Nurse Lucia is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms:

after the birth of the first child and every 2 years thereafter.

after the first menstrual period and annually thereafter.

every 3 years between ages 20 and 40 and annually thereafter.

Which intervention is appropriate for the nurse caring for a male client in severe pain receiving a continuous I.V. infusion of morphine?

Obtaining baseline vital signs before administering the first dose

Assisting with a naloxone challenge test before therapy begins

Discontinuing the drug immediately if signs of dependence appear

Changing the administration route to P.O. if the client can tolerate fluids

Obtaining baseline vital signs before administering the first dose

A 35 years old client with ovarian cancer is prescribed hydroxyurea (Hydrea). an antimetabolite drug. Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. The mechanism of action of antimetabolites interferes with:

normal cellular processes during the S phase of the cell cycle.

cell division or mitosis during the M phase of the cell cycle.

normal cellular processes during the S phase of the cell cycle.

the chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (cell cycle–nonspecific).

one or more stages of ribonucleic acid (RNA) synthesis. DNA synthesis. or both (cell cycle–nonspecific).

When caring for a male client diagnosed with a brain tumor of the parietal lobe. the nurse expects to assess:

contralateral homonymous hemianopia.

A female client is undergoing tests for multiple myeloma. Diagnostic study findings in multiple myeloma include:

Bence Jones protein in the urine.

a decreased serum creatinine level.

Bence Jones protein in the urine.

A 35 years old client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis (inflammation of the mouth)?

Red. open sores on the oral mucosa

White. cottage cheese–like patches on the tongue

Red. open sores on the oral mucosa

For a female client with newly diagnosed cancer. the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client?

“Client doesn’t guess at prognosis.”

“Client verbalizes feelings of anxiety.”

“Client doesn’t guess at prognosis.”

“Client uses any effective method to reduce tension.”

“Client stops seeking information.”

What should a male client over age 52 do to help ensure early identification of prostate cancer?

Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly.

Have a transrectal ultrasound every 5 years.

Perform monthly testicular self-examinations. especially after age 50.

Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly.

Cancer And Oncology | NCLEX Quiz 144

1.

Nurse Lucia is providing breast cancer education at a community facility. The American Cancer Society recommends that women get mammograms:
- A.
  
  Yearly after age 40.
- B.
  
  After the birth of the first child and every 2 years thereafter.
- C.
  
  After the first menstrual period and annually thereafter.
- D.
  
  Every 3 years between ages 20 and 40 and annually thereafter.
Correct Answer
A. Yearly after age 40.

Explanation
The American Cancer Society recommends a mammogram yearly for women over age 40. The other statements are incorrect. It’s recommended that women between ages 20 and 40 have a professional breast examination (not a mammogram) every 3 years.

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2.

Which intervention is appropriate for the nurse caring for a male client in severe pain receiving a continuous I.V. infusion of morphine?
- A.
  
  Assisting with a naloxone challenge test before therapy begins
- B.
  
  Discontinuing the drug immediately if signs of dependence appear
- C.
  
  Changing the administration route to P.O. if the client can tolerate fluids
- D.
  
  Obtaining baseline vital signs before administering the first dose
Correct Answer
D. Obtaining baseline vital signs before administering the first dose

Explanation
The nurse should obtain the client’s baseline blood pressure and pulse and respiratory rates before administering the initial dose and then continue to monitor vital signs throughout therapy. A naloxone challenge test may be administered before using a narcotic antagonist. not a narcotic agonist. The nurse shouldn’t discontinue a narcotic agonist abruptly because withdrawal symptoms may occur. Morphine commonly is used as a continuous infusion in clients with severe pain regardless of the ability to tolerate fluids.

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3.

A 35 years old client with ovarian cancer is prescribed hydroxyurea (Hydrea). an antimetabolite drug. Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. The mechanism of action of antimetabolites interferes with:
- A.
  
  Cell division or mitosis during the M phase of the cell cycle.
- B.
  
  Normal cellular processes during the S phase of the cell cycle.
- C.
  
  The chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (cell cycle–nonspecific).
- D.
  
  One or more stages of ribonucleic acid (RNA) synthesis. DNA synthesis. or both (cell cycle–nonspecific).
Correct Answer
B. Normal cellular processes during the S phase of the cell cycle.

Explanation
Antimetabolites act during the S phase of the cell cycle. contributing to cell destruction or preventing cell replication. They’re most effective against rapidly proliferating cancers. Miotic inhibitors interfere with cell division or mitosis during the M phase of the cell cycle. Alkylating agents affect all rapidly proliferating cells by interfering with DNA; they may kill dividing cells in all phases of the cell cycle and may also kill nondividing cells. Antineoplastic antibiotic agents interfere with one or more stages of the synthesis of RNA. DNA. or both. preventing normal cell growth and reproduction.

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4.

The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for?
- A.
  
  Actinic
- B.
  
  Asymmetry
- C.
  
  Arcus
- D.
  
