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.
"I'll use hats to protect my head from the sun when my hair falls out."
B.
"If I get nauseous, I'll try to eat several small, bland meals each day."
C.
"Most of the adverse effects should go away shortly after my last radiation treatment."
D.
"I'll allow myself plenty of time to rest between activities."
Question #2
Which is a sign or symptom of septic shock?
A.
Increased urine output
B.
Warm, moist skin
C.
Hypertension
D.
Altered mental status
Question #3
The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise?
A.
Avoid intake of fluids.
B.
Eat wholesome meals.
C.
Eat warm or hot foods.
D.
Avoid spicy and fatty foods.
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.
Most clients believe the discomfort is well worth the cure for cancer.
B.
Clinical trials are opening up new cancer treatments all the time.
C.
Nausea and vomiting are only a factor for the first 24 hours after treatment.
D.
Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.
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.
To prevent metastasis
B.
Angiogenesis
C.
Fatigue
D.
Stomatitis
Question #6
To combat the most common adverse effects of chemotherapy, a nurse should administer an:
A.
antimetabolite.
B.
antiemetic.
C.
antibiotic
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 can be given at lower doses.
C.
The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.
D.
The first two drugs are toxic to cancer cells, and the third drug promotes cell growth.
Question #8
Which type of hematopoietic stem cell transplantation (HSCT) is characterized by cells from a donor other than the patient?
A.
Homogenic
B.
Syngeneic
C.
Autologous
D.
Allogeneic
Question #9
Which oncologic emergency involves the failure in the negative feedback mechanism that normally regulates the release of antidiuretic hormone (ADH)?
A.
Disseminated intravascular coagulation (DIC)
B.
Cardiac tamponade
C.
Syndrome of inappropriate antidiuretic hormone release (SIADH)
D.
Tumor lysis syndrome
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.
“New hair growth will return without any change to color or texture.”
B.
“Clients with alopecia will have delay in grey hair.”
C.
“Wigs can be used after the chemotherapy is completed.”
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.
Neutropenia
B.
Extravasation
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 an entire lesion and the surrounding tissue.
C.
It removes a wedge of tissue for diagnosis.
D.
It is used to remove cancerous cells using a needle.
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.
Palliative
B.
Prophylactic
C.
Reconstructive
D.
Diagnostic
Question #14
What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen?
A.
It attacks cancer cells during their vulnerable phase.
B.
It causes a systemic reaction.
C.
It functions against disseminated disease.
D.
It targets normal body cells as well as cancer cells.
Question #15
What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen?
A.
Take measures to acidify the urine and prevent uric acid crystallization.
B.
Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL.
C.
Encourage fluid intake to dilute the urine.
D.
Limit fluids to 1,000 mL daily to prevent accumulation of the drug’s end products after cell lysis.
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.
DIC
B.
Superior vena cava syndrome (SVCS)
C.
SIADH
D.
Cardiac tamponade
Question #18
The nurse evaluates teaching as effective when a female client states that she will
A.
Obtain a cancer history from her parents.
B.
Exercise 30 minutes 3 times each week.
C.
Use sunscreen when outdoors.
D.
Decrease tobacco smoking from one pack/day to half a pack/day
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.
Stay away from protein beverages.
B.
Encourage eating cheese, eggs, and legumes
C.
Encourage maximum fluid intake
D.
Suck on hard candy during treatment.
Question #20
Which of the following is a term used to describe the process of programmed cell death?
A.
Apoptosis
B.
Mitosis
C.
Angiogenesis
D.
Carcinogenesis
Question #21
In which phase of the cell cycle does cell division occur?
A.
S phase
B.
Mitosis
C.
G2 phase
D.
G1 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.
“With your family history, there is nothing you can do to prevent getting cancer.”
B.
“Cancer often skips a generation, so don’t worry about it.”
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.
Allergy history
B.
Drug history
C.
Blood studies
Question #24
A side-effect of chemotherapy is renal damage. To prevent this, the nurse should:
A.
Limit fluids to 1,000 mL/day to minimize stress on the renal tubules.
B.
Modify the diet to acidify the urine, thus preventing uric acid crystallization.
C.
Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL.
D.
Encourage fluid intake, if possible, to dilute the urine.
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.
Have visitors wear dosimeters for safety
B.
Place a chair next to the bed to allow the spouse to sit.
C.
Place the client in a private room.
D.
Allow visitors to telephone only.
Question #26
A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention?
A.
The I.V. site is red and swollen.
B.
The client begins to shiver.
C.
The laboratory reports a white blood cell (WBC) count of 1,000/mm3.
D.
The client states he is nauseous.
Question #27
A nurse is caring for a client receiving chemotherapy. Which nursing action is most appropriate for handling chemotherapeutic agents?
A.
Break needles after the infusion is discontinued.
B.
Throw I.V. tubing in the trash after the infusion is stopped.
C.
Disconnect I.V. tubing with gloved hands.
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.
Serum potassium level of 2.6 mEq/L
B.
Blood pressure of 120/64 to 130/72 mm Hg
C.
