ONCOLOGY

The community health nurse is creating a poster for an educational session for a
group of community members and will be discussing the risk factors associated
with breast cancer. Which risk factors for breast cancer would 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 for a client with laryngeal cancer who had a laryngectomy. Which instructions would be included in the list? Select all that apply.

1.Restrict fluid intake
2.Obtain a MedicAlert bracelet.
3.Keep the humidity in the home low
4.Prevent debris from entering the stoma.
5.Prevent debris from entering the stoma.
6.Avoid swimming and use care when showering.

The primary health care provider prescribes a 24-hour urine collection for vanillylmandelic acid (VMA). The community health nurse visits the client at home and instructs the client in the procedure for the collection of the urine. Which statement, if made by the client, would indicate a need for further instruction?

1."I can take medication if I need to during the collection."
2."When I start the collection, I will urinate and discard that specimen."
3."I will pour the urine in the collection bottle each time I urinate and refrigerate the urine."
4."I will start the collection in 2 days. Starting now, I cannot eat or drink any tea, chocolate,
vanilla, or fruit until the test is completed."

A client had a colectomy 2 days earlier to remove a bowel tumor and had a new colostomy created. The client is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse?

1.This is a normal, expected event.
2.The client is experiencing early signs of ischemic bowel.
3.The client would not have the nasogastric tube removed.
4.This indicates inadequate preoperative bowel preparation.

A client who has undergone gastric surgery to remove a tumor has a nasogastric (NG) tube connected to low intermittent suction that is not draining properly. Which action would the nurse take initially?

1.Call the surgeon to report the problem.
2.Reposition the NG tube to the proper location.
3.Check the suction device to make sure it is working.
4.Irrigate the NG tube with saline to remove the obstruction.

The nurse is caring for a client after abdominal surgery to treat a malignant bowel tumor with creation of a colostomy. The nurse is assessing the client for a prolapsed stoma and would expect to note which observation if this is present?

1.A sunken and hidden stoma.
2.A narrow and flattened stoma.
3.A stoma that is dusky or bluish.
4.A stoma that is elongated with a swollen appearance.

The nurse is preparing to teach a client with a new colostomy about how to perform a colostomy irrigation. Which information would the nurse include in the teaching plan?

1.Use 500 to 1000 mL of warm tap water.
2.Suspend the irrigant 36 inches above the stoma.
3.Insert the irrigation cone ½ inch into the stoma.
4.If cramping occurs, open the irrigation clamp farther.

The nurse is completing an admission assessment for a client with suspected esophageal cancer. Which statement made by the client indicates the presence of a risk factor for esophageal cancer?

1."I've been smoking for 20 years now."
2."I eat plenty of fresh fruits and vegetables."
3."I'm 5 feet, 8 inches tall and weigh 160 pounds."
4."My alcohol consumption is about 2 beers per month."

The nurse is caring for a client who has just returned from the operating room after colectomy to remove a bowel tumor and the creation of a colostomy. The nurse is assessing the drainage in the pouch attached to the site where the colostomy was formed and notes serosanguineous drainage. Which nursing action is appropriate based on this assessment?

1.Apply ice to the stoma site.
2.Apply pressure to the stoma site.
3.Notify the primary health care provider (PHCP).
4.Document the amount and characteristics of the drainage.

The nurse is caring for a client postoperatively after creation of a colostomy to treat a bowel tumor. What is an appropriate potential client problem?

1.Fear
2.Sexual dysfunction
3.Altered body image
4.Excessive nutritional intake

The nurse is reviewing laboratory test results for the client with liver cancer and notes that the client's albumin level is low. Which nursing action is focused on the consequence of low albumin levels?

1.Evaluating for asterixis
2.Inspecting for petechiae
3.Palpating for peripheral edema
4.Evaluating for decreased level of consciousness

When assessing a lesion diagnosed as basal cell carcinoma, the nurse most likely expects to note which findings? Select all that apply.

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
5.Location in the bald spot atop the head that is exposed to outdoor sunlight

The nurse in the ambulatory care unit is providing home care instructions to a client after cryotherapy for the treatment of malignant skin lesions. Which statement would be most appropriate for the nurse to include in the home care instructions for this client?


