Cancer

Question 1

Trends in the incidence and death rates of cancer include the fact that

a. lung cancer is the most common type of cancer in men.
b. a higher percentage of women than men have lung cancer.
c. breast cancer is the leading cause of cancer deaths in women.
d. African Americans have a higher death rate from cancer than whites.

Answer 1

d

Question 2

What features of cancer cells distinguish them from normal cells (select all that apply)?

a. Cells lack contact inhibition.
b. Oncogenes maintain normal cell expression.
c. Cells return to a previous undifferentiated state.
d. Proliferation occurs when there is a need for more cells.
e. New proteins characteristic of embryonic stage emerge on cell membrane.

Answer 2

a,c,e

Question 3

A characteristic of the stage of progression in the development of cancer is

a. oncogenic viral transformation of target cells.
b. a reversible steady growth facilitated by carcinogens.
c. a period of latency before clinical detection of cancer.
d. proliferation of cancer cells despite host control mechanisms.

Answer 3

d

Question 4

The primary protective role of the immune system related to malignant cells is

a. surveillance for cells with tumor-associated antigens.
b. binding with free antigen released by malignant cells.
c. production of blocking factors that immobilize cancer cells.
d. reacting to a new set of antigenic determinants on cancer cells.

Answer 4

a

Question 5

The nurse is caring for a 59-year-old woman who had surgery 1 day ago for removal of a malignant abdominal mass. The patient is awaiting the pathology report. She is tearful and says that she is scared to die. The most effective nursing intervention at this point is to use this opportunity to

a. motivate change in an unhealthy lifestyle.
b. teach her about the seven warning signs of cancer.
c. instruct her about healthy stress relief and coping practices.
d. let her communicate about the meaning of this experience.

Answer 5

d

Question 6

The goals of cancer treatment are based on the principle that

a. surgery is the single most effective treatment for cancer.
b. initial treatment is always directed toward cure of the cancer.
c. a combination of treatment modalities is effective for controlling many cancers.
d. although cancer cure is rare, quality of life can be increased with treatment modalities.

Answer 6

c

Question 7

The most effective method of administering a chemotherapy agent that is a vesicant is to

a. give it orally.
b. give it intraarterially.
c. use an Ommaya reservoir.
d. use a central venous access device.

Answer 7

d

Question 8

The nurse explains to a patient undergoing brachytherapy of the cervix that she

a. must undergo simulation to locate the treatment area.
b. requires the use of radioactive precautions during nursing care.
c. may experience desquamation of the skin on the abdomen and upper legs.
d. requires shielding of the ovaries during treatment to prevent ovarian damage.

Answer 8

b

Question 9

A patient on chemotherapy and radiation for head and neck cancer has a WBC count of 1.9 × 103/µL, hemoglobin of 10.8 g/dL, and a platelet count of 99 × 103/µL. Based on the CBC results, what is the most serious clinical finding?

a. Cough, rhinitis, and sore throat
b. Fatigue, nausea, and skin redness at site of radiation
c. Temperature of 101.9° F, fatigue, and shortness of breath
d. Skin redness at site of radiation, headache, and constipation

Answer 9

c

Question 10

To prevent fever and shivering during an infusion of rituximab (Rituxan), the nurse should premedicate the patient with

a. aspirin.
b. acetaminophen.
c. sodium bicarbonate.
d. meperidine (Demerol).

Answer 10

b

Question 11

The nurse counsels the patient receiving radiation therapy or chemotherapy that

a. effective birth control methods should be used for the rest of the patient’s life.
b. if nausea and vomiting occur during treatment, the treatment plan will be modified.
c. after successful treatment, a return to the person’s previous functional level can be expected.
d. the cycle of fatigue-depression-fatigue that may occur during treatment may be reduced by restricting activity.

