1

1. Marco who was diagnosed with brain tumor was scheduled for craniotomy. In A. Flapping hand tremors
preventing the development of cerebral edema after surgery, the nurse should B. An elevated hematocrit level
expect the use of: C. Hypotension
A. Diuretics D. Hypokalemia
B. Antihypertensive
C. Steroids 6. A client is admitted to the hospital with benign prostatic hyperplasia, the
D. Anticonvulsants nurse most relevant assessment would be:
A. Flank pain radiating in the groin
2. Halfway through the administration of blood, the female client complains of B. Distention of the lower abdomen
lumbar pain. After stopping the infusion Nurse Hazel should: C. Perineal edema
A. Increase the flow of normal saline D. Urethral discharge
B. Assess the pain further
C. Notify the blood bank 7. A client has undergone with penile implant. After 24 hrs of surgery, the
D. Obtain vital signs. client’s scrotum was edematous and painful. The nurse should:
A. Assist the client with sitz bath
3. Nurse Maureen knows that the positive diagnosis of HIV infection is made B. Apply war soaks in the scrotum
based on which of the following: C. Elevate the scrotum using a soft support
A. A history of high-risk sexual behaviors. D. Prepare for a possible incision and drainage
B. Positive ELISA and western blot tests
C. Identification of an associated opportunistic infection 8. Nurse Hazel receives emergency laboratory results for a client with chest
D. Evidence of extreme weight loss and high fever pain and immediately informs the physician. An increased myoglobin level
suggests which of the following?
4. Nurse Maureen is aware that a client who has been diagnosed with chronic A. Liver disease
renal failure recognizes an adequate amount of high-biologic-value protein when B. Myocardial damage
the food the client selected from the menu was: C. Hypertension
A. Raw carrots D. Cancer
B. Apple juice
C. Whole wheat bread 9. Nurse Maureen would expect a client with mitral stenosis would demonstrate
D. Cottage cheese symptoms associated with congestion in the:
A. Right atrium
5. Kenneth who was diagnosed with uremic syndrome has the potential to B. Superior vena cava
develop complications. Which among the following complications should the C. Aorta
nurse anticipates: D. Pulmonary
 2

10. A client has been diagnosed with hypertension. The nurse priority nursing C. Grains
diagnosis would be: D. Broccoli
A. Ineffective health maintenance
B. Impaired skin integrity 15. Karen has been diagnosed with aplastic anemia. The nurse monitors for
C. Deficient fluid volume changes in which of the following physiologic functions?
D. Pain A. Bowel function
B. Peripheral sensation
11. Nurse Hazel teaches the client with angina about common expected side C. Bleeding tendencies
effects of nitroglycerin including: D. Intake and output
A. high blood pressure
B. stomach cramps 16. Lydia is scheduled for elective splenectomy. Before the client goes to surgery,
C. headache the nurse in charge final assessment would be:
D. shortness of breath A. signed consent
B. vital signs
12. The following are lipid abnormalities. Which of the following is a risk factor C. name band
for the development of atherosclerosis and PVD? D. empty bladder
A. High levels of low-density lipid (LDL) cholesterol
B. High levels of high-density lipid (HDL) cholesterol 17. What is the peak age range for acquiring acute lymphocytic leukemia(ALL)?
C. Low concentration triglycerides A. 4 to 12 years.
D. Low levels of LDL cholesterol. B. 20 to 30 years
C. 40 to 50 years
13. Which of the following represents a significant risk immediately after D. 60 60 70 years
surgery for repair of aortic aneurysm?
A. Potential wound infection 18. Marie with acute lymphocytic leukemia suffers from nausea and headache.
B. Potential ineffective coping These clinical manifestations may indicate all of the following except:
C. Potential electrolyte balance A. effects of radiation
D. Potential alteration in renal perfusion B. chemotherapy side effects
C. meningeal irritation
14. Nurse Josie should instruct the client to eat which of the following foods to D. gastric distension
obtain the best supply of Vitamin B12?
A. dairy products 19. A client has been diagnosed with Disseminated Intravascular
B. vegetables Coagulation(DIC). Which of the following is contraindicated with the client?
 3

A. Administering Heparin 24. Patricia a 20-year-old college student with diabetes mellitus requests
B. Administering Coumadin additional information about the advantages of using a pen-
C. Treating the underlying cause like insulin delivery devices. The nurse explains that the advantages of these
D. Replacing depleted blood products devices over syringes include:
A. Accurate dose delivery
20. Which of the following findings is the best indication that fluid replacement B. Shorter injection time
for the client with hypovolemic shock is adequate? C. Lower cost with reusable insulin cartridges
A. Urine output greater than 30ml/hr D. Use of smaller gauge needle.
B. Respiratory rate of 21 breaths/minute
C. Diastolic blood pressure greater than 90 mmHg 25. A male client’s left tibia was fractured in an automobile accident, and a cast
D. Systolic blood pressure greater than 110 mmHg is applied. To assess for damage to major blood vessels from the fracture tibia,
the nurse in charge should monitor the client for:
21. Which of the following signs and symptoms would Nurse Maureen include in A. Swelling of the left thigh
teaching plan as an early manifestation of laryngeal cancer? B. Increased
A. Stomatitis skin temperature of the foot
B. Airway obstruction C. Prolonged reperfusion of the toes after blanching
C. Hoarseness D. Increased blood pressure
D. Dysphagia
26. After a long leg cast is removed, the male client should:
22. Karina a client with myasthenia gravis is to receive immunosuppressive A. Cleanse the leg by scrubbing with a brisk motion
therapy. The nurse understands that this therapy is effective because it: B. Put leg through full range of motion twice daily
A. Promotes the removal of antibodies that impair the transmission of impulses C. Report any discomfort or stiffness to the physician
B. Stimulates the production of acetylcholine at the neuromuscular junction. D. Elevate the leg when sitting for long periods of time.
C. Decreases the production of autoantibodies that attack the acetylcholine receptors.
D. Inhibits the breakdown of acetylcholine at the neuromuscular junction. 27. While performing a physical assessment of a male client with gout of the
great toe, Nurse Vivian should assess for additional tophi (urate deposits) on the:
23. A female client is receiving IV Mannitol. An assessment specific to safe A. Buttocks
administration of the said drug is: B. Ears
A. Vital signs q4h C. Face
B. Weighing daily D. Abdomen
C. Urine output hourly
D. Level of consciousness q4h 28. Nurse Katrina would recognize that the demonstration of crutch walking
with tripod gait was understood when the client places weight on the:
 4

A. Palms of the hands and axillary regions 33. A 22-year-old client suffered from his first tonic-clonic seizure. Upon
B. Palms of the hand awakening, the client asks the nurse, “What caused me to have a seizure? Which
C. Axillary regions of the following would the nurse include in the primary cause of tonic-clonic
D. Feet, which are set apart seizures in adults more the 20 years?
A. Electrolyte imbalance
29. Mang Jose with rheumatoid arthritis states, “the only time I am without pain B. Head trauma
is when I lie in bed perfectly still”. During the convalescent stage, the nurse in C. Epilepsy
charge with Mang Jose should encourage: D. Congenital defect
A. Active joint flexion and extension
B. Continued immobility until pain subsides 34. What is the priority nursing assessment in the first 24 hours after admission
C. Range of motion exercises twice daily of the client with thrombotic CVA?
D. Flexion exercises three times daily A. Pupil size and pupillary response
B. cholesterol level
30. A male client has undergone spinal surgery, the nurse should: C. Echocardiogram
A. Observe the client’s bowel movement and voiding patterns D. Bowel sounds
B. Log-roll the client to prone position
C. Assess the client’s feet for sensation and circulation 35. Nurse Linda is preparing a client with multiple sclerosis for discharge from
D. Encourage client to drink plenty of fluids the hospital to home. Which of the following instruction is most appropriate?
A. “Practice using the mechanical aids that you will need when future disabilities
31. Marina with acute renal failure moves into the diuretic phase after one week arise”.
of therapy. During this phase the client must be assessed for signs of developing: B. “Follow good health habits to change the course of the disease”.
A. Hypovolemia C. “Keep active, use stress reduction strategies, and avoid fatigue”.
B. renal failure D. “You will need to accept the necessity for a quiet and inactive lifestyle”.
C. metabolic acidosis 36. The nurse is aware the early indicator of hypoxia in the unconscious client is:
D. hyperkalemia A. Cyanosis
32. Nurse Judith obtains a specimen of clear nasal drainage from a client with a B. Increased respirations
head injury. Which of the following tests differentiates mucus C. Hypertension
from cerebrospinal fluid (CSF)? D. Restlessness
A. Protein
B. Specific gravity 37. A client is experiencing spinal shock. Nurse Myrna should expect the
C. Glucose function of the bladder to be which of the following?
D. Microorganism A. Normal
B. Atonic
 5

