects, such as jewelry, because the strong
magnetic field can pull on them, causing injury to the
client and (if they fly off) to others. The client must lie
still during the MRI but can talk to those performing the
test by way of the microphone inside the scanner tunnel.
The client should hear thumping sounds, which are
caused by the sound waves thumping on the magnetic
field.
















































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30 items set b
1. Nina, an oncology nurse educator is speaking to
a womens 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
childbearing age.
c. Breast cancer requires a mastectomy.
d. Men can develop breast cancer.
2. Nurse Meredith is instructing a premenopausal
woman about breast self-examination. The nurse
should tell the client to do her self-examination:
a. at the end of her menstrual cycle.
b. on the same day each month.
c. on the 1st day of the menstrual cycle.
d. immediately after her menstrual period.
3. Nurse Kent is teaching a male client to perform
monthly testicular self-examinations. Which of the
following points would be appropriate to make?
a. Testicular cancer is a highly curable type of
cancer.
b. Testicular cancer is very difficult to diagnose.
c. Testicular cancer is the number one cause of
cancer deaths in males.
d. Testicular cancer is more common in older
men.
4. Rhea, has malignant lymphoma. As part of her
chemotherapy, the physician prescribes
chlorambucil (Leukeran), 10 mg by mouth daily.
When caring for the client, the nurse teaches her
about adverse reactions to chlorambucil, such as
alopecia. How soon after the first administration of
chlorambucil might this reaction occur?
a. Immediately
b. 1 week
c. 2 to 3 weeks
d. 1 month
5. A male client is receiving the cell cycle
nonspecific alkylating agent thiotepa (Thioplex), 60
mg weekly for 4 weeks by bladder instillation as
part of a chemotherapeutic regimen to treat bladder
cancer. The client asks the nurse how the drug
works. How does thiotepa exert its therapeutic
effects?
a. It interferes with deoxyribonucleic acid (DNA)
replication only.
b. It interferes with ribonucleic acid (RNA)
transcription only.
c. It interferes with DNA replication and RNA
transcription.
d. It destroys the cell membrane, causing lysis.
6. 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
7. 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
8. Gian, a community health nurse is instructing a
group of female clients about breast self-
examination. The nurse instructs the client to
perform the examination:
a. At the onset of menstruation
b. Every month during ovulation
c. Weekly at the same time of day
d. 1 week after menstruation begins
9. Nurse Cecilia is caring for a client who has
undergone a vaginal hysterectomy. The nurse
avoids which of the following in the care of this
client?
a. Elevating the knee gatch on the bed
b. Assisting with range-of-motion leg exercises
c. Removal of antiembolism stockings twice daily
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d. Checking placement of pneumatic compression
boots
10. Mina, who is suspected of an ovarian tumor is
scheduled for a pelvic ultrasound. The nurse
provides which preprocedure instruction to the
client?
a. Eat a light breakfast only
b. Maintain an NPO status before the procedure
c. Wear comfortable clothing and shoes for the
procedure
d. Drink six to eight glasses of water without
voiding before the test
11. A male client is diagnosed as having a bowel
tumor and several diagnostic tests are prescribed.
The nurse understands that which test will confirm
the diagnosis of malignancy?
a. Biopsy of the tumor
b. Abdominal ultrasound
c. Magnetic resonance imaging
d. Computerized tomography scan
12. A female client diagnosed with multiple
myeloma and the client asks the nurse about the
diagnosis. The nurse bases the response on which
description of this disorder?
a. Altered red blood cell production
b. Altered production of lymph nodes
c. Malignant exacerbation in the number of
leukocytes
d. Malignant proliferation of plasma cells within
the bone
13. Nurse Bea is reviewing the laboratory results
of a client diagnosed with multiple myeloma.
