Oncology NCLEX practice questions

Oncology NCLEX practice questions ScienceMedicineNursing arensdorf Save Cancer & Oncology Nursing NCLEX ...50 terms dwren47Preview Med Surg Gastrointestinal NCLEX Q...86 terms Jasmine_Lawson4 Preview Oncology NCLEX 23 terms araymer22Preview Med-S 63 terms rcs1 1. A male client has an abnormal result on a Papanicolaou test. After admitting, he read his chart while the nurse was out of the room, the client asks what dysplasia means. Which definition should the nurse provide?

• Presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin
• Increase in the number of normal cells in a normal arrangement in a tissue or an organ
• Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found
• Alteration in the size, shape, and organization of differentiated cells

1.Answer D. Dysplasia refers to an alteration in the size, shape, and organization of differentiated cells. The presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin is called anaplasia. An increase in the number of normal cells in a normal arrangement in a tissue or an organ is called hyperplasia. Replacement of one type of fully differentiated cell by another in tissues where the second type normally 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 cancer diagnosis. Which expected outcome would be appropriate for this client?

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

2.Answer A. 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 B is inappropriate because suppressing speculation may prevent the client from coming to terms with the crisis and planning accordingly. Option C is undesirable because some methods of reducing tension, such as illicit drug or alcohol use, may prevent the client from coming to terms with the threat of death as well as cause physiologic harm. Option D isn't appropriate because seeking information can help a client with cancer gain a sense of control over the crisis.

• 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?

• Related to visual field deficits
• Related to difficulty swallowing
• Related to impaired balance
• Related to psychomotor seizures

3.Answer C. A client with a cerebellar brain tumor may suffer injury from impaired balance as well as disturbed gait and incoordination. Visual field deficits, difficulty swallowing, and psychomotor seizures may result from dysfunction of the pituitary gland, pons, occipital lobe, parietal lobe, or temporal lobe — not from a cerebellar brain tumor. Difficulty swallowing suggests medullary dysfunction. Psychomotor seizures suggest temporal lobe dysfunction.

• 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:

• hair loss.
• stomatitis.
• fatigue.
• vomiting.

4.Answer C. Radiation therapy may cause fatigue, skin toxicities, and anorexia regardless of the treatment site. Hair loss, stomatitis, and vomiting are site-specific, not generalized, adverse effects of radiation therapy.

• 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:

• breast self-examination.
• mammography.
• fine needle aspiration.
• chest X-ray.

5.Answer C. Fine needle aspiration and biopsy provide cells for histologic examination to confirm a diagnosis of cancer. A breast self- examination, if done regularly, is the most reliable method for detecting breast lumps early. Mammography is used to detect tumors that are too small to palpate. Chest X-rays can be used to pinpoint rib metastasis.

• A male client undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should

include which instruction?

• "Keep the stoma uncovered."
• "Keep the stoma dry."
• "Have a family member perform stoma care initially until you get used to the procedure."
• "Keep the stoma moist."

6.Answer D. The nurse should instruct the client to keep the stoma moist, such as by applying a thin layer of petroleum jelly around the edges, because a dry stoma may become irritated. The nurse should recommend placing a stoma bib over the stoma to filter and warm air before it enters the stoma. The client should begin performing stoma care without assistance as soon as possible to gain independence in self-care activities.

• A female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance

induced by chemotherapy?

• Urine output of 400 ml in 8 hours
• Serum potassium level of 3.6 mEq/L
• Blood pressure of 120/64 to 130/72 mm Hg
• Dry oral mucous membranes and cracked lips

7.Answer D. Chemotherapy commonly causes nausea and vomiting, which may lead to fluid and electrolyte imbalances. Signs of fluid loss include dry oral mucous membranes, cracked lips, decreased urine output (less than 40 ml/hour), abnormally low blood pressure, and a serum potassium level below 3.5 mEq/L.

