Cancer And Oncology | NCLEX Quiz 140

1. Nausea and vomiting are common adverse effects of radiation and chemotherapy. When should a nurse administer antiemetics?

30 minutes before the initiation of therapy.

With the administration of therapy.

Immediately after nausea begins.

When therapy is completed.

Antiemetics are most beneficial when given before the onset of nausea and vomiting. To calculate the optimum time for administration. the first dose is given 30 minutes to 1 hour before nausea is expected. and then every 2. 4. or 6 hours for approximately 24 hours after chemotherapy. If the antiemetic was given with the medication or after the medication. it could lose its maximum effectiveness when needed.

Explanation

Antiemetics are most beneficial when given before the onset of nausea and vomiting. To calculate the optimum time for administration. the first dose is given 30 minutes to 1 hour before nausea is expected. and then every 2. 4. or 6 hours for approximately 24 hours after chemotherapy. If the antiemetic was given with the medication or after the medication. it could lose its maximum effectiveness when needed.

2. The client with cancer is receiving chemotherapy and develops thrombocytopenia. The nurse identifies which intervention as the highest priority in the nursing plan of care?

Ambulation three times a day

Monitoring temperature

Monitoring the platelet count

Monitoring for pathological factors

Thrombocytopenia indicates a decrease in the number of platelets in the circulating blood. A major concern is monitoring for and preventing bleeding. Option 2 relates to monitoring for infection particularly if leukopenia is present. Options 1 and 4. although important in the plan of care are not related directly to thrombocytopenia.

Explanation

Thrombocytopenia indicates a decrease in the number of platelets in the circulating blood. A major concern is monitoring for and preventing bleeding. Option 2 relates to monitoring for infection particularly if leukopenia is present. Options 1 and 4. although important in the plan of care are not related directly to thrombocytopenia.

3. The nurse is instructing the client to perform a testicular self-examination. The nurse tells the client:

To examine the testicles while lying down.

The best time for the examination is after a shower

To gently feel the testicle with one finger to feel for a growth

That testicular examination should be done at least every 6 months.

The testicular-self examination is recommended monthly after a warm shower or bath when the scrotal skin is relaxed. The client should stand to examine the testicles. Using both hands. with the fingers under the scrotum and the thumbs on top. the client should gently roll the testicles. feeling for any lumps.

Explanation

The testicular-self examination is recommended monthly after a warm shower or bath when the scrotal skin is relaxed. The client should stand to examine the testicles. Using both hands. with the fingers under the scrotum and the thumbs on top. the client should gently roll the testicles. feeling for any lumps.

4. A client is diagnosed with multiple myeloma. The client asks the nurse about the diagnosis. The nurse bases the response on which of the following descriptions of this disorder?

Malignant exacerbation in the number of leukocytes.

Altered red blood cell production.

Altered production of lymph nodes

Malignant proliferation of plasma cells and tumors within the bone.

Multiple myeloma is a B cell neoplastic condition characterized by abnormal malignant proliferation of plasma cells and the accumulation of mature plasma cells in the bone marrow. Option 1 describes the leukemic process. Options 2 and 3 are not characteristics of multiple myeloma.

Explanation

Multiple myeloma is a B cell neoplastic condition characterized by abnormal malignant proliferation of plasma cells and the accumulation of mature plasma cells in the bone marrow. Option 1 describes the leukemic process. Options 2 and 3 are not characteristics of multiple myeloma.

5. Which of the following medications usually is given to a client with leukemia as prophylaxis against P. carinii pneumonia?

Bactrim

Oral nystatin suspension

Prednisone

Vincristine (Oncovin)

The most frequent cause of death from leukemia is overwhelming infection. P. carinii infection is lethal to a child with leukemia. As prophylaxis against P. carinii pneumonia. continuous low doses of co-trimoxazole (Bactrim) are frequently prescribed. Oral nystatin suspension would be indicated for the treatment of thrush. Prednisone isn’t an antibiotic and increases susceptibility to infection. Vincristine is an antineoplastic agent.

Explanation

The most frequent cause of death from leukemia is overwhelming infection. P. carinii infection is lethal to a child with leukemia. As prophylaxis against P. carinii pneumonia. continuous low doses of co-trimoxazole (Bactrim) are frequently prescribed. Oral nystatin suspension would be indicated for the treatment of thrush. Prednisone isn’t an antibiotic and increases susceptibility to infection. Vincristine is an antineoplastic agent.

6. The community nurse is conducting a health promotion program at a local school and is discussing the risk factors associated with cancer. Which of the following. if identified by the client as a risk factor. indicates a need for further instructions?