Urine output of 400 ml in 8 hours
D.
Sodium level of 142 mEq/L
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.
Serving small portions of bland food
C.
Administering metoclopramide and dexamethasone as ordered
D.
Encouraging rhythmic breathing exercises
Question #30
For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan?
A.
Inspecting the skin for petechiae once every shift
B.
Providing for frequent rest periods
C.
Placing the client in strict isolation
D.
Administering aspirin if the temperature exceeds 102° F (38.8° C)
Question #31
Which statement by a client undergoing external radiation therapy indicates the need for further teaching?
A.
"I'm worried I'll expose my family members to radiation."
B.
"I'll wear protective clothing when outside."
C.
"I'll wash my skin with mild soap and water only."
D.
"I'll not use my heating pad during my treatment."
Question #32
Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure?
A.
Blood studies
B.
Drug history
C.
Family history
D.
Allergy 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.
Flush the toilet twice after every use.
C.
Shield your throat area when near others.
D.
Use disposable utensils for the next month.
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.
Green, leafy vegetables
B.
Ham and bacon
C.
Eggs and milk
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.
Stage 3 pressure ulcer on the left heel
B.
Ate 75% of all meals during the day
C.
Temperature of 98.3° F (36.8° C)
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.
eats red meat such as steaks or hamburgers every day
B.
works as a secretary at a medical radiation treatment center
C.
uses the treadmill for 30 minutes on 5 days each week
D.
drinks one glass of wine at dinner each night
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.
Obtaining acupressure treatments
C.
Using imagery techniques
D.
Practicing relaxation techniques
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 toilet patterns.
B.
Monitor the client’s heart rate.
C.
Monitor the client’s physical condition.
D.
Monitor the client closely to prevent infection.
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.
Random, rapid growth of the tumor
B.
Emission of abnormal proteins
C.
Tumor pressure against normal tissues
D.
Cells colonizing to distant body parts
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.
Nausea and vomiting
B.
Stomatitis
C.
Extravasation
D.
Bone pain
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.
chemotherapy exposure and risk factors.
C.
reinforcement of the client's medication regimen.
D.
signs and symptoms of infection.
Question #43
During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior?
A.
Progression
B.
Initiation
C.
Prolongation
D.
Promotion
Question #44
Which is a growth-based classification of tumors?
A.
Leukemia
B.
Carcinoma
C.
Sarcoma
D.
Malignancy
Question #45
A benign tumor of the blood vessels is a(n)
A.
hemangioma
B.
chondroma
C.
neuroma
D.
osteoma
Question #46
A decrease in circulating white blood cells is
A.
granulocytopenia
B.
leukopenia
C.
thrombocytopenia
D.
neutropenia
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 experience menopause now."
B.
"You will be unable to have children."
C.
"You will need to practice birth control measures."
D.
"You will continue having your menses every month."
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 side effect of the neoplastic drugs
B.
A normal reaction to the diagnosis of cancer.
C.
A psychiatric diagnosis everyone has at one time or another.
D.
An aberrant psychologic reaction to the chemotherapy.
Question #49
Which statement is true about malignant tumors?
A.
They demonstrate cells that are well differentiated.
B.
They grow by expansion.
C.
They usually grow slowly.
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 prevent the formation of new cancer cells
B.
To remove the tumor from the brain
C.
To analyze the lymph nodes involved
D.
To destroy marginal tissues
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.
Reproductive trac
B.
White blood cells (WBCs)
C.
Colon
D.
Liver
Question #52
A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention?
A.
The I.V. site is red and swollen.
B.
The client states he is nauseous.
C.
The laboratory reports a white blood cell (WBC) count of 1,000/mm3.
D.
The client begins to shiver.
Question #53
The drug interleukin-2 is an example of which type of biologic response modifier?
A.
Monoclonal antibodies
B.
Retinoids
C.
Cytokine
D.
Antimetabolites
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.
Provide aseptic care to the incision postoperatively
B.
Clarify information provided by the physician.
C.
Provide time for the patient to discuss her concerns.
D.
Counsel the patient about the possibility of losing her breast.
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 replace my toothbrush every month."
C.
"I use an alcohol-based mouthwash every morning."
D.
"I clean my teeth gently several times per day."
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 gloves.
B.
inhalation of aerosols.
C.
absorption through the gown.
D.
absorption through the goggles.
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.
Fatigue related to deficient blood cells
B.
Anxiety related to change in role function
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.
Nitrosoureas
B.
Alkylating
C.
Antimetabolite
D.
Mitotic spindle poisons
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.
Exposure to chemicals and spermicides
B.
Inherited gene mutation
C.
Smoking and tobacco use
D.
Increased tumor suppressor genes
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.
Malignant tumor
B.
Benign fibrocystic disease
C.
Malignant tumor with metastasis to surrounding tissue
D.
Normal finding
Question #61
The nurse is completing an admission assessment for a client receiving interstitial implants for prostate cancer. The nurse documents this as
A.
systemic radiation.
B.
brachytherapy.
C.
a contact mold.
D.
external beam radiation therapy.
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