C. Spastic C. 33-year-old client

D. Uncontrolled D. 15-year-old client

38. Which of the following stage is the carcinogen irreversible? 43. Nurse Jon assesses vital signs on a client undergone epidural anesthesia.
A. Progression stage Which of the following would the nurse assess next?
B. Initiation stage A. Headache
C. Regression stage B. Bladder distension
D. Promotion stage C. Dizziness
D. Ability to move legs
39. Among the following components thorough pain assessment, which is the
most significant? 44. Nurse Katrina should anticipate that all of the following drugs may be used
A. Effect in the attempt to control the symptoms of Ménière’s Disease except:
B. Cause A. Antiemetics
C. Causing factors B. Diuretics
D. Intensity C. Antihistamines
D. Glucocorticoids
40. A 65 year old female is experiencing flare-up of pruritus. Which of the
client’s action could aggravate the cause of flare-ups? 45. Which of the following complications associated with tracheostomytube?
A. Sleeping in cool and humidified environment A. Increased cardiac output
B. Daily baths with fragrant soap B. Acute respiratory distress syndrome (ARDS)
C. Using clothes made from 100% cotton C. Increased blood pressure
D. Increasing fluid intake D. Damage to laryngeal nerves

41. Atropine sulfate (Atropine) is indicated in all but one of the following client? 46. Nurse Faith should recognize that fluid shift in an client with burn injury
A. A client with high blood results from increase in the:
B. A client with bowel obstruction A. Total volume of circulating whole blood
C. A client with glaucoma B. Total volume of intravascular plasma
D. A client with U.T.I. C. Permeability of capillary walls
D. Permeability of kidney tubules
42. Among the following clients, which among them is high risk for potential
hazards from the surgical experience? 47. An 83-year-old woman has several ecchymotic areas on her right arm. The
A. 67-year-old client bruises are probably caused by:
B. 49-year-old client
 6

A. increased capillary fragility and permeability A. Decrease in pH (due to increased lactate production)
B. increased blood supply to the skin B. Increased Oxidative phosporylation
C. self-inflicted injury C. Influx of calcium
D. elder abuse D. Influx of potassium

48. Nurse Anna is aware that early adaptation of client with renal carcinoma is: 3. Adaptive cell responses such as aplasia and atrophy are potentially reversible
A. nausea and vomiting processes.
B. flank pain A. True
C. weight gain B. False
D. intermittent hematuria
4. After an accident, you are unable to workout for months and so your muscles
49. A male client with tuberculosis asks Nurse Brian how long the chemotherapy (skeletal) are looking smaller than usual. What has happened here? (select 2)
must be continued. Nurse Brian’s accurate reply would be: Discuss
A. 1 to 3 weeks A. Muscle atrophy
B. 6 to 12 months B. Muscle aplasia
C. 3 to 5 months C. Muscle Hypertrophy
D. 3 years and more D. Muscle Hyperplasia
E. The size of the muscle cells shrunk over time
50. A client has undergone laryngectomy. The immediate nursing priority would F. The number of muscle cells has decreased over time
be:
A. Keep trachea free of secretions
B. Monitor for signs of infection 5. A patient comes in after surgery after being diagnosed with a rare condition in
C. Provide emotional support which small bone formations have developed intraocularly. You diagnose this as ...
D. Promote means of communication Discuss
A. Intraocular squamous metaplasia
B. Intraocular myeloid metaplasia
1. Which of the following is the most common cause of cell injury? C. A vitamin A deficiency
A. Chemical injury D. Intraocular osseous metaplasia
B. Hypoxia
C. Infections 6. Intradermal nevi fall into which category?
D. Immunologic and Autoimmune diseases A. Aplasia
B. Dysplasia
2. A decrease in ATP will have which of the following cellular effects? (select 2) C. Hyperplasia
 7

D. Metaplasia A. Decreased apoptosis of cells

B. Increased apoptosis of cells
7. AMD occurs when _______ accumulates in the retina and eventually causes C. No change in apoptosis of cells
macular degeneration. This combination of _______ accumulation and atrophy can be
referred to as __________ 13. Necrosis which occurred secondary to vascular occlusion and affected lower
A. Lipofuscin, Lipofuscin, Brown Atrophy extremities would most likely be called
B. Lipofuscin, Bilirubin, Icterus A. Gangrenous necrosis
C. Hemosiderin, Hemosiderin, Jaundice B. Coagulation necrosis
D. Lipofuscin, Lipofuscin, Dystrophic Calcification C. Liquefaction necrosis
D. Casseous necrosis
8. Which of the following is not a sign of irreversible cell injury?
A. Severe membrane damage
B. Lysosomal rupture
C. Pigment accumulation (lipofuscin, hemosiderin, melanin, ...) 1. A male client has an abnormal result on a Papanicolaou test. After admitting,
D. Pyknosis he read his chart while the nurse was out of the room, the client asks what
E. Karyolysis dysplasia means. Which definition should the nurse provide?
A. Presence of completely undifferentiated tumor cells that don’t resemble cells of the
10. After an ischemic injury, which of the following will survive the longest without tissues of their origin
irreversible cell damage? B. Increase in the number of normal cells in a normal arrangement in a tissue or an
A. Bicep muscle cells organ
B. Liver cells C. Replacement of one type of fully differentiated cell by another in tissues where the
C. Myocardial cells second type normally isn’t found
D. Neurons D. Alteration in the size, shape, and organization of differentiated cells

11. All of the following are markers of irreversible cell damage, eventually leading to 2. For a female client with newly diagnosed cancer, the nurse formulates
cell death, except for? a nursing diagnosis of Anxiety related to the threat of death secondary to cancer
A. Lysergic acid diethylamide (LSD) diagnosis. Which expected outcome would be appropriate for this client?
B. Aspartate aminotransferase (AST) A. “Client verbalizes feelings of anxiety.”
C. Creatine phospokinase (CPK) B. “Client doesn’t guess at prognosis.”
D. Lactate dehydrogenase (LDH) C. “Client uses any effective method to reduce tension.”
D. “Client stops seeking information.”
12. If tumor suppressor p53 was deactivated, which of the following would be
expected to occur
 8

3. A male client with a cerebellar brain tumor is admitted to an acute care 7. A female client is receiving chemotherapy to treat breast cancer. Which
facility. The nurse formulates a nursing diagnosis of Risk for injury. Which assessment finding indicates a fluid and electrolyte imbalance induced by
“related-to” phrase should the nurse add to complete the nursing diagnosis chemotherapy?
statement? A. Urine output of 400 ml in 8 hours
A. Related to visual field deficits B. Serum potassium level of 3.6 mEq/L
B. Related to difficulty swallowing C. Blood pressure of 120/64 to 130/72 mm Hg
C. Related to impaired balance D. Dry oral mucous membranes and cracked lips
D. Related to psychomotor seizures
8. Nurse April is teaching a group of women to perform breast self-examination.
4. A female client with cancer is scheduled for radiation therapy. The nurse The nurse should explain that the purpose of performing the examination is to
knows that radiation at any treatment site may cause a certain adverse effect. discover:
Therefore, the nurse should prepare the client to expect: A. cancerous lumps.
A. hair loss. B. areas of thickness or fullness.
B. stomatitis. C. changes from previous self-examinations.
C. fatigue. D. fibrocystic masses.
D. vomiting.
9. A client, age 41, visits the gynecologist. After examining her, the physician
5. Nurse April is teaching a client who suspects that she has a lump in her breast. suspects cervical cancer. The nurse reviews the client’s history for risk factors
The nurse instructs the client that a diagnosis of breast cancer is confirmed by: for this disease. Which history finding is a risk factor for cervical cancer?
A. breast self-examination. A. Onset of sporadic sexual activity at age 17
B. mammography. B. Spontaneous abortion at age 19
C. fine needle aspiration. C. Pregnancy complicated with eclampsia at age 27
D. chest X-ray. D. Human papillomavirus infection at age 32

6. A male client undergoes a laryngectomy to treat laryngeal cancer. When 10. A female client is receiving methotrexate (Mexate), 12 g/m2 I.V., to
teaching the client how to care for the neck stoma, the nurse should include treat osteogenic carcinoma. During methotrexate therapy, the nurse expects the
which instruction? client to receive which other drug to protect normal cells?
A. “Keep the stoma uncovered.” A. probenecid (Benemid)
B. “Keep the stoma dry.” B. cytarabine (ara-C, cytosine arabinoside [Cytosar-U])
C. “Have a family member perform stoma care initially until you get used to the C. thioguanine (6-thioguanine, 6-TG)
procedure.” D. leucovorin (citrovorum factor or folinic acid [Wellcovorin])
D. “Keep the stoma moist.”
 9

