Nursing 406 - Adult Health Care » Spring 2020 » Chapter 15 Quiz
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Question #1
A nurse is teaching a client who is receiving radiation treatment for left lower lobe lung cancer. Which client statement indicates a need for further teaching?
A.
"If I get nauseous, I'll try to eat several small, bland meals each day."
B.
"Most of the adverse effects should go away shortly after my last radiation treatment."
C.
"I'll allow myself plenty of time to rest between activities."
D.
"I'll use hats to protect my head from the sun when my hair falls out."
Question #2
Which is a sign or symptom of septic shock?
A.
Warm, moist skin
B.
Hypertension
C.
Altered mental status
D.
Increased urine output
Question #3
The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise?
A.
Eat wholesome meals.
B.
Avoid spicy and fatty foods.
C.
Eat warm or hot foods.
D.
Avoid intake of fluids.
Question #4
A client diagnosed with cancer makes the following statement to the nurse: “I guess I will tell my health care provider to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die.” Which of the following facts supports the use of chemotherapy for this client?
A.
Clinical trials are opening up new cancer treatments all the time.
B.
Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.
C.
Nausea and vomiting are only a factor for the first 24 hours after treatment.
D.
Most clients believe the discomfort is well worth the cure for cancer.
Question #5
A client with metastatic pancreatic cancer underwent surgery to remove a malignant tumor in the pancreas. Despite the tumor being removed, the physician informs the client that chemotherapy must be started. Why might the physician opt for chemotherapy?
A.
Fatigue
B.
Stomatitis
C.
Angiogenesis
D.
To prevent metastasis
Question #6
To combat the most common adverse effects of chemotherapy, a nurse should administer an:
A.
antibiotic
B.
antimetabolite.
C.
antiemetic.
D.
anticoagulant.
Question #7
A 36-year-old man is receiving three different chemotherapeutic agents for Hodgkin’s disease. The nurse explains to the client that the three drugs are given over an extended period because:
A.
The second and third drugs increase the effectiveness of the first drug.
B.
The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.
C.
The first two drugs are toxic to cancer cells, and the third drug promotes cell growth.
D.
The three drugs can be given at lower doses.
Question #8
Which type of hematopoietic stem cell transplantation (HSCT) is characterized by cells from a donor other than the patient?
A.
Autologous
B.
Allogeneic
C.
Homogenic
D.
Syngeneic
Question #9
Which oncologic emergency involves the failure in the negative feedback mechanism that normally regulates the release of antidiuretic hormone (ADH)?
A.
Tumor lysis syndrome
B.
Syndrome of inappropriate antidiuretic hormone release (SIADH)
C.
Disseminated intravascular coagulation (DIC)
D.
Cardiac tamponade
Question #10
The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia?
A.
“Clients with alopecia will have delay in grey hair.”
B.
“Wigs can be used after the chemotherapy is completed.”
C.
“New hair growth will return without any change to color or texture.”
D.
“The hair loss is usually temporary.”
Question #11
A client with a brain tumor is undergoing radiation and chemotherapy for treatment of cancer. The client has recently reported swelling in the gums, tongue, and lips. Which is the most likely cause of these symptoms?
A.
Extravasation
B.
Neutropenia
C.
Nadir
D.
Stomatitis
Question #12
The nurse is caring for a client undergoing an incisional biopsy. Which statement does the nurse understand to be true about an incisional biopsy?
A.
It treats cancer with lymph node involvement.
B.
It removes a wedge of tissue for diagnosis.
C.
It is used to remove cancerous cells using a needle.
D.
It removes an entire lesion and the surrounding tissue.
Question #13
The nurse at the clinic explains to the patient that the surgeon will be removing a mole on the patient’s back that has the potential to develop into cancer. The nurse informs the patient that this is what type of procedure?
A.
Prophylactic
B.
Reconstructive
C.
Palliative
D.
Diagnostic
Question #14
What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen?
A.
It targets normal body cells as well as cancer cells.
B.
