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.
"Most of the adverse effects should go away shortly after my last radiation treatment."
B.
"I'll use hats to protect my head from the sun when my hair falls out."
C.
"If I get nauseous, I'll try to eat several small, bland meals each day."
D.
"I'll allow myself plenty of time to rest between activities."
Question #2
Which is a sign or symptom of septic shock?
A.
Altered mental status
B.
Hypertension
C.
Warm, moist skin
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.
Most clients believe the discomfort is well worth the cure for cancer.
B.
Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.
C.
Clinical trials are opening up new cancer treatments all the time.
D.
Nausea and vomiting are only a factor for the first 24 hours after treatment.
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.
Angiogenesis
B.
To prevent metastasis
C.
Stomatitis
D.
Fatigue
Question #6
To combat the most common adverse effects of chemotherapy, a nurse should administer an:
A.
antimetabolite.
B.
anticoagulant.
C.
antiemetic.
D.
antibiotic
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.
Allogeneic
B.
Autologous
C.
Syngeneic
D.
Homogenic
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.
“New hair growth will return without any change to color or texture.”
C.
“The hair loss is usually temporary.”
D.
“Wigs can be used after the chemotherapy is completed.”
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.
Nadir
B.
Neutropenia
C.
Extravasation
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 is used to remove cancerous cells using a needle.
C.
It removes an entire lesion and the surrounding tissue.
D.
It removes a wedge of tissue for diagnosis.
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.
Palliative
C.
Diagnostic
D.
Reconstructive
Question #14
What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen?
A.
It functions against disseminated disease.
B.
It attacks cancer cells during their vulnerable phase.
C.
It causes a systemic reaction.
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.
Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL.
B.
Encourage fluid intake to dilute the urine.
C.
Limit fluids to 1,000 mL daily to prevent accumulation of the drug’s end products after cell lysis.
D.
Take measures to acidify the urine and prevent uric acid crystallization.
Question #16
Chemotherapeutic agents have which effect associated with the renal system?
A.
Hypokalemia
B.
Increased uric acid excretion
C.
Hypercalcemia
D.
Hypophosphatemia
Question #17
Which occurs when fluid accumulates in the pericardial space and compresses the heart?
A.
SIADH
B.
Cardiac tamponade
C.
DIC
D.
Superior vena cava syndrome (SVCS)
Question #18
The nurse evaluates teaching as effective when a female client states that she will
A.
Exercise 30 minutes 3 times each week.
B.
Use sunscreen when outdoors.
C.
Obtain a cancer history from her parents.
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.
Encourage eating cheese, eggs, and legumes
B.
Stay away from protein beverages.
C.
Suck on hard candy during treatment.
D.
Encourage maximum fluid intake
Question #20
Which of the following is a term used to describe the process of programmed cell death?
A.
Mitosis
B.
Apoptosis
C.
Carcinogenesis
D.
Angiogenesis
Question #21
In which phase of the cell cycle does cell division occur?
A.
S phase
B.
G2 phase
C.
Mitosis
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.
“Cancer often skips a generation, so don’t worry about it.”
B.
“You can’t prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is.”
C.
“With your family history, there is nothing you can do to prevent getting cancer.”
D.
“If you eat right, exercise, and get enough rest, you can prevent breast cancer.”
Question #23
Which does a nurse thoroughly evaluate before a hematopoietic stem cell transplant (HSCT) procedure?
A.
Drug history
B.
Blood studies
C.
Allergy history
Question #24
A side-effect of chemotherapy is renal damage. To prevent this, the nurse should:
A.
Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL.
B.
Modify the diet to acidify the urine, thus preventing uric acid crystallization.
C.
Encourage fluid intake, if possible, to dilute the urine.
D.
Limit fluids to 1,000 mL/day to minimize stress on the renal tubules.
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 the client in a private room.
B.
Place a chair next to the bed to allow the spouse to sit.
C.
Have visitors wear dosimeters for safety
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 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.
Wear disposable gloves and protective clothing.
B.
Disconnect I.V. tubing with gloved hands.
