Adult Health - Oncology

The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would the nurse expect to note specifically in this disorder? 
1. Increased calcium level 
2. Increased white blood cells 
3. Decreased blood urea nitrogen level
4. Decreased number of plasma cells in the bone marrow

The nurse is developing a plan of care for the client with multiple myeloma and includes which priority intervention in the plan? 
1. Encouraging fluids 
2. Providing frequent oral care 
3. Coughing and deep breathing 
4. Monitoring the red blood cell count

A client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment finding would the nurse expect to note specifically in the client? 
1. Fatigue 
2. Weakness 
3. Weight gain 
4. Enlarged lymph nodes

During the admission assessment of a client with advanced ovarian cancer, the nurse recognizes which symptom as typical of the disease? 
1. Diarrhea 
2. Hypermenorrhea 
3. Abnormal bleeding 
4. Abdominal distention

The nurse is caring for a client with bladder cancer and bone metastasis. What signs/symptoms would the nurse recognize as indications of a possible oncological emergency? Select all that apply. 
1. Facial edema in the morning 
2. Serum calcium level of 12 mg/dL 
3. Weight loss of 20 lb in 1 month 
4. Serum sodium level of 136 mg/dL 
5. Serum potassium level of 3.4 mg/dL 
6.Numbness and tingling of the lower extremities

A client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing which condition? 
1. Rupture of the bladder 
2. The development of a vesicovaginal fistula 
3. Extreme stress caused by the diagnosis of cancer 
4. Altered perineal sensation as a side effect of radiation therapy

A client is diagnosed with multiple myeloma and the client asks the nurse about the diagnosis. The nurse bases the response on which description of this disorder? 
1. Altered red blood cell production 
2. Altered production of lymph nodes 
3. Malignant exacerbation in the number of leukocytes 
4. Malignant proliferation of plasma cells within the bone

The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the client identifies which item as an associated risk factor? 
1. Age younger than 50 years 
2. History of colorectal polyps 
3. Family history of colorectal cancer 
4. Chronic inflammatory bowel disease

The nurse is assessing the perineal wound in a client who has returned from the operating room following an abdominal perineal resection and notes serosanguineous drainage from the wound. Which nursing intervention is most appropriate? 
1. Clamp the Penrose drain. 
2. Change the dressing as prescribed. 
3. Notify the health care provider (HCP). 
4. Remove and replace the perineal packing.

The nurse is reviewing the history of a client with bladder cancer. The nurse expects to note documentation of which most common symptom of this type of cancer? 
1. Dysuria 
2. Hematuria 
3. Urgency on urination 
4. Frequency of urination

The nurse is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care? 
1. "I change my pouch every week." 
2. "I change the appliance in the morning."
3. "I empty the urinary collection bag when it is two-thirds full." 
4. "When I'm in the shower I direct the flow of water away from my stoma."

A client with carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH) as a complication of the cancer. The nurse anticipates that the health care provider will request which prescriptions? Select all that apply. 
1. Radiation 
2. Chemotherapy 
3. Increased fluid intake 
4. Decreased oral sodium intake 
5. Serum sodium level determination 
6. Medication that is antagonistic to antidiuretic hormone

The nurse is monitoring a client for signs and symptoms related to superior vena cava syndrome. Which is an early sign of this oncological emergency? 
1. Cyanosis 
2. Arm edema 
3. Periorbital edema 
4. Mental status changes

The nurse manager is teaching the nursing staff about signs and symptoms related to hypercalcemia in a client with metastatic prostate cancer and tells the staff that which is a late sign of this oncological emergency? 
1. Headache 
2. Dysphagia 
3. Constipation 
4. Electrocardiographic changes

As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which statement? 
1. "I should avoid blowing my nose." 
2. "I may need a platelet transfusion if my platelet count is too low." 
3. "I'm going to take aspirin for my headache as soon as I get home." 
4. "I will count the number of pads and tampons I use when menstruating."

