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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 personal sensation as the side effect of radiation
therapy
72. The client with leukemia is receiving busulfan (Myleran) and
allupurinol (Zyloprim) is prescribed for the client. The nurse tells
the client that the purpose of the allupurinol is to prevent:
a) nausea
b) alopecia
c) vomiting
d) hyperuricemia
73. The client receiving chemotherapy is experiencing mucositis.
The nurse advises the client to use which of the following as the
best substance to rinse the mouth?
a) alcohol-based mouthwash
b) hydrogen peroxide mixture
c) lemon-flavored mouthwash
d) weak salt and bicarbonate mouth rinse
74. The community nurse is conducting a health promotion
program and the topic of the discussion relates to the risk factors
for gastric cancer. Which risk factor, if identified by a client,
indicates a need for further discussion?
a) smoking
b) a high-fat diet
c) foods containing nitrates
d) a diet of smoked, highly salted, and spiced food
75. A gastrectomy is performed on a client with gastric cancer. In
the immediate postoperative period, the nurse notes bloody
drainage from the nasogastric tube. Which of the following is the
appropriate nursing intervention?
a) notify the physician
b) measure abdominal girth
c) irrigate the nasogastric tube
d) continue to monitor the drainage
76. The nurse is teaching a client about the risk factors associated
with colorectal cancer. The nurse determines that further teaching
related to colorectal cancer is necessary if the client identifies
which of the following as an associated risk factor?
a) age younger than 50 years
b) history of colorectal polyps
c) family history of colorectal cancer
d) chronic inflammatory bowel disease
77. The nurse is performing an admission assessment on a client
diagnosed with a right colon tumor. The nurse asks the client
about which characteristic symptom of this type of tumor?
a) rectal bleeding
b) flat, ribbon-like stool
c) crampy, colicky abdominal pain
d) alternating constipation and diarrhea
78. The nurse is reviewing the preoperative orders of a client with
a colon tumor who is scheduled for abdominal perineal resection
and notes that the physician has prescribed neomycin (Mycifradin)
for the client. The nurse determines that this medication has been
prescribed primarily:
a) to prevent immune dysfunction
b) because the client has an infection
c) to decrease the bacteria in the bowel
d) because the client is allergic to penicillin
79. The nurse is assessing the perineal wound in a client who has
returned from the operating room following an abdominal perineal
resection and notes serosanguineous drainage from the wound.
Which nursing intervention is most appropriate?
a) notify the physician
b) clamp the penrose drain
c) change the dressing as prescribed
d) remove and replace the perineal packing
80. The nurse is assessing the colostomy of a client who has had
an abdominal perineal resection for a bowel tumor. Which of the
following assessment findings indicates that the colostomy is
beginning to function?
a) absent bowel sounds
b) the passage of flatus
c) the client's ability to tolerate food
1. Constipation
2. Dumping syndrome
3. Gastric spasm
4. Intestinal spasms
39. A client with rectal cancer may exhibit which of the
following symptoms?
1. Abdominal fullness
2. Gastric fullness
3. Rectal bleeding
4. Right upper quadrant pain
40. A client with which of the following conditions may be
likely to develop rectal cancer?
1. Adenomatous polyps
2. Diverticulitis
3. Hemorrhoids
4. Peptic ulcer disease
41. Which of the following treatments is used for rectal
cancer but not for colon cancer?
1. Chemotherapy
2. Colonoscopy
3. Radiation
4. Surgical resection
47. A client with irritable bowel syndrome is being
prepared for discharge. Which of the following meal plans
should the nurse give the client?
1. Low fiber, low-fat
2. High fiber, low-fat
3. Low fiber, high-fat
4. High-fiber, high-fat
48. A client presents to the emergency room, reporting
that he has been vomiting every 30 to 40 minutes for the
past 8 hours. Frequent vomiting puts him at risk for which
of the following?
