Chapter 57 (Test 3)

Question 1

A patient has developed stomatitis from chemotherapy. Which intervention is appropriate for a patient with this condition?
a. Instruction in the following of a liquid diet
b. Using a commercial mouthwash after each meal
c. Cleaning teeth with a cotton swab dipped in hydrogen peroxide
d. Using a soft toothbrush

Answer 1

ANS: D

Question 2

Which patient will be the highest priority for referral for a prostate-specific antigen (PSA)?
a. 43-year-old Hispanic man
b. 45-year-old African American man
c. 49-year-old Korean man
d. 50-year-old Native American man

Answer 2

ANS: B

Question 3

A patient, age 56, has been advised that his prostate-specific antigen (PSA) level is elevated. Which test will be the next definitive diagnostic test?
a. CA-125 test
b. Transrectal ultrasound
c. Needle biopsy of the prostate
d. MRI

Answer 3

ANS: B

Question 4

A patient undergoing chemotherapy to treat breast cancer has an abscess near the rectal area. Which laboratory result is likely associated with this finding?
a. White blood cells 2400/mm3
b. Red blood cells 5.2 million/mm3
c. Platelet count 165,000/mm3
d. Hematocrit 47%

Answer 4

ANS: A

Question 5

After reporting abdominal pain, the patient has blood drawn for a CA-19-9. When he asks the nurses the purpose of this test, which response is appropriate?
a. It tests for hepatobiliary cancer.
b. It tests for colorectal cancer.
c. It tests for bladder cancer.
d. It tests for lung cancer.

Answer 5

ANS: A

Question 6

A patient receiving chemotherapy for treatment of cancer has a white blood cell count of 1600/mm3. This finding prompts a change in the plan of care to provide whichintervention?
a. Adequate fluid intake
b. Protection from falls
c. Protection against infection
d. Frequent small nutritious snacks

Answer 6

ANS: C

Question 7

Which advice will the nurse provide to the patient who found a lump in her breast a week ago during breast self-examination?
a. Arrange for an examination by her health care provider.
b. Wait until her next ovulatory cycle and check the lump again.
c. Postpone appointment until the lump enlarges. d. Apply warm, moist compresses.

Answer 7

ANS: A

Question 8

How many minutes of daily exercise does the American Cancer Society recommend as a prevention of cancer?
a. 10 minutes
b. 15 minutes
c. 20 minutes
d. 30 minutes

Answer 8

ANS: C

Question 9

Using the TNM staging classification system, the nurse will interpret a tumor staged as T4N3M2 in which way?
a. No evidence of primary tumor, lymph node involvement, or distant metastasis
b. Carcinoma in situ, regional lymph node involvement, and metastasis to one site
c. Enlarging tumor, increasing lymph node involvement, and distant metastasis
d. Enlarging tumor, no lymph node involvement, or distant metastasis

Answer 9

ANS: C

Question 10

A patient undergoing radiation therapy says, “I feel so useless. I have no energy, no appetite, and I fall asleep whenever I sit down.” Which response by the nurse is most therapeutic?
a. “Fatigue is part of your illness. Taking several long naps in the daytime is helpful.”
b. “Fatigue is an unfortunate side effect of radiation. It may help to take frequent rest
periods.”
c. “You really shouldn’t be fatigued. Let me make an appointment with your health
care provider to get this checked out.”
d. “Don’t worry about it. You probably deserve the rest!”

Answer 10

ANS: B

Question 11

The nurse instructs a patient who has been smoking for 5 years about the warning signs of cancer. The nurse tells him that one of cancer’s eight warning signals include whichchange?
a. nagging cough or hoarseness.
b. a sore that does not heal rapidly.
c. gallbladder disease.
d. hematopoietic changes.

Answer 11

ANS: A

Question 12

Which meal represents foods that help prevent cancer?
a. Broiled steak, baked potato, whole wheat roll, soy milk
b. Baked ham, rice and gravy, apples stewed in butter, whole milk
c. Fried pork chops, candied sweet potatoes, white rolls and butter, iced tea
d. Broiled chicken, cabbage with onion and garlic, and soy milk

Answer 12

ANS: D

Question 13

There is a risk of nausea and vomiting from chemotherapy and targeted therapy. Which sets of drugs used for cancer treatment represent a high risk in this regard?
a. Butyrophenones, phenothiazines, metoclopramide
b. Methotrexate, 5-fluorouracil, doxorubicin
c. Carmustine, Cisplatin , Dacarbazine
d. It does not matter. Chemotherapy provided to all patients will definitely trigger
chemotherapy induced nausea/vomiting (CINV).

