ONCOLOGY

1. Mr. Arroy is in continuous pain from cancer

that has metastasized to the bone. Pain
medication provides little relief and he refuses
to move. The nurse should plan to:
a. Reassure him that the nurses will not
hurt him
b. Let him perform his own activities of
daily living
c. Handle him gently when assisting with
required care
d. Complete A.M. care quickly as possible
when necessary
2. A female client with breast cancer is
currently receiving radiation therapy for
treatment. The client is complaining of
apathy, hard to concentrate on something,
and feeling tired despite of having time to
rest and more sleep. These complain suggest
symptoms of
a. Hypocalcemia
b. radiation pneumonitis
c. advanced breast cancer
d. fatigue
3. A chemotherapeutic agent 5FU is ordered
as an adjunct measure to surgery. Which of
the ff. statements about chemotherapy is
true?
a. it is a local treatment affecting only
tumor cells
b. it affects both normal and tumor cells
c. it has been proven as a complete cure
for cancer
d. it is often used as a palliative measure.
4. Which of the following signs and symptoms
would Nurse Maureen include in teaching plan
as an early manifestation of laryngeal cancer?
a. Stomatitis
b. Airway obstruction
c. Hoarseness
d. Dysphagia
5. Karina a client with myasthenia gravis is to
receive immunosuppressive therapy.
The nurse understands that this
therapy is effective because it:
a. Promotes the removal of antibodies
that impair the transmission of
impulses
b. Stimulates the production of
acetylcholine at the neuromuscular
junction.
c. Decreases the production of auto
antibodies that attack the acetylcholine
receptors.
d. Inhibits the breakdown of acetylcholine
at the neuromuscular junction.
6. Which of the following stage the
carcinogen is irreversible?

a.
b.
c.
d.

Progression stage
Initiation stage
Regression stage
Promotion stage

7. Nurse Clarence is aware that early

adaptation of client with renal carcinoma is:
a. Nausea and vomiting
b. flank pain
c. weight gain
d. intermittent hematuria
8. A newly admitted client is diagnosed with
Hodgkins disease undergoes an excisional
cervical lymph node biopsy under local
anesthesia. What does the nurse assess first
after the procedure?
a. Vital signs
b. Incision site
c. Airway
d. Level of consciousness
9. Cancer patients have special nutrition
needs and issues related to eating. The client
receving chemotherapy refuses to eat the
food that was delivered to him and said that
the food tastes funny. The appropriate
nursing intervention is:
a. Obtain an order for total parenteral
nutrition
b. Keep the client on NPO
c. Administer anti-emetic as ordered by
physician
d. Provide oral hygiene care
10. A client with testicular cancer is
scheduled for a right orchiectomy. The nurse
knows that an orchiectomy is the
a. surgical removal of the entire scrotum
b. surgical removal of a testicle
c. dissection of related lymph nodes
d. partial surgical removal of the penis
11. A client is being evaluated for cancer of
the colon. In preparing the client for barium
enema, the nurse should:
a. Give laxative the night before and a
cleansing enema in the morning before
the test
b. Render an oil retention enema and give
laxative the night before
c. Instruct the client to swallow 6
radiopaque tablets the evening before the
study
d. Place the client on CBR a day before the
study
12. The client has a good understanding of
the means to reduce the chances of colon
cancer when he states:
a. I will exercise daily.
b. I will include more red meat in my diet.
c. I will have an annual chest x-ray.

d. I will include more fresh fruits and

vegetables in my diet.
13. A client, who is suspected of having
Pheochromocytoma, complains of sweating,
palpitation and headache. Which assessment
is essential for the nurse to make first?
a. Pupil reaction
b. Hand grips
c. Blood pressure
d. Blood glucose
14. The nurse is conducting an education
session for a group of smokers in a stop
smoking class. Which finding would the
nurse state as a common symptom of lung
cancer? :
a. Dyspnea on exertion
b. Foamy, blood-tinged sputum
c. Wheezing sound on inspiration
d. Cough or change in a chronic cough
15. A client admitted with newly diagnosed
with Hodgkins disease. Which of the following
would the nurse expect the client to report?
a. Lymph node pain
b. Weight gain
c. Night sweats
d. Headache
16. When teaching a client about the signs of
colorectal cancer, Nurse Trish stresses that
the most common complaint of persons with
colorectal cancer is:
a. Abdominal pain
b. Hemorrhoids
c. Change in caliber of stools
d. Change in bowel habits
17. A patient with a left frontal lobe tumor
has a craniotomy. Four hours post surgery,
which data indicates increased ICP?
a. BP 160/90
b. Patient is difficult to arouse
c. Patient has a positive Babinski response
d. Patient has urinary incontinence
18. The most common preferred treatment
for cancer is
a. Chemotherapy
b. Radiation therapy
c. Surgery
d. Bone marrow transplant
19. A client on chemotherapy has a platelet
count of 26,000 mm. Which nursing
intervention must be included in the client's
care plan?
a. Having the client use an electric razor
and soft-bristle toothbrush
b. Premedicating the client 30 minutes
before chemotherapy with an antiemetic
c Preparing to administer leukocyte-poor
packed red blood cells (RBCs)

d. Screening all visitors and staff for

infection prior to allowing them to enter the
room
20. Which intervention would be most
appropriate for a client who is 12 days
postchemotherapy and being admitted with
shortness of breath, a dry hacking cough, and
a temperature of 101 F?
a. Having the dietary department serve the
meals as hot as possible
b. Initiating the prescribed I.V. antibiotics
after checking the white blood cell (WBC)
count
c. Limiting the protein and calories in the
client's diet
d. Reassuring the client that fatigue is a
common occurrence after chemotherapy
21. The nurse is planning the care for a client
with cancer who is about to enter a hospice
treatment program. Which nursing diagnosis
and outcome would be appropriate for this
client?
a. Imbalanced nutrition: The client will eat
three meals/snacks a day
b. Impaired social interaction: The client will
attend one outing per week
c. Anticipatory grieving: The client will
participate in end-of-life care planning
d. Deficient knowledge: The client will state
three reasons for cancer therapy
22. The nurse knows that a 28-year-old
female client with Hodgkin's disease who is
receiving chemotherapy understands the
discharge teaching when the client says which
statement?
a. "I should begin to try to have a baby as
soon as possible."
b. "If I begin to run a fever, I should call
my doctor."
c. "If I feel tired, I should go to the gym
and work out."
d. "If my mouth gets sore, I'll need to fast
until it goes away."
23. After chemotherapy, a client who is
scheduled to begin treatment with a biologic
response modifier (BRM) asks the nurse how
this treatment will help him. The nurse bases
the response on the knowledge that this type
of treatment stimulates:
a. reproduction of cancer cells.
b. the body's natural immune defenses.
c. the liver to produce an anti-tumor
hormone.
d. the pancreas to produce an anti-cancer
hormone.
24. Larry is diagnosed as having myelocytic
leukemia and is admitted to the hospital for
chemotherapy. Larry discusses his recent
diagnosis of leukemia by referring to