It attacks cancer cells during their vulnerable phase.
C.
It causes a systemic reaction.
D.
It functions against disseminated disease.
Question #15
What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen?
A.
Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL.
B.
Limit fluids to 1,000 mL daily to prevent accumulation of the drug’s end products after cell lysis.
C.
Take measures to acidify the urine and prevent uric acid crystallization.
D.
Encourage fluid intake to dilute the urine.
Question #16
Chemotherapeutic agents have which effect associated with the renal system?
A.
Hypokalemia
B.
Hypophosphatemia
C.
Hypercalcemia
D.
Increased uric acid excretion
Question #17
Which occurs when fluid accumulates in the pericardial space and compresses the heart?
A.
Cardiac tamponade
B.
Superior vena cava syndrome (SVCS)
C.
SIADH
D.
DIC
Question #18
The nurse evaluates teaching as effective when a female client states that she will
A.
Use sunscreen when outdoors.
B.
Decrease tobacco smoking from one pack/day to half a pack/day
C.
Exercise 30 minutes 3 times each week.
D.
Obtain a cancer history from her parents.
Question #19
An oncology nurse is caring for a client who relates that certain tastes have changed. The client states that “meat tastes bad.” What nursing intervention can be used to increase protein intake for a client with taste changes?
A.
Suck on hard candy during treatment.
B.
Encourage eating cheese, eggs, and legumes
C.
Encourage maximum fluid intake
D.
Stay away from protein beverages.
Question #20
Which of the following is a term used to describe the process of programmed cell death?
A.
Apoptosis
B.
Angiogenesis
C.
Mitosis
D.
Carcinogenesis
Question #21
In which phase of the cell cycle does cell division occur?
A.
G1 phase
B.
G2 phase
C.
Mitosis
D.
S phase
Question #22
While doing a health history, a client tells the nurse that her mother, grandmother, and sister died of cancer. The client wants to know what she can do to keep from getting cancer. What would be the nurse's best response?
A.
“Cancer often skips a generation, so don’t worry about it.”
B.
“With your family history, there is nothing you can do to prevent getting cancer.”
C.
“If you eat right, exercise, and get enough rest, you can prevent breast cancer.”
D.
“You can’t prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is.”
Question #23
Which does a nurse thoroughly evaluate before a hematopoietic stem cell transplant (HSCT) procedure?
A.
Blood studies
B.
Drug history
C.
Allergy history
Question #24
A side-effect of chemotherapy is renal damage. To prevent this, the nurse should:
A.
Modify the diet to acidify the urine, thus preventing uric acid crystallization.
B.
Encourage fluid intake, if possible, to dilute the urine.
C.
Limit fluids to 1,000 mL/day to minimize stress on the renal tubules.
D.
Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL.
Question #25
A nurse is receiving a client with a radioactive implant for the treatment of cervical cancer. What is the nurse's best action
A.
Place a chair next to the bed to allow the spouse to sit.
B.
Allow visitors to telephone only.
C.
Have visitors wear dosimeters for safety
D.
Place the client in a private room.
Question #26
A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention?
A.
The client states he is nauseous.
B.
The I.V. site is red and swollen.
C.
The client begins to shiver.
D.
The laboratory reports a white blood cell (WBC) count of 1,000/mm3.
Question #27
A nurse is caring for a client receiving chemotherapy. Which nursing action is most appropriate for handling chemotherapeutic agents?
A.
Throw I.V. tubing in the trash after the infusion is stopped.
B.
Disconnect I.V. tubing with gloved hands.
C.
Break needles after the infusion is discontinued.
D.
Wear disposable gloves and protective clothing.
Question #28
A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication?
A.
Urine output of 400 ml in 8 hours
B.
Serum potassium level of 2.6 mEq/L
C.
Sodium level of 142 mEq/L
D.
Blood pressure of 120/64 to 130/72 mm Hg
Question #29
After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention?
A.
Withholding fluids for the first 4 to 6 hours after chemotherapy administration
B.