Answer 13

ANS: C

Question 14

Which event happens during the process of immunosurveillance?
a. T cells recognizing and destroying the abnormal cell
b. White blood cells (WBC) destroying the abnormal cell
c. Excretion of histamine to interfere with the replication of the abnormal cell
d. B cells attaching to abnormal cell

Answer 14

ANS: A

Question 15

The nurse caring for a patient who is being treated for cancer of the cervix by a radioactive implant discovers that the applicator with the radioactive material has become dislodged and is lying in the bed between the patient’s legs. Which action will the nurse take?
a. Use long-handled forceps grasp the applicator and wrap it in a towel.
b. Help the patient to a chair and cover the applicator with a rubber sheet.
c. Reassure the patient by staying at the bedside and call for help.
d. Do not touch the applicator; notify the radiation safety officer.

Answer 15

ANS: D

Question 16

Which person will the nurse instruct to avoid visiting a patient being treated with internal radiation therapy?
a. A 78 year old using a walker
b. An 18-year-old woman
c. A woman pregnant in the third trimester
d. A 24-year-old nursing mother

Answer 16

ANS: C

Question 17

A patient, age 63, has terminal cancer of the liver and is cared for by his wife at home. His abdominal pain has become increasingly severe, and he now says it is intense most of the time. The nurse recognizes that teaching regarding pain management has been effective based on which measure implemented by this patient?
a. Limiting the use of opiate analgesics to prevent addiction
b. Using analgesics only when the pain becomes more than he can tolerate
c. Taking analgesics around the clock on a regular schedule, using additional dosesfor breakthrough pain
d. Resigning himself to the fact that pain is an inevitable consequence of cancer

Answer 17

ANS: C

Question 18

A female patient, age 59, has lost7 lb in the first 3 weeks of her chemotherapy and does not eat because nothing tastes good. The nurse expects to see which goal addressed in the plan of care?
a. Patient will verbalize understanding of the need for increased nutrition.
b. Patient will be free from nutrition related infections.
c. Patient will maintain current weight.
d. Patient will undergo psychiatric evaluation regarding anorexia.

Answer 18

ANS: C

Question 19

A patient receiving external radiation treatments should be given which recommendation to protect the patient’s skin?
a. Applying warm compresses to damaged skin
b. Encouraging patient to apply fragrant lotion to skin
c. Patting the skin dry after the bath
d. Exposing skin to sun for 10 minutes a day

Answer 19

ANS: C

Question 20

Which statement is appropriate for a nurse to tell a patient before insertion of the radioactive implant?
a. “Nurses will always be available, but they will spend only short periods of time at your bedside.”
b. “Personal cleanliness is essential, so you will be given a complete bed bath each day.”
c. “Your diet will be changed to a high-fiber diet to encourage daily bowel movements.”
d. “Your bed linens will be completely changed each day to minimize radioactive contamination.”

Answer 20

ANS: A

Question 21

A male patient is undergoing external radiation therapy on an outpatient basis for treatment of Hodgkin disease. After 2 weeks of treatment, he tells the nurse that he is so tired he can hardly get out of bed in the morning. Which is an appropriate intervention?
a. Take two rest periods during the day.
b. Ambulate in the hall four times a day.
c. Select two activities for distraction.
d. Investigate a consultation with a psychiatrist for treatment of depression.

Answer 21

ANS: A

Question 22

The patient receiving radiation therapy reports not liking the conspicuous markings on the skin. In which manner can the nurse explain about these markings?
a. They are residues of the treatment and can be washed off.
b. They are caused by radiation and will fade in time.
c. They are indicators of the amount of radiation the patient is receiving.
d. They are markers for treatment and should be left on.

Answer 22

ANS: D

Question 23

The nurse will question which intervention in the plan of care who has experienced a weight loss during chemotherapy to treat cancer?
a. provide adequate, easily digestible, soft, bland foods.
b. give small, frequent, highly nutritional meals.
c. allow extra time to eat.
d. offer three large meals of highly nutritious foods.