Which of the following would the nurse expect to
note specifically in this disorder?
a. Increased calcium
b. Increased white blood cells
c. Decreased blood urea nitrogen level
d. Decreased number of plasma cells in the bone
marrow
14. Vanessa, a community health nurse conducts a
health promotion program regarding testicular
cancer to community members. The nurse
determines that further information needs to be
provided if a community member states that which
of the following is a sign of testicular cancer?
a. Alopecia
b. Back pain
c. Painless testicular swelling
d. Heavy sensation in the scrotum
15. The male client is receiving external radiation
to the neck for cancer of the larynx. The most likely
side effect to be expected is:
a. Dyspnea
b. Diarrhea
c. Sore throat
d. Constipation
16. Nurse Joy is caring for a client with an
internal radiation implant. When caring for the
client, the nurse should observe which of the
following principles?
a. Limit the time with the client to 1 hour per shift
b. Do not allow pregnant women into the clients
room
c. Remove the dosimeter badge when entering the
clients room
d. Individuals younger than 16 years old may be
allowed to go in the room as long as they are 6 feet
away from the client
17. A cervical radiation implant is placed in the
client for treatment of cervical cancer. The nurse
initiates what most appropriate activity order for
this client?
a. Bed rest
b. Out of bed ad lib
c. Out of bed in a chair only
d. Ambulation to the bathroom only
18. A female client is hospitalized for insertion of
an internal cervical radiation implant. While giving
care, the nurse finds the radiation implant in the
bed. The initial action by the nurse is to:
a. Call the physician
b. Reinsert the implant into the vagina
immediately
c. Pick up the implant with gloved hands and
flush it down the toilet
d. Pick up the implant with long-handled forceps
and place it in a lead container.
19. 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
b. Restrict fluid intake
c. Teach the client and family about the need for
hand hygiene
d. Insert an indwelling urinary catheter to prevent
skin breakdown
20. The home health care nurse is caring for a
male client with cancer and the client is
complaining of acute pain. The appropriate nursing
assessment of the clients pain would include which
of the following?
a. The clients pain rating
b. Nonverbal cues from the client
c. The nurses impression of the clients pain
d. Pain relief after appropriate nursing
intervention
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21. Nurse Mickey is caring for a client who is
postoperative following a pelvic exenteration and
the physician changes the clients diet from NPO
status to clear liquids. The nurse makes which
priority assessment before administering the diet?
a. Bowel sounds
b. Ability to ambulate
c. Incision appearance
d. Urine specific gravity
22. A male client is admitted to the hospital with a
suspected diagnosis of Hodgkins disease. Which
assessment findings would the nurse expect to note
specifically in the client?
a. Fatigue
b. Weakness
c. Weight gain
d. Enlarged lymph nodes
23. During the admission assessment of a 35 year
old client with advanced ovarian cancer, the nurse
recognizes which symptom as typical of the
disease?
a. Diarrhea
b. Hypermenorrhea
c. Abdominal bleeding
d. Abdominal distention
24. Nurse Kate is reviewing the complications of
colonization with a client who has microinvasive
cervical cancer. Which complication, if identified
by the client, indicates a need for further teaching?
a. Infection
b. Hemorrhage
c. Cervical stenosis
d. Ovarian perforation
25. 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.
26. Sarah, 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
phrase of coping is this client experiencing?
a. Anger
b. Denial
c. Bargaining
d. Depression
27. Nurse Farah is caring for a client following a
mastectomy. Which assessment finding indicates
that the client is experiencing a complication related
to the surgery?
a. Pain at the incisional site
b. Arm edema on the operative side
c. Sanguineous drainage in the Jackson-Pratt drain
d. Complaints of decreased sensation near the
operative site
28. The nurse is admitting a male client with
laryngeal cancer to the nursing unit. The nurse
assesses for which most common risk factor for this
type of cancer?
a. Alcohol abuse
b. Cigarette smoking
c. Use of chewing tobacco
d. Exposure to air pollutants
29. The female client who has been receiving
radiation therapy for bladder cancer tells the nurse
that it feels as if she is voiding through the vagina.
The nurse interprets that the client may be
experiencing:
a. Rupture of the bladder
b. The development of a vesicovaginal fistula
c. Extreme stress caused by the diagnosis of
cancer
d. Altered perineal sensation as a side effect of
radiation therapy
30. 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













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30 items set b answers

1. Answer D. Men can develop breast cancer,
although they seldom do. The most reliable method
for detecting breast cancer is monthly self-
examination, not mammography. Lung cancer
causes more deaths than breast cancer in women of
all ages. A mastectomy may not be required if the
tumor is small, confined, and in an early stage.