A client is diagnosed as having a bowel tumor. The nurse should monitor the client for which complications of this type of tumor? Select all that apply. 
1. Flatulence 
2. Peritonitis 
3. Hemorrhage 
4. Fistula formation 
5. Bowel perforation 
6.Lactose intolerance

The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm? 
1. Placing cool compresses on the affected arm 
2. Elevating the affected arm on a pillow above heart level 
3. Avoiding arm exercises in the immediate postoperative period 
4. Maintaining an intravenous site below the antecubital area on the affected side

The nurse has admitted a client to the clinical nursing unit after undergoing a right mastectomy. The nurse should plan to place the right arm in which position? 
1. Elevated on a pillow 
2. Level with the right atrium 
3. Dependent to the right atrium 
4. Elevated above shoulder level

The nurse teaches skin care to a client receiving external radiation therapy. Which client statement indicates the need for further instruction? 
1. "I will handle the area gently." 
2. "I will wear loose-fitting clothing." 
3. "I will avoid the use of deodorants." 
4. "I will limit sun exposure to 1 hour daily."

The community health nurse is preparing a poster for an educational session for a group of women and will be discussing the risk factors associated with breast cancer. Which risk factors for breast cancer should the nurse list on the poster? Select all that apply. 
1. Multiparity 
2. Early menarche 
3. Early menopause 
4. Family history of breast cancer 
5. High-dose radiation exposure to chest 
6. Previous cancer of the breast, uterus, or ovaries

The nurse is preparing a list of home care instructions regarding stoma and laryngectomy care to a client with laryngeal cancer who had a laryngectomy. Which instructions should be included in the list? Select all that apply. 
1. Restrict fluid intake. 
2. Obtain a Medic-Alert bracelet. 
3. Keep the humidity in the home low. 
4. Prevent debris from entering the stoma. 
5. Avoid exposure to people with infections. 
6. Avoid swimming and use care when showering.

The nurse is teaching a client who has had a laryngectomy for laryngeal cancer how to use an artificial larynx. Which statement should the nurse include in the teaching? 
1. "Hold the device alongside the neck." 
2. "Insert the device into the tracheostomy." 
3. "Swallow air into the esophagus to make speech." 
4. "Hold the device over the upper portion of the sternum."

A client has been hospitalized for a cervical radiation implant for treating cancer. The implant is removed, and the nurse provides home care instructions to the client. Which statement made by the client indicates a need for further instructions? 
1. "Cream may be used to relieve dryness or itching." 
2. "Some vaginal bleeding is expected for 1 to 3 months." 
3. "Sexual intercourse may be resumed after 7 to 10 days." 
4. "Foul-smelling vaginal discharge is a sign of an infection."

The nurse is providing instructions to the client receiving external radiation therapy. Which statement, if made by the client, indicates the need for further instruction? 
1. "I will dry affected areas with patting motions." 
2. "I will wear soft clothing over the affected site." 
3. "I will use a washcloth to wash the affected area." 
4. "I need to make sure I carry my purse on the unaffected side."

The home health care nurse is visiting a client who has undergone a mastectomy. The nurse determines that the client demonstrates greatest adjustment to the loss of the breast if which behavior is noted? 
1. The client looks at the surgical site. 
2. The client performs the prescribed arm exercises. 
3. The client takes the pain medication as prescribed. 
4. The client has read all of the postoperative materials provided by the hospital nurse.

The home health care nurse is providing instructions to a client after a vulvectomy. Which instruction should the nurse provide to the client? 
1. "You can engage in sexual activity in 2 weeks." 
2. "It is all right to begin to drive a car as long as you do not drive long distances." 
3. "Resume activities slowly, keeping in mind that walking is a beneficial activity." 
4. "It is important to rest and sit in a chair with your legs elevated as much as possible."

The ambulatory care nurse is providing discharge instructions to a female client who underwent cryosurgery with laser therapy because of a positive Papanicolaou smear. Which statement, if made by the client, indicates an understanding of the instructions? 
1. "I should take sitz baths every 4 hours for the next week." 
2. "I should expect the vaginal discharge to be clear and watery." 
3. "Very strong pain medications will be needed to relieve any discomfort that I may have." 
4. "If I note any odor to the vaginal discharge, I should call the health care provider immediately."

The nurse has provided discharge instructions to a client who underwent a right mastectomy with axillary lymph node dissection. Which statement, if made by the client, indicates a need for further instruction regarding home care measures? 
1. "It is all right to use a straight razor to shave under my arms." 
2. "I must be sure to use thick potholders when I am cooking." 
3. "I must be sure not to have blood pressures taken or blood drawn from my right arm." 
4. "I should inform all of my other health care providers that I have had this surgical procedure."

