Cancer And Oncology | NCLEX Quiz 147

1. Nurse Melinda is caring for a client who is postoperative following a pelvic exenteration and the physician changes the client's diet from NPO status to clear liquids. The nurse makes which priority assessment before administering the diet?

Bowel sounds

Ability to ambulate

Incision appearance

Urine specific gravity

The client is kept NPO until peristalsis returns. usually in 4 to 6 days. When signs of bowel function return. clear fluids are given to the client. If no distention occurs. the diet is advanced as tolerated. The most important assessment is to assess bowel sounds before feeding the client. Options B. C. and D are unrelated to the subject of the question.

Explanation

The client is kept NPO until peristalsis returns. usually in 4 to 6 days. When signs of bowel function return. clear fluids are given to the client. If no distention occurs. the diet is advanced as tolerated. The most important assessment is to assess bowel sounds before feeding the client. Options B. C. and D are unrelated to the subject of the question.

2. A female client is hospitalized for insertion of an internal cervical radiation implant. While giving care. the nurse finds the radiation implant in the bed. The initial action by the nurse is to:

Call the physician

Reinsert the implant into the vagina immediately

Pick up the implant with gloved hands and flush it down the toilet

Pick up the implant with long-handled forceps and place it in a lead container.

A lead container and long-handled forceps should be kept in the client’s room at all times during internal radiation therapy. If the implant becomes dislodged. the nurse should pick up the implant with long-handled forceps and place it in the lead container. Options A. B. and C are inaccurate interventions.

Explanation

A lead container and long-handled forceps should be kept in the client’s room at all times during internal radiation therapy. If the implant becomes dislodged. the nurse should pick up the implant with long-handled forceps and place it in the lead container. Options A. B. and C are inaccurate interventions.

3. Nurse Joy is caring for a client with an internal radiation implant. When caring for the client. the nurse should observe which of the following principles?

Limit the time with the client to 1 hour per shift

Do not allow pregnant women into the client’s room

Remove the dosimeter badge when entering the client’s room

The time that the nurse spends in a room of a client with an internal radiation implant is 30 minutes per 8-hour shift. The dosimeter badge must be worn when in the client’s room. Children younger than 16 years of age and pregnant women are not allowed in the client’s room.

Explanation

The time that the nurse spends in a room of a client with an internal radiation implant is 30 minutes per 8-hour shift. The dosimeter badge must be worn when in the client’s room. Children younger than 16 years of age and pregnant women are not allowed in the client’s room.

4. The male client is receiving external radiation to the neck for cancer of the larynx. The most likely side effect to be expected is:

Dyspnea

Diarrhea

Sore throat

Constipation

In general. only the area in the treatment field is affected by the radiation. Skin reactions. fatigue. nausea. and anorexia may occur with radiation to any site. whereas other side effects occur only when specific areas are involved in treatment. A client receiving radiation to the larynx is most likely to experience a sore throat. Options B and D may occur with radiation to the gastrointestinal tract. Dyspnea may occur with lung involvement.

Explanation

In general. only the area in the treatment field is affected by the radiation. Skin reactions. fatigue. nausea. and anorexia may occur with radiation to any site. whereas other side effects occur only when specific areas are involved in treatment. A client receiving radiation to the larynx is most likely to experience a sore throat. Options B and D may occur with radiation to the gastrointestinal tract. Dyspnea may occur with lung involvement.

5. A male client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment findings would the nurse expect to note specifically in the client?

Fatigue

Weakness

Weight gain

Enlarged lymph nodes

Hodgkin’s disease is a chronic progressive neoplastic disorder of lymphoid tissue characterized by the painless enlargement of lymph nodes with progression to extralymphatic sites. such as the spleen and liver. Weight loss is most likely to be noted. Fatigue and weakness may occur but are not related significantly to the disease.

Explanation

Hodgkin’s disease is a chronic progressive neoplastic disorder of lymphoid tissue characterized by the painless enlargement of lymph nodes with progression to extralymphatic sites. such as the spleen and liver. Weight loss is most likely to be noted. Fatigue and weakness may occur but are not related significantly to the disease.