2. Answer D. Premenopausal women should do
their self-examination immediately after the
menstrual period, when the breasts are least tender
and least lumpy. On the 1st and last days of the
cycle, the womans breasts are still very tender.
Postmenopausal women because their bodies lack
fluctuation of hormone levels, should select one
particular day of the month to do breast self-
examination.
3. Answer A. Testicular cancer is highly curable,
particularly when its treated in its early stage. Self-
examination allows early detection and facilitates
the early initiation of treatment. The highest
mortality rates from cancer among men are in men
with lung cancer. Testicular cancer is found more
commonly in younger men.
4. Answer C. Chlorambucil-induced alopecia
occurs 2 to 3 weeks after therapy begins.
5. Answer C. Thiotepa interferes with DNA
replication and RNA transcription. It doesnt
destroy the cell membrane.
6. Answer B. The testicular-self examination is
recommended monthly after a warm bath or shower
when the scrotal skin is relaxed. The client should
stand to examine the testicles. Using both hands,
with fingers under the scrotum and thumbs on top,
the client should gently roll the testicles, feeling for
any lumps.
7. Answer C. Thrombocytopenia indicates a
decrease in the number of platelets in the circulating
blood. A major concern is monitoring for and
preventing bleeding. Option A elates to monitoring
for infection, particularly if leukopenia is present.
Options B and D, although important in the plan of
care, are not related directly to thrombocytopenia.
8. Answer D. The breast self-examination should
be performed monthly 7 days after the onset of the
menstrual period. Performing the examination
weekly is not recommended. At the onset of
menstruation and during ovulation, hormonal
changes occur that may alter breast tissue.
9. Answer A. The client is at risk of deep vein
thrombosis or thrombophlebitis after this surgery, as
for any other major surgery. For this reason, the
nurse implements measures that will prevent this
complication. Range-of-motion exercises,
antiembolism stockings, and pneumatic
compression boots are helpful. The nurse should
avoid using the knee gatch in the bed, which
inhibits venous return, thus placing the client more
at risk for deep vein thrombosis or
thrombophlebitis.
10. Answer D. A pelvic ultrasound requires the
ingestion of large volumes of water just before the
procedure. A full bladder is necessary so that it will
be visualized as such and not mistaken for a
possible pelvic growth. An abdominal ultrasound
may require that the client abstain from food or
fluid for several hours before the procedure. Option
C is unrelated to this specific procedure.
11. Answer A. A biopsy is done to determine
whether a tumor is malignant or benign. Magnetic
resonance imaging, computed tomography scan,
and ultrasound will visualize the presence of a mass
but will not confirm a diagnosis of malignancy.
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12. Answer D. Multiple myeloma is a B-cell
neoplastic condition characterized by abnormal
malignant proliferation of plasma cells and the
accumulation of mature plasma cells in the bone
marrow. Options A and B are not characteristics of
multiple myeloma. Option C describes the leukemic
process.
13. Answer A. Findings indicative of multiple
myeloma are an increased number of plasma cells in
the bone marrow, anemia, hypercalcemia caused by
the release of calcium from the deteriorating bone
tissue, and an elevated blood urea nitrogen level. An
increased white blood cell count may or may not be
present and is not related specifically to multiple
myeloma.
14. Answer A. Alopecia is not an assessment
finding in testicular cancer. Alopecia may occur,
however, as a result of radiation or chemotherapy.
Options B, C, and D are assessment findings in
testicular cancer. Back pain may indicate metastasis
to the retroperitoneal lymph nodes.
15. Answer C. In general, only the area in the
treatment field is affected by the radiation. Skin
reactions, fatigue, nausea, and anorexia may occur
with radiation to any site, whereas other side effects
occur only when specific areas are involved in
treatment. A client receiving radiation to the larynx
is most likely to experience a sore throat. Options B
and D may occur with radiation to the
gastrointestinal tract. Dyspnea may occur with lung
involvement.
16. Answer B. The time that the nurse spends in a
room of a client with an internal radiation implant is
30 minutes per 8-hour shift. The dosimeter badge
must be worn when in the clients room. Children
younger than 16 years of age and pregnant women
are not allowed in the clients room.