11. The nurse is interviewing a male client about his past medical history. Which 15. Nurse Lucia is providing breast cancer education at a community facility.
preexisting condition may lead the nurse to suspect that a client has colorectal The American Cancer Society recommends that women get mammograms:
cancer? A. yearly after age 40.
A. Duodenal ulcers B. after the birth of the first child and every 2 years thereafter.
B. Hemorrhoids C. after the first menstrual period and annually thereafter.
C. Weight gain D. every 3 years between ages 20 and 40 and annually thereafter.
D. Polyps
16. Which intervention is appropriate for the nurse caring for a male client in
12. Nurse Amy is speaking to a group of women about early detection of breast severe pain receiving a continuous I.V. infusion of morphine?
cancer. The average age of the women in the group is 47. Following the A. Assisting with a naloxone challenge test before therapy begins
American Cancer Society guidelines, the nurse should recommend that the B. Discontinuing the drug immediately if signs of dependence appear
women: C. Changing the administration route to P.O. if the client can tolerate fluids
A. perform breast self-examination annually. D. Obtaining baseline vital signs before administering the first dose
B. have a mammogram annually.
C. have a hormonal receptor assay annually. 17. A 35 years old client with ovarian cancer is prescribed hydroxyurea
D. have a physician conduct a clinical examination every 2 years. (Hydrea), an antimetabolite drug. Antimetabolites are a diverse group of
antineoplastic agents that interfere with various metabolic actions of the cell.
13. A male client with a nagging cough makes an appointment to see the The mechanism of action of antimetabolites interferes with:
physician after reading that this symptom is one of the seven warning signs of A. cell division or mitosis during the M phase of the cell cycle.
cancer. What is another warning sign of cancer? B. normal cellular processes during the S phase of the cell cycle.
A. Persistent nausea C. the chemical structure of deoxyribonucleic acid (DNA) and chemical binding
B. Rash between DNA molecules (cell cycle–nonspecific).
C. Indigestion D. one or more stages of ribonucleic acid (RNA) synthesis, DNA synthesis, or both
D. Chronic ache or pain (cell cycle–nonspecific).

14. For a female client newly diagnosed with radiation-induced 18. The ABCD method offers one way to assess skin lesions for possible skin
thrombocytopenia, the nurse should include which intervention in the plan of cancer. What does the A stand for?
care? A. Actinic
A. Administering aspirin if the temperature exceeds 102° F (38.8° C) B. Asymmetry
B. Inspecting the skin for petechiae once every shift C. Arcus
C. Providing for frequent rest periods D. Assessment
D. Placing the client in strict isolation
 10

19. When caring for a male client diagnosed with a brain tumor of the parietal A. Have a digital rectal examination and prostate-specific antigen (PSA) test
lobe, the nurse expects to assess: done yearly.
A. short-term memory impairment. B. Have a transrectal ultrasound every 5 years.
B. tactile agnosia. C. Perform monthly testicular self-examinations, especially after age 50.
C. seizures. D. Have a complete blood count (CBC) and blood urea nitrogen (BUN) and
D. contralateral homonymous hemianopia. creatinine levels checked yearly.

20. 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.
21. 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
22. During chemotherapy, an oncology client has a nursing diagnosis of impaired
oral mucous membrane related to decreased nutrition and immunosuppression
secondary to the cytotoxic effects of chemotherapy. Which nursing intervention
is most likely to decrease the pain of stomatitis?
A. Recommending that the client discontinue chemotherapy
B. Providing a solution of hydrogen peroxide and water for use as a mouth rinse
C. Monitoring the client’s platelet and leukocyte counts
D. Checking regularly for signs and symptoms of stomatitis
23. What should a male client over age 52 do to help ensure early identification
of prostate cancer?
24. 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
25. A male client is in isolation after receiving an internal radioactive implant to
treat cancer. Two hours later, the nurse discovers the implant in the bed linens.
What should the nurse do first?
A. Stand as far away from the implant as possible and call for help.
B. Pick up the implant with long-handled forceps and place it in a lead-lined
container.
C. Leave the room and notify the radiation therapy department immediately.
D. Put the implant back in place, using forceps and a shield for self-protection, and
call for help.
26. Jenny, with advanced breast cancer is prescribed tamoxifen (Nolvadex).
When teaching the client about this drug, the nurse should emphasize the
importance of reporting which adverse reaction immediately?
A. Vision changes
B. Hearing loss
C. Headache
D. Anorexia

27. A female client with cancer is being evaluated for possible metastasis. Which
of the following is one of the most common metastasis sites for cancer cells?
A. Liver
B. Colon
C. Reproductive tract
D. White blood cells (WBCs)
28. A 34-year-old female client is requesting information about mammograms
and breast cancer. She isn’t considered at high risk for breast cancer. What
should the nurse tell this client?
A. She should have had a baseline mammogram before age 30.
B. She should eat a low-fat diet to further decrease her risk of breast cancer.
C. She should perform breast self-examination during the first 5 days of
each menstrual cycle.
D. When she begins having yearly mammograms, breast self-examinations will no
longer be necessary.
29. Nurse Brian is developing a plan of care for marrow suppression, the major
dose-limiting adverse reaction to floxuridine (FUDR). How long after drug
administration does bone marrow suppression become noticeable?
A. 24 hours
B. 2 to 4 days
C. 7 to 14 days
D. 21 to 28 days
30. The nurse is preparing for a female client for magnetic resonance imaging
(MRI) to confirm or rule out a spinal cord lesion. During the MRI scan, which of
the following would pose a threat to the client?
A. The client lies still.
B. The client asks questions.
C. The client hears thumping sounds.
D. The client wears a watch and wedding band.
11
31. Nina, an oncology nurse educator, is speaking to a women’s group about
breast cancer. Questions and comments from the audience reveal a
misunderstanding of some aspects of the disease. Various members of the
audience have made all of the following statements. Which one is accurate?
A. Mammography is the most reliable method for detecting breast cancer.
B. Breast cancer is the leading killer of women of childbearing age.
C. Breast cancer requires a mastectomy.
D. Men can develop breast cancer.
32. Nurse Mary is instructing a premenopausal woman about breast self-
examination. The nurse should tell the client to do her self-examination:
A. at the end of her menstrual cycle.
B. on the same day each month.
C. on the 1st day of the menstrual cycle.
D. immediately after her menstrual period.
33. Nurse Kent is teaching a male client to perform monthly testicular self-
examinations. Which of the following points would be appropriate to make?
A. Testicular cancer is a highly curable type of cancer.
B. Testicular cancer is very difficult to diagnose.
C. Testicular cancer is the number one cause of cancer deaths in males.
D. Testicular cancer is more common in older men.
34. Rhea, has malignant lymphoma. As part of her chemotherapy, the physician
prescribes chlorambucil (Leukeran), 10 mg by mouth daily. When caring for the
client, the nurse teaches her about adverse reactions to chlorambucil, such as
alopecia. How soon after the first administration of chlorambucil might this
reaction occur?
A. Immediately
B. 1 week
C. 2 to 3 weeks
D. 1 month