A client is admitted to the nursing unit after undergoing radical prostatectomy for cancer. The nurse anticipates that which problem would be of most concern to the client in the immediate postoperative period? 
1. Concern about the outcome of surgery 
2. Continuous pain because of the effects of cancer 
3. Appearance disturbance as a result of the presence of a suprapubic catheter 
4. Concern about caring for self at home because of insufficient help after discharge

The nurse is performing an admission assessment for a client with a diagnosis of bladder cancer. The nurse should expect to note which symptom as the most likely initial assessment finding in this client? 
1. Burning 
2. Urgency 
3. Hematuria 
4. Frequency

The home care nurse visits a client who has just returned home from the hospital after a mastectomy. The client has a Jackson Pratt drain in place. The nurse instructs the client to avoid which action? 
1. Emptying the drain to prevent infection 
2. Elevation of the arm when lying or sitting 
3. Full range-of-motion exercises to the upper arm 
4. Applying lotion to the area after the incision heals

The nurse is reviewing the laboratory test results for a client with a diagnosis of leukemia who is receiving chemotherapy. The nurse notes that the client's platelet count is 20,000 cells/mm³. The nurse should prepare to implement which specific action based on this finding? 
1. Remove the fresh flowers from the client's room. 
2. Remove the rectal thermometer from the client's room. 
3. Instruct family members to wear a mask when entering the client's room. 
4. Call the dietary department to report that the client will be on a low-bacteria diet.

The clinic nurse has conducted a health screening clinic to identify clients who are at risk for cervical cancer. The nurse is reviewing the assessment findings in the records of the clients who attended the clinic. Which client is at lowest risk for developing this type of cancer? 
1. A multiparity client 
2. A single white client 
3. A client with a history of chronic cervicitis 
4. A client who had early, frequent intercourse with multiple sexual partners

The nurse is reviewing the medical record for a client who has been diagnosed with Hodgkin's disease. The nurse would expect to note which most likely assessment finding related to this diagnosis? 
1. Weight gain 
2. Increased appetite 
3. Swollen cervical lymph nodes 
4. Complaints of lack of energy

The nurse is reviewing the record of a client who was admitted to the hospital with a diagnosis of ovarian cancer. The nurse understands that which assessment finding is unlikely to occur with this disorder? 
1. Pain 
2. Frequent diarrhea 
3. Abdominal distention 
4. Urinary frequency and urgency

The nurse is reviewing the laboratory test results for a client with bladder cancer with bone metastasis. Which finding should alert the nurse that health care provider (HCP) notification is required? 
1. Calcium level of 15 mg/dL 
2. Potassium level of 3.8 mEq/L 
3. Platelet count of 200,000 cells/mm³ 
4. White blood cell (WBC) count of 6,000 cells/mm³

The community health nurse is providing a session to community members about the risks associated with laryngeal cancer. Which statement by a person attending the session indicates correct understanding of the risk factors? 
1. "Exposure to airborne carcinogens can cause this type of cancer." 
2. "Alcohol consumption is not associated with this type of cancer." 
3. "Cigarette smoking does not contribute to the development of this type of cancer." 
4. "Overuse of the voice is not associated with this type of cancer unless it causes spitting up of blood."

A client is admitted to the hospital with suspected bladder cancer. The nurse assesses the client for which as the earliest manifestation(s) of the disease? 
1. Proteinuria and dysuria 
2. Hematuria with no pain 
3. Painful urination and hematuria 
4. Pyuria and palpable abdominal mass

The nurse is reviewing the progress notes for a client admitted to the nursing unit with a suspected diagnosis of leukemia. The nurse notes that the diagnosis of leukemia has been confirmed. The nurse interprets that results have been reported to the health care provider for which diagnostic test? 
1. Platelet count 
2. Bone marrow biopsy 
3. White blood cell count 
4. Complete blood cell count

The new nurse is assigned to provide care for a client recently diagnosed with a melanoma. The charge nurse asks the nurse about the characteristics of this type of skin lesion. Which statement by the nurse indicates an understanding of this type of lesion? 
1. "It is contagious." 
2. "Metastasis is rare." 
3. "It is highly metastatic." 
4. "It is characterized by local invasion."