  Assessment
Correct Answer
B. Asymmetry

Explanation
When following the ABCD method for assessing skin lesions. the A stands for “asymmetry.” the B for “border irregularity.” the C for “color variation.” and the D for “diameter.”

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5.

When caring for a male client diagnosed with a brain tumor of the parietal lobe. the nurse expects to assess:
- A.
  
  Short-term memory impairment.
- B.
  
  Tactile agnosia.
- C.
  
  Seizures.
- D.
  
  Contralateral homonymous hemianopia.
Correct Answer
B. Tactile agnosia.

Explanation
Tactile agnosia (inability to identify objects by touch) is a sign of a parietal lobe tumor. Short-term memory impairment occurs with a frontal lobe tumor. Seizures may result from a tumor of the frontal. temporal. or occipital lobe. Contralateral homonymous hemianopia suggests an occipital lobe tumor.

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6.

A female client is undergoing tests for multiple myeloma. Diagnostic study findings in multiple myeloma include:
- A.
  
  A decreased serum creatinine level.
- B.
  
  Hypocalcemia.
- C.
  
  Bence Jones protein in the urine.
- D.
  
  A low serum protein level.
Correct Answer
C. Bence Jones protein in the urine.

Explanation
Presence of Bence Jones protein in the urine almost always confirms the disease. but absence doesn’t rule it out. Serum calcium levels are elevated because calcium is lost from the bone and reabsorbed in the serum. Serum protein electrophoresis shows elevated globulin spike. The serum creatinine level may also be increased.

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7.

A 35 years old client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis (inflammation of the mouth)?
- A.
  
  White. cottage cheese–like patches on the tongue
- B.
  
  Yellow tooth discoloration
- C.
  
  Red. open sores on the oral mucosa
- D.
  
  Rust-colored sputum
Correct Answer
C. Red. open sores on the oral mucosa

Explanation
The tissue-destructive effects of cancer chemotherapy typically cause stomatitis. resulting in ulcers on the oral mucosa that appear as red. open sores. White. cottage cheese–like patches on the tongue suggest a candidal infection. another common adverse effect of chemotherapy. Yellow tooth discoloration may result from antibiotic therapy. not cancer chemotherapy. Rust-colored sputum suggests a respiratory disorder. such as pneumonia.

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8.

For a female client with newly diagnosed cancer. the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client?
- A.
  
  “Client verbalizes feelings of anxiety.”
- B.
  
  “Client doesn’t guess at prognosis.”
- C.
  
  “Client uses any effective method to reduce tension.”
- D.
  
  “Client stops seeking information.”
Correct Answer
B. “Client doesn’t guess at prognosis.”

Explanation
To decrease the pain of stomatitis. the nurse should provide a solution of hydrogen peroxide and water for the client to use as a mouth rinse. (Commercially prepared mouthwashes contain alcohol and may cause dryness and irritation of the oral mucosa.) The nurse also may administer viscous lidocaine or systemic analgesics as prescribed. Stomatitis occurs 7 to 10 days after chemotherapy begins; thus. stopping chemotherapy wouldn’t be helpful or practical. Instead. the nurse should stay alert for this potential problem to ensure prompt treatment. Monitoring platelet and leukocyte counts may help prevent bleeding and infection but wouldn’t decrease pain in this highly susceptible client. Checking for signs and symptoms of stomatitis also wouldn’t decrease the pain.

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9.

What should a male client over age 52 do to help ensure early identification of prostate cancer?
- A.
  
  Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly.
- B.
  
  Have a transrectal ultrasound every 5 years.
- C.
  
  Perform monthly testicular self-examinations. especially after age 50.
- D.
  
  Have a complete blood count (CBC) and blood urea nitrogen (BUN) and creatinine levels checked yearly.
Correct Answer
A. Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly.

Explanation
The incidence of prostate cancer increases after age 50. The digital rectal examination. which identifies enlargement or irregularity of the prostate. and PSA test. a tumor marker for prostate cancer. are effective diagnostic measures that should be done yearly. Testicular self-examinations won’t identify changes in the prostate gland due to its location in the body. A transrectal ultrasound. CBC. and BUN and creatinine levels are usually done after diagnosis to identify the extent of the disease and potential metastases

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10.

A male client complains of sporadic epigastric pain. yellow skin. nausea. vomiting. weight loss. and fatigue. Suspecting gallbladder disease. the physician orders a diagnostic workup. which reveals gallbladder cancer. Which nursing diagnosis may be appropriate for this client?
- A.
  
  Anticipatory grieving
- B.
  
  Impaired swallowing
- C.
  
  Disturbed body image
- D.
  
  Chronic low self-esteem
Correct Answer
A. Anticipatory grieving

Explanation
Anticipatory grieving is an appropriate nursing diagnosis for this client because few clients with gallbladder cancer live more than 1 year after diagnosis. Impaired swallowing isn’t associated with gallbladder cancer. Although surgery typically is done to remove the gallbladder and. possibly. a section of the liver. it isn’t disfiguring and doesn’t cause Disturbed body image. Chronic low self-esteem isn’t an appropriate nursing diagnosis at this time because the diagnosis has just been made.

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