35. A male client is receiving the cell cycle–nonspecific alkylating agent thiotepa
(Thioplex), 60 mg weekly for 4 weeks by bladder instillation as part of a
chemotherapeutic regimen to treat bladder cancer. The client asks the nurse
how the drug works. How does thiotepa exert its therapeutic effects?
A. It interferes with deoxyribonucleic acid (DNA) replication only.
B. It interferes with ribonucleic acid (RNA) transcription only.
C. It interferes with DNA replication and RNA transcription.
D. It destroys the cell membrane, causing lysis.
36. The nurse is instructing the 35 year old client to perform a testicular self-
examination. The nurse tells the client:
A. To examine the testicles while lying down
B. That the best time for the examination is after a shower
C. To gently feel the testicle with one finger to feel for a growth
D. That testicular self-examination should be done at least every 6 months
37. A female client with cancer is receiving chemotherapy and develops
thrombocytopenia. The nurse identifies which intervention as the highest
priority in the nursing plan of care?
A. Monitoring temperature
B. Ambulation three times daily
C. Monitoring the platelet count
D. Monitoring for pathological fractures
38. Gio, a community health nurse, is instructing a group of female clients about
breast self-examination. The nurse instructs the client to perform the
examination:
A. At the onset of menstruation
B. Every month during ovulation
C. Weekly at the same time of day
D. 1 week after menstruation begins
12
39. Nurse Cindy is caring for a client who has undergone a vaginal
hysterectomy. The nurse avoids which of the following in the care of this client?
A. Elevating the knee gatch on the bed
B. Assisting with range-of-motion leg exercises
C. Removal of antiembolism stockings twice daily
D. Checking placement of pneumatic compression boots
40. Mina, who is suspected of an ovarian tumor is scheduled for a pelvic
ultrasound. The nurse provides which preprocedure instruction to the client?
A. Eat a light breakfast only
B. Maintain an NPO status before the procedure
C. Wear comfortable clothing and shoes for the procedure
D. Drink six to eight glasses of water without voiding before the test
41. A male client is diagnosed as having a bowel tumor and several diagnostic
tests are prescribed. The nurse understands that which test will confirm the
diagnosis of malignancy?
A. Biopsy of the tumor
B. Abdominal ultrasound
C. Magnetic resonance imaging
D. Computerized tomography scan
42. A female client diagnosed with multiple myeloma and the client asks the
nurse about the diagnosis. The nurse bases the response on which description of
this disorder?
A. Altered red blood cell production
B. Altered production of lymph nodes
C. Malignant exacerbation in the number of leukocytes
D. Malignant proliferation of plasma cells within the bone
43. Nurse Bea is reviewing the laboratory results of a client diagnosed with
multiple myeloma. Which of the following would the nurse expect to note
specifically in this disorder?

A. Increased calcium
B. Increased white blood cells
C. Decreased blood urea nitrogen level
D. Decreased number of plasma cells in the bone marrow
44. Vanessa, a community health nurse conducts a health promotion program
regarding testicular cancer to community members. The nurse determines that
further information needs to be provided if a community member states that
which of the following is a sign of testicular cancer?
A. Alopecia
B. Back pain
C. Painless testicular swelling
D. Heavy sensation in the scrotum
45. The male client is receiving external radiation to the neck for cancer of
the larynx. The most likely side effect to be expected is:
A. Dyspnea
B. Diarrhea
C. Sore throat
D. Constipation
46. 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?
A. Limit the time with the client to 1 hour per shift
B. Do not allow pregnant women into the client’s room
C. Remove the dosimeter badge when entering the client’s room
D. Individuals younger than 16 years old may be allowed to go in the room as long as
they are 6 feet away from the client
47. 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?
A. Bed rest
B. Out of bed ad lib
13
C. Out of bed in a chair only
D. Ambulation to the bathroom only
48. 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:
A. Call the physician
B. Reinsert the implant into the vagina immediately
C. Pick up the implant with gloved hands and flush it down the toilet
D. Pick up the implant with long-handled forceps and place it in a lead
container.
49. 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:
A. Restrict all visitors
B. Restrict fluid intake
C. Teach the client and family about the need for hand hygiene
D. Insert an indwelling urinary catheter to prevent skin breakdown
50. 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?
A. The client’s pain rating
B. Nonverbal cues from the client
C. The nurse’s impression of the client’s pain
D. Pain relief after appropriate nursing intervention
51. 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?
A. Bowel sounds
B. Ability to ambulate
 14

C. Incision appearance 56. Sarah, a hospice nurse visits a client dying of ovarian cancer. During the
D. Urine specific gravity visit, the client expresses that “If I can just live long enough to attend my
daughter’s graduation, I’ll be ready to die.” Which phrase of coping is this client
52. A male client is admitted to the hospital with a suspected diagnosis of experiencing?
Hodgkin’s disease. Which assessment findings would the nurse expect to note A. Anger
specifically in the client? B. Denial
A. Fatigue C. Bargaining
B. Weakness D. Depression
C. Weight gain
D. Enlarged lymph nodes 57. Nurse Farah is caring for a client following a mastectomy. Which assessment
finding indicates that the client is experiencing a complication related to
53. During the admission assessment of a 35 year old client with advanced the surgery?
ovarian cancer, the nurse recognizes which symptom as typical of the disease? A. Pain at the incisional site
A. Diarrhea B. Arm edema on the operative side
B. Hypermenorrhea C. Sanguineous drainage in the Jackson-Pratt drain
C. Abdominal bleeding D. Complaints of decreased sensation near the operative site
D. Abdominal distention
58. The nurse is admitting a male client with laryngeal cancer to the nursing
54. Nurse Kate is reviewing the complications of colonization with a client who unit. The nurse assesses for which most common risk factor for this type of
has microinvasive cervical cancer. Which complication, if identified by the client, cancer?
indicates a need for further teaching? A. Alcohol abuse
A. Infection B. Cigarette smoking
B. Hemorrhage C. Use of chewing tobacco
C. Cervical stenosis D. Exposure to air pollutants
D. Ovarian perforation
59. The female client who has been receiving radiation therapy for bladder
55. Mr. Miller has been diagnosed with bone cancer. You know this type of cancer tells the nurse that it feels as if she is voiding through the vagina. The
cancer is classified as: nurse interprets that the client may be experiencing:
A. sarcoma. A. Rupture of the bladder
B. lymphoma. B. The development of a vesicovaginal fistula
C. carcinoma. C. Extreme stress caused by the diagnosis of cancer
D. melanoma. D. Altered perineal sensation as a side effect of radiation therapy

60. The client with leukemia is receiving busulfan (Myleran) and allopurinol
(Zyloprim). The nurse tells the client that the purpose if the allopurinol is to
prevent:
A. Nausea
B. Alopecia
C. Vomiting
D. Hyperuricemia
1. While being prepared for a biopsy of a lump in the right breast, the patient
asks the nurse what the difference is between a benign tumor and a malignant
tumor. The nurse explains that a benign tumor differs from a malignant tumor
in that benign tumors
A. do not cause damage to adjacent tissue.
B. do not spread to other tissues and organs.
C. are simply an overgrowth of normal cells.
D. frequently recur in the same site.
2. A patient who has been told by the health care provider that the cells in a
bowel tumor are poorly differentiated asks the nurse what is meant by “poorly
differentiated.” Which response should the nurse make?
A. “The cells in your tumor do not look very different from normal bowel cells.”
B. “The tumor cells have DNA that is different from your normal bowel cells.”
C. “Your tumor cells look more like immature fetal cells than normal bowel
cells.”
D. “The cells in your tumor have mutated from the normal bowel cells.”
3. A patient who smokes tells the nurse, “I want to have a yearly chest x-rayso
that if I get cancer, it will be detected early.” Which response by the nurse is
most appropriate?
A. “Chest x-rays do not detect cancer until tumors are already at least a half-
inch in size.”
B. “Annual x-rays will increase your risk for cancer because of exposure to
radiation.”
15
C. “Insurance companies do not authorize yearly x-rays just to detect early lung
cancer.”
D. “Frequent x-rays damage the lungs and make them more susceptible to cancer.”
4. In teaching about cancer prevention to a community group, the nurse stresses
promotion of exercise, normal body weight, and low-fat diet because
A. most people are willing to make these changes to avoid cancer.
B. dietary fat and obesity promote growth of many types of cancer.
C. people who exercise and eat healthy will make other lifestyle changes.
D. obesity and lack of exercise cause cancer in susceptible people.
5. During a routine health examination, a 30-year-old patient tells the nurse
about a family history of colon cancer. The nurse will plan to
A. teach the patient about the need for a colonoscopy at age 50.
B. ask the patient to bring in a stool specimen to test for occult blood.
C. schedule a sigmoidoscopy to provide baseline data about the patient.
D. have the patient ask the doctor about specific tests for colon cancer.
6. When reviewing the chart for a patient with cervical cancer, the nurse notes
that the cancer is staged as Tis, N0, M0. The nurse will teach the patient that
A. the cancer cells are well-differentiated.
B. it is difficult to determine the original site of the cervical cancer.
C. further testing is needed to determine the spread of the cancer.
D. the cancer is localized to the cervix.
7. Which statement by a patient who is scheduled for a needle biopsy of the
prostate indicates that the patient understands the purpose of a biopsy?
A. “The biopsy will tell the doctor whether the cancer has spread to my other organs.”
B. “The biopsy will help the doctor decide what treatment to use for my enlarged
prostate.”
C. “The biopsy will determine how much longer I have to live.”
D. “The biopsy will indicate the effect of the cancer on my life.”