C.
Break needles after the infusion is discontinued.
D.
Throw I.V. tubing in the trash after the infusion is stopped.
Question #28
A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication?
A.
Blood pressure of 120/64 to 130/72 mm Hg
B.
Urine output of 400 ml in 8 hours
C.
Serum potassium level of 2.6 mEq/L
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.
Administering metoclopramide and dexamethasone as ordered
C.
Serving small portions of bland food
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.
Administering aspirin if the temperature exceeds 102° F (38.8° C)
B.
Providing for frequent rest periods
C.
Inspecting the skin for petechiae once every shift
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 wear protective clothing when outside."
B.
"I'll not use my heating pad during my treatment."
C.
"I'm worried I'll expose my family members to radiation."
D.
"I'll wash my skin with mild soap and water only."
Question #32
Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure?
A.
Allergy history
B.
Family history
C.
Blood studies
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.
Use disposable utensils for the next month.
C.
Flush the toilet twice after every use.
D.
Shield your throat area when near others.
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.
Fish and poultry
C.
Ham and bacon
D.
Eggs and milk
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.
Temperature of 98.3° F (36.8° C)
B.
Stage 3 pressure ulcer on the left heel
C.
Ate 75% of all meals during the day
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.
uses the treadmill for 30 minutes on 5 days each week
C.
drinks one glass of wine at dinner each night
D.
works as a secretary at a medical radiation treatment center
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.
Practicing relaxation techniques
B.
Using imagery techniques
C.
Taking prescribed ondansetron
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.
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.
Bone pain
B.
Nausea and vomiting
C.
Stomatitis
D.
Extravasation
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.
chemotherapy exposure and risk factors.
B.
expected chemotherapy-related adverse effects.
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.
Sarcoma
B.
Carcinoma
C.
Leukemia
D.
Malignancy
Question #45
A benign tumor of the blood vessels is a(n)
A.
hemangioma
B.
neuroma
C.
chondroma
D.
osteoma
Question #46
A decrease in circulating white blood cells is
A.
neutropenia
B.
leukopenia
C.
thrombocytopenia
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 continue having your menses every month."
B.
"You will be unable to have children."
C.
"You will need to practice birth control measures."
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 demonstrate cells that are well differentiated.
B.
They gain access to the blood and lymphatic channels
C.
They usually grow slowly.
D.
They grow by expansion.
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 analyze the lymph nodes involved
B.
To prevent the formation of new cancer cells
C.
To destroy marginal tissues
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.
Colon
B.
Liver
C.
White blood cells (WBCs)
D.
Reproductive trac
Question #52
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 laboratory reports a white blood cell (WBC) count of 1,000/mm3.
C.
The client begins to shiver.
D.
The I.V. site is red and swollen.
Question #53
The drug interleukin-2 is an example of which type of biologic response modifier?
A.
Cytokine
B.
Monoclonal antibodies
C.
Retinoids
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.
Provide time for the patient to discuss her concerns.
C.
Counsel the patient about the possibility of losing her breast.
D.
Clarify information provided by the physician.
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 clean my teeth gently several times per day."
B.
"I lubricate my lips with petroleum jelly."
C.
"I replace my toothbrush every month."
D.
"I use an alcohol-based mouthwash every morning."
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.
Risk for infection related to inadequate defenses
B.
Anxiety related to change in role function
C.
Activity intolerance related to side effects of chemotherapy
D.
Fatigue related to deficient blood cells
Question #58
5-Fluorouracil (5FU) is classified as which type of antineoplastic agent?
A.
Mitotic spindle poisons
B.
Antimetabolite
C.
Alkylating
D.
Nitrosoureas
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.
Inherited gene mutation
B.
Increased tumor suppressor genes
C.
Exposure to chemicals and spermicides
D.
Smoking and tobacco use
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 with metastasis to surrounding tissue
B.
Normal finding
C.
Benign fibrocystic disease
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.
brachytherapy.
B.
a contact mold.
C.
external beam radiation therapy.
D.
systemic radiation.
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