The nurse is performing a skin assessment on a client diagnosed with malignant melanoma. The nurse should expect to note which characteristic of this type of skin lesion? 
1. An irregularly shaped lesion 
2. A small papule with a dry, rough scale 
3. A firm nodular lesion topped with crust 
4. A pearly papule with a central crater and a waxy border

The nurse is reviewing the record of a client admitted to the hospital with a diagnosis of Hodgkin's disease. Which assessment findings noted in the client's record is associated with this diagnosis? Select all that apply. 
1. Fever 
2. Weight loss 
3. Night sweats 
4. Visual changes 
5. Enlarged, painless lymph nodes

The nurse is reviewing the laboratory test results for a client receiving chemotherapy. The nurse notes that the white blood cell count is extremely low and places the client on neutropenic precautions. Which interventions are a component of these types of precautions? Select all that apply. 
1. Allowing only fresh fruits in the client's room 
2. Removing fresh-cut flowers from the client's room 
3. Encouraging the client to eat any type of fresh vegetables 
4. Instructing family members on the proper technique for hand washing 
5. Instructing family members to wear a mask when entering the client's room

The nurse is preparing to care for a client with a diagnosis of metastatic cancer. The nurse notes documentation in the client's chart that the client is experiencing cachexia. Which should the nurse expect to note on assessment of the client? 
1. Elevated blood pressure and ascites 
2. Sunken eyes and a hollow cheek appearance 
3. Periorbital edema and swelling around the ears 
4. Generalized edema and the presence of weight gain

The nurse is caring for a client with leukemia who is receiving intravenous chemotherapy. The nurse reviews the laboratory results and notes that the white blood cell count is 2000 cells/mm³, the platelet count is 150,000 cells/mm³, the clotting time is 10 minutes, and the ammonia level is 20 mcg/dL. Which nursing action would be appropriate? 
1. Place the client on bleeding precautions. 
2. Place the client on neutropenic precautions. 
3. Remove the rectal thermometer from the client's room. 
4. Instruct the dietary department to eliminate all proteins from the diet.

The client has undergone mastectomy. The nurse determines that the client is making the best adjustment to the loss of the breast if which behavior is observed? 
1. Refusing to look at the wound 
2. Reading the postoperative care booklet 
3. Asking for pain medication when needed 
4. Participating in the care of the surgical drain

The client is preparing for discharge from the hospital after radical vulvectomy. The nurse plans to teach this client that which activity is acceptable after discharge because it will not precipitate complications? 
1. Walking 
2. Driving a car 
3. Sexual activity 
4. Sitting for lengthy periods

A community health nurse is providing an educational session on cancer of the cervix to women living in the community. The nurse informs the community residents that which is an early sign of this type of cancer? 
1. Abdominal pain 
2. Constant and profuse bleeding 
3. Irregular vaginal bleeding or spotting 
4. Dark and foul-smelling vaginal drainage

A nurse is reviewing the diagnostic test results for a client who had a Papanicolaou smear performed. The nurse notes that the health care provider has documented stage I cancer of the cervix. The nurse should make which interpretation? 
1. The carcinoma is strictly confined to the cervix. 
2. The carcinoma has extended to the pelvic wall and the lower third of the vagina. 
3. The carcinoma has extended beyond the cervix but has not extended to the pelvic wall. 
4. The carcinoma has extended beyond the true pelvis or has clinically involved the bladder or rectal mucosa.

A nurse is reviewing a plan of care for a client with cancer of the cervix who is undergoing treatment with a cesium (radiation) implant. Which nursing interventions are appropriate for this client? Select all that apply. 
1. Maintain the client on bed rest. 
2. Place the client on a low-fiber diet. 
3. Keep the head of the bed flat at all times. 
4. Restrict visitors to visiting for 60 minutes per day. 
5. Stand at the entrance of the room to communicate with the client when possible.

A nurse is providing discharge instructions to a client who has undergone treatment of cervical cancer with a radiation (cesium) implant. Which instruction should the nurse provide to the client? 
1. Avoid douching for at least 1 year. 
2. Use a vaginal dilator three times a week. 
3. Sexual activity can be resumed in about 2 months. 
4. Bed rest is recommended for at least 1 week after discharge.