8. The nurse is teaching a postmenopausal patient with breast cancer about the
expected outcomes of her cancer treatment. The nurse evaluates that the
teaching has been effective when the patient says
A. “After cancer has not recurred for 5 years, it is considered cured.”
B. “I will need to have follow-up examinations for many years after I have
treatment before I can be considered cured.”
C. “Cancer is considered cured if the entire tumor is surgically removed.”
D. “Cancer is never considered cured, but the tumor can be controlled
with surgery, chemotherapy, and radiation.”
9. A patient with a large stomach tumor that is attached to the liver is scheduled
to have a debulking procedure. The nurse explains that the expected outcome of
this surgery is
A. control of the tumor growth by removal of malignant tissue.
B. promotion of better nutrition by relieving the pressure in the stomach.
C. relief of pain by cutting sensory nerves in the stomach.
D. reduction of the tumor burden to enhance adjuvant therapy.
10. External-beam radiation is planned for a patient with endometrial cancer.
The nurse teaches the patient that an important measure to prevent
complications from the effects of the radiation is to
A. test all stools for the presence of blood.
B. inspect the mouth and throat daily for the appearance of thrush.
C. perform perianal care with sitz baths and meticulous cleaning.
D. maintain a high-residue, high-fat diet.
11. Which action by a nursing assistant (NA) caring for a patient with a
temporary radioactive cervical implant indicates that the RN should intervene?
A. The NA places the patient’s bedding in the laundry container in the hallway.
B. The NA flushes the toilet once after emptying the patient’s bedpan.
C. The NA stands by the patient’s bed for an hour talking with the patient.
D. The NA gives the patient an alcohol-containing mouthwash for oral care.
16
12. A patient with Hodgkin’s lymphoma is undergoing external radiation
therapy on an outpatient basis. After 2 weeks of treatment, the patient tells the
nurse, “I am so tired I can hardly get out of bed in the morning.” An
appropriate intervention for the nurse to plan with the patient is to
A. exercise vigorously when fatigue is not as noticeable.
B. consult with a psychiatrist for treatment of depression.
C. establish a time to take a short walk every day.
D. maintain bed rest until the treatment is completed.
13. Which information obtained by the nurse about a patient with colon cancer
who is scheduled for external radiation therapy to the abdomen indicates a need
for patient teaching?
A. The patient swims a mile 5 days a week.
B. The patient eats frequently during the day.
C. The patient showers with Dove soap daily.
D. The patient has a history of dental caries.
14. A patient undergoing external radiation has developed a dry desquamation
of the skin in the treatment area. The nurse knows that teaching about
management of the skin reaction has been effective when the patient says
A. “I can use ice packs to relieve itching in the treatment area.”
B. “I can buy a steroid cream to use on the itching area.”
C. “I will expose the treatment area to a sun lamp daily.”
D. “I will scrub the area with warm water to remove the scales.”
15. A patient with metastatic cancer of the colon experiences severe vomiting
following each administration of chemotherapy. An important nursing
intervention for the patient is to
A. teach about the importance of nutrition during treatment.
B. have the patient eat large meals when nausea is not present.
C. administer prescribed antiemetics 1 hour before the treatments.
D. offer dry crackers and carbonated fluids during chemotherapy.

16. When the nurse is administering a vesicant chemotherapeutic agent
intravenously, an important consideration is to
A. stop the infusion if swelling is observed at the site.
B. infuse the medication over a short period.
C. administer the chemotherapy through small-bore catheter.
D. hold the medication unless a central venous line is available.
17. A chemotherapeutic agent known to cause alopecia is prescribed for a
patient. To maintain the patient’s self-esteem, the nurse plans to
A. suggest that the patient limit social contacts until regrowth of the hair occurs.
B. encourage the patient to purchase a wig or hat and wear it once hair loss
begins.
C. have the patient wash the hair gently with a mild shampoo to minimize hair loss.
D. inform the patient that hair loss will not be permanent and that the hair will grow
back.
18. A patient with ovarian cancer tells the nurse, “I don’t think my husband
cares about me anymore. He rarely visits me.” On one occasion when the
husband was present, he told the nurse he just could not stand to see his wife so
ill and never knew what to say to her. An appropriate nursing diagnosis in this
situation is
A. compromised family coping related to disruption in lifestyle and role changes.
B. impaired home maintenance related to perceived role changes.
C. risk for caregiver role strain related to burdens of caregiving responsibilities.
D. interrupted family processes related to effect of illness on family members.
19. A patient receiving head and neck radiation and systemic chemotherapy has
ulcerations over the oral mucosa and tongue and thick, ropey saliva. An
appropriate intervention for the nurse to teach the patient is to
A. remove food debris from the teeth and oral mucosa with a stiff toothbrush.
B. use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth.
C. gargle and rinse the mouth several times a day with an antiseptic mouthwash.
17
D. rinse the mouth before and after each meal and at bedtime with a saline
solution.
20. A patient who is receiving interleukin-2 (IL-2) therapy (Proleukin) complains
to the nurse about all of these symptoms. Which one is most important to report
to the health care provider?
A. Generalized aches
B. Dyspnea
C. Decreased appetite
D. Insomnia
1. A 32-year-old male patient is to undergo radiation therapy to the pelvic area
for Hodgkin’s lymphoma. He expresses concern to the nurse about the effect
of chemotherapy on his sexual function. The best response by the nurse to the
patient’s concerns is
A. “Radiation does not cause the problems with sexual functioning that occur with
chemotherapy or surgical procedures used to treat cancer.”
B. “It is possible you may have some changes in your sexual function, and you
may want to consider pretreatment harvesting of sperm if you want children.”
C. “The radiation will make you sterile, but your ability to have sexual intercourse
will not be changed by the treatment.”
D. “You may have some temporary impotence during the course of the radiation, but
normal sexual function will return.”
2. A 40-year-old divorced mother of four school-age children is hospitalized with
metastatic cancer of the ovary. The nurse finds the patient crying, and she tells
the nurse that she does not know what will happen to her children when she dies.
The most appropriate response by the nurse is
A. “Why don’t we talk about the options you have for the care of your
children?”
B. “Many patients with cancer live for a long time, so there is time to plan for your
children.”

C. “For now you need to concentrate on getting well, not worry about your children.”
D. “Perhaps your ex-husband will take the children when you can’t care for them.”
3. A patient who has terminal cancer of the liver and is cared for by family
members at home tells the nurse, “I have intense pain most of the time now.”
The nurse recognizes that teaching regarding pain management has been
effective when the patient
A. uses the ordered opioid pain medication whenever the pain is greater than 5 on a
10-point scale.
B. states that nonopioid analgesics may be used when the maximal dose of the opioid
is reached without adequate pain relief.
C. agrees to take the medications by the IV route to improve effectiveness.
D. takes opioids around the clock on a regular schedule and uses additional
doses when breakthrough pain occurs.
4. Interleukin-2 (IL-2) is used as adjuvant therapy for a patient with metastatic
renal cell carcinoma. The nurse teaches the patient that the purpose of therapy
with this agent is to
A. protect normal kidney cells from the damaging effects of chemotherapy.
B. enhance the patient’s immunologic response to tumor cells.
C. stimulate malignant cells in the resting phase to enter mitosis.
D. prevent the bone marrow depression caused by chemotherapy.
5. The home health nurse is caring for a patient who has been
receiving interferon therapy for treatment of cancer. Which statement by the
patient may indicate a need for a change in treatment?
A. “I have frequent muscle aches and pains.”
B. “I rarely have the energy to get out of bed.”
C. “I take acetaminophen (Tylenol) every 4 hours.”
D. “I experience chills after I inject the interferon.”
18
6. Which information noted by the nurse reviewing the laboratory results of a
patient who is receiving chemotherapy is most important to report to the health
care provider?
A. Hemoglobin of 10 g/L
B. WBC count of 1700/µl
C. Platelets of 65,000/µl
D. Serum creatinine level of 1.2 mg/dl
7. A bone marrow transplant is being considered for treatment of a patient with
acute leukemia that has not responded to chemotherapy. In discussing the
treatment with the patient, the nurse explains that
A. hospitalization will be required for several weeks after the hematopoietic stem
cell transplant (HSCT).
B. the transplant of the donated cells is painful because of the nerves in the tissue
lining the bone.
C. donor bone marrow cells are transplanted immediately after an infusion of
chemotherapy.
D. the transplant procedure takes place in a sterile operating room to minimize
the risk for infection.
8. The nurse teaches a patient with cancer of the liver about high-protein, high-
calorie diet choices. Which snack choice by the patient indicates that the
teaching has been effective?
A. Fresh fruit salad
B. Orange sherbet
C. Strawberry yogurt
D. French fries
9. The nurse has identified the nursing diagnosis of imbalanced nutrition: less
than body requirements related to altered taste sensation in a patient with lung
cancer who has had a 10% loss in weight. An appropriate nursing intervention
that addresses the etiology of this problem is to
 19