17. Answer A. The client with a cervical radiation
implant should be maintained on bed rest in the
dorsal position to prevent movement of the
radiation source. The head of the bed is elevated to
a maximum of 10 to 15 degrees for comfort. The
nurse avoids turning the client on the side. If turning
is absolutely necessary, a pillow is placed between
the knees and, with the body in straight alignment,
the client is logrolled.
18. Answer D. A lead container and long-handled
forceps should be kept in the clients room at all
times during internal radiation therapy. If the
implant becomes dislodged, the nurse should pick
up the implant with long-handled forceps and place
it in the lead container. Options A, B, and C are
inaccurate interventions.
19. Answer C. In the neutropenic client,
meticulous hand hygiene education is implemented
for the client, family, visitors, and staff. Not all
visitors are restricted, but the client is protected
from persons with known infections. Fluids should
be encouraged. Invasive measures such as an
indwelling urinary catheter should be avoided to
prevent infections.
20. Answer A. The clients self-report is a critical
component of pain assessment. The nurse should
ask the client about the description of the pain and
listen carefully to the clients words used to
describe the pain. The nurses impression of the
clients pain is not appropriate in determining the
clients level of pain. Nonverbal cues from the
client are important but are not the most appropriate
pain assessment measure. Assessing pain relief is an
important measure, but this option is not related to
the subject of the question.
21. Answer A. The client is kept NPO until
peristalsis returns, usually in 4 to 6 days. When
signs of bowel function return, clear fluids are given
to the client. If no distention occurs, the diet is
advanced as tolerated. The most important
assessment is to assess bowel sounds before feeding
the client. Options B, C, and D are unrelated to the
subject of the question.
22. Answer D. Hodgkins disease is a chronic
progressive neoplastic disorder of lymphoid tissue
characterized by the painless enlargement of lymph
nodes with progression to extralymphatic sites, such
as the spleen and liver. Weight loss is most likely to
be noted. Fatigue and weakness may occur but are
not related significantly to the disease.
23. Answer D. Clinical manifestations of ovarian
cancer include abdominal distention, urinary
frequency and urgency, pleural effusion,
malnutrition, pain from pressure caused by the
growing tumor and the effects of urinary or bowel
obstruction, constipation, ascites with dyspnea, and
ultimately general severe pain. Abnormal bleeding,
often resulting in hypermenorrhea, is associated
with uterine cancer.
24. Answer D. Conization procedure involves
removal of a cone-shaped area of the cervix.
Complications of the procedure include
hemorrhage, infection, and cervical stenosis.
Ovarian perforation is not a complication.
25. Answer A. Tumors that originate from
bone,muscle, and other connective tissue are called
sarcomas.
26. Answer C. Denial, bargaining, anger,
depression, and acceptance are recognized stages
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that a person facing a life-threatening illness
experiences. Bargaining identifies a behavior in
which the individual is willing to do anything to
avoid loss or change prognosis or fate. Denial is
expressed as shock and disbelief and may be the
first response to hearing bad news. Depression may
be manifested by hopelessness, weeping openly, or
remaining quiet or withdrawn. Anger also may be a
first response to upsetting news and the
predominant theme is why me? or the blaming of
others.
27. Answer B. Arm edema on the operative side
(lymphedema) is a complication following
mastectomy and can occur immediately
postoperatively or may occur months or even years
after surgery. Options A, C, and D are expected
occurrences following mastectomy and do not
indicate a complication.
28. Answer B. The most common risk factor
associated with laryngeal cancer is cigarette
smoking. Heavy alcohol use and the combined use
of tobacco increase the risk. Another risk factor is
exposure to environmental pollutants.
29. Answer B. A vesicovaginal fistula is a genital
fistula that occurs between the bladder and vagina.
The fistula is an abnormal opening between these
two body parts and, if this occurs, the client may
experience drainage of urine through the vagina.
The clients complaint is not associated with
options A, C, and D.
30. Answer D. Allopurinol decreases uric acid
production and reduces uric acid concentrations in
serum and urine. In the client receiving
chemotherapy, uric acid levels increase as a result
of the massive cell destruction that occurs from the
chemotherapy. This medication prevents or treats
hyperuricemia caused by chemotherapy.
Allopurinol is not used to prevent alopecia, nausea,
or vomiting.