1. Metabolic acidosis with hyperkalemia
2. Metabolic acidosis with hypokalemia
3. Metabolic alkalosis with hyperkalemia
4. Metabolic alkalosis with hypokalemia
49. Five days after undergoing surgery, a client develops a
small-bowel obstruction. A Miller-Abbott tube is inserted
for bowel decompression. Which nursing diagnosis takes
priority?
1. Imbalanced nutrition: Less than body requirements
2. Acute pain
3. Deficient fluid volume
4. Excess fluid volume
50. When teaching an elderly client how to prevent
constipation, which of the following instructions should the
nurse include?
1. Drink 6 glasses of fluid each day.
2. Avoid grain products and nuts.
3. Add at least 4 grams of bran to your cereal each morning.
4. Be sure to get regular exercise.
51. In a client with diarrhea, which outcome indicates that
fluid resuscitation is successful?
1. The client passes formed stools at regular intervals
2. The client reports a decrease in stool frequency and liquidity
3. The client exhibits firm skin turgor
4. The client no longer experiences perianal burning.
52. When teaching a community group about measures to
prevent colon cancer, which instruction should the nurse
include?
1. Limit fat intake to 20% to 25% of your total daily
calories.
2. Include 15 to 20 grams of fiber into your daily diet.
3. Get an annual rectal examination after age 35.
4. Undergo sigmoidoscopy annually after age 50.
53. A 30-year old client experiences weight loss, abdominal
distention, crampy abdominal pain, and intermittent
diarrhea after birth of her 2nd child. Diagnostic tests
reveal gluten-induced enteropathy. Which foods must she
eliminate from her diet permanently?
1. Milk and dairy products
2. Protein-containing foods
3. Cereal grains (except rice and corn)
4. Carbohydrates
54. After a right hemicolectomy for treatment of colon
cancer, a 57-year old client is reluctant to turn while on
bed rest. Which action by the nurse would be appropriate?
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.
34. 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
35. A male client is receiving the cell cyclenonspecific
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.
37. 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
41. 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
46. 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
50. 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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1) Before discharge, the nurse scheduled the client who
had a colostomy for colorectal cancer for discharge
instruction about resuming activities. The nurse should
plan to help the client understands that:
A. After surgery, changes in activities must be made to
accommodate for the physiologic changes caused by the
operation.
B. Most sports activities, except for swimming, can be resumed
based on the clients overall physical condition.
C. With counseling and medical guidance, a near normal lifestyle,
including complete sexual function is possible.
D. Activities of daily living should be resumed as quickly as
possible to avoid depression and further dependency.
Q.3) Which of the following characteristics are risk factors
for colorectal cancer?
A. Familial polyposis
B. Age younger than 40
C. Low fat, low protein, high fiber diet
D. History of skin cancer
Q.4) A patient received surgery and chemotherapy for
colon cancer, completing therapy 3 months previously, and
continuously.
C. Check the gastrostomy tube for position every 2 days.
D. Maintain the client on bed rest during the feedings.
6. A male client is recovering from a small-bowel resection.
To relieve pain, the physician prescribes meperidine
(Demerol), 75 mg I.M. every 4 hours. How soon after
administration should meperidine onset of action occur?
A. 5 to 10 minutes
B. 15 to 30 minutes
C. 30 to 60 minutes
D. 2 to 4 hours
7. The nurse is caring for a male client with cirrhosis.
Which assessment findings indicate that the client has
deficient vitamin K absorption caused by this hepatic
disease?
A. Dyspnea and fatigue
B. Ascites and orthopnea
C. Purpura and petechiae
D. Gynecomastia and testicular atrophy
8. Which condition is most likely to have a nursing
diagnosis of fluid volume deficit?
A. Appendicitis
B. Pancreatitis
C. Cholecystitis
D. Gastric ulcer
9. While a female client is being prepared for discharge,
the nasogastric (NG) feeding tube becomes cloggeD. To
remedy this problem and teach the clients family how to
deal with it at home, what should the nurse do?