A. provide foods that are highly spiced to stimulate the taste buds.
B. avoid presenting foods for which the patient has a strong dislike.
C. add strained baby meats to foods such as soups and casseroles.
D. teach the patient to eat whatever is nutritious since food is tasteless.
10. After the nurse has explained the purpose of and schedule for chemotherapy
to a 23-year-old patient who recently received a diagnosis of acute leukemia, the
patient asks the nurse to repeat the information. Based on this assessment, which
nursing diagnosis is most likely for the patient?
A. Acute confusion related to infiltration of leukemia cells into the central nervous
system
B. Knowledge deficit: chemotherapy related to a lack of interest in learning about
treatment
C. Risk for ineffective health maintenance related to anxiety about new leukemia
diagnosis
D. Risk for ineffective adherence to treatment related to denial of need for
chemotherapy
13. A with tumor lysis syndrome (TLS) is taking allopurinol (Zyloprim). Which
laboratory value should the nurse monitor to determine the effectiveness of the
medication?
A. Blood urea nitrogen (BUN)
B. Serum phosphate
C. Serum potassium
D. Uric acid level
14. When assessing a patient’s needs for psychologic support after the patient
has been diagnosed with stage I cancer of the colon, which question by the nurse
will provide the most information?
A. “Can you tell me what has been helpful to you in the past when coping with
stressful events?”
B. “How long ago were you diagnosed with this cancer?”
C. “Are you familiar with the stages of emotional adjustment to a diagnosis like
cancer of the colon?”
D. “How do you feel about having a possibly terminal illness?”

11. A hospitalized patient who has received chemotherapy for leukemia develops 15. A 61-year-old woman who is 5 feet, 3 inches tall and weighs 125 pounds (57
neutropenia. Which observation by the RN caring for the patient indicates that kg) tells the nurse that she has a glass of wine two or three times a week. The
the nurse should take action? patient works for the post office and has a 5-mile mail-delivery route. This is her
A. The patient’s visitors bring in some fresh peaches from home. first contact with the health care system in 20 years. Which of these topics will
B. The patient ambulates several times a day in the room. the nurse plan to include in patient teaching about cancer? (Select all that
C. The patient uses soap and shampoo to shower every other day. apply.)
D. The patient cleans with a warm washcloth after having a stool. A. Alcohol use
B. Physical activity
12. Which action by a nursing assistant (NA) when caring for a patient who is C. Body weight
pancytopenic indicates a need for the nurse to intervene? D. Colorectal screening
A. The NA assists the patient to use dental floss after eating. E. Tobacco use
B. The NA makes an oral rinse using 1 teaspoon of salt in a liter of water. F. Mammography
C. The NA adds baking soda to the patient’s saline oral rinses. G. Pap testing
D. The NA puts fluoride toothpaste on the patient’s toothbrush. H. Sunscreen use

1. A patient with a diagnosis of lung cancer is receiving chemotherapy and reports
nausea and loss of appetite resulting in decreased food intake. What should the
healthcare provider recommend to promote adequate nutrition? Advise the patient to:
A. Eat only favorite foods to increase appetite.
B. Eat small meals throughout the day.
C. Eat large meals but less frequently throughout the day.
D. Eat only when feeling hungry.
2. A patient who recently stopped smoking asks a healthcare provider about the risks
of developing lung cancer. The healthcare provider’s best response is:
A. “If lung cancer hasn’t developed yet, the ongoing risk is equivalent to a non-
smoker.”
B. “In 8 months, the risk of developing lung cancer is twice as high as a non-
smoker.”
C. “In 15 years, the risk of developing lung cancer will be equivalent to a
non-smoker.”
D. “An elevated risk of developing lung cancer compared to a non-smoker will
remain constant life-long.”
3. A patient whose lung cancer has metastasized to the bone reports lethargy, nausea,
and vomiting. The healthcare provider monitor suspects the patient is experiencing
hypercalcemia. Which of the following assessments associated with hypercalcemia
would confirm the healthcare provider's suspicion?
A. Decreased deep tendon reflexes
B. Presence of Chvostek sign
C. Abdominal cramps and diarrhea
D. Serum calcium level 10mg/dL (2.5mmol/L)
4. While undergoing radiation therapy for lung cancer, the patient develops dry, itchy,
and flakey skin. The healthcare provider will recommend the patient to:
A. Increase time between treatments to reduce exposure to radiation.
B. Cleanse the area with lukewarm water to avoid tissue damage.
20
C. Use an exfoliator to remove dead cells from the irritated area.
D. Apply ice on the irritated area to reduce inflammation.
5. A patient with a diagnosis of small cell carcinoma in the right lung exhibits
shortness of breath, facial and periorbital edema, and jugular vein distension. Which
action should the healthcare provider do first?
A. Obtain an electrocardiogram (ECG).
B. Take a full set of vital signs.
C. Administer oxygen.
D. Increase the IV flow rate.
6. When caring for a patient receiving intravenous chemotherapy for lung cancer, the
healthcare provider will plan to administer the prescribed antiemetic to the patient:
A. Before starting the infusion.
B. When the patient complains of nausea.
C. One half hour after the infusion has started.
D. One hour after the infusion is complete.
7. The healthcare provider is preparing to administer chemotherapy to a patient with
lung cancer. The patient asks why combinations of different drugs are being used to
treat the cancer. Which of the following is the best response?
A. “You can go longer between treatments if we use different chemotherapeutic
drugs.”
B. “The cost of treatment is much less if a combination of drugs is used.”
C. “Patients experience less adverse effects from combination chemotherapy.”
D. “It reduces the cancer cells ability to become resistant to the
chemotherapy.”
8. A patient with a diagnosis of lung cancer is given an intravenous (IV) bolus of an
opioid agonist medication. For which problem will it be a priority for the healthcare
provider to monitor?
A. Nausea and vomiting
B. Tolerance to drug effects
 21

C. Constipation A. Malignant cells have a potential for limitless replication.

D. Respiratory depression B. Normal cells are less specialized than malignant cells.
C. Metabolism in malignant cells tends to be higher than that of normal
9. The healthcare provider is caring for a postoperative patient who has undergone a cells.
lobectomy. The plan of care will include positioning the patient: D. As a malignant tumor grows, it can make its own blood supply.
A. Laying on the non-operative side. E. Malignant cells tend to stick together much more than normal cells
B. Supine in high Fowler’s position.
C. Laying on the operative side. 13. The healthcare provider is assessing a patient’s risk of lung cancer by calculating
D. Supine with the head of the bed flat. the pack-year history. The patient has smoked two packs of cigarettes each day for 20
years.
10. A patient T3N2M1 squamous cell carcinoma is being evaluated for treatment.  Multiply the packs smoked per day by the number of years the patient has
Based on the staging of this cancer, the healthcare provider anticipates this patient’s smoked.
cancer will be treated by:  2 packs/day multiplied by 20 years = 40.
A. Wedge resection  This patient has a 40 pack-year history.
B. Chemotherapy
C. Segmental resection 14. The healthcare provider is assessing a patient with a diagnosis of lung cancer after
D. Radiation a left lobectomy. Which of the following assessments is an early indication the patient
has developed atelectasis?
11. A patient recovering from a lobectomy has a chest tube attached to a water-seal Choose all answers that apply:
drainage system. The healthcare provider notices the fluid in the water-seal column A. Central cyanosis
has stopped fluctuating. Which of the following would explain why the fluctuations B. Inspiratory wheezing bilaterally
have stopped? C. Intercostal retractions
Choose all answers that apply: D. Decreased breath sounds in the right lung
A. The lung has begun to collapse. E. Low grade fever
B. Positive intrapleural pressure has increased.
C. The lung has fully expanded. 15. The healthcare provider has an order to give an opioid analgesic 100mcg IV to a
D. There may be fibrin clots in the tubing. patient for post-thoracotomy pain. The drug is available as 0.05mg/mL. How many
E. The drainage system has a leak in it. mL will the healthcare provider administer?
 First, convert mg to micrograms.
12. A student working on an oncology unit asks the healthcare provider how  The drug strength is 50mcg/mL.
malignant cells are different from normal cells. Which of the following should be  In order to give 100mcg, 2mL will be given.
included in the answer?
Choose all answers that apply:
 22