• Nurse April is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the

examination is to discover:

• cancerous lumps.
• areas of thickness or fullness.
• changes from previous self-examinations.
• fibrocystic masses.

8.Answer C. Women are instructed to examine themselves to discover changes that have occurred in the breast. Only a physician can diagnose lumps that are cancerous, areas of thickness or fullness that signal the presence of a malignancy, or masses that are fibrocystic as opposed to malignant.

• A client, age 41, visits the gynecologist. After examining her, the physician suspects cervical cancer. The nurse reviews the client's history for

risk factors for this disease. Which history finding is a risk factor for cervical cancer?

• Onset of sporadic sexual activity at age 17
• Spontaneous abortion at age 19
• Pregnancy complicated with eclampsia at age 27
• Human papillomavirus infection at age 32

9.Answer D. Like other viral and bacterial venereal infections, human papillomavirus is a risk factor for cervical cancer. Other risk factors for this disease include frequent sexual intercourse before age 16, multiple sex partners, and multiple pregnancies. A spontaneous abortion and pregnancy complicated by eclampsia aren't risk factors for cervical cancer.

• A female client is receiving methotrexate (Mexate), 12 g/m2 I.V., to treat osteogenic carcinoma. During methotrexate therapy, the nurse

expects the client to receive which other drug to protect normal cells?

• probenecid (Benemid)
• cytarabine (ara-C, cytosine arabinoside [Cytosar-U])
• thioguanine (6-thioguanine, 6-TG)
• leucovorin (citrovorum factor or folinic acid [Wellcovorin])

10.Answer D. Leucovorin is administered with methotrexate to protect normal cells, which methotrexate could destroy if given alone.Probenecid should be avoided in clients receiving methotrexate because it reduces renal elimination of methotrexate, increasing the risk of methotrexate toxicity. Cytarabine and thioguanine aren't used to treat osteogenic carcinoma.

• The nurse is interviewing a male client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client

has colorectal cancer?

• Duodenal ulcers
• Hemorrhoids
• Weight gain
• Polyps

11.Answer D. Colorectal polyps are common with colon cancer. Duodenal ulcers and hemorrhoids aren't preexisting conditions of colorectal cancer. Weight loss — not gain — is an indication of colorectal cancer.

• Nurse Amy is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47.

Following the American Cancer Society guidelines, the nurse should recommend that the women:

• perform breast self-examination annually.
• have a mammogram annually.
• have a hormonal receptor assay annually.
• have a physician conduct a clinical examination every 2 years.

12.Answer B. The American Cancer Society guidelines state, "Women older than age 40 should have a mammogram annually and a clinical examination at least annually [not every 2 years]; all women should perform breast self-examination monthly [not annually]." The hormonal receptor assay is done on a known breast tumor to determine whether the tumor is estrogen- or progesterone-dependent.

• A male client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning

signs of cancer. What is another warning sign of cancer?

• Persistent nausea
• Rash
• Indigestion
• Chronic ache or pain

13.Answer C. Indigestion, or difficulty swallowing, is one of the seven warning signs of cancer. The other six are a change in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, a thickening or lump in the breast or elsewhere, an obvious change in a wart or mole, and a nagging cough or hoarseness. Persistent nausea may signal stomach cancer but isn't one of the seven major warning signs. Rash and chronic ache or pain seldom indicate cancer.

• For a female client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the plan of

care?

• Administering aspirin if the temperature exceeds 102° F (38.8° C)
• Inspecting the skin for petechiae once every shift
• Providing for frequent rest periods
• Placing the client in strict isolation

14.Answer B. Because thrombocytopenia impairs blood clotting, the nurse should inspect the client regularly for signs of bleeding, such as petechiae, purpura, epistaxis, and bleeding gums. The nurse should avoid administering aspirin because it may increase the risk of bleeding.Frequent rest periods are indicated for clients with anemia, not thrombocytopenia. Strict isolation is indicated only for clients who have highly contagious or virulent infections that are spread by air or physical contact.