Cancer Oncology Nursing NCLEX Practice Quiz

Cancer & Oncology Nursing NCLEX Practice Quiz ScienceMedicineNursing dwren47 Save Oncology NCLEX practice question...30 terms arensdorfPreview Cancer nclex questions 26 terms Sarah_Crum3Preview

Med-Surg Ch25: Patient with Cancer...

63 terms rcs11Preview Oncolo 18 terms kay A 32-year-old woman meets with the nurse on her first official visit since undergoing a left mastectomy. When asked how she is doing, the woman states her appetite is still not good, she is not getting much sleep because she doesn't go to bed until her husband is asleep, and she is really anxious to get back to work. Which of the following nursing interventions should the nurse explore to support the client's current needs?

a) Ask open-ended questions about sexuality issues related to her mastectomy

b) Suggest that the client learn relaxation techniques to help with her insomnia

c) Call the physician to discuss allowing the client to return to work earlier

d) Perform a nutritional assessment to assess for anorexia

a) Ask open-ended questions about sexuality issues related to her mastectomy

• Correct Answer: A. Ask open-ended questions about sexuality issues related to her mastectomy

Option A: The content of the client's comments suggests that she is avoiding intimacy with her husband by waiting until he is asleep before going to bed. Addressing sexuality issues is appropriate for a client who has undergone a mastectomy.Option B: Suggesting that she learn relaxation techniques to help her with her insomnia is appropriate; however, the nurse must first address the psychosocial and sexual issues that are contributing to her sleeping difficulties.Option C: Rushing her return to work may debilitate her and add to her exhaustion.Option D: A nutritional assessment may be useful, but there is no indication that she has anorexia.One of the most serious blood coagulation complications for individuals with cancer and for those undergoing cancer treatments is disseminated intravascular coagulation (DIC). The most common cause of this bleeding disorder is:

a) Brain metastasis

b) Sepsis

c) Intravenous heparin therapy

• underlying liver disease

b) Sepsis

- Correct Answer: B. Sepsis

Option B: Bacterial endotoxins released from gram-negative bacteria activate the Hageman factor or coagulation factor XII. This factor inhibits coagulation via the intrinsic pathway of homeostasis, as well as stimulating fibrinolysis.Option D: Liver disease can cause multiple bleeding abnormalities resulting in chronic, subclinical DIC; however, sepsis is the most common cause.

A pneumonectomy is a surgical procedure sometimes indicated for the treatment of non-small-cell lung cancer. A pneumonectomy involves

removal of:

a) One lobe of a lung

b) An entire lung field

c) One or more segments of a lung lobe

d) A small, wedge-shaped lung surface

b) An entire lung field

- Correct Answer: B. An entire lung field

Option B: A pneumonectomy is the removal of an entire lung field indicated for the treatment of non-small cell lung cancer that has not spread outside of the lung tissue. It is performed on patients who will have adequate lung function in the unaffected lung.Option D: A wedge resection refers to the removal of a wedge-shaped section of lung tissue. It may be used to remove a tumor and a small amount of normal tissue around it/

Option A: A lobectomy is the removal of one lobe.

Option C: Removal of one or more segments of a lung lobe is called a partial lobectomy.A 36-year-old man with lymphoma presents with signs of impending septic shock 9 days after chemotherapy. The nurse would expect which of the following to be present?

• low-grade fever, chills, tachycardia

b) Elevated temperature, oliguria, hypotension

c) Flushing, decreased oxygen saturation, mild hypotension

d) High-grade fever, normal blood pressure, increased respirations

• low-grade fever, chills, tachycardia

- Correct Answer: A. Low-grade fever, chills, tachycardia

Option A: Nine days after chemotherapy, one would expect the client to be immunocompromised. The clinical signs of shock reflect changes in cardiac function, vascular resistance, cellular metabolism, and capillary permeability. Low-grade fever, tachycardia, and flushing may be early signs of shock.Option B: Oliguria and hypotension are late signs of shock. Urine output can be initially normal or increased.Options C and D: The client with impending signs of septic shock may not have decreased oxygen saturation levels and normal blood pressure.Which of the following represents the most appropriate nursing intervention for a client with pruritus caused by cancer or the treatments?

a) Silk sheets

b) Steroids

c) Medicated cool baths

d) Administration of antihistamines

c) Medicated cool baths

- Correct Answer: C. Medicated cool baths

Option C: Nursing interventions to decrease the discomfort of pruritus include those that prevent vasodilation, decrease anxiety, and maintain skin integrity and hydration. Medicated baths with salicylic acid or colloidal oatmeal can be soothing as a temporary relief.Option A: Using silk sheets is not a practical intervention for the hospitalized client with pruritus.Options B and D: The use of antihistamines or topical steroids depends on the cause of pruritus, and these agents should be used with caution.