statistical facts and figures. The nurse

recognizes that Larry is using the defense
mechanism known as:
A. Reaction formation
B. Sublimation
C. Intellectualization
D. Projection
25. Which statement by the client indicates to
the nurse that the patient understands
precautions necessary during internal
radiation therapy for cancer of the cervix?
a. I should get out of bed and walk around
in my room.
b. My 7 year old twins should not come to
visit me while Im receiving treatment.
c. I will try not to cough, because the
force might make me expel the
application.
d. I know that my primary nurse has to
wear one of those badges like the people in
the x-ray department, but they are not
necessary for anyone else who comes in
here.
26. A post-operative complication of
mastectomy is lymphedema. This can be
prevented by
a. ensuring patency of wound drainage
tube
b. placing the arm on the affected side in a
dependent position
c. restricting movement of the affected
arm
d. frequently elevating the arm of the
affected side above the level of the heart.
27. High uric acid levels may develop in
clients who are receiving chemotherapy. This
is caused by:
a. The inability of the kidneys to excrete
the drug metabolites
b. Rapid cell catabolism
c. Toxic effect of the antibiotic that are
given concurrently
d. The altered blood ph from the acid
medium of the drugs
28. Maria Sison, 40 years old, single, was
admitted to the hospital with a diagnosis of
Breast Cancer. She was scheduled for radical
mastectomy. Nursing care during the
preoperative period should consist of:
a. assuring Maria that she will be cured of
cancer
b. assessing Marias expectations and
doubts
c. maintaining a cheerful and optimistic
environment
d. keeping Marias visitors to a minimum so
she can have time for herself
29. Maria refuses to acknowledge that her
breast was removed. She believes that her

breast is intact under the dressing. The nurse

should
a. call the MD to change the dressing so
Kathy can see the incision
b. recognize that Kathy is experiencing
denial, a normal stage of the grieving
process
c. reinforce Kathys belief for several days
until her body can adjust to stress of
surgery.
d. remind Kathy that she needs to accept
her diagnosis so that she can begin
rehabilitation exercises.
30. Mr. Pablo, diagnosed with Bladder Cancer,
is scheduled for a cystectomy with the
creation of an ileal conduit in the morning. He
is wringing his hands and pacing the floor
when the nurse enters his room. What is the
best approach?
a. "Good evening, Mr. Pablo. Wasn't it a
pleasant day, today?"
b. "Mr, Pablo, you must be so worried, I'll
leave you alone with your thoughts.
c. Mr. Pablo, you'll wear out the hospital
floors and yourself at this rate."
d. "Mr. Pablo, you appear anxious to me.
How are you feeling about tomorrow's
surgery?"
31. Mr. Perez is in continuous pain from
cancer that has metastasized to the bone.
Pain medication provides little relief and he
refuses to move. The nurse should plan to:
a. Reassure him that the nurses will not
hurt him
b. Let him perform his own activities of
daily living
c. Handle him gently when assisting with
required care
d. Complete A.M. care quickly as possible
when necessary
32. A client, who is suspected of having
Pheochromocytoma, complains of sweating,
palpitation and headache. Which assessment
is essential for the nurse to make first?
a. Pupil reaction
b. Hand grips
c. Blood pressure
d. Blood glucose
33. The client is admitted to the outpatient
surgery center for removal of a malignant
melanoma. Which assessment data indicate
the lesion is a malignant melanoma?
a. The lesion is asymmetrical and has
irregular borders.
b. The lesion has a waxy appearance with
pearl-like borders.
c. The lesion has a thickened and scaly
appearance.
d. The lesion appeared as a thickened area
after an injury.

34. The female client admitted for an

unrelated diagnosis asks the nurse to check
her back because it itches all the time in that
one spot. When the nurse assesses the
clients back, the nurse notes an irregularshaped lesion with some scabbed-over areas
surrounding the lesion. Which action should
the nurse implement first?
a. Notify the HCP to check the lesion on
rounds.
b. Measure the lesion and note the color.
c. Apply lotion to the lesion.
d. Instruct the client to make sure the HCP
checks the lesion.
35. The nurse is caring for a client diagnosed
with squamous cell skin cancer and writes a
psychosocial problem of fear. Which nursing
interventions should be included in the plan
of care?
a. Explain to the client that the fears are
unfounded.
b. Encourage the client to verbalize the
feeling of being afraid.
c. Have the HCP discuss the clients fear with
the client.
d. Instruct the client regarding all planned
procedures.
36. The client has had a squamous cell
carcinoma removed from the lip. Which
discharge instructions should the nurse
provide?
a. Notify the HCP if a lesion that does not
heal develops around the mouth.
b. Squamous cell carcinoma tumors do not
metastasize.
c. Limit foods to liquid or soft consistency for
1 month.
d. Apply heat to the area for 20 minutes
every 4 hours.
37. The nurse is caring for clients in an
outpatient surgery clinic. Which client should
be assessed first?
a. The client scheduled for a skin biopsy who
is crying.
b. The client who had surgery three (3) hours
ago and is sleeping.
c. The client who needs to void prior to
discharge.
d. The client who has received discharge
instructions and is ready to go home.
38. The nurse and unlicensed assistive
personnel are caring for clients in a
dermatology clinic. Which task should not be
delegated to the unlicensed assistant?
a. Stock the rooms with the equipment
needed.
b. Weigh the clients and position the clients
for the examination.

c. Discuss problems the client has

experienced since the previous visit.
d. Take the biopsy specimens to the
laboratory.
39. Which client is at the greatest risk for the
development of skin cancer?
a. The African American male who lives in the
northeast.
b. The elderly Hispanic female who moved
from Mexico as a child.
c. The client who has a family history of basal
cell carcinoma.
d. The client with fair complexion who cannot
get a tan.
40. The nurse participating in a health fair is
discussing malignant melanoma with a group
of clients. Which information regarding the
use of sunscreen is important to include?
a. Sunscreen is only needed during the
hottest hours of the day.
b. Toddlers should not have sunscreen applied
to their skin.
c. Sunscreen does not help prevent skin
cancer.
d. The higher the number of the sunscreen,
the more it blocks UV rays.
41. The school nurse is preparing to teach a
health promotion class to high school seniors.
Which information regarding self-care should
be included in the teaching?
a. Wear a sunscreen with a protection factor
of 10 or less when in the sun.
b. Try to stay out of the sun between 0300
and 0500 daily.
c. Perform a thorough skin check monthly.
d. Remember that caps and long sleeves do
not help prevent skin cancer.
42. Which client physiological outcome (goal)
is appropriate for a client diagnosed with skin
cancer who has had surgery to remove the
lesion?
a. The client will express feelings of fear.
b. The client will ask questions about the
diagnosis.
c. The client will state a diminished level of
pain.
d. The client will demonstrate care of
operative site.
43. The middle-aged client has had 2 lesions
diagnosed as basal cell carcinoma removed.
Which discharge instruction should the nurse
include?
a. Teach the client that there is no more risk
for cancer.
b. Refer the client to a prosthesis specialist
for prosthesis.
c. Instruct the client how to apply sunscreen
to the area.
d. Demonstrate care of the surgical site.