A nurse has provided discharge instructions to a client after radical vulvectomy. Which statement by the client indicates a need for further instruction? 
1. "I should avoid sexual activity for 4 to 6 weeks." 
2. "I should wash the perineum after each voiding." 
3. "It is all right to ride in a car as much as I want, as long as I am not driving the car." 
4. "I need to report any redness, swelling, or drainage to the health care provider (HCP)."

A nurse is caring for a client with metastatic breast cancer. The client describes a new and sudden sharp pain in the back. Based on this assessment finding, which is the priority nursing intervention? 
1. Document the findings. 
2. Administer pain medication. 
3. Notify the health care provider (HCP). 
4. Place a heating pad on the client's back.

The nurse is counseling a woman about decreasing her risk for cervical cancer. Which statement by the client indicates a need for further counseling? 
1. "I need to seek prompt treatment for vaginitis." 
2. "Condoms are needed only if I do not trust a new partner." 
3. "A partner who is uncircumcised will present an increased risk." 
4. "I need to keep appointments for Pap smears at the frequency advised by my health care provider."

A woman has just been told by the health care provider that she has breast cancer. The woman responds, "Oh, no! Does this mean I'm going to die?" The nurse interprets the woman's initial reaction as which response? 
1. Fear 
2. Rage 
3. Denial 
4. Anxiety

The nurse has provided instructions to a client receiving external radiation therapy. Which client statement would indicate a need for further instruction regarding self-care related to the radiation therapy? 
1. "I need to eat a high-protein diet." 
2. "I need to avoid exposure to sunlight." 
3. "I need to wash my skin with a mild soap and pat dry." 
4. "I need to apply pressure on the irritated area by wearing snug clothing to prevent bleeding."

The nurse has provided instructions to a client regarding testicular self-examination (TSE). Which client statement indicates the need for further teaching regarding TSE? 
1. "I know to report any small lumps." 
2. "I examine myself every 2 months." 
3. "I examine myself after I take a warm shower." 
4. "I feel a hard and cord-like thing in back and going up."

A client seeks treatment in an ambulatory clinic for a complaint of hoarseness that has lasted for 6 weeks. On the basis of this symptom, the nurse should consider developing a plan of care on which possible medical diagnosis? 
1. Thyroid cancer 
2. Acute laryngitis 
3. Laryngeal cancer 
4. Bronchogenic cancer

A client calls the ambulatory care clinic and tells the nurse that she found an area that looks like the peel of an orange when performing breast self-examination (BSE) but found no other changes. What is the nurse'sbest response to this client? 
1. "Good job performing your BSE. I am sure that is nothing to be concerned about." 
2. "Make sure you tell the health care provider your finding at your next regularly scheduled visit." 
3. "I am glad you called to report this finding. Can you come to the clinic to see your health care provider tomorrow?" 
4. "Do you have a thermometer? You need to take your temperature and call back if you have a fever over 101° F/38.3° C."

The nurse is taking a history from a client suspected of having testicular cancer. Which data will be most helpful in determining the risk factors for this type of cancer? 
1. Age and race 
2. Marital status 
3. Number of children 
4. Number of sexual partners

For the client with stomatitis resulting from chemotherapy for leukemia, the care plan should include which intervention? 
1. Inspect the mouth every week for fungus. 
2. Encourage foods with neutral or cool temperatures. 
3. Give the client spicy foods to stimulate the sense of taste. 
4. Perform frequent oral hygiene using a commercial alcohol-based mouthwash.

Which interventions are appropriate for a client with leukemia who is experiencing thrombocytopenia? Select all that apply. 
1. Use a straight-edge razor for shaving. 
2. Obtain a rectal temperature every 8 hours. 
3. Check secretions for frank or occult blood. 
4. Give vitamin K by the intramuscular route. 
5. Encourage fluid intake to avoid constipation.
6. Provide oral sponges or a soft toothbrush for oral care.

The nurse is providing care to a client who has undergone modified right radical mastectomy for the treatment of breast cancer. Which activity should the nurse incorporate in the plan of care? 
1. Keep Jackson-Pratt drains fully inflated to provide adequate suction. 
2. Perform venipunctures and blood pressures on the operative side only. 
3. Inform the client that drains will be removed on the second postoperative day. 
4. Maintain head of the bed elevation at 30 degrees with the right arm elevated on a pillow.