1."Apply ice to the site to prevent swelling."
2."Clean the site with alcohol 3 times daily."
3."Apply a warm, damp washcloth if discomfort occurs."
4."Avoid showering or taking baths until seen by the primary health care provider in 1
week."

The nurse is providing information to a client scheduled for a skin biopsy. The
client asks the nurse how painful the procedure is. The nurse would plan to make
which response to the client?

1."The procedure is painless."
2."A preoperative medication will put you to sleep."
3."An analgesic will be prescribed after the procedure."
4."The local anesthetic may cause a stinging sensation."

The nurse is reviewing the discharge instructions for the client who had a skin biopsy of a suspected cancer lesion. Which statement, if made by the client, would indicate a need for further instruction?

1."I will keep the dressing dry."
2."I will watch for any drainage from the wound."
3."I will use the antibiotic ointment as prescribed."
4."I will return tomorrow to have the sutures removed."

The nurse has provided discharge instructions to a client who has had cryosurgery to remove a malignant skin lesion. The nurse determines that the client understands the instructions if the client makes which statements? Select all that apply.

1."I need to avoid baths or showers for 7 to 10 days."
2."I need to clean the site as prescribed to prevent infection."
3."I need to apply ice to the site continuously to prevent swelling."
4."I need to expect some swelling and tenderness in the affected area."
5."I need to apply alcohol-soaked dressings twice a day for 30 minutes each time."

The nurse is providing home care instructions to the client who just had surgery for squamous cell carcinoma. The nurse provides follow-up teaching and explains to the client to watch for which characteristics of this type of skin carcinoma?

1.Irregularly shaped, pigmented papules or plaques
2.Pearly papule with a central crater and rolled, waxy borders
3.Small macules or papules with dry, rough, adherent yellow or brown scale
4.Firm, nodular lesion topped with a crust or with a central area of ulceration

The nurse is teaching the client about risk factors for skin cancer. Which statements by the client indicate that teaching was successful? Select all that apply.

1."I have to avoid excessive exposure to sunlight."
2."My dark skin color predisposes me to skin cancer."
3."I am at higher risk for skin cancer because my parent had it."
4."I am at higher risk for skin cancer because I am 20 years old."
5."I am immune to skin cancer because I work as a pest control exterminator."

The nurse is providing teaching to a client with breast cancer who will undergo chemotherapy for cancer, and alopecia is expected from the chemotherapeutic agent. Which statement made by the client indicates a need for further teaching?

1."Excessive hair brushing needs to be avoided."
2."I can't believe my hair loss is going to be permanent."
3."I guess I'll have to stop using my electric hair dryer and curling rod."
4."I will have my hair stylist cut my hair short just before I start my treatments."

The nurse in the surgical care center will be assisting the primary health care provider to perform a punch biopsy of a client's skin lesion that is suspicious for skin cancer. Which interventions would be included in the preprocedure plan of
care? Select all that apply.

1.Obtain an informed consent.
2.Clean the area of the lesion with water.
3.Prepare to apply direct pressure to the biopsy site after the procedure.
4.Tell the client that a small piece of tissue will be removed for examination.
5.Teach the client about the need to cleanse the site postprocedure with hydrogen peroxide
and a topical corticosteroid every 4 hours.

A client scheduled for a skin biopsy of a lesion suspected to be cancerous is concerned and asks the nurse how painful the procedure is. Which statement is the appropriate response by the nurse?

1."There is no pain associated with this procedure."
2."The local anesthetic may cause a burning or stinging sensation."
3."A preoperative medication will be given, so you will be sleeping and will not feel any
pain."
4."There is some pain, but the primary health care provider will prescribe an opioid analgesic after the procedure."

The nurse is reviewing the postprocedure plan of care formulated by a nursing student for a client with prostate cancer who is scheduled for a bone biopsy to assess a bone tumor. The nurse determines that the student needs additional
teaching about postprocedure care if which inaccurate intervention is documented?

1.Elevating the limb
2.Monitoring vital signs every 4 hours
3.Administering opioid analgesics intramuscularly
4.Monitoring the biopsy site for swelling, bleeding, or hematoma

A client who had cranial surgery 5 days earlier to remove a brain tumor has a few cognitive deficits and does not seem to be progressing as quickly as the client or family had hoped. The nurse plans to implement which approach as most helpful to the client and family at this time?