44. The nurse is working on a renal surgery

unit. After the afternoon report, which client
should the nurse assess first?
a. The male client who just returned from a
CT scan and states that he left his glasses in
the x-ray department.
b. The client who is one (1) day post-op and
has a moderate amount of serous drainage on
the dressing.
c. The client who is scheduled for surgery in
the morning and wants an explanation of the
operative procedure before signing the
permit.
d. The client who had ileal conduit surgery
this morning and has not had any drainage in
the drainage bag.
45. Which is a modifiable risk factor for the
development of cancer of the bladder?
a. Previous exposure to chemicals.
b. Pelvic radiation therapy.
c. Cigarette smoking.
d. Parasitic infections of the bladder.
46. The client diagnosed with cancer of the
bladder is scheduled to have a cutaneous
urinary diversion procedure. Which
preoperative teaching intervention specific to
the procedure should be included?
a. Demonstrate turn, cough, and deep
breathing.
b. Explain that a bag will drain the urine from
now on.
c. Instruct the client on the use of a PCA
pump.
d. Take the client to the ICD so that he or she
can become familiar with it.
47. The client diagnosed with cancer of the
bladder is undergoing intravesical
chemotherapy.
Which instruction should the nurse provide
the client about the pre-therapy routine?
a. Instruct the client to remain NPO after
midnight before the procedure.
b. Explain the use of chemotherapy in bladder
cancer.
c. Teach the client to administer Neupogen, a
biologic response modifier.
d. Have the client take Tylenol, an analgesic,
before coming to the clinic.
48. The nurse is planning the care of a
postoperative client with an ileal conduit.
Which intervention should be included in the
plan of care?
1. Provide meticulous skin care and pouching.
2. Apply sterile drainage bags daily.
3. Monitor the pH of the urine weekly.
4. Assess the stoma site every day.
49. The nurse and a licensed practical nurse
(LPN) are caring for a group of clients.

Which intervention should be assigned to the

LPN?
a. Assessment of the client who has had a
Kock pouch procedure.
b. Monitoring of the post-op client with a WBC
of 22,000 mm/dL.
c. Administration of the prescribed
antineoplastic medications.
d. Care for the client going for a MRI of the
kidneys.
50. The male client diagnosed with metastatic
cancer of the bladder is emaciated and
refuses to eat. Which nursing action is an
example of the ethical principle of
paternalism?
a. The nurse allows the client to talk about
not wanting to eat.
b. The nurse tells the client that if he does
not eat, a feeding tube will be placed.
c. The nurse consults the dietitian about the
clients nutritional needs.
d. The nurse asks the family to bring favorite
foods for the client to eat.
51. The client diagnosed with cancer of the
bladder states, I have young children. I am
too young to die. Which statement is the
nurses best response?
a. This cancer is treatable and you should
not give up.
b. Cancer occurs at any age. It is just one of
those things.
c. You are afraid of dying and what will
happen to your children.
d. Have you talked to your children about
your dying?
52. The client with a continent urinary
diversion is being discharged. Which
discharge instructions should the nurse
include in the teaching?
a. Have the client demonstrate catheterizing
the stoma.
b. Instruct the client on how to pouch the
stoma.
c. Explain the use of a bedside drainage bag
at night.
d. Tell the client to call the HCP if the
temperature is 99_F or less.
53. Which information regarding the care of a
cutaneous ileal conduit should the nurse
teach?
a. Teach the client to instill a few drops of
vinegar into the pouch.
b. Tell the client that the stoma should be
slightly dusky colored.
c. Inform the client that large clumps of
mucus are expected.
d. Tell the client that it is normal for the urine
to be pink or red in color.

54. The client is 2 days post

ureterosigmoidostomy for cancer of the
bladder. Which assessment data warrant
notification of the HCP by the nurse?
a. The client complains of pain at a 3, 30
minutes after being medicated.
b. The client complains that it hurts to cough
and deep breathe.
c. The client ambulates to the end of the hall
and back before lunch.
d. The client is lying in a fetal position and
has a rigid abdomen.
55. The female client diagnosed with bladder
cancer with a cutaneous urinary diversion
states, Will I be able to have children now?
Which statement is the nurses best
response?
a. Cancer does not make you sterile, but
sometimes the therapy can.
b. Are you concerned that you cant have
children?
c. You will be able to have as many children
as you want.
d. Let me have the chaplain come to talk
with you about this.

b. Assisting with range-of-motion leg

exercises
c. Removal of antiembolism stockings twice
daily
d. Checking placement of pneumatic
compression boots
60. The 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. Computed tomography scan
61. A client is 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

56. 1. The nurse is instructing the 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-examinations should be
done at least every 6 months

62. The nurse 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 level
b. Increased white blood cells
c. Decreased blood urea nitrogen level
d. Decreased number of plasma cells in the
bone marrow

57. The community nurse is conducting a

health promotion program at a local school
and is discussing the risk factors associated
with cervical cancer. Which of the following,
if identified by the client as a risk factor for
cervical cancer, indicates a need for further
teaching?
a. Smoking
b. Multiple sex partners
c. First intercourse after age 20
d. Annual gynecological examinations

63. The nurse is developing a plan of care for

the client with multiple myeloma and includes
which priority intervention in the plan?
a. Encouraging fluids
b. Providing frequent oral care
c. Coughing and deep breathing
d. Monitoring the red blood cell count

58. The community health nurse is instructing

a group of female clients about breast selfexamination. The nurse instructs the clients
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
59. The nurse 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

64. The oncology nurse specialist provides an

educational session to nursing staff regarding
the characteristics of Hodgkin's disease. The
nurse determines that further teaching is
needed if a nursing staff member states that
which of the following is a characteristic of
the disease?
a. Presence of Reed-Sternberg cells
b. Occurs most often in the older client
c. Prognosis depending on the stage of the
disease
d. Involvement of lymph nodes, spleen, and
liver
65. The 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
66. The 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
67. The nurse 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
client's room.
c. Remove the dosimeter badge when
entering the client's 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.
68. 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
69. The 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.
70. The nurse is caring for a 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.

71. The home health care nurse is caring for

a client with cancer and the client is
complaining of acute pain. The appropriate
nursing assessment of the client's pain would
include which of the following?
a. The client's pain rating
b. Nonverbal cues from the client
c. The nurse's impression of the client's pain
d. Pain relief after appropriate nursing
intervention
72. The nurse is caring for a client who is
postoperative following a pelvic exenteration
and the physician changes the client's 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
73. The client is admitted to the hospital with
a suspected diagnosis of Hodgkin's disease.
Which assessment finding would the nurse
expect to note specifically in the client?
a. Fatigue
b. Weakness
c. Weight gain
d. Enlarged lymph nodes
74. During the admission assessment of a
client with advanced ovarian cancer, the
nurse recognizes which symptom as typical of
the disease?
a. Diarrhea
b. Hypermenorrhea
c. Abnormal bleeding
d. Abdominal distention
75. When assessing the laboratory results of
the client with bladder cancer and bone
metastasis, the nurse notes a calcium level of
12 mg/dL. The nurse recognizes that this is
consistent with which oncological
emergency?
a. Hyperkalemia
b. Hypercalcemia
c. Spinal cord compression
d. Superior vena cava syndrome
76. The client reports to the nurse that when
performing testicular self-examination, he
found a lump the size and shape of a pea.
The appropriate response to the client is
which of the following?
a. Lumps like that are normal; don't worry.
b. Let me know if it gets bigger next month.
c. That could be cancer. I'll ask the doctor to
examine you.
d. That's important to report even though it
might not be serious.