The community health nurse is preparing a poster for an educational session for a group of women and will be discussing the risk factors associated with breast cancer. Which risk factors for breast cancer should the nurse list on the poster? Select all that apply. 
1. Multiparity 
2. Early menarche 
3. Early menopause 
4. Family history of breast cancer 
5. High-dose radiation exposure to chest 
6. Previous cancer of the breast, uterus, or ovaries

The community nurse is conducting a health promotion program at a local school and is discussing the risk factors associated with cervical cancer. Which are risk factors for cervical cancer? Select all that apply. 
1. Smoking 
2. Multiple sex partners 
3. Human papillomavirus infection 
4. Annual gynecological examinations 
5. First intercourse before 17 years of age

The nurse should include which intervention in the care of a client who has undergone a vaginal hysterectomy for the treatment of cancer? Select all that apply. 
1. Elevate the knee gatch on the bed. 
2. Encourage ambulation as prescribed. 
3. Remove antiembolism stockings twice daily. 
4. Assist with range-of-motion (ROM) leg exercises. 
5. Check placement of pneumatic compression boots.

The oncology nurse specialist provides an educational session to nursing staff regarding the characteristics of Hodgkin's disease. The nurse determines that further teaching is needed if a nursing staff member states that which is a characteristic of the disease? 
1. Reed-Sternberg cells are present. 
2. The lymph nodes, spleen, and liver are involved. 
3. The prognosis depends on the stage of the disease. 
4. The disease occurs most often in those older than 75 years of age.

The community health nurse conducts a health promotion program for community members regarding testicular cancer. The nurse determines that further information needs to be provided if a community member states that which is a sign of testicular cancer? 
1. Alopecia 
2. Back pain 
3. Painless testicular swelling 
4. Heavy sensation in the scrotum

A client is receiving external radiation to the neck for cancer of the larynx. Which is the most likely expected effect? 
1. Dyspnea 
2. Diarrhea 
3. Sore throat 
4. Constipation

A cervical radiation implant is placed in a client who is undergoing treatment of cervical cancer. The nurse should initiate which activity prescription as the most appropriate for this client? 
1. Bed rest 
2. Out of bed ad lib 
3. Out of bed in a chair only 
4. Ambulation to the bathroom only

The client reports to the nurse that while performing testicular self-examination, he found a lump the size and shape of a pea. Which statement is the appropriate response to the client? 
1. "Lumps like that are normal. Don't worry." 
2. "Let me know if it gets bigger next month." 
3. "That's important to report even though it might not be serious." 
4. "That could be cancer. I'll ask the health care provider (HCP) to examine you."

The nurse is admitting a client with laryngeal cancer to the nursing unit. What should the nurse assess for as the most common risk factor for this type of cancer? 
1. Alcohol abuse 
2. Cigarette smoking 
3. Use of chewing tobacco 
4. Exposure to air pollutants

A client receiving chemotherapy is experiencing mucositis. The nurse should advise the client to use which item as the best substance to rinse the mouth? 
1. Alcohol-based mouthwash 
2. Hydrogen peroxide mixture 
3. Lemon-flavored mouthwash 
4. Weak salt and bicarbonate mouth rinse

A nurse is reviewing the preoperative prescriptions for a client with a colon tumor who is scheduled for abdominal perineal resection and notes that the health care provider has prescribed neomycin (Mycifradin) for the client. The nurse determines that this medication has been prescribed primarily for which purpose? 
1. To prevent an immune dysfunction 
2. Because the client has an infection 
3. To decrease the bacteria in the bowel 
4. Because the client is allergic to penicillin

The nurse is caring for a client who has undergone a radical neck dissection and creation of a tracheostomy because of laryngeal cancer and is providing discharge instructions to the client. Which should be included in the instructions? Select all that apply. 
1. Protect the stoma from water. 
2. Use a humidifier if dryness is a problem. 
3. Keep powders and sprays away from the stoma site. 
4. Use an air conditioner to provide cool air to assist in breathing. 
5. Apply a thin layer of petrolatum to the skin around the stoma to prevent cracking.

