NSG320 NCLEX EXAM QUESTIONS

NSG320 NCLEX EXAM QUESTIONS &

ANSWERS

The registered nurse is teaching a student nurse about the seven warning signs of cancer. Which warning sign stated by the student nurse indicates ineffective learning?

• Indigestion
• Severe headache
• Unusual bleeding
• Difficult in swallowing

Severe headache is not a warning sign of cancer. Severe headache may indicate a stroke. Indigestion may indicate stomach cancer. Unusual bleeding may indicate uterine cancer. Difficulty in swallowing may indicate esophageal cancer.Text Reference - p. 255

Which tumor classification in a patient indicates carcinoma in situ?

• T0
• Tis
• Tx

D. T1-4

The TNM classification system is used to determine the anatomic extent of the disease involvement according to three parameters: tumor size and invasiveness, presence or absence of regional spread to lymph nodes, and metastases. Carcinoma in situ (CIS) has its own designation in the system (Tis), because it has all the histologic characteristics of cancer except invasion, which is a primary feature of the TNM staging system. T0 is the designation used when there is no evidence of a primary tumor. TX is the designation used for tumors that cannot be found or measured. T1-4 is the designation used for tumors that ascend in degrees and increase in size.Text Reference - p. 254

Which technique does the surgeon use to improve tissue localization during biopsy?

• Craniotomy
• Thoracotomy
• Sigmoidoscopy
• Computed tomography

Computed tomography is a diagnostic procedure that can be performed in combination with biopsy to improve tissue localization; this technique helps to visualize the tumor. Craniotomy and thoracotomy are surgical procedures that are performed when the tumor is not easily accessible. Sigmoidoscopy is an endoscopic examination, which is useful to diagnose cancer, but it does not help in tumor localization.Text Reference - p. 256

The nurse is with a patient who appears anxious while waiting for a biopsy for cancer detection. Which statement made by the nurse will help calm this patient down and achieve accurate test results?

• "We will talk about the pain during the biopsy procedure."
• "It's nothing new; every person detected with cancer feels this way."
• "I know you are anxious but it is nothing new, you are just over thinking it."
• "You may have pain during the procedure, but you will receive treatment for it."

Reassuring and informing the patient that he or she will have pain during the procedure that will be treated will help reduce the patient's anxiety and ensure accurate test results. The patient is anxious that he or she may have cancer so the nurse should focus on helping the patient. Redirecting the conversation by saying "We will discuss later" will discourage open communication. Providing false reassurance by saying, "These effects are common and everyone has the same effect" will discourage communication and make the patient feel neglected. Generalizing the patient's concern by saying that it's nothing new and everyone feels same will also reduce effective communication.

Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.Text Reference - p. 255

What can the nurse do to facilitate cancer prevention for the patient in the promotion stage of cancer development?

• Teach the patient to exercise daily
• Teach the patient promoting factors to avoid
• Tell the patient to have the cancer surgically removed now
• Teach the patient which vitamins will improve the immune system

The promotion stage of cancer is characterized by the reversible proliferation of the altered cells. Changing the lifestyle to avoid promoting factors (dietary fat, obesity, cigarette smoking, and alcohol consumption) can reduce the chance of cancer development. Daily exercise and vitamins alone will not prevent cancer. Surgery at this stage may not be possible without a critical mass of cells, and this advice would not be the nurse's role.Text Reference - p. 251

The medical records of a patient indicate stage IV malignant cancer. What would be the anatomic extent of the disease?

• Cancer is in situ
• Tumor growth is localized
• Spread of cancer cells is limited
• Cells have undergone metastasis

In a patient with stage IV malignant cancer, the cells have undergone metastasis.Cancer in situ indicates stage 0 malignancy. The limited spread of cancer cells indicates stage II malignancy. Localized growth of the tumor indicates stage III malignancy.

Test-Taking Tip: Sometimes the reading of a question in the middle or toward the end of an exam may trigger your mind with the answer or provide an important clue to an earlier question.Text Reference - p. 254

The medical records of a patient indicate a chondrosarcoma. What does the nurse interpret from this finding?

• The patient has a malignant tumor in bone.
• The patient has a benign tumor in nerve cells.
• The patient has a malignant tumor in cartilage.
• The patient has a benign tumor in striated muscle

A chondrosarcoma is a malignant tumor in cartilage. A malignant tumor in bone is an osteosarcoma. A benign tumor in the nerve cells is called a ganglioneuroma. A benign tumor in the striated muscle is called a rhabdomyoma.

Test-Taking Tip: Do not worry if you select the same numbered answer repeatedly, because there usually is no pattern to the answers.

Text Reference - p. 254

The registered nurse is teaching a student nurse about the precautionary measures that should be maintained to reduce the risk of cancer. Which statement made by the student nurse indicates the need for further teaching?

• "Include regular exercise regime in your lifestyle."
• "Include food items containing saturated fat in your diet."
• "Undergo regular screening tests for cancer including self-examination."
• "Avoid exposure to cancer-promoting agents, such as cigarette smoking."

The student nurse's statement about including food items containing fat into the diet indicates the need for further teaching. Saturated foods should not be consumed because tumor cells multiply using these low-density lipoproteins (LDLs). Regular exercise will help to maintain proper weight and relieve symptoms of stress. It is important to undergo regular screening tests for breast, colon, cervical, and prostate cancer as recommended by the American Cancer Society. This should be done to identify the presence of cancer in its initial stage. Avoiding exposure to cancer- promoting agents, such as cigarette smoke, will reduce the chances of initiating cancer because cigarette smoke is a carcinogen, capable of promoting cancer.Text Reference - p. 255

The nurse is assisting a patient with stage IV lung cancer who is stressed. Which statement by the nurse would help this patient feel better?

• "Lung cancers are easily treatable."
• "Anyone diagnosed with cancer feels the way you do."
• "Let's discuss this when you have your family with you."
• "This must be very difficult for you, let me know if I can be of any help."

The statement, "This must be very difficult for you," would be appropriate for communicating with the patient. This statement doesn't provide a false assurance and helps the patient to share his or her feelings. The statement, "lung cancers are easily treatable," will provide a false assurance. The statement, "Let's discuss this when you have your family with you," redirects the discussion. The statement, "Anyone diagnosed with cancer feels the way you do" is a generalized statement. These statements are self-protective strategies which deny the patient's opportunity to share the meaning of their experience.Text Reference - p. 255