77. The 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 daughter's graduation, I'll be
ready to die. Which phase of coping is this
client experiencing?
a. Anger
b. Denial
c. Bargaining
d. Depression
78. The nurse 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
79. The nurse is admitting a 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
80. 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
81. The client with leukemia is receiving
busulfan (Myleran) and allopurinol (Zyloprim)
is prescribed for the client. The nurse tells the
client that the purpose of the allopurinol is to:
a. Prevent nausea
b. Prevent alopecia
c. Prevent vomiting
d. Prevent hyperuricemia
82. 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
83. 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
84. 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.
85. 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?
1. Age younger than 50 years
2. History of colorectal polyps
3. Family history of colorectal cancer
4. Chronic inflammatory bowel disease
86. 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 an 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
87. 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 appropriate?
a. Notify the physician.
b. Clamp the Penrose drain.
c. Change the dressing as prescribed.
d. Remove and replace the perineal packing.
88. 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
d. Bloody drainage from the colostomy

89. The nurse is caring for a client following a

radical neck dissection and creation of a
tracheostomy performed for laryngeal cancer
and is providing discharge instructions to the
client. Which statement by the client indicates
a need for further instructions?
a. I will protect the stoma from water.
b. I need to keep powders and sprays away
from the stoma site.
c. I need to use an air conditioner to provide
cool air to assist in breathing.
d. I need to apply a thin layer of petrolatum
to the skin around the stoma to prevent
cracking.
90. What is the purpose of cytoreductive
(debulking) surgery for ovarian cancer?
a. Cancer control by reducing the size of the
tumor
b. Cancer prevention by removal of
precancerous tissue
c. Cancer cure by removing all gross and
microscopic tumor cells
d. Cancer rehabilitation by improving the
appearance of a previously treated body part
91. Hormone therapy is prescribed as the
mode of treatment for a client with prostate
cancer. The nurse understands that the goal
of this form of treatment is to:
a. Increase testosterone levels.
b. Increase prostaglandin levels.
c. Limit the amount of circulating androgens.
d. Increase the amount of circulating
androgens.
92. The nurse is caring for a client with
cancer of the prostate following a
prostatectomy. The nurse provides discharge
instructions to the client and tells the client
to:
a. Avoid driving the car for 1 week.
b. Restrict fluid intake to prevent
incontinence.
c. Avoid lifting objects heavier than 20 lb for
at least 6 weeks.
d. Notify the physician if small blood clots are
noticed during urination.
93. The oncology nurse is providing a
teaching session to a group of nursing
students regarding the risks and causes of
bladder cancer.
Which statement by a student indicates a
need for further teaching?
a. Bladder cancer most often occurs in
women.
b. Using cigarettes and coffee drinking can
increase the risk.
c. Bladder cancer generally is seen in clients
older than age 40.
d. Environmental health hazards have been
attributed as a cause.

94. The nurse is reviewing the history of a

client with bladder cancer. The nurse expects
to note documentation of which most
common symptom of this type of cancer?
a. Dysuria
b. Hematuria
c. Urgency on urination
d. Frequency of urination
95. The nurse is caring for a client following
intravesical instillation of an
alkylating chemotherapeutic agent into the
bladder for the treatment of bladder cancer.
Following the instillation, the nurse should
instruct the client to:
a. Urinate immediately.
b. Maintain strict bed rest.
c. Change position every 15 minutes.
d. Retain the instillation fluid for 30 minutes.
96. The nurse is assessing the stoma of a
client following an ureterostomy. Which of
the following should the nurse expect to
note?
1. A dry stoma
2. A pale stoma
3. A dark-colored stoma
4. A red and moist stoma
97. The nurse is caring for a client following a
mastectomy. Which nursing intervention
would assist in preventing lymphedema of the
affected arm?
a. Placing cool compresses on the affected
arm
b. Elevating the affected arm on a pillow
above heart level
c. Avoiding arm exercises in the immediate
postoperative period
d. Maintaining an intravenous site below the
antecubital area on the affected side
98. A nurse is monitoring a client for signs
and symptoms related to superior vena cava
syndrome.
Which of the following is an early sign of this
oncological emergency?
a. Cyanosis
b. Arm edema
c. Periorbital edema
d. Mental status changes
99. A nurse manager is teaching the nursing
staff about signs and a symptom related to
hypercalcemia in a client with metastatic
prostate cancer and tells the staff that which
of the following is a serious late sign of this
oncological emergency?
a. Headache
b. Dysphagia
c. Constipation
d. Electrocardiographic changes

100. As part of chemotherapy education, the

nurse teaches a female client about the risk
for bleeding and self-care during the period of
the greatest bone marrow suppression (the
nadir). The nurse understands that further
teaching is needed when the client states:
a. I should avoid blowing my nose.
b. I may need a platelet transfusion if my
platelet count is too low.
c. I'm going to take aspirin for my headache
as soon as I get home.
d. I will count the number of pads and
tampons I use when menstruating.
101. The nurse is monitoring the laboratory
results of a client receiving an antineoplastic
medication by the intravenous route. The
nurse plans to initiate bleeding precautions if
which laboratory result is noted?
a. A clotting time of 10 minutes
b. An ammonia level of 20 mcg/dL
c. A platelet count of 50,000/mm3
d. A white blood cell count of 5,000/mm3
102. The nurse is analyzing the laboratory
results of a client with leukemia who has
received a regimen of chemotherapy. Which
of the following laboratory values would the
nurse specifically note as a result of the
massive cell destruction that occurred from
the chemotherapy?
a. Anemia
b. Decreased platelets
c. Increased uric acid level
d. Decreased leukocyte count
103. The nurse is providing medication
instructions to a client with breast cancer who
is receiving cyclophosphamide (Cytoxan,
Neosar). The nurse tells the client to:
a. Take the medication with food.
b. Increase fluid intake to 2000 to 3000 mL
daily.
c. Decrease sodium intake while taking the
dedication.
d. Increase potassium intake while taking the
medication.
104. The client with nonHodgkin's
lymphoma is receiving daunorubicin
(DaunoXome). Which of the following would
indicate to the nurse that the client is
experiencing a toxic effect related to the
medication?
a. Fever
b. Diarrhea
c. Complaints of nausea and vomiting
d. Crackles on auscultation of the lungs
105. Chemotherapy dosage is frequently
based on total body surface area
(BSA), so it is important for the nurse to do
which of the following before administering
chemotherapy?

a. Measure abdominal girth.

b. Calculate body mass index.
c. Ask the client about his or her height and
weight.
d. Weigh and measure the client on the day
of drug administration.
106. The client with squamous cell carcinoma
of the larynx is receiving
bleomycin (Blenoxane) intravenously. The
nurse caring for the client anticipates that
which diagnostic study will be prescribed?
a. Echocardiography
b. Electrocardiography
c. Cervical radiographphy
d. Pulmonary function studies
107. Each chemotherapeutic agent has a
specific nadir. The nurse administering a
combination chemotherapy regimen
understands the importance of:
a. Giving two agents from the same
medication class
b. Giving two agents with like nadirs at the
same time
c. Testing the client's knowledge about each
agent's nadir
d. Avoid giving agents with the same nadirs
and toxicities at the same time
108. The clinic nurse prepares a teaching plan
for the client receiving an antineoplastic
medication. When implementing the plan, the
nurse tells the client:
a. To take aspirin (acetylsalicylic acid) as
needed for headache
b. Drink beverages containing alcohol in
moderate amounts each evening
c. Consult with health care providers before
receiving immunizations
d. That it is not necessary to consult health
care providers before receiving a flu vaccine
at the local health fair
109. The client with bladder cancer is
receiving cisplatin (Platinol) and vincristine
(Oncovin, Vincasar PFS). The nurse preparing
to give the medication understands that the
purpose of administering both these
medications is to:
a. Prevent alopecia
b. Decrease the destruction of cells
c. Increase the therapeutic response
d. Prevent gastrointestinal side effects
110. The client with lung cancer is receiving a
high dose of methotrexate (Rheumatrex,
Trexall). Leucovorin (citrovorum factor, folic
acid) is also prescribed. The nurse caring for
the client understands that the purpose of
administering the leucovorin is to:
a. Preserve normal cells.
b. Promote DNA synthesis.
c. Promote medication excretion.

d. Promote the synthesis of nucleic acids.