A. Irrigate the tube with cola.
B. Advance the tube into the intestine.
C. Apply intermittent suction to the tube.
D. Withdraw the obstruction with a 30-ml syringe.
12. Which diagnostic test would be used first to evaluate a
client with upper GI bleeding?
A. Endoscopy
B. Upper GI series
C. Hemoglobin (Hb) levels and hematocrit (HCT)
D. Arteriography
19. A male client undergoes 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 tube
C. Irrigate the tube
D. Increase the suction level
23. While palpating a female clients right upper quadrant
(RUQ), the nurse would expect to find which of the
following structures?
A. Sigmoid colon
B. Appendix
C. Spleen
D. Liver
24. A male client has undergone a colon resection. While
turning him, wound dehiscence with evisceration occurs.
The nurses first response is to:
A. call the physician.
B. place saline-soaked sterile dressings on the wound.
C. take a blood pressure and pulse.
D. pull the dehiscence closed.
////////////
" A gastrectomy is performed on a client with gastric cancer. In the
immediate postoperative period, the nurse notes bloody drainage
from the nasogastric tube. Which of the following is the
appropriate nursing intervention?"
"a) notify the physician
b) measure abdominal girth
c) irrigate the nasogastric tube
d) continue to monitor the drainage (CORRECT)"
"1. While being prepared for a biopsy, the patient asks the nurse
what the difference is between a benign tumor and a malignant
tumor. The nurse explains that a benign tumor differs from a
malignant tumor in that benign tumors
"a. do not cause damage to adjacent tissue.
b. do not spread to other tissues and organs.
c. are simply an overgrowth of normal cells.
d. frequently recur in the same site."
B. 20-22 cm
C. 10-12.5 cm
D. <15 cm
Q.32) Which diagnostic test is best to evaluate liver enlargement
and ascites?
A. Ultrasound
B. X-Ray
C. CT scan
D. Nuclear Medicine
E. Arteriogram
Q.33) CT scan of the liver
A. good for evaluating small masses <1cm
B. good for differentiating cysts vs. solid mass
C. evaluates function of liver
Q.34) Which is the largest lobe of liver?
A. Right
B. Left
C. Quadrate
D. Caudate
/////////
The occupational health nurse is preparing a presentation to a
group of factory workers about preventing colon cancer. Which
information should be included?
1. Wear a high filtration mask around chemicals.
2. Eat several servings of cruciferous vegetables daily.
3. Take a multivitamin daily.
4. Do not engage in high-risk sexual behavior.
The nurse is admitting a male client with a diagnosis of
adenocarcinoma of the rectosigmoid colon. Which assessment
data support this diagnosis?
1. Reports up to 20 bloody stools per day.
2. States he has a feeling of fullness after a heavy meal.
3. Has diarrhea alternating with constipation.
4. Complains of RLQ pain with rebound tenderness.
The 85 y.o. male client diagnosed with colon cancer asks the
nurse, "Why did I get colon cancer?" Which is best response about
colon cancer?
1. Lack of fiber in the diet.
2. Greatest incidence among those younger than 50.
3. Has no known risk factors.
4. Rare among male clients.
The nurse is planning care of a client who has had an abdominal
perineal resection for colon cancer. Which interventions should the
nurse implement? Select all that apply:
1. Provide meticlulous skin care to stoma.
2. Assess the flank incision.
3. Maintain the indwelling catheter.
4. Irrigate the JP drains every shift.
5. Position the client semi-recumbent.
The client who has had an abdominal perineal resection is being
discharged. Which info should nurse teach?
1. The stoma should be a white, blue, or purple color.
2. Limit ambulation to prevent the pouch from coming off.
3. Take pain meds when pain level is at 8.
4. Empty pouch when 1/3 to 1/2 full.
the nurse caring for the pt 1day post op sigmoid resection notes a
moderate amount of dark reddish brown drainage on the midline
abdominal incision. Which intervention is first?