Which should be identified by the nurse as the purpose of cytoreductive (debulking) surgery for ovarian cancer? 
1. Cancer control by reducing the size of the tumor 
2. Cancer prevention by removing precancerous tissue 
3. Cancer cure by removing all gross and microscopic tumor cells 
4. Cancer rehabilitation by improving the appearance of a previously treated body part

Hormone therapy is prescribed as the mode of treatment for a client with prostate cancer. The nurse should understand that which is the goal of this form of treatment? 
1. To increase testosterone levels 
2. To increase prostaglandin levels 
3. To limit the amount of circulating androgens 
4. To increase the amount of circulating androgens

The nurse is caring for a client with cancer of the prostate who has undergone a prostatectomy. Which action should the nurse tell the client to take when providing discharge instructions?
1. Avoid driving the car for a few days. 
2. Restrict fluid intake to prevent incontinence. 
3. Avoid lifting objects heavier than 20 lb for at least 6 weeks. 
4. Notify the health care provider if small blood clots are noticed during urination.

The oncology nurse is providing a teaching session to a group of nursing students regarding the risks and causes of bladder cancer. Which statement by a student would indicate a need for further teaching? 
1. "Bladder cancer most often occurs in women." 
2. "Using cigarettes and coffee drinking can increase the risk." 
3. "Bladder cancer generally is seen in clients older than age 40." 
4. "Environmental health hazards have been implicated as a cause."

The nurse is caring for a client after intravesical instillation of an alkylating chemotherapeutic agent for the treatment of bladder cancer. After the instillation, which action should the nurse instruct the client to take? 
1. Urinate immediately. 
2. Maintain strict bed rest. 
3. Change position every 15 minutes. 
4. Retain the instillation fluid for 30 minutes.

The community nurse is conducting a health promotion program, and the topic of the discussion relates to the risk factors for gastric cancer. Which item, if identified as a risk factor by a client, indicates a need for further discussion? 
1. Smoking 
2. A low-fat diet 
3. Foods containing nitrates 
4. A diet of smoked, highly salted, and spiced foods

A client with leukemia is receiving busulfan (Myleran) and allopurinol (Zyloprim). The nurse should tell the client that the purpose of the allopurinol is to prevent which symptom? 
1. Nausea 
2. Alopecia 
3. Vomiting 
4. Hyperuricemia

A 67-year-old man is receiving outpatient radiation treatments for carcinoma of the oropharynx and has developed dysphagia. The nurse develops a teaching plan regarding dysphagia and includes which interventions in the plan? Select all that apply. 
1. Teach the man to speak slowly. 
2. Teach the man to enunciate clearly. 
3. Encourage the man to drink only thin liquids. 
4. Teach the man to examine his oral mucosa daily. 
5. Encourage the man to use artificial saliva to manage dryness.

A client with a medical diagnosis of breast cancer is undergoing chemotherapy. The client complains to the nurse about losing her hair and severe fatigue from the treatment. Which interventions should the nurse implement for this client? Select all that apply. 
1. Teach the client how to resolve specific concerns of her personal life. 
2. Review side effects of chemotherapy and treatment with the client. 
3. Teach the client to pace activities with rest so as to maintain strength. 
4. Offer information on available counseling services and support groups. 
5. Tell the client about some other clients who have had breast cancer treatment. 
6. Inquire how the cancer diagnosis and treatment affect the client's normal routine.

The nurse is caring for a client undergoing external radiation. The client has developed a dry desquamation of the skin in the treatment area and the nurse is teaching him or her about management of the skin reaction. Which comment made by the client suggests understanding of the instructions? 
1. "I don't need to stay out of the sun or put on sunscreen." 
2. "I can use ice packs to relieve itching in the treatment area." 
3. "When bathing I will use lukewarm water on the affected area." 
4. "I can lubricate the irritated area with an ointment like bacitracin."

Which clinical manifestation is consistent with the medical diagnosis of chronic lymphocytic leukemia (CLL)? 
1. Anemia 
2. Bleeding 
3. Pancytopenia 
4. Lymphadenopathy

A client with bladder cancer has undergone surgical removal of the bladder with construction of an ileal conduit. Which assessment findings by the nurse would indicate that the client is developing complications? Select all that apply. 
1. Dusky appearance of the stoma 
2. Stoma protrusion from the skin 
3. Sharp abdominal pain with rigidity 
4. Urine output greater than 30 mL/hr 
5. Mucus shreds in the urine collection bag

A client who is receiving chemotherapy for breast cancer develops myelosuppression. Which instructions should the nurse include in the client's discharge teaching plan? Select all that apply. 
1. Avoid contact sports. 
2. Wash hands frequently. 
3. Increase intake of fresh fruits and vegetables. 
4. Avoid crowded places such as shopping malls. 
5. Treat a sore throat with over-the-counter products. 
6.Avoid people who have received live attenuated vaccines.