111. The client with ovarian cancer is being
treated with vincristine (Oncovin, Vincasar
PFS). The nurse monitors the client, knowing
that which of the following indicates a side
effect specific to this medication?
a. Diarrhea
b. Hair loss
c. Chest pain
d. Numbness and tingling in the fingers and
toes
112. The nurse is reviewing the history and
physical examination of a client who will be
receiving asparaginase (Elspar), an
antineoplastic agent.
The nurse contacts the physician before
administering the medication if which of the
following is documented in the client's
history?
a. Pancreatitis
b. Diabetes mellitus
c. Myocardial infarction
d. Chronic obstructive pulmonary disease
113. Tamoxifen (Nolvadex) is prescribed for
the client with metastatic breast carcinoma.
The nurse administering the medication
understands that the primary action of this
medication is to:
a. Increase DNA and RNA synthesis.
b. Promote the biosynthesis of nucleic acids.
c. Increase estrogen concentration and
estrogen response.
d. Compete with estradiol for binding to
estrogen in tissues containing high
concentrations of receptors.
114. The client with metastatic breast cancer
is receiving tamoxifen (Nolvadex). The nurse
specifically monitors which laboratory value
while the client is taking this medication?
a. Glucose level
b. Calcium level
c. Potassium level
d. Prothrombin time
115. Megestrol acetate (Megace), an
antineoplastic medication, is prescribed for
the client with metastatic endometrial
carcinoma. The nurse reviews the client's
history and contacts the physician if which of
the following is documented in the client's
history?
a. Gout
b. Asthma
c. Thrombophlebitis
d. Myocardial infarction
116. A female client with carcinoma of the
breast is admitted to the hospital for
treatment with intravenously administered
doxorubicin (Adriamycin). The client tells the

nurse that she has been told by herfriends

that she is going to lose all her hair. The
appropriate nursing response is which of the
following?
a. Your friends are correct.
b. You will not lose your hair.
c. Hair loss may occur, but it will grow back
just as it is now.
d. Hair loss may occur, and it will grow back,
but it may have a different color or texture.
117. The clinic nurse prepares instructions for
a client who developed stomatitis following
the administration of a course of
antineoplastic medications. The nurse tells
the client to:
a. Rinse the mouth with baking soda or
saline.
b. Avoid foods and fluids for the next 24
hours.
c. Swab the mouth daily with lemon and
glycerin pads.
d. Brush the teeth and use waxed dental floss
three times a day.
118. The client with acute myelocytic
leukemia is being treated with busulfan
(Myleran, Busulfex). Which of the following
laboratory values would the nurse specifically
monitor during treatment with this
medication?
a. Clotting time
b. Blood glucose level
c. Uric acid level
d. Potassium level
119. The client with small cell lung cancer is
being treated with etoposide (VePesid). The
nurse monitors the client during
administration, knowing that which of the
following indicates a side effect specific to this
medication?
a. Alopecia
b. Chest pain
c. Pulmonary fibrosis
d. Orthostatic hypotension
120. The nurse is assigned to care for several
male and female clients who take estrogen or
progestins. The nurse knows that this group
of clients is a increased risk for which
complication of the medication?
a. Sepsis
b. Dehydration
c. Deep vein thrombosis
d. Electrocardiographic changes
121. The nurse has admitted a client to the
clinical nursing unit following a modified right
radical mastectomy for the treatment of
breast cancer. The nurse plans to place the
right arm in which of the following positions?
a. Elevated above shoulder level
b. Elevated on a pillow

c. Level with the right atrium

d. Dependent to the right atrium
122. A 6-year-old child has just been
diagnosed with localized Hodgkin's disease
and chemotherapy is planned to begin
immediately. The mother of the child asks the
nurse why radiation therapy was not
prescribed as a part of the treatment. The
appropriate and supportive response to the
mother is:
a. I'm not sure. I'll discuss it with the
physician.
b. The child is too young to have radiation
therapy.
c. It's very costly, and chemotherapy works
just as well.
d. The physician would prefer that you
discuss treatment options with the
oncologist.
123. The nurse teaches skin care to the client
receiving external radiation therapy. Which of
the following statements, if made by the
client, would indicate the need for further
instruction?
a. I will handle the area gently.
b. I will avoid the use of deodorants.
c. I will limit sun exposure to 1 hour daily.
d. I will wear loose-fitting clothing.
124. A 13-year-old child is diagnosed with
Ewing's sarcoma of the femur.
Following a course of radiation and
chemotherapy, it has been decided that leg
amputation is necessary. Following the
amputation, the child becomes very
frightened because of aching and cramping
felt in the missing limb. Which nursing
statement would be appropriate to assist in
alleviating the child's fear?
a. This aching and cramping is normal and
temporary and will subside.
b. This normally occurs after the surgery and
we will teach you ways to deal with it.
c. The pain medication that I give you will
take these feelings away.
d. This pain is not real pain and relaxation
exercises will help it go away.
125. A breast feeding mother develops
mastitis in the left breast and is put on an
antibiotic for seven days. She asks the nurse
if she can continue breast feeding. The
nurse's best answer would be:
a. "Only breast feed from the right breast."
b. "Do not breast feed or stimulate the
breasts until the infection is resolved."
c. "Continue breast feeding, this is not a
contraindication."
d. "Pump the breasts and discard the milk
until the infection resolves."