6. A cervical radiation implant is placed in the client for treatment of cervical cancer. The nurse initiates what most appropriate activity order for this client?

Bed rest

Out of bed ad lib

Out of bed in a chair only

Ambulation to the bathroom only

The client with a cervical radiation implant should be maintained on bed rest in the dorsal position to prevent movement of the radiation source. The head of the bed is elevated to a maximum of 10 to 15 degrees for comfort. The nurse avoids turning the client on the side. If turning is absolutely necessary. a pillow is placed between the knees and. with the body in straight alignment. the client is logrolled.

Explanation

The client with a cervical radiation implant should be maintained on bed rest in the dorsal position to prevent movement of the radiation source. The head of the bed is elevated to a maximum of 10 to 15 degrees for comfort. The nurse avoids turning the client on the side. If turning is absolutely necessary. a pillow is placed between the knees and. with the body in straight alignment. the client is logrolled.

7. The home health care nurse is caring for a male client with cancer and the client is complaining of acute pain. The appropriate nursing assessment of the client's pain would include which of the following?

The client’s pain rating

Nonverbal cues from the client

The nurse’s impression of the client’s pain

Pain relief after appropriate nursing intervention

The client’s self-report is a critical component of pain assessment. The nurse should ask the client about the description of the pain and listen carefully to the client’s words used to describe the pain. The nurse’s impression of the client’s pain is not appropriate in determining the client’s level of pain. Nonverbal cues from the client are important but are not the most appropriate pain assessment measure. Assessing pain relief is an important measure. but this option is not related to the subject of the question.

Explanation

The client’s self-report is a critical component of pain assessment. The nurse should ask the client about the description of the pain and listen carefully to the client’s words used to describe the pain. The nurse’s impression of the client’s pain is not appropriate in determining the client’s level of pain. Nonverbal cues from the client are important but are not the most appropriate pain assessment measure. Assessing pain relief is an important measure. but this option is not related to the subject of the question.

8. The nurse is caring for a female client experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. The nurse plans to:

Restrict all visitors

Restrict fluid intake

Teach the client and family about the need for hand hygiene

Insert an indwelling urinary catheter to prevent skin breakdown

In the neutropenic client. meticulous hand hygiene education is implemented for the client. family. visitors. and staff. Not all visitors are restricted. but the client is protected from persons with known infections. Fluids should be encouraged. Invasive measures such as an indwelling urinary catheter should be avoided to prevent infections.

Explanation

In the neutropenic client. meticulous hand hygiene education is implemented for the client. family. visitors. and staff. Not all visitors are restricted. but the client is protected from persons with known infections. Fluids should be encouraged. Invasive measures such as an indwelling urinary catheter should be avoided to prevent infections.

9. During the admission assessment of a 35 year old client with advanced ovarian cancer. the nurse recognizes which symptom as typical of the disease?

Diarrhea

Hypermenorrhea

Abdominal bleeding

Abdominal distention

Clinical manifestations of ovarian cancer include abdominal distention. urinary frequency and urgency. pleural effusion. malnutrition. pain from pressure caused by the growing tumor and the effects of urinary or bowel obstruction. constipation. ascites with dyspnea. and ultimately general severe pain. Abnormal bleeding. often resulting in hypermenorrhea. is associated with uterine cancer.

Explanation

Clinical manifestations of ovarian cancer include abdominal distention. urinary frequency and urgency. pleural effusion. malnutrition. pain from pressure caused by the growing tumor and the effects of urinary or bowel obstruction. constipation. ascites with dyspnea. and ultimately general severe pain. Abnormal bleeding. often resulting in hypermenorrhea. is associated with uterine cancer.

10. Nurse Kate is reviewing the complications of colonization with a client who has microinvasive cervical cancer. Which complication. if identified by the client. indicates a need for further teaching?

Infection

Hemorrhage

Cervical stenosis

Ovarian perforation

Conization procedure involves removal of a cone-shaped area of the cervix. Complications of the procedure include hemorrhage. infection. and cervical stenosis. Ovarian perforation is not a complication.

Explanation

Conization procedure involves removal of a cone-shaped area of the cervix. Complications of the procedure include hemorrhage. infection. and cervical stenosis. Ovarian perforation is not a complication.