Cancer And Oncology | NCLEX Quiz 139 | Attempts: 3424

1.

The client with a benign lung tumor is treated in which of the following ways?

A.

The tumor is treated with radiation only.
B.

The tumor is treated with chemotherapy only.
C.

The tumor is left alone unless symptoms are present.
D.

The tumor is removed. involving the least possible amount of tissue.

Correct Answer
D. The tumor is removed. involving the least possible amount of tissue.

Explanation
The tumor is removed to prevent further compression of the lung tissue as the tumor grows. which could lead to respiratory decompensation. If for some reason it can’t be removed. then radiation or chemotherapy may be used to try to shrink the tumor.

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2.

In the client with terminal lung cancer. the focus of nursing care is on which of the following nursing interventions?

A.

Provide emotional support
B.

Provide nutritional support
C.

Provide pain control
D.

Prepare the client’s will

Correct Answer
C. Provide pain control

Explanation
The client with terminal lung cancer may have extreme pleuritic pain and should be treated to reduce his discomfort. Preparing the client and his family for the impending death and providing emotional support is also important but shouldn’t be the primary focus until the pain is under control. Nutritional support may be provided. but as the terminal phase advances. the client’s nutritional needs greatly decrease. Nursing care doesn’t focus on helping the client prepare the will.

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3.

What are the three most important prognostic factors in determining long-term survival for children with acute leukemia?

A.

Histologic type of disease. initial platelet count. and type of treatment
B.

Type of treatment and client’s sex
C.

Histologic type of disease. initial WBC count. and client’s age at diagnosis
D.

Progression of illness. WBC at the time of diagnosis. and client’s age at the time of diagnosis.

Correct Answer
C. Histologic type of disease. initial WBC count. and client’s age at diagnosis

Explanation
The factor whose prognostic value is considered to be of greatest significance in determining the long-range outcome is the histologic type of leukemia. Children with a normal or low WBC count appear to have a much better prognosis than those with a high WBC count. Children diagnosed between ages 2 and 10 have consistently demonstrated a better prognosis because age 2 or after 10.

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4.

Which of the following complications are three main consequences of leukemia?

A.

Bone deformities. spherocytosis. and infection.
B.

Anemia. infection. and bleeding tendencies
C.

Lymphocytopoiesis. growth delays. and hirsutism
D.

Polycythemia. decreased clotting time. and infection.

Correct Answer
B. Anemia. infection. and bleeding tendencies

Explanation
The three main consequences of leukemia are anemia. caused by decreased erythrocyte production; infection secondary to neutropenia; and bleeding tendencies. from decreased platelet production. Bone deformities don’t occur with leukemia although bones may become painful because of the proliferation of cells in the bone marrow. Spherocytosis refers to erythrocytes taking on a spheroid shape and isn’t a feature in leukemia. Mature cells aren’t produced in adequate numbers. Hirsutism and growth delay can be a result of large doses of steroids but isn’t common in leukemia. Anemia. not polycythemia. occurs. Clotting times would be prolonged.

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5.

A child is seen in the pediatrician’s office for complaints of bone and joint pain. Which of the following other assessment findings may suggest leukemia?

A.

Abdominal pain
B.

Increased activity level
C.

Increased appetite
D.

Petechiae

Correct Answer
D. Petechiae

Explanation
The most frequent signs and symptoms of leukemia are a result of infiltration of the bone marrow. These include fever. pallor. fatigue. anorexia. and petechiae. along with bone and joint pain. Increased appetite can occur but it usually isn’t a presenting symptom. Abdominal pain may be caused by areas of inflammation from normal flora within the GI tract or any number of other causes.

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6.

Which of the following assessment findings in a client with leukemia would indicate that the cancer has invaded the brain?

A.

Headache and vomiting.
B.

Restlessness and tachycardia
C.

Hypervigilant and anxious behavior
D.

Increased heart rate and decreased blood pressure.

Correct Answer
A. Headache and vomiting.

Explanation
The usual effect of leukemic infiltration of the brain is increased intracranial pressure. The proliferation of cells interferes with the flow of cerebrospinal fluid in the subarachnoid space and at the base of the brain. The increased fluid pressure causes dilation of the ventricles. which creates symptoms of severe headache. vomiting. irritability. lethargy. increased blood pressure. decreased heart rate. and eventually. coma. Often children with a variety of illnesses are hypervigilant and anxious when hospitalized.

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7.

Which of the following types of leukemia carries the best prognosis?

A.

Acute lymphoblastic leukemia
B.

Acute myelogenous leukemia
C.

Basophilic leukemia
D.

Eosinophilic leukemia

Correct Answer
A. Acute lymphoblastic leukemia

Explanation
Acute lymphoblastic leukemia. which accounts for more than 80% of all childhood cases. carries the best prognosis. Acute myelogenous leukemia. with several subtypes. accounts for most of the other leukemias affecting children. Basophilic and eosinophilic leukemia are named for the specific cells involved. These are much rarer and carry a poorer prognosis.

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8.

Which of the following clients is most at risk for developing multiple myeloma?

A.

A 20-year-old Asian woman
B.

A 30-year-old White man
C.

A 50-year-old Hispanic woman
D.

A 60-year-old African-American man

Correct Answer
D. A 60-year-old African-American man

Explanation
A spinal tap is performed to assess for central nervous system infiltration. It wouldn’t be done to decrease ICP nor does it aid in the classification of the leukemia. Spinal taps can result in brain stem herniation in cases of ICP. A spinal tap can be done to rule out meningitis but this isn’t the indication for the test on a leukemic client.

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9.

Which of the following tests in performed on a client with leukemia before initiation of therapy to evaluate the child’s ability to metabolize chemotherapeutic agents?

A.

Lumbar puncture
B.

Liver function studies
C.

Complete blood count (CBC)
D.

Peripheral blood smear

Correct Answer
B. Liver function studies

Explanation
Liver and kidney function studies are done before initiation of chemotherapy to evaluate the child’s ability to metabolize the chemotherapeutic agents. A CBC is performed to assess for anemia and white blood cell count. A peripheral blood smear is done to assess the maturity and morphology of red blood cells. A lumbar puncture is performed to assess for central nervous system infiltration.

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10.

Which of the following immunizations should not be given to a 4-month-old sibling of a client with leukemia?

A.

Diphtheria and tetanus and pertussis (DPT) vaccine.
B.

Hepatitis B vaccine
C.

Haemophilus influenzae type b vaccines (Hib)
D.

Oral poliovirus vaccine (OPV)

Correct Answer
D. Oral poliovirus vaccine (OPV)

Explanation
OPV is a live attenuated virus excreted in the stool. The excreted virus can be communicated to the immunosuppressed child. resulting in an overwhelming infection. Inactivated polio vaccine would be indicated because it isn’t a live virus and wouldn’t pose the threat of infection. DTP. Hib. and hepatitis B vaccines can be given accordingly to the recommended schedule.

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