1. Mark the drainage on the dressing with the time and
date.
2. Change the dressing immediately using sterile technique.
3. Notify the health care provider immediately.
4. Reinforce the dressing with a sterile gauze pad.
The nurse is caring for pts in an outpatient clinic. Which info
should the nurse teach regarding the American Cancer Society's
recommendations for early detection of colon cancer?
1. Beginning at age 60, a digital rectal exam should be done
annually.
2. After pt reaches middle age, yearly fecal occult test.
3. At age 50, a colonoscopy, then once every 5-10 years.
4. A flexible sigmoidoscopy should be done yearly after age 40.
The nurse writes a psychosocial problem of "risk for altered sexual
functioning related to new colostomy. Which intervention should
the nurse implement?
1. Tell pt. that there should be no intimacy for at least 3 months.
2. Ensure that the pt and partner are able to change the ostomy
pouch.
3. Demonstrate with charts possible sexual positions for the pt. to
assume.
39. A client with rectal cancer may exhibit which of the following
symptoms?
Abdominal fullness
Gastric fullness
Rectal bleeding
Right upper quadrant pain
40. A client with which of the following conditions may be likely
to develop rectal cancer?
Adenomatous polyps
Diverticulitis
Hemorrhoids
Peptic ulcer disease
41. Which of the following treatments is used for rectal cancer
but not for colon cancer?
Chemotherapy
Colonoscopy
Radiation
Surgical resection
52. When teaching a community group about measures to
prevent colon cancer, which instruction should the nurse include?
Limit fat intake to 20% to 25% of your total daily calories.
Include 15 to 20 grams of fiber into your daily diet.
Get an annual rectal examination after age 35.
Undergo sigmoidoscopy annually after age 50.
55. A client has a percutaneous endoscopic gastrostomy tube
inserted for tube feedings. Before starting a continuous feeding,
the nurse should place the client in which position?
Semi-Fowlers
Supine
Reverse Trendelenburg
High Fowlers
57. The client being seen in a physicians office has just been
scheduled for a barium swallow the next day. The nurse writes
down which of the following instructions for the client to follow
before the test?
Fast for 8 hours before the test
Eat a regular supper and breakfast
Continue to take all oral medications as scheduled.
Monitor own bowel movement pattern for constipation
58. The nurse is monitoring a client for the early signs of
dumping syndrome. Which symptom indicates this occurrence?
Abdominal cramping and pain
Bradycardia and indigestion
Sweating and pallor
Double vision and chest pain
62. The nurse is performing a colostomy irrigation on a client.
During the irrigation, a client begins to complain of abdominal
cramps. Which of the following is the most appropriate nursing
action?
Notify the physician
Increase the height of the irrigation
Stop the irrigation temporarily.
Medicate with dilaudid and resume the irrigation
63. The nurse is teaching the client how to perform a colostomy
irrigation. To enhance the effectiveness of the irrigation and fecal
returns, what measure should the nurse instruct the client to do?
Increase fluid intake
Reduce the amount of irrigation solution
Perform the irrigation in the evening
Place heat on the abdomen
66. The nurse instructs the ileostomy client to do which of the
following as a part of essential care of the stoma?
Cleanse the peristomal skin meticulously
Take in high-fiber foods such as nuts
Massage the area below the stoma
Limit fluid intake to prevent diarrhea.
67. The client who has undergone creation of a colostomy has a
nursing diagnosis of Disturbed body image. The nurse would
evaluate that the client is making the most significant progress
toward identified goals if the client:
Watches the nurse empty the colostomy bag
Looks at the ostomy site
Reads the ostomy product literature
Practices cutting the ostomy appliance
68. The nurse is assessing for stoma prolapse in a client with a
colostomy. The nurse would observe which of the following if
stoma prolapse occurred?
Sunken and hidden stoma
Dark- and bluish-colored stoma