A 56-year-old woman is currently receiving radiation therapy to the chest wall for recurrent breast cancer. She calls her health care provider to report that she has pain while swallowing and burning and tightness in her chest. Which of the following complications of radiation therapy is A.Radiation enteritis likely responsible for her symptoms?

a) Radiation enteritis

b) Stomatitis

c) Esophagitis

d) Hiatal hernia

c) Esophagitis

- Correct Answer: C. Esophagitis

Option C: Difficulty in swallowing, pain, and tightness in the chest are signs of esophagitis, which is a common complication of radiation therapy of the chest wall.Option A: Radiation enteritis is a damage to the intestinal lining caused by radiation therapy. Symptoms include diarrhea, rectal pain, and bleeding or mucus from the rectum.Option B: Stomatitis results from the local effects of radiation to the oral mucosa. Symptoms include mouth ulcers, red patches, swelling, and oral dysaesthesia.Option D: Hiatal hernia may also cause symptoms of dysphagia and chest pain but is not related to radiation therapy.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 asked what dysplasia means. Which definition should the nurse provide?

a) Alteration in the size, shape, and organization of differentiated cells

b) Increase in the number of normal cells in a normal arrangement in a tissue or an organ

c) Presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin

d) Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found

a) Alteration in the size, shape, and organization of differentiated cells

• orrect Answer: A. Alteration in the size, shape, and organization of differentiated cells

Option A: Dysplasia refers to an alteration in the size, shape, and organization of differentiated cells.Option B: An increase in the number of normal cells in a normal arrangement in a tissue or an organ is called hyperplasia.Option C: The presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin is called anaplasia.Option D: Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found is called metaplasia.For a female client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of anxiety related to the threat of death secondary to a cancer diagnosis. Which expected outcome would be appropriate for this client?

• "Client stops seeking information."
• "Client uses any effective method to reduce tension."
• "Client doesn't guess at prognosis."
• "Client verbalizes feeling of anxiety."
• "Client verbalizes feeling of anxiety."

- Correct Answer: D. "Client verbalizes feelings of anxiety."

Option D: Verbalizing feelings is the client's first step in coping with the situational crisis. It also helps the health care team gain insight into the client's feelings, helping guide psychosocial care.Option A: Seeking information can help a client with cancer gain a sense of control over the crisis.Option B: This 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 physiological harm.Option C: Suppressing speculation may prevent the client from coming to terms with the crisis and planning accordingly.

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 psychomotor seizures

b) Related to impaired balance

c) Related to visual field deficits

d) Related to difficulty swallowing

b) Related to impaired balance

- Correct Answer: B. Related to impaired balance

Option B: A client with a cerebellar brain tumor may suffer injury from impaired balance as well as disturbed gait and incoordination.

Option A: Psychomotor seizures suggest temporal lobe dysfunction.

Option C: 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.

Option D: Difficulty swallowing suggests medullary dysfunction.

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) Fatigue

b) Vomiting

c) Hair loss

d) Stomatitis

a) Fatigue

- Correct Answer: A. Fatigue

Option A: Radiation therapy may cause fatigue, skin toxicities, and anorexia regardless of the treatment site. Fatigue occurs when the treatment damages and destroys not only the healthy cells but also the cancer cells.Options B, C, and D: Hair loss, stomatitis, and vomiting are site-specific, not generalized, adverse effects of radiation therapy.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

• chest x-ray

c) Fine needle aspiration

- Correct Answer: C. Fine needle aspiration

Option C: Fine needle aspiration and biopsy provide cells for histologic examination to confirm a diagnosis of cancer. During the procedure, a needle is inserted into the lump and a sample of tissue is taken for examination.Option A: A breast self-examination, if done regularly, is the most reliable method for detecting breast lumps early.

Option B: Mammography is used to detect tumors that are too small to palpate.

Option D: Chest X-rays can be used to pinpoint rib metastasis.