1.Emphasize progress in a realistic manner.
2.Set high goals to give the client something to "aim for."
3.Tell the family to be extremely optimistic with the client.
4.Inform the client and family of standardized goals of care.

A client had a transsphenoidal resection of the pituitary gland to remove a pituitary tumor. The nurse notes drainage on the nasal dressing.
Suspecting cerebrospinal fluid (CSF) leakage, the nurse would look for drainage that is of which characteristic?

1.Serosanguineous only
2.Bloody with very small clots
3.Sanguineous only with no clot formation
4.Serosanguineous, surrounded by clear to straw-colored fluid

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 creating 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

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

A client is diagnosed as having a bowel tumor. The nurse would 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 has admitted a client to the clinical nursing unit after undergoing a right mastectomy. The nurse would 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 is participating in a health screening clinic and is preparing teaching materials about colorectal cancer. Which risk factor for colorectal cancer would
the nurse include? 

1.High-fiber, low-fat diet
2.Age older than 30 years
3.Distant relative with colorectal cancer
4.Personal history of ulcerative colitis or gastrointestinal polyps

The nurse is teaching a client who has had a laryngectomy for laryngeal cancer how to use an artificial larynx. Which statement would 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 removal of a cervical radiation implant used to treat 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 instruction?

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 who is receiving external radiation therapy to the breast for the treatment of cancer. 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 bags of groceries 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 the 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 preparing to provide instructions to a client after a vulvectomy. Which instruction would 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 client who underwent cryosurgery with laser therapy because of a positive Papanicolaou test. Which statement by the client indicates an understanding of the instructions?

1."I need to take sitz baths every 4 hours for the next week."
2."I would expect the vaginal discharge to be clear and watery."
3."Very strong pain medications will be needed to relieve any discomfort I may have."
4."If I note any odor to the vaginal discharge, I would call the primary 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 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 need to 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 home care nurse visits a client who has just returned home from the hospital after a mastectomy with a suction drain in place. Which observed client behavior requires a need for further teaching?

1.Empties the drain to prevent infection
2.Elevates the arm when lying and sitting
3.Applies lotion to the area after the incision heals
4.Performs full range-of-motion exercises to the upper arm

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 mm3 (200 × 109/L). The nurse would prepare to implement which 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 check which diagnostic test noted in the client's record to determine the stage of the disease?


1.Blood studies
2.Bone marrow examination
3.Excisional lymph node biopsy
4.Positron emission topography (PET) scan

The nurse is reviewing the laboratory test results for a client with bladder cancer with bone metastasis. The nurse would contact the primary health care provider (PHCP) if which finding is noted?


1.Calcium level of 15 mg/dL (3.75 mmol/L)
2.Potassium level of 3.8 mEq/L (3.8 mmol/L)
3.Platelet count of 200,000 mm3 (200 × 109/L)
4.White blood cell (WBC) count of 6000 mm3 (6 × 109/L)

The community health nurse has conducted a teaching session for community members about the risk factors for laryngeal cancer. Which statement by a person attending the session indicates that teaching was effective?

1."Alcohol consumption is not associated with this type of cancer."
2."Exposure to airborne carcinogens can cause 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 early signs and symptoms of the disease?


1.Proteinuria and dysuria
2.Hematuria and absence of pain
3.Painful urination and hematuria
4.Pyuria and palpable abdominal mass

The nurse is caring for a client who the physician suspects could have leukemia. The nurse anticipates that the physician will prescribe which of the following to confirm the diagnosis?

1.Platelet count
2.Bone marrow biopsy
3.White blood cell count
4.Complete blood cell count

The nurse conducted discharge teaching for the client diagnosed with melanoma. Which statement by a client indicates that education was effective?

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 would 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 are 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 with leukemia receiving chemotherapy. The nurse notes that the white blood cell and neutrophil counts are extremely low and places the client on neutropenic precautions. Which interventions are components 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 types 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

A client has just been told by the primary health care provider about a diagnosis of breast cancer. The client responds, "Oh, no! Does this mean I'm going to die? The nurse interprets the client's initial reaction as which response?


Fear
Rage
Denial
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 to treat lung cancer?

"I need to eat a high-protein diet."
"I need to avoid exposure to sunlight."
"I need to wash my skin with a mild soap and pat dry."
"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?