1. All of the following statements are not true about antineoplastic agents, 6. Antineoplastic antibiotics exert their therapeutic action through which
except: mechanism?
A. These drugs assume the role of the innate defenses of humans in destroying A. Causing a mutant DNA molecule
rapidly-dividing cells. B. Inhibiting DNA polymerase
B. Normal cells are always spared from the effects of antineoplastic agents. C. Preventing the cells to divide.
C. A and B D. Works with hormones to stop stimulating growth of tumors
D. None of the above
7. As part of pre-operative preparation, a patient showing signs of problems with
2. A student nurse was asked to give an example of an antimetabolite. He would blood clotting should be asked about usage of which herb?
be correct to state which drug as an example? A. Saw palmetto
A. mercaptopurine B. Echinacea
B. cisplatin C. St. John’s wort
C. dactinomycin D. Ginkgo
D. vincristine
8. How soon after therapy should blood tests be done to monitor bone marrow
3. The goal of utilization of drugs as one component of chemotherapy is: function?
A. to disintegrate the tumors completely A. At least a week after
B. to decrease the size of the neoplasm B. 2 weeks after
C. to stop the genetic mutations responsible for cancers C. 3 weeks after
D. to prevent metastasis of neoplasms D. 5 days

4. Which patient complaint would be the least of concern of a nurse taking care 9. Which drug has been approved for use in treating CML?
of an elderly on antineoplastic agents? A. Bortezomib
A. RUQ pain B. Imatinib
B. facial puffiness C. Pazopanib
C. keloid formation on previous IV site D. Erlotinib
D. oliguria
10. Which is an absolute contraindication in patients receiving nilotinib, a cancer
5. At which stage of cell cycle is alkylating agent specific? cell-specific agent?
A. G1 phase A. hypomagnesemia
B. S phase B. short QT syndrome
C. M phase C. hypercalcemia
D. None. It is non-specific. D. intake of digitalis
23

1. A client diagnosed with widespread lung cancer asks the nurse why he must be
careful to avoid crowds and people who are ill. What is the nurse's best response?
A. "With lung cancer, you are more likely to develop pneumonia and could pass
this on to other people who are already ill."
B. "When lung cancer is in the bones, it becomes a bone marrow malignancy,
which stops producing immune system cells."
C. "The large amount of mucus produced by the cancer cells is a good breeding
ground for bacteria and other microorganisms."
D. "When lung cancer is in the bones, it can prevent production of immune
system cells, making you less resistant to infection."
2. Which precaution is most important for the nurse to teach a client receiving
radiation therapy for head and neck cancer?
A. Avoid eating red meat during treatment.
B. Pace your leisure activities to prevent fatigue.
C. See your dentist twice yearly for the rest of your life.
D. Avoid using headphones or headsets until your hair grows back.
3. A client receiving high-dose chemotherapy who has bone marrow suppression has
been receiving daily injections of epoetin alfa (Procrit). Which assessment finding
indicates to the nurse that today's dose should be held and the health care provider
notified?
A. Hematocrit of 28%
B. Total white blood cell count of 6200 cells/mm3
C. Blood pressure change from 130/90 mm Hg to 148/98 mm Hg
D. Temperature change from 99° F (37.2 C) to 100 F (37.8 C)
4. Which action is most important for the nurse to implement to prevent nausea and
vomiting in a client who is prescribed to receive the first round of IV chemotherapy?
A. Keep the client NPO during the time chemotherapy is infusing.
B. Administer antiemetic drugs before administering chemotherapy.
C. Ensure that the chemotherapy is infused over a 4- to 6-hour period.
24
D. Assess the client for manifestations of dehydration hourly during the
infusion period.
5. A client being treated for advanced breast cancer with chemotherapy reports that
she must be allergic to one of her drugs because her entire face is swollen. What
assessment does the nurse perform?
A. Asks whether the client has other known allergies
B. Checks the capillary refill on fingernails bilaterally
C. Examines the client's neck and chest for edema and engorged veins
D. Compares blood pressure measured in the right arm with that in the left arm
6. The nurse is teaching the 47-year-old female client about recommended screening
practices for breast cancer. Which statement by the client indicates understanding of
the nurse's instructions?
A. "My mother and grandmother had breast cancer, so I am at risk."
B. "I get a mammography every 2 years since I turned 30."
C. "A clinical breast examination is performed every month since I turned 40."
D. "A CT scan will be done every year after I turn 50."
7. The nurse is giving a group presentation on cancer prevention and recognition.
Which statement by an older adult client indicates understanding of the nurse's
instructions?
A. "Cigarette smoking always causes lung cancer."
B. "Taking multivitamins will prevent me from developing cancer."
C. "If I have only one shot of whiskey a day, I probably will not develop cancer."
D. "I need to report the pain going down my legs to my health care
provider."
8. A 72-year-old client recovering from lung cancer surgery asks the nurse to explain
how she developed cancer when she has never smoked. Which factor may explain the
possible cause?
A. A diagnosis of diabetes treated with insulin and diet
B. An exercise regimen of jogging 3 miles 4x/wk
 25

C. A history of cardiac disease A. Limit sodium intake.

D. Advancing age B. Avoid beef and processed meats.
C. Increase consumption of whole grains.
9. The nurse reviews the chart of the client admitted with a diagnosis of glioblastoma D. Eat "colorful fruits and vegetables," including greens.
with a T1NXM0 classification. Which explanation does the nurse offer when the E. Avoid gas-producing vegetables such as cabbage.
client asks what the terminology means?
A. "Two lymph nodes are involved in this tumor of the glial cells, and another 13. The nurse presents a cancer prevention program to teens. Which of the following
tumor is present." will have the greatest impact in cancer prevention?
B. "The brain tumor measures about 1 to 2 cm and shows no regional lymph A. Avoid asbestos.
nodes and no distant metastasis." B. Wear sunscreen.
C. "This type of tumor in the brain is small with some lymph node involvement; C. Get the human papilloma virus (HPV) vaccine.
another tumor is present somewhere else in your body." D. Do not smoke cigarettes.
D. "Glioma means this tumor is benign, so I will have to ask your health care
provider the reason for the chemotherapy and radiation." 14. The nurse is teaching a group of clients about cancers related to tobacco or
tobacco smoke. Identify the common cancers related to tobacco use. Select all that
10. The client has a diagnosis of lung cancer. To which areas does the nurse anticipate apply.
that this client's tumor may metastasize? Select all that apply. A. Cardiac cancer
A. Brain B. Lung cancer
B. Bone C. Cancer of the tongue
C. Lymph nodes D. Skin cancer
D. Kidneys E. Cancer of the larynx
E. Liver
15. The nurse suspects metastasis from left breast cancer to the thoracic spine when
11. The nurse manager in a long-term care facility is developing a plan for primary the client has which symptom?
and secondary prevention of colorectal cancer. Which tasks associated with the A. Vomiting
screening plan will be delegated to nursing assistants within the facility? B. Back pain
A. Testing of stool specimens for occult blood C. Frequent urination
B. Teaching about the importance of dietary fiber D. Cyanosis of the toes
C. Referring clients for colonoscopy procedures
D. Giving vitamin and mineral supplements 16. The nurse explains to the client that which risk factor most likely contributed to
his primary liver carcinoma?
12. The nurse is conducting a community health education class on diet and cancer A. Infection with hepatitis B virus
risk reduction. What should be included in the discussion? Select all the apply. B. Consuming a diet high in animal fat
 26

C. Exposure to radon 21. A 52-year-old client relates to the nurse that she has never had a mammogram
D. Familial polyposis because she is terrified that she will have cancer. Which response by the nurse is
therapeutic?
17. The nurse is caring for an adult client with Down syndrome who reports fatigue A. "Don't worry, most lumps are discovered by women during breast self-
and shortness of breath. Which type of cancer has been identified in clients with examination."
Down syndrome? B. "Does anyone in your family have breast cancer?"
A. Breast cancer C. "Finding a cancer in the early stages increases the chance for cure."
B. Colorectal cancer D. "Have you noticed a lump or thickening in your breast?"
C. Malignant melanoma
D. Leukemia 22. Which information must the organ transplant nurse emphasize before each client
is discharged?
18. The nurse includes which of the following in teaching regarding the warning signs A. Taking immune suppressant medications increases your risk for cancer
of cancer? Select all that apply. and the need for screenings.
A. Persistent constipation B. You are at increased risk for cancer when you reach 60 years of age.
B. Scab present for 6 months C. Immunosuppressant medications will decrease your risk for developing
C. Curdlike vaginal discharge cancers.
D. Axillary swelling D. After 6 months, you may stop immune suppressant medications, and your risk
E. Headache for cancer will be the same as that of the general population.