Encouraging rhythmic breathing exercises
C.
Administering metoclopramide and dexamethasone as ordered
D.
Serving small portions of bland food
Question #30
For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan?
A.
Providing for frequent rest periods
B.
Inspecting the skin for petechiae once every shift
C.
Administering aspirin if the temperature exceeds 102° F (38.8° C)
D.
Placing the client in strict isolation
Question #31
Which statement by a client undergoing external radiation therapy indicates the need for further teaching?
A.
"I'll wash my skin with mild soap and water only."
B.
"I'm worried I'll expose my family members to radiation."
C.
"I'll not use my heating pad during my treatment."
D.
"I'll wear protective clothing when outside."
Question #32
Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure?
A.
Blood studies
B.
Allergy history
C.
Family history
D.
Drug history
Question #33
The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important?
A.
Prepare food separately from family members.
B.
Shield your throat area when near others.
C.
Use disposable utensils for the next month.
D.
Flush the toilet twice after every use.
Question #34
According to the tumor-node-metastasis (TNM) classification system, T0 means there is
A.
No distant metastasis
B.
No evidence of primary tumor
C.
Distant metastasis
D.
No regional lymph node metastasis
Question #35
What foods should the nurse suggest that the patient consume less of in order to reduce nitrate intake because of the possibility of carcinogenic action?
A.
Ham and bacon
B.
Eggs and milk
C.
Green, leafy vegetables
D.
Fish and poultry
Question #36
A nurse is caring for a client receiving chemotherapy. Which assessment finding places the client at the greatest risk for an infection?
A.
Ate 75% of all meals during the day
B.
Temperature of 98.3° F (36.8° C)
C.
Stage 3 pressure ulcer on the left heel
D.
White blood cell (WBC) count of 9,000 cells/mm3
Question #37
The nurse is evaluating the client's risk for cancer. What lifestyle change should the nurse recommend?
A.
uses the treadmill for 30 minutes on 5 days each week
B.
works as a secretary at a medical radiation treatment center
C.
drinks one glass of wine at dinner each night
D.
eats red meat such as steaks or hamburgers every day
Question #38
A client calls the oncology office nurse and reports nausea and vomiting one week after receiving chemotherapy. What action should the nurse recommend?
A.
Taking prescribed ondansetron
B.
Practicing relaxation techniques
C.
Using imagery techniques
D.
Obtaining acupressure treatments
Question #39
The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant?
A.
Monitor the client’s heart rate.
B.
Monitor the client closely to prevent infection.
C.
Monitor the client’s toilet patterns.
D.
Monitor the client’s physical condition.
Question #40
The client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse?
A.
Tumor pressure against normal tissues
B.
Cells colonizing to distant body parts
C.
Random, rapid growth of the tumor
D.
Emission of abnormal proteins
Question #41
The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action?
A.
Stomatitis
B.
Extravasation
C.
Bone pain
D.
Nausea and vomiting
Question #42
A nurse is performing a home visit for a client who received chemotherapy within the past 24 hours. The nurse observes a small child playing in the bathroom, where the toilet lid has been left up. Based on these observations, the nurse modifies the client's teaching plan to include:
A.
expected chemotherapy-related adverse effects.
B.
signs and symptoms of infection.
C.
reinforcement of the client's medication regimen.
D.
chemotherapy exposure and risk factors.
Question #43
During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior?
A.
Progression
B.
Initiation
C.
Promotion
D.
Prolongation
Question #44
Which is a growth-based classification of tumors?
A.
Malignancy
B.
Sarcoma
C.
Carcinoma
D.
Leukemia
Question #45
A benign tumor of the blood vessels is a(n)
A.
chondroma
B.
neuroma
C.
osteoma
D.
hemangioma
Question #46
A decrease in circulating white blood cells is
A.
leukopenia
B.
thrombocytopenia
C.
neutropenia
D.
granulocytopenia
Question #47
A young female client has received chemotherapeutic medications and asks about any effects the treatments will have related to her sexual health. The most appropriate statement by the nurse is
A.