"I know to report any small lumps."
"I examine myself every 2 months."
"I examine myself after I take a warm shower."
"I feel something like a cord in the 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 would consider developing a plan of care for which possible medical diagnosis?


Thyroid cancer
Acute laryngitis
Laryngeal cancer
Bronchogenic cancer

A client calls the ambulatory care clinic and tells the nurse that they 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's best response to this client?

-"Good job performing your BSE. I am sure that is nothing to be concerned about."
-"Make sure you tell the primary health care provider about your finding at the next regularly scheduled visit."
-"I am glad you called to report this finding. Can you come to the clinic to see your
primary health care provider tomorrow?"
-"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?

Age and race
Marital status
Number of children
Number of sexual partners

Which interventions are the most appropriate for a client who is experiencing thrombocytopenia? Select all that apply.

-Use a straight-edge razor for shaving.
-Obtain a rectal temperature every 8 hours.
-Check secretions for frank or occult blood.
-Give vitamin K by the intramuscular route.
-Encourage fluid intake to avoid constipation.
-Provide oral sponges or a soft toothbrush for oral care.

The nurse is providing care to a client who has undergone modified right mastectomy for the treatment of breast cancer. Which activity would the nurse incorporate into the plan of care?

-Keep suction drains fully inflated to provide adequate suction.
-Perform venipunctures and blood pressures on the operative side only.
-Inform the client that drains will be removed on the second postoperative day.
-Maintain head of the bed elevation at 30 degrees with the right arm elevated on a pillow.

The community health nurse is preparing an educational session for a group of clients and will be discussing the primary prevention strategies and treatment measures for breast cancer. What information would the nurse include in the
educational session?

-Older individuals are more likely to get mammograms.
-Treatment decisions are based on a individual's overall health.
-Those younger than age 65 are more likely to get breast cancer.
-An individual's age is the main factor used to decide which screening methods to use.

The community nurse is planning to conduct a health promotion program at a local school to discuss the risk factors associated with cervical cancer. Which are risk factors for cervical cancer? Select all that apply.

-Smoking
-Chlamydia infection
-Human papillomavirus infection
-Having a family history of cervical cancer
-Gynecological screening exams (Pap smears) starting at age 21

The nurse would include which intervention in the care of a client who has undergone a vaginal hysterectomy for the treatment of cancer? Select all that apply.

-Elevate the knee gatch on the bed.
-Encourage ambulation as prescribed.
-Remove antiembolism stockings twice daily.
-Assist with range-of-motion (ROM) leg exercises.
-Check placement of pneumatic compression boots

The oncology nurse specialist provides an educational session for 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?

-Reed-Sternberg cells are present.
-The lymph nodes, spleen, and liver are involved.
-The prognosis depends on the stage of the disease.
-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?


-Alopecia
-Back pain
-Painless testicular swelling
-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?


-Dyspnea
-Diarrhea
-Sore throat
-Constipation

A cervical radiation implant is placed in a client who is undergoing treatment of cervical cancer. The nurse would initiate which activity prescription as the most appropriate for this client?

-Bed rest
-Out of bed ad lib
-Out of bed in a chair only
-Ambulation to the bathroom only

The client reports to the nurse that while performing testicular self-examination, a lump the size and shape of a pea was found. Which statement is the most appropriate response to the client?

-"Lumps like that are normal. Don't worry."
-"Let me know if it gets bigger next month."
-"That's important to report even though it might not be serious."
-"That could be cancer. I'll ask the primary health care provider to examine you."

The nurse is admitting a client with laryngeal cancer to the nursing unit. What would the nurse assess for as the most common risk factor for this type of
cancer?


-Alcohol abuse
-Cigarette smoking
-Use of chewing tobacco
-Exposure to air pollutants

The nurse is reviewing the preoperative prescriptions for a client with a colon tumor who is scheduled for abdominal perineal resection and notes that the primary health care provider has prescribed neomycin for the client. After discussing a prescription for neomycin with the nursing student who is caring for the client, the nurse determines that the student understands the rationale for administration if which statement is made?


-"The client is allergic to penicillin."
-"It will help to decrease the bacteria in the bowel."
-"It is given to prevent an immune dysfunction postoperatively."
-"It is given because the client has an infection that must be treated prior to surgery."

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 would be included in the instructions? Select all that apply.