126. You are working in the Dermatology

Clinic. A patient has a Basal Carcinoma In
Situ removed from his left lower leg. When
he returns for follow-up in one week, you
note that the wound has healed with minimal
scarring. Which type of healing process does
this represent?
a. Primary intention
b. Secondary intention
c. Tertiary intention
d. Dehiscence
127. A client receiving chemotherapy has
developed sores in his mouth. He asks the
nurse why
this happened. What is the nurses best
response?
a. It is a sign that the medication is
working.
b. You need to have better oral hygiene.
c. The cells in the mouth are sensitive to the
chemotherapy.
d. This always happens with chemotherapy.
The correct answer is C: The cells in the
mouth are sensitive to the chemotherapy.
128. Marco who was diagnosed with brain
tumor was scheduled for craniotomy. In
preventing the development of cerebral
edema after surgery, the nurse should expect
the use of:
a. Diuretics
b. Antihypertensive
c. Steroids
d. Anticonvulsants
129. A high-fiber diet is thought to reduce the
risk of colon cancer because it:
a. absorbs water from the intestinal wall.
b. promotes the excretion of bile.
c. stops diarrhea.
d. is low in kilocalories.
130. Pain tolerance in an elderly patient with
cancer would:
a. stay the same.
b. be lowered.
c. be increased.
d. no effect on pain tolerance.
131. When administering a narcotic with a
non-narcotic to relieve severe cancer pain,
the nurse must remember:
a. this combination enhances pain relief.
b. this combination treats pain both centrally
and peripherally.
c. the narcotic potentiates action of the nonnarcotic.
d. each drug works in its own right.
132. A cancer patient has had a resurgence of
severe acute pain. Which of the following
routes of medication is most appropriate for
this patient?
a. oral administration NSAIDS

b. oral administration of narcotics

c. rectal administration of NSAIDS
d. injectable pain reliever
133. Which of the following statements about
the use of antidepressants with pain relief in
cancer pain is true?
a. Antidepressants have no effect.
b. Antidepressants enhance the effect of
analgesics.
c. Antidepressants decrease the effect of
analgesics.
d. Antidepressants promote more rapid
excretion of the medications.
134. The use of radiation therapy in the care
of a patient with abdominal cancer would be:
a. to relive metastatic pain as well as
symptoms from local extension of primary
disease.
b. to be a palliative treatment to relieve pain
and maintain symptom control for the
duration of the patients life.
c. to be used alone as a therapeutic agent.
d. to help tissue to shrink and possible tumor
eradication.
135. In planning for pain control in a postoperative cancer patient, the nurse
understands:
a. radiation therapy alone will be used.
b. noninvasive analgesic approaches should
be tried before invasive palliative approaches.
c. never use radiation therapy, unless you are
sure the patient will die.
d. radiation therapy is complementary to
analgesic drug therapies.
136. What considerations should be noted by
the nurse when pharmacological support is
given for cancer patients having procedures?
a. The needs of the individual and the type of
procedures to be done.
b. All children and adults should have heavy
dosages of drugs.
c. All children no matter what age, should
have hypnosis, distraction, imagery, and
relaxation therapy.
d. No special considerations are necessary.
137. Cancer pain depends upon what?
a. the age of the patient and how much fear
and anxiety is present
b. the type of cancer, the site of the cancer,
and the time of the initial pain episode
c. the type of cancer, the stage of the cancer,
and the threshold (tolerance for pain)
d. the psychosocial state of the client, how
well they accept the diagnosis, and the sex of
the patient
138. A client received testing and was just
informed she has leukemia. Which statement
by the nurse is most therapeutic?

a. We have treatments for leukemia that are

quite effective.
b. Dont worry, because your type of
leukemia is treatable.
c. Lots of people have leukemia and are
successfully treated.
d. How does it feel for you to hear you have
leukemia?
139. Which of the following may be a
complication of previous infection with human
papilloma virus (HPV)?
a. Cervical cancer
b. Breast cancer
c. Bone cancer
d. Skin cancer
140. A client has been treated for uterine
cancer with internal radiation therapy. Which
of the following complications may she
develop later?
a. cystitis
b. arthritis
c. hepatitis
d. neuritis
141. The client, aged 28, was recently
diagnosed with Hodgkins disease. After
staging, therapy is planned to include
combination radiation therapy and systemic
chemotherapy with MOPP (nitrogen mustard,
vincristine {Onconvin}, prednisone, and
procarbazine). In planning care for the client,
the nurse should anticipate which of the
following effects to contribute to a sense of
altered body image?
a. cushingoid appearance
b. alopecia
c. temporary or permanent sterility
d. pathologic fractures
142. Which mnemonic is used to remember
the seven warning signs of cancer?
a. CAUTION
b. DANGERS
c. WARNING
d. CANCERS
143. Cancer is characterized by which of the
following cell changes?
a. Rapid proliferation
b. Toxin production
c. Increased differentiation
d. Indiscriminate proliferation
144. A client has a cancerous tumor on his
tibia. What name is given this type of tumor?
1. Adenoma
2. Osteoma
3. Fibroma
4. Meningioma

145. A 54-year-old man is admitted to the

hospital for a colostomy related to a recent
diagnosis of colon cancer.
During the preoperative period, what is the
most important aspect of this clients nursing
care?
a. Assure the client that he will be cured of
cancer.
b. Assess understanding of the procedure and
expectation of bodily appearance after
surgery.
c. Maintain a cheerful and optimistic
environment.
d. Keep visitors to a minimum, so that he can
have time to think things through.
146. A client who is getting radiation asks the
nurse why these sores developed in the
clients mouth. What is the most appropriate
response?
a. Dont worry; it always happens with
radiation.
b. Your oral hygiene needs improvement.
c. It is a sign that the radiation is effective.
d. The sores result because the cells in the
mouth are sensitive to the radiation.
147. A client develops stomatitis during the
course of radiation therapy. Nursing care for
this problem should include:
a. A soft, bland diet.
b. Restricting fluids to decrease salivation.
c. Rinsing the mouth every two hours with a
dilute mouthwash.
d. Encouraging the client to drink hot liquids.
148. The chemotherapeutic agent 5fluorourcacil (5-FU) is ordered for a client as
an adjunct measure to surgery. Which
statement about chemotherapy is true?
a. It is a local treatment affecting only tumor
cells.
b. It is a systemic treatment affecting both
tumor and normal cells.
c. It has not yet been proved an effective
treatment for cancer.
d. It is often the drug of choice because it
causes few if any side effects.
149. Which instruction should be given in a
health education class regarding testicular
cancer?
a. All males should perform a testicular exam
after the age of 30.
b. Testicular exams should be performed on a
daily basis.
c. Reddening or darkening of the scrotum is a
normal finding.
d. Testicular exams should be performed after
a warm bath or shower.
150. During surgery, it is found that a client
with adenocarcinoma of the rectum has

positive peritoneal lymph nodes. What is the

next most likely site of metastasis?
a. Brain
b. Bone
c. Liver
d. Mediastinum
151. Medical treatment for a client with
cervical cancer will include a hysterectomy
followed by internal radiation. Although she is
32 years old and has three children, the client
tells the nurse that she is anxious regarding
the impending treatment and loss of her
femininity. Which interaction is most
appropriate?
a. Tell the client that now she does not have
to worry about pregnancy.
b. Provide the client with adequate
information about the effects of treatment on
sexual functioning.
c. Refer her to the physician.
d. Avoid the question. Nurses are not
specialists in providing sexual counseling.
152. When a client is having external
radiation for lung cancer, what side effect is
most likely to be experienced?
a. Alopecia
b. Bone marrow suppression
c. Stomatitis
d. Dyspnea
153. A 25-year-old male client receiving
external radiation treatments tells you that he
fears he is radioactive and a danger to his
family and friends. How would the nurse
dispel his fears?
a. Inform him that radiation machines are
risk free.
b. Explain that once the machine is off,
radiation is no longer emitted.
c. Avoid telling him that his fears are in fact
true.
d. Instruct him to spend short periods of time
with his family and friends.
154. The nurse assesses for findings of early
cervical cancer by which of the following?
a. A dark, foul-smelling vaginal discharge
b. Pressure on the bladder or bowel, or both
c. Back and leg pain and weight loss
d. Vaginal discharge (leucorrhea)
155. The nurse discusses with a client in the
healthcare clinic the possibility of endometrial
cancer. Which of the following statements is
incorrect concerning endometrial cancer?
a. Diagnosis is most frequently established by
a dilation and curettage (D&C).
b. Prolonged use of exogenous estrogen
increases the occurrence.
c. The first and most important symptom is
abnormal bleeding.