"You will need to practice birth control measures."
B.
"You will continue having your menses every month."
C.
"You will be unable to have children."
D.
"You will experience menopause now."
Question #48
The oncology nurse is giving chemotherapy to a client in a short stay area. The client confides that they are very depressed. The nurse recognizes depression as which of the following?
A.
A normal reaction to the diagnosis of cancer.
B.
An aberrant psychologic reaction to the chemotherapy.
C.
A psychiatric diagnosis everyone has at one time or another.
D.
A side effect of the neoplastic drugs
Question #49
Which statement is true about malignant tumors?
A.
They usually grow slowly.
B.
They demonstrate cells that are well differentiated.
C.
They grow by expansion.
D.
They gain access to the blood and lymphatic channels
Question #50
The physician is attending to a 72-year-old client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician’s recommendation?
A.
To destroy marginal tissues
B.
To prevent the formation of new cancer cells
C.
To analyze the lymph nodes involved
D.
To remove the tumor from the brain
Question #51
A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells?
A.
Liver
B.
White blood cells (WBCs)
C.
Reproductive trac
D.
Colon
Question #52
A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention?
A.
The client begins to shiver.
B.
The laboratory reports a white blood cell (WBC) count of 1,000/mm3.
C.
The I.V. site is red and swollen.
D.
The client states he is nauseous.
Question #53
The drug interleukin-2 is an example of which type of biologic response modifier?
A.
Cytokine
B.
Antimetabolites
C.
Monoclonal antibodies
D.
Retinoids
Question #54
A patient is admitted for an excisional biopsy of a breast lesion. What intervention should the nurse provide for the care of this patient?
A.
Clarify information provided by the physician.
B.
Counsel the patient about the possibility of losing her breast.
C.
Provide time for the patient to discuss her concerns.
D.
Provide aseptic care to the incision postoperatively
Question #55
An oncology clinic nurse is reinforcing prevention measures for oropharyngeal infections to a client receiving chemotherapy. Which statement by the client indicates that teaching was successful?
A.
"I lubricate my lips with petroleum jelly."
B.
"I use an alcohol-based mouthwash every morning."
C.
"I clean my teeth gently several times per day."
D.
"I replace my toothbrush every month."
Question #56
A nurse caring for a client who has just received chemotherapy infusion is wearing a disposable gown, gloves, and goggles for protection. The nurse knows that accidental exposure to chemotherapy agents can occur through:
A.
absorption through the gown.
B.
absorption through the gloves.
C.
absorption through the goggles.
D.
inhalation of aerosols.
Question #57
A male client has been unable to return to work for 10 days following chemotherapy as the result of ongoing fatigue and inability to perform usual activities. Laboratory test results are WBCs 2000/mm³, RBCs 3.2 x 10¹²/L, and platelets 85,000/mm³. The nurse notes that the client is anxious. Which of the following is the priority nursing diagnosis?
A.
Anxiety related to change in role function
B.
Fatigue related to deficient blood cells
C.
Activity intolerance related to side effects of chemotherapy
D.
Risk for infection related to inadequate defenses
Question #58
5-Fluorouracil (5FU) is classified as which type of antineoplastic agent?
A.
Mitotic spindle poisons
B.
Nitrosoureas
C.
Antimetabolite
D.
Alkylating
Question #59
While completing an admission assessment, the client reports a family history of ovarian cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology?
A.
Increased tumor suppressor genes
B.
Inherited gene mutation
C.
Smoking and tobacco use
D.
Exposure to chemicals and spermicides
Question #60
The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest?
A.
Normal finding
B.
Benign fibrocystic disease
C.
Malignant tumor with metastasis to surrounding tissue
D.
Malignant tumor
Question #61
The nurse is completing an admission assessment for a client receiving interstitial implants for prostate cancer. The nurse documents this as
A.
a contact mold.
B.
brachytherapy.
C.
systemic radiation.
D.
external beam radiation therapy.
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