Answer 23

ANS: D

Question 24

A patient who has malignant cancer secondary to a high-grade lymphoma has been admitted with muscle weakness, tetany, paresthesia, and convulsion. The nurse notices the patient is being treated for tumor lysis syndrome (TLS) and initial treatment has not been successful. The nurse will prepare the patient to undergo which procedure?
a. Whole blood transfusion
b. A bone marrow biopsy
c. Immediate radiation treatment
d. Dialysis

Answer 24

ANS: D

Question 25

Which is an appropriate intervention for a patient experiencing thrombocytopenia?
a. Requesting an order for aspirin for discomfort
b. Trimming toenails close
c. Using an electric razor
d. Vigorous tooth cleaning

Answer 25

ANS: C

Question 26

The nurse explains to a 43-year-old patient with a benign tumor in her right breast that a benign tumor differs from a malignant tumor in that benign tumors have whichquality?
a. do not cause damage to adjacent tissue.
b. are simply an overgrowth of normal cells.
c. do not spread to other tissues and organs.
d. frequently recur in the same site.

Answer 26

ANS: C

Question 27

For which reason is seeking medical attention when any cancer warning signs occur frequently delayed?
a. Difficulty accessing a health care provider or getting a referral consult.
b. Lack of knowledge of the warning signs of cancer.
c. Fear of the possible diagnosis of cancer and hoping signs will go away.
d. Self-examination being complex and difficult to perform.

Answer 27

ANS: C

Question 28

The nurse knows which description is characteristic of malignant tumors?
a. Smooth, well defined; movable when palpated
b. Resembles parent tissue; rarely fatal
c. Rate of growth varies; rarely contained within a capsule
d. Remains localized; slow growth

Answer 28

ANS: C

Question 29

The difference between an excisional biopsy and an incisional biopsy is that an excisional biopsy involves which technique?
a. use of a needle to obtain fluid samples.
b. removal of the entire lesion.
c. taking a “bite” from the lesion for study.
d. shaving of the superficial layers of the lesion.

Answer 29

ANS: B

Question 30

What is the function of organizations like The Lost Chord Club, Reach for Recovery, and I Can Cope?
a. Arrange for transportation to a clinic.
b. Provide a small amount of financial support to patients.
c. Send volunteers to speak with a person facing a lifestyle change.
d. Arrange for reduced drug costs.

Answer 30

ANS: C

Question 31

Which characteristic is common in malignant tumors?
a. Usually contained within a capsule.
b. Divide and multiply in the same manner as normal cells.
c. Proliferate and respond to treatment.
d. Progress and destroy surrounding tissues while spreading to distant parts of the
body.

Answer 31

ANS: D

Question 32

MULT RESP

Which nursing intervention is appropriate for a patient undergoing treatment for cancer whose nutritional intake is less than body requirements? (Select all that apply.)
a. Provide adequate, easily digestible, soft, bland foods.
b. Give small, frequent, highly nutritional meals.
c. Allow extra time to eat.
d. Offer three regular meals of highly nutritious foods.
e. Provide spicy foods to stimulate the appetite.

Answer 32

ANS: A, B, C

Question 33

MULT RESP

Select the food that is recommended for prevention of colorectal cancer in men. (Select all that apply.)
a. Oranges
b. Ham
c. Skinless chicken
d. Asparagus
e. Cheddar cheese
f. Squash

Answer 33

ANS: A, C, F

Question 34

MULT RESP

The nurse is aware that American men and women have which site for cancer in common? (Select all that apply.)
a. Lung
b. Brain
c. Colon d. Liver
e. Rectum f. Thyroid

Answer 34

ANS: A, C, E

Question 35

MULT RESP

Which is a risk factor for cancer? (Select all that apply.)
a. Ethnicity
b. Environmental irritants
c. Alcoholism
d. Hereditary factors
e. Excessive exercise
f. Exposure to ultraviolet light

Answer 35

ANS: B, C, D, F

Question 36

MULT RESP

For which possible sign of testicular cancer would the nurse encourage the patient to look for during self-testicular examination? (Select all that apply.)
a. Smooth consistency of testicle
b. Stomachache
c. Breast enlargement
d. Heavy feeling in the scrotum
e. Enlarged blood vessels in scrotum
f. Hematuria

Answer 36

ANS: B, C, D

Question 37

MULT RESP

The nurse expects which nursing intervention to be in the plan of care for a patient experiencing thrombocytopenia following chemotherapy to treat cancer? (Select all that apply.)
a. Take aspirin daily to promote blood flow.
b. Avoid all sexual contact
c. Use a soft toothbrush for mouth care
d. Take antibiotics before elective surgery
e. Apply direct pressure for 5 - 10 minutes if bleeding occurs

Answer 37

ANS: C, E

Question 38

MULT RESP

How do cancer cells differ from normal cells? (Select all that apply.)
a. They replicate in an organized manner.
b. Their cellular arrangement is abnormal.
c. They have an irregular shape.
d. They have abnormal chromosomes.
e. They have a different mitosis process.

Answer 38

ANS: B, C, D, E