Viral factors

Stress

Low-fat and high-fiber diets

Exposure to radiation

Viruses may be one of multiple agents acting to initiate carcinogenesis and have been associated with several types of cancer. Increased stress has been associated with causing the growth and proliferation of cancer cells. Two forms of radiation. ultraviolet and ionizing. can lead to cancer. A diet high in fat may be a factor in the development of breast. colon. and prostate cancers. High-fiber diets may reduce the risk of colon cancer.

Explanation

Viruses may be one of multiple agents acting to initiate carcinogenesis and have been associated with several types of cancer. Increased stress has been associated with causing the growth and proliferation of cancer cells. Two forms of radiation. ultraviolet and ionizing. can lead to cancer. A diet high in fat may be a factor in the development of breast. colon. and prostate cancers. High-fiber diets may reduce the risk of colon cancer.

7. Which of the following treatment measures should be implemented for a child with leukemia who has been exposed to the chickenpox?

No treatment is indicated.

Acyclovir (Zovirax) should be started on exposure

Varicella-zoster immunoglobulin (VZIG) should be given with the evidence of disease

VZIG should be given within 72 hours of exposure.

Varicella is a lethal organism to a child with leukemia. VZIG. given within 72 hours. may favorably alter the course of the disease. Giving the vaccine at the onset of symptoms wouldn’t likely decrease the severity of the illness. Acyclovir may be given if the child develops the disease but not if the child has been exposed.

Explanation

Varicella is a lethal organism to a child with leukemia. VZIG. given within 72 hours. may favorably alter the course of the disease. Giving the vaccine at the onset of symptoms wouldn’t likely decrease the severity of the illness. Acyclovir may be given if the child develops the disease but not if the child has been exposed.

8. In which of the following diseases would bone marrow transplantation not be indicated in a newly diagnosed client?

Acute lymphocytic leukemia

Chronic myeloid leukemia

Severe aplastic anemia

Severe combined immunodeficiency

For the first episode of acute lymphocytic anemia. conventional therapy is superior to bone marrow transplantation. In severe combined immunodeficiency and in severe aplastic anemia. bone marrow transplantation has been employed to replace abnormal stem cells with healthy cells from the donor’s marrow. In myeloid leukemia. bone marrow transplantation is done after chemotherapy to infuse healthy marrow and to replace marrow stem cells ablated during chemotherapy.

Explanation

For the first episode of acute lymphocytic anemia. conventional therapy is superior to bone marrow transplantation. In severe combined immunodeficiency and in severe aplastic anemia. bone marrow transplantation has been employed to replace abnormal stem cells with healthy cells from the donor’s marrow. In myeloid leukemia. bone marrow transplantation is done after chemotherapy to infuse healthy marrow and to replace marrow stem cells ablated during chemotherapy.

9. Parents of pediatric clients who undergo irradiation involving the central nervous system should be warned about postirradiation somnolence. When does this neurologic syndrome usually occur?

Immediately

Within 1 to 2 weeks

Within 5 to 8 weeks

Within 3 to 6 months

Postirradiation somnolence may develop 5 to 8 weeks after CNS irradiation and may last 3 to 15 days. It’s characterized by somnolence with or without fever. anorexia. nausea. and vomiting. Although the syndrome isn’t thought to be clinically significant. parents should be prepared to expect such symptoms and encourage the child needed rest.

Explanation

Postirradiation somnolence may develop 5 to 8 weeks after CNS irradiation and may last 3 to 15 days. It’s characterized by somnolence with or without fever. anorexia. nausea. and vomiting. Although the syndrome isn’t thought to be clinically significant. parents should be prepared to expect such symptoms and encourage the child needed rest.

10. The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which of the following would the nurse expect to note specifically in this disorder?

Decreased number of plasma cells in the bone marrow.

Increased WBC’s

Increased calcium levels

Decreased blood urea nitrogen

Findings indicative of multiple myeloma are an increased number of plasma cells in the bone marrow. anemia. hypercalcemia caused by the release of calcium from the deteriorating bone tissue. and an elevated blood urea nitrogen level. An increased white blood cell count may or may not be present and is not related specifically to multiple myeloma.

Explanation

Findings indicative of multiple myeloma are an increased number of plasma cells in the bone marrow. anemia. hypercalcemia caused by the release of calcium from the deteriorating bone tissue. and an elevated blood urea nitrogen level. An increased white blood cell count may or may not be present and is not related specifically to multiple myeloma.