d. This malignancy tends to spread rapidly to

other organs.
156. The Pap smear reveals that a client has
cancer of the cervix. The mode of treatment
is an abdominal hysterectomy. The client
voices concern about undergoing menopause.
In counseling her, which statement would be
most appropriate?
a. A surgical menopause will occur, and
treatment with estrogen therapy will be
necessary.
b. The ovaries will continue to function and
produce estrogen, thus preventing
menopause as a result of surgery.
c. Ovarian hormone secretion ceases, but the
hypothalamus will continue to secrete FSH,
and this prevents menopause.
d. The ovaries will cease functioning, and it
will be necessary to take estrogen.
157. Cancer of the lungs is caused by:
a. Airway atrisia.
b. Hepatitis A.
c. Cigarette smoking.
d. Congenital defects.
158. A client begins a regimen of
chemotherapy. Her platelet counts falls to
98,000. Which action is least necessary at
this time?
a. Test all excreta for occult blood.
b. Use a soft toothbrush or foam cleaner for
oral hygiene.
c. Implement reverse isolation.
d. Avoid IM injections.
159. High uric acid levels may develop in
clients who are receiving chemotherapy. This
is caused by:
a. The inability of the kidneys to excrete the
drug metabolites.
b. Rapid cell catabolism.
c. Toxic effects of the prophylactic antibiotics
that are given concurrently.
d. The altered blood pH from the acid
medium of the drugs.
160. Which of the following statements, if
made by a cancer patient with hair loss
secondary to chemotherapy, indicates the
goal for new coping patterns is being met?
a. I think Ill get some new barrettes for my
hair.
b. I washed my wig today.
c. I asked my mom to bring my shampoo.
d. Im thinking about changing my hair
color.
161. A patient with breast cancer is
undergoing chemotherapy. She develops
myelosuppression.
Her discharge teaching should include:

a. Manage sore throat with over-the-counter

preparations.
b. Wear a mask when going out to shop.
c. You can babysit ill grandchildren.
d. Avoid activities that may cause bleeding.
162. Antimetabolites used for cancer
treatment work by:
a. Enhancing cell growth.
b. Bone marrow ablation.
c. Inhibiting cell growth and proliferation.
d. Limiting the ability of the cancer to
metastasize.
163. The synthetic cannabis derivative
dronabinol
(Marinol) can be used to treat cancer patients
for:
a. Depression.
b. Nausea.
c. Pain.
d. Mucositis.
164. Which statement is incorrect regarding
lung cancer?
a. The 5-year survival rate depends on tumor
histology and disease stage at the time
treatment is initiated.
b. Small-cell lung cancer has an excellent
prognosis.
c. The 5-year survival rate for lung cancer is
less than 15 percent.
d. Lung cancer is usually widespread by the
time it is detected on chest x-ray.
165. A client is scheduled for external
radiation treatment for laryngeal cancer. Of
the following, which is not a common
systemic side effect of this treatment?
a. Nausea
b. Fatigue
c. Malaise
d. Dry desquamation of the skin
166. When teaching the client about
upcoming external radiation treatments, the
nurse should stress the importance of:
a. Massaging the area daily.
b. Exposing the area to sunlight for 30
minutes each day.
c. Not using soap on the treatment area and
ink markings.
d. Applying cosmetic creams over the area to
conceal reddened areas.
167. A recent diagnosis of cancer has caused
a patient severe anxiety. The plan of care
should include:
a. Teaching the stages of grieving.
b. Providing distraction during time of stress.
c. Teaching chemotherapy aspects.
d. Encouraging verbalization of concerns
regarding diagnosis.

168. A patient is undergoing chemotherapy

following a laryngectomy for laryngeal cancer.
The patient begins complaining of a sore
mouth. The nurse should assess for:
a. Xerostomia.
b. Halatosis.
c. Stomatitis.
d. Dysgeusia.
169. The main goal of cancer chemotherapy
is to:
a. Limit the toxic side effects.
b. Attack the cancer as early as possible.
c. Cure or provide palliation if the cancer is
not curable.
d. Provide the patient with a suitable quality
of life.
170. A client receiving radiation therapy for a
cancer tumor asked the nurse, How is the
radiation treatments done? The nurse replied
that:
a. The agents act on inhibiting DNA synthesis.
b. The therapy can be either internal or
external beam.
c. The agents used kill all the cancer cells.
d. The therapy of the beam of radiation is for
the total body.
171. A 67-year-old man is admitted to the
hospital with a tentative diagnosis of
bronchogenic carcinoma. His chief complaint
is dyspnea and a chronic cough. The
physician orders a sputum sample for
cytologic testing. Important nursing
implications involved with obtaining a sputum
sample for cytology should include which of
the following?
a. Obtain the specimen in the evening hours.
b. Collect the specimen in the morning before
the client eats and drinks.
c. Have the client brush his teeth before
collection of the specimen.
d. Keep the client NPO for 24 hours before
collection of the specimen.
172. A 4-year-old Mexican American client
has recently been diagnosed with leukemia.
What intervention would be appropriate when
considering the clients culture?
a. Limit all visitors, including extended family.
b. Encourage visits from extended as well as
immediate family.
c. Ban all visits from alternative healers.
d. Make diet selections for the child and
family.
173. An 85-year-old man with end-stage
prostate cancer has a living will expressing
his desire for a dignified death and comfort
care measures without resuscitation
measures. Advocate, your role is to:
a. Support the daughters decision.

b. Encourage the patient to revoke his living

will.
c. Support the patients decision and
encourage him to discuss his feeling with his
daughter.
d. Ignore the patients decision for nonresuscitation.
174. Mr. Davis, an 80 year old, is being
discharged from the hospital with a new
diagnosis of lung cancer. The adult children
have made arrangements for him to live with
his youngest son. To promote optimal
continuity of care, the nurse should:
a. Immediately arrange for hospice care.
b. Convince the family that institutionalized
care would be better.
c. Assist with the discharge as planned.
d. Explore options for community health
services with the family.
175. A patient with advanced cancer of the
stomach is undergoing surgery to take out
part or debulk the tumor. This is known as
______ surgery.
a. Tertiary
b. Restorative
c. Curative
d. Palliative
176. Which of the following primary
precautions is aimed at reducing the risk of
breast cancer in a female 50 years of age and
older?
a. Pap smear
b. Colonoscopy
c. Ultrasound
d. Mammography
177. Your patient is considering participating
in a multi-site trial of a new cancer
medication. According to the Patients Bill of
Rights, it is important for the patient to know
that:
a. All costs of research are paid by the
patient.
b. He has the right to refuse to participate in
research without fear of loss of care.
c. The physicians will no longer be caring for
him if he does not participate in the research.
d. The research study is his only hope of
treatment.
178. Which of the following statements about
cancer cachexia is true?
a. It is no different than simple starvation
because the metabolic rate declines in
response to tumor growth.
b. Cancer cachexia occurs as a result of
chemotherapy but not radiation therapy.
c. Cancer cachexia occurs as a result of
tumorinduced changes.
d. Cancer cachexia is only seen in clients who
have limited caloric intake.