-Protect the stoma from water.
-Use a humidifier if dryness is a problem.
-Keep powders and sprays away from the stoma site.
-Use an air conditioner to provide cool air to assist in breathing.
-Apply a thin layer of non–oil-based ointment to the skin around the stoma to prevent cracking.

Which statement made by a client who will undergo cytoreductive (debulking) surgery for ovarian cancer indicates that teaching by the nurse was effective?


-"The surgery will remove precancerous tissue."
-"The surgery will help to reduce the size of the tumor."
-"The surgery will cure the cancer by removing all small and large tumor cells."
-"The goal of this surgery is to improve my appearance so I will feel better about myself."

The nurse is caring for a client with prostate cancer who is being treated with a hormone therapy. What would the nurse monitor for in order to evaluate the
effect of this treatment?

-An increase in testosterone levels
-An increase in prostaglandin levels
-An increase the amount of circulating androgens
-A decline in the amount of circulating androgens

The nurse is caring for a client with cancer of the prostate who has undergone a prostatectomy. Which action would the nurse plan to include in discharge instructions?

-Avoid driving the car for a few days.
-Restrict fluid intake to prevent incontinence.
-Avoid lifting objects heavier than 20 Lb (9 kg) for at least 6 weeks.
-Notify the primary health care provider if small blood clots are noticed during urination.

The oncology nurse is providing a teaching session for 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?


-"Bladder cancer most often occurs in women."
-"Using cigarettes and drinking coffee can increase the risk."
-"Bladder cancer generally is seen in clients older than age 40."
-"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. What would the
nurse instruct the client to do after the instillation?

-Urinate immediately.
-Maintain strict bed rest.
-Change position every 15 minutes.
-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?


-Smoking
-A low-fat diet
-Foods containing nitrates
-A diet of smoked, highly salted, and spiced foods

A client with leukemia is receiving busulfan and allopurinol. The nurse would plan to tell the client that the purpose of the allopurinol is to prevent which problem?

-Nausea
-Alopecia
-Vomiting
-High uric acid levels

A 67-year-old client 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.


-Teach the client to speak slowly.
-Teach the client to enunciate clearly.
-Encourage the client to drink only thin liquids.
-Teach the client to examine the oral mucosa daily.
-Encourage the client 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 hair loss and severe fatigue from the treatment. Which interventions would the nurse plan to implement for this client? Select all that apply.


-Review side effects of chemotherapy and treatment with the client.
-Teach the client how to resolve specific concerns of her personal life.
-Teach the client to pace activities with rest so as to maintain strength.
-Offer information on available counseling services and support groups.
-Tell the client about some other clients who have had breast cancer treatment.
-Inquire how the cancer diagnosis and treatment affect the client's normal routine.

The nurse is monitoring a client with chronic lymphocytic leukemia (CLL). Which sign would the nurse specifically monitor for and report to the primary health care provider?

-Anemia
-Bleeding
-Pancytopenia
-Lymphadenopathy

A client with bladder cancer has undergone surgical removal of the bladder with creation of an ileal conduit. Which assessment findings indicate that the client is developing complications? Select all that apply.


-Dusky appearance of the stoma
-Stoma protrusion from the skin
-Sharp abdominal pain with rigidity
-Urine output greater than 30 mL/hour
-Mucous shreds in the urine collection bag

A client who is receiving chemotherapy for breast cancer develops myelosuppression. Which instructions would the nurse plan to include in the
client's discharge teaching plan? Select all that apply.


-Avoid contact sports.
-Wash hands frequently.
-Increase intake of fresh fruits and vegetables.
-Avoid crowded places such as shopping malls.
-Treat a sore throat with over-the-counter products.
-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 would monitor the client for which side and adverse effects of external radiation? Select all that apply.

-Cystitis
-Stomatitis
-Dysgeusia
-Leukopenia
-Xerostomia
-Thrombocytopenia

The nurse in the primary health care provider's office is performing a postoperative assessment of a client who underwent right mastectomy 2 weeks
ago. The client tells the nurse that they are very concerned because they have numbness in the area of the surgery and along the inner side of the arm from the armpit to the elbow. The nurse would provide which information to the client about this concern?

-These sensations are signs of a complication.
-These sensations probably will be permanent.
-These sensations dissipate over several months and usually resolve after 1 year.
-It is nothing to worry about because most people who have this type of surgery experience this problem.