Answer 11

c

Question 12

A patient on chemotherapy for 10 weeks started at a weight of 121 lb. She now weighs 118 lb and has no sense of taste. Which nursing intervention would be a priority?

a. Advise the patient to eat foods that are fatty, fried, or high in calories.
b. Discuss with the physician the need for parenteral or enteral feedings.
c. Advise the patient to drink a nutritional supplement beverage at least three times a day.
d. Advise the patient to experiment with spices and seasonings to enhance the flavor of food.

Answer 12

d

Question 13

A 70-year-old male patient has multiple myeloma. His wife calls to report that he sleeps most of the day, is confused when awake, and complains of nausea and constipation. Which complication of cancer is this most likely caused by?

a. Hypercalcemia
b. Tumor lysis syndrome
c. Spinal cord compression
d. Superior vena cava syndrome

Answer 13

a

Question 14

A patient has recently been diagnosed with early stages of breast cancer. What is most appropriate for the nurse to focus on?

a. Maintaining the patient’s hope
b. Preparing a will and advance directives
c. Discussing replacement child care for the patient’s children
d. Discussing the patient’s past experiences with her grandmother’s cancer

Answer 14

a

Question 15

Symptoms of BPH are primarily caused by

a. obstruction of the urethra.
b. untreated chronic prostatitis.
c. decreased bladder compliance.
d. excessive secretion of testosterone.

Answer 15

a

Question 16

Postoperatively, a patient who has had a laser prostatectomy has continuous bladder irrigation with a three-way urinary catheter with a 30-mL balloon. When he complains of bladder spasms with the catheter in place, the nurse should

a. deflate the balloon to 10 mL to decrease bulk in the bladder.
b. deflate the balloon and then reinflate to ensure that it is patent.
c. encourage the patient to try to have a bowel movement to relieve colon pressure.
d. explain that this feeling is normal and that he should not try to urinate around the catheter.

Answer 16

d

Question 17

Which factors would place a patient at a higher risk for prostate cancer (select all that apply)?

a. Older than 65 years
b. Asian or Native American
c. Long-term use of an indwelling urethral catheter
d. Father diagnosed and treated for early stage prostate cancer
e. Previous history of undescended testicle and testicular cancer

Answer 17

a,d

Question 18

A patient scheduled for a prostatectomy for prostate cancer expresses the fear that he will have erectile dysfunction. In responding to this patient, the nurse should keep in mind that

a. erectile dysfunction can occur even with a nerve-sparing procedure.
b. the most common complication of this surgery is postoperative bowel incontinence.
c. retrograde ejaculation affects sexual function more frequently than erectile dysfunction.
d. preoperative sexual function is the most important factor in determining postoperative erectile dysfunction.

Answer 18

a

Question 19

The nurse explains to the patient with chronic bacterial prostatitis who is undergoing antibiotic therapy that (select all that apply)

a. all patients require hospitalization.
b. pain will lessen once treatment has ended.
c. course of treatment is generally 2 to 4 weeks.
d. long-term therapy may be indicated in immunocompromised patient.
e. if the condition is unresolved and untreated, he is at risk for prostate cancer.

Answer 19

b,d

Question 20

In assessing a patient for testicular cancer, the nurse understands that the manifestations of this disease often include

a. acute back spasms and testicular pain.
b. rapid onset of scrotal swelling and fever.
c. fertility problems and bilateral scrotal tenderness.
d. painless mass and heaviness sensation in the scrotal area.

Answer 20

d

Question 21

The nurse should explain to the patient who has erectile dysfunction (ED) that (select all that apply)

a. the most common cause is benign prostatic hypertrophy.
b. ED may be due to medications or conditions such as diabetes.
c. only men who are over 65 years or older benefit from PDE5 inhibitors.
d. there are medications and devices that can be used to help with erections.
e. this condition is primarily due to anxiety and best treated with psychotherapy.

Answer 21

b,d

Question 22

To decrease the patient’s discomfort related to discussing his reproductive organs, the nurse should

a. relate his sexual concerns to his sexual partner.
b. arrange to have male nurses care for the patient.
c. maintain a nonjudgmental attitude toward his sexual practices.
d. use technical terminology when discussing reproductive function.

Answer 22

c