179. A 52-year-old male client being treated

for cancer doesnt understand why he is being
given a female hormone, megesterol
acetate (Megace), as part of the treatment
regimen. He is afraid that it will alter his
appearance. How would you respond to the
clients concern of altered body image?
a. Tell the client that the physical changes are
only temporary.
b. Tell the client that this medication is used
for its ability to stimulate appetite.
c. Tell the client that you understand his
concern and that he should not take it.
d. Tell the client that the medication will be
used for a short time and any effects will be
self-limiting.
180. What interventions would be appropriate
for a client admitted to the oncology unit for
chemotherapy and radiation therapy who is
experiencing dysgeusia?
a. Premedicate the client with an antiemetic.
b. Observe the client for signs of dehydration.
c. Use highly seasoned foods to stimulate
taste buds.
d. Obtain an order for zinc and give with food
or milk to treat symptoms.
181. Mr. Hart is your patient who has a new
diagnosis of lung cancer who is deemed
terminally ill. During your assessment of
discharge needs, you find that he has no
available caregiver in the home but will need
assistance with ADLs. You discuss with the
discharge planner:
a. Home care.
b. Adult day care.
c. Long-term care with hospice services.
d. Respite care.
182. Which assessment finding would indicate
to the nurse that an antitussive medication
administered to a client with bronchogenic
cancer is having the desired effect?
a. Dyspnea is relieved.
b. Coughing is decreased.
c. Expectoration is increased.
d. Wheezes and gurgles have diminished.
183. Which assessment finding should the
nurse interpret as indicative of impending
spinal cord compression in a client with
metastatic prostate cancer?
a. Increasing back pain, which is worse when
standing than when lying down
b. Lower extremity weakness and/or
paresthesias
c. Urgency accompanied by bladder spasms
d. Lower extremity muscle cramping
184. A client having cryosurgery for removal
of a squamous cell carcinoma asks if the

procedure will hurt. Which is the correct

answer for the nurse to give?
a. You will not feel anything.
b. There will be a brief tingling pain.
c. There will be no pain but you may
experience a slight odd smell.
d. There will be a momentary, stabbing
pain.
185. When teaching at a health fair, the nurse
is asked if there is really a relationship
between tobacco smoke and lung cancer.
Which information should serve as the basis
for the nurses response?
a. There is a relationship and it is between
certain types of lung cancer and both
smoking and being exposed to second-hand
smoke.
b. Exposure to carcinogens such as asbestos
and uranium account for a greater portion of
lung cancer than does tobacco use.
c. Radon takes precedence over tobacco
smoke as a factor responsible for lung cancer.
d. Tobacco smoking is associated with the
majority of lung cancers of all types.
186. What symptom reported in the health
history of a 55- year-old woman should be
interpreted by the nurse as requiring
immediate follow-up evaluation for cancer of
the right colon?
a. Black, tarry stools
b. Loose, frothy stool
c. Flat, ribbon-shaped stool
d. Mahogany-colored, formed stool
187. When teaching a local club group about
oral cancer, which comment by a participant
indicates that the nurse needs to clarify the
information presented?
a.Most oral cancers occur on the tongue.
b. The most rapidly spread oral cancer is on
the floor of the mouth.
c. Early oral cancers are generally
asymptomatic.
d. Smoking is a risk factor for cancer of the
lip.
188. Which symptom should the nurse
interpret as requiring a check for endometrial
cancer?
a. Postmenopausal bleeding
b. Persistent leukorrhea
c. Painful sexual intercourse
d. Intermittent amenorrhea
189. How should the nurse interpret the
leakage of fecal matter from the vagina of a
client with advanced cancer?
a. Anal sphincter has been impaired
b. Cancer has metastasized to the GI tract
c. Rectovaginal fistula has developed

d. Rectum is being compressed by the tumor

mass
190. Which assessment finding is
characteristic of advanced ovarian cancer?
a. Ascites
b. Purpura
c. Splenomegaly
d. Hypoactive DTRs
191. Which client with breast cancer is a
candidate for treatment with Tamoxifen?
a. A 32-year-old client with a lumpectomy for
a small tumor and no sign of spread
b. A 58-year-old client with negative estrogen
receptor
(ER) status
c. A 41-year-old client with metastatic
disease
d. A 66-year-old client with estrogen sensitive
disease
192. Which test confirms the diagnosis of
prostate cancer?
a. PSA
b. Alkaline phosphatase
c. Ultrasound of the prostate
d. Prostate biopsy
193. Lupron is prescribed for a client with
prostate cancer. Which assessment data best
indicates that the medication is having the
desired effect?
a. Client reports pain is controlled
b. Vomiting has stopped
c. Urine is free of blood
d. PSA level has dropped
194. Which condition can pain in young
women with ovarian cancer mimic?
a. Appendicitis
b. Constipation
c. PMS
d. Urinary tract infection
195. When caring for a client having
radiation therapy the nurse receives a report
that the clients laboratory values are normal
and there are no signs of anemia, infection,
or bleeding. Which conclusion should the
nurse draw from this information?
a. Radiation has not yet reached a
therapeutic level.
b. The client is free of side effects of
radiation.
c. Nutritional status is normal.
d. Bone-marrow suppression is not a
problem.
196. When assessing skin of a client having
external radiation therapy, which fact should
the nurse keep in mind?
a. Skin damage is preceded by changes in
oral mucous membranes.

b. Most skin changes occur 48 weeks after

the start of radiation.
c. Skin areas with poor blood flow are at
greatest risk for injury.
d. Intertriginous areas are at particular risk
for skin reactions.
197. How should the care of a client
undergoing brachytherapy be assigned?
a. To male nurses whenever possible
b. On a rotating basis among nonpregnant
nursing staff
c. Consistently to the same nurses
d. Never to a nurse with a history of cancer
198. A client having radiation therapy asks
the nurse if his blood cells are going to be
affected. Which fact should form the basis of
the nurses answer?
a. Bone marrow and therefore blood cells are
affected with almost all ports of radiation.
b. If radiation is delivered to the hip or leg,
no effect should occur.
c. It depends on whether or not medications
are being taken that sensitize blood cells to
radiation.
d. Speed and volume of blood to tissues of
the port will determine the effect.
199. A client having chemotherapy for breast
cancer reports a temperature of 101.4 F. How
should the nurse interpret this fact?
a. Sign of infection, which needs to be
reported right away
b. Side effect of chemotherapy, not requiring
intervention
c. Sign of infection, which needs monitoring
and reporting if it persists for 48 hours
d. Indicator of dehydration requiring client
teaching regarding fluid intake
200. A client who had a dose of
chemotherapy at 8 a.m. calls the clinic at
2:30 p.m. complaining of nausea and
vomiting despite having taken the prescribed
medication. She asks how much worse the
nausea and vomiting is going to get. On
which fact should the nurses answer be
based?
a. Nausea and vomiting is totally
unpredictable.
b. Nausea and vomiting typically peak in the
first 12 hours.
c. Nausea and vomiting will ease on going to
bed.
d. Vomiting should cease in about 36 hours
but nausea may persist for 710 days.