A client with laryngeal cancer has undergone laryngectomy and is now receiving external radiation therapy to the head and neck. The nurse should monitor the client for which adverse effects of external radiation? Select all that apply. 
1. Cystitis 
2. Stomatitis 
3. Dysgeusia 
4. Leukopenia 
5. Xerostomia 
6. Thrombocytopenia

A nurse in the health care provider's office is performing a postoperative assessment of a client who underwent mastectomy of her right breast 2 weeks ago. The client tells the nurse that she is very concerned because she has numbness in the area of the surgery and along the inner side of the arm from the armpit to the elbow. The nurse should provide which information to the client about her complaint? 
1. These sensations are signs of a complication. 
2. These sensations probably will be permanent. 
3. These sensations dissipate over several months and usually resolve after 1 year. 
4. It is nothing to worry about because most women who have this type of surgery experience this problem.

A nurse has instructed the client in the correct technique for breast self-examination (BSE). For a portion of the examination, the client will lie down. If the client were to examine the right breast, the nurse would tell the client to place a pillow in which location? 
1. Under the left scapula 
2. Under the left shoulder 
3. Under the right shoulder 
4. Under the small of the back

A nurse would identify that which food should be increased in the diet to help decrease the risk of cancer development? 
1. Bacon 
2. Broccoli 
3. Bologna 
4. Broiled beef

According to the American Cancer Society, fecal occult blood testing should be done annually after which age? 
1. 30 
2. 40 
3. 50 
4. 60

A 27-year-old female client is undergoing evaluation of lumps in her breasts. In determining whether the client could have fibrocystic breast disorder, the nurse should ask her whether the breast lumps seem to become more prominent or troublesome at which time? 
1. After menses 
2. Before menses 
3. During menses 
4. At any time, regardless of the menstrual cycle

The nurse is assigned to the care of a client scheduled for surgery for a right colon tumor. Which is the most characteristic manifestation of cancer at this site? 
1. Frequent diarrhea 
2. Crampy gas pains 
3. Flat, ribbon-like stools 
4. Dull abdominal pain exacerbated by walking

A client has undergone abdominal perineal resection for a bowel tumor. The nurse interprets that the client's colostomy is beginning to function if which sign is noted? 
1. Absent bowel sounds 
2. The passage of flatus 
3. Blood drainage from the colostomy 
4. The client's ability to tolerate food

A nurse monitoring an oncological client assesses for which early sign of vena cava syndrome? 
1. Cyanosis 
2. Arm edema 
3. Periorbital edema 
4. Mental status changes

A client is admitted to the hospital with a tentative diagnosis of bladder cancer. The nurse expects the client history to reveal which earliest manifestations of the disease? 
1. Proteinuria and dysuria 
2. Hematuria with no pain 
3. Painful urination and hematuria 
4. Pyuria and palpable abdominal mass

A client with liver cancer who is receiving chemotherapy tells the nurse that some foods taste bitter. The nurse would try to limit which food that is most likely to cause this bitter taste for the client? 
1. Pork 
2. Custard 
3. Potatoes 
4. Cantaloupe

A client is having a diagnostic workup for colorectal cancer. Which factors in the client's history will place the client at increased risk for this type of cancer? Select all that apply. 
1. A high-fiber diet 
2. A diet high in fats 
3. Minimal alcohol intake 
4. A diet high in carbohydrates 
5. A history of inflammatory bowel disease 
6. A maternal grandfather who had a history of heart disease

The nurse is teaching a group of adults about the warning signs of cancer. Which signs should the nurse provide to the group? Select all that apply. 
1. Areas of alopecia 
2. Sores that do not heal 
3. Nagging cough or hoarseness 
4. Indigestion or difficulty swallowing 
5. Change in bowel or bladder habits 
6. Absence or decreased frequency of menses