19. The nurse is assessing a client with lung cancer. Which symptom does the nurse 23. The home health RN is caring for a client who has a history of a kidney transplant
anticipate finding? and takes cyclosporine (Sandimmune) and prednisone (Deltasone) to prevent
A. Easy bruising rejection. Which assessment data would be most important to communicate to the
B. Dyspnea transplant team?
C. Night sweats A. The temperature is 96.6° F.
D. Chest wound B. The client reports joint pain.
C. The oral mucosa appears pink and dry.
20. Which activity performed by the community health nurse best reflects primary D. A lump is palpable in the client's axilla.
prevention of cancer?
A. Assisting women to obtain free mammograms 24. A client who is scheduled to undergo radiation for prostate cancer is admitted to
B. Teaching a class on cancer prevention the hospital by the registered nurse. Which statement by the client is most important
C. Encouraging long-term smokers to get a chest x-ray to communicate to the physician?
D. Encouraging sexually active women to get annual (Pap) smears A. "I am allergic to iodine."
B. "My urinary stream is very weak."
 27

C. "My legs are numb and weak." B. Relief of symptoms or improved quality of life
D. "I am incontinent when I cough." C. Allowing other therapies to be more effective
D. Prolonging the client's survival time
25. When the nurse is counseling a 60-year-old African-American male client with all
of these risk factors for lung cancer, teaching should focus most on which risk factor? 29. Which statement made by the client allows the nurse to recognize whether the
A. Tobacco use client who is receiving brachytherapy for ovarian cancer understands the treatment
B. Ethnicity plan?
C. Gender A. "I may lose my hair during this treatment."
D. Increased age B. "I must be positioned in the same way during each treatment."
C. "I will have a radioactive device in my body for a short time."
26. The registered nurse is teaching a group of nursing students about malignant D. "I will be placed in a semiprivate room for company."
transformation. Which statement about the process of malignant transformation is
true? 30. Which potential side effects should be included in the teaching plan for a client
A. Mutation of genes is an irreversible event that always leads to cancer undergoing radiation therapy for laryngeal cancer? select all that apply.
development in the initiation phase. A. Fatigue
B. Insulin and estrogen enhance the division of an initiated cell during the B. Changes in color of hair
promotion phase. C. Change in taste
C. Tumors form when carcinogens invade the gene structure of the cell in the D. Changes in skin of the neck
latency phase. E. Difficulty swallowing
D. Nutrition of cancer cells is provided by tumor angiogenesis factor (TAF) in
the promotion stage. 31. The client receiving chemotherapy will experience the lowest level of bone
marrow activity and neutropenia during which period?
27. The nurse receives report on a client with a glioblastoma. Recognizing that A. Peak
cancers are classified by their tissue of origin, the nurse begins to plan care for a B. Trough
client with which type of cancer? C. Nadir
A. Liver D. Adjuvant
B. Smooth muscle
C. Fatty tissue 32. The nurse teaches the client that intraperitoneal chemotherapy will be delivered
D. Brain where?
A. Into the veins of the legs
28. Which of these does the nurse recognize as the goal of palliative surgery for the B. Into the lung
client with cancer? C. Into the heart
A. Cure of the cancer D. Into the abdominal cavity
 28

33. The registered nurse is teaching a nursing student about the importance of A. Explain that this occurs in some clients and is usually permanent.
observing for bone marrow suppression during chemotherapy. Select the person who B. Encourage the client that a small glass of wine may help her relax.
displays bone marrow suppression. C. Protect the client from infection.
A. Client with hemoglobin of 7.4 and hematocrit of 21.8 D. Allow the client an opportunity to express her feelings.
B. Client with diarrhea and potassium level of 2.9 mEq/L
C. Client with 250,000 platelets 38. Which client problem does the nurse set as the priority for the client experiencing
D. Client with 5000 white blood cells/mm3 chemotherapy-induced peripheral neuropathy?
A. Potential for lack of understanding related to side effects of chemotherapy
34. The registered nurse would correct the nursing student when caring for a client B. Risk for Injury related to sensory and motor deficits
with neutropenia secondary to chemotherapy in which circumstance? C. Potential for ineffective coping strategies related to loss of motor control
A. Student scrubs the hub of IV tubing before administering an antibiotic. D. Altered sexual function related to erectile dysfunction
B. Nurse overhears the student explaining to the client the importance of
handwashing. 39. The nurse is caring for a client who is receiving rituximab (Rituxan) for treatment
C. Student teaches the client that symptoms of neutropenia include fatigue of lymphoma. It is essential for the nurse to observe for which side effect?
and weakness. A. Alopecia
D. The nurse observes the student providing oral hygiene and perineal care. B. Allergy
C. Fever
35. Which signs or symptoms should the nurse report immediately because they D. Chills
indicate thrombocytopenia secondary to cancer chemotherapy? Select all that apply.
A. Bruises 40. Which intervention will be most helpful in preventing disseminated intravascular
B. Fever coagulation (DIC)?
C. Petechiae A. Monitoring platelets
D. Epistaxis B. Administering packed red blood cells
E. Pallor C. Using strict aseptic technique to prevent infection
D. Administering low-dose heparin therapy for clients on bedrest.
36. Which intervention will be most helpful for the client with mucositis?
A. Administering a biological response modifier 41. When caring for a client with suspected SIADH, the nurse reviews the medical
B. Encouraging oral care with commercial mouthwash record to uncover which signs and symptoms consistent with this syndrome? (select
C. Providing oral care with a disposable mouth swab all that apply)
D. Maintaining NPO until the lesions have resolved A. Hyponatremia
B. Mental status changes
37. A client who is undergoing chemotherapy for breast cancer reports problems with C. Azotemia
concentration and memory. Which intervention is indicated at this time? D. Bradycardia
 29

E. Weakness F. Teach the client to omit raw fruits and vegetables from his diet.

42. The nurse anticipates administering which medication to treat hyperuricemia 46. Which of the following findings would alarm the nurse when caring for a client
associated with tumor lysis syndrome (TLS)? receiving chemotherapy who has a platelet count of 17,000/mm3?
A. Recombinant erythropoietin (Procrit) A. Increasing shortness of breath
B. Allopurinol (Zyloprim) B. Diminished bilateral breath sounds
C. Potassium chloride C. Change in mental status
D. Radioactive iodine 131 D. Weight gain of 4 pounds in 1 day

43. When caring for a client with cachexia, the nurse expects to note which symptom? 47. Which teaching is most appropriate for a client with chemotherapy-induced
A. Weight loss neuropathy?
B. Anemia A. Bathe in cold water.
C. Bleeding tendencies B. Wear cotton gloves when cooking.
D. Motor deficits C. Consume a diet high in fiber.
D. Make sure shoes are snug.
44. When caring for a client who has had a colostomy created as part of a regimen to
treat colon cancer, which activities would help to support the client in accepting 48. The nurse is teaching a client who is receiving an anti-estrogen drug about the
changes in appearance or function? Select all that apply. side effects she may encounter. Which of these should the nurse include in the
A. Explain to the client that the colostomy is only temporary. discussion? Select all that apply.
B. Encourage the client to participate in changing the ostomy. A. Heavy menses
C. Obtain a psychiatric consultation. B. Smooth facial skin
D. Offer to have a person who is coping with a colostomy visit. C. Hyperkalemia
E. Encourage the client and family members to express their feelings and D. Breast tenderness
concerns E. Weight loss
F. Deep vein thrombosis (DVT).
45. The nurse has received in report that the client receiving chemotherapy has severe
neutropenia. Which of the following does the nurse plan to implement? Select all that 49. Which medication does the nurse plan to administer to a client before
apply. chemotherapy to decrease the incidence of nausea?
A. Assess for fever. A. Morphine
B. Observe for bleeding. B. Ondansetron (Zofran)
C. Administer pegfilgrastim (Neulasta). C. Naloxone (Narcan)
D. Do not permit fresh flowers or plants in the room. D. Diazepam (Valium)
E. Do not allow his 16-year-old son to visit.

50. A newly graduated RN has just finished a 6-week orientation to the oncology unit.
Which of these clients would be most appropriate to assign to the new graduate?
A. A 30-year-old with acute lymphocytic leukemia who will receive combination
chemotherapy today
B. A 40-year-old with chemotherapy-induced nausea and vomiting who has had
no urine output for 16 hours
C. A 45-year-old with pancytopenia who will require IV administration of
erythropoietin (Procrit)
D. A 72-year-old with tumor lysis syndrome who is receiving normal saline IV at
a rate of 250 mL/hr
51. The RN working on an oncology unit has just received report on these clients.
Which client should be assessed first?
A. A client with chemotherapy-induced neutropenia who has just been
admitted with an elevated temperature
B. A client with lymphoma who will need administration of an antiemetic before
receiving chemotherapy
C. A client with metastatic breast cancer who is scheduled for external beam
radiation in 1 hour
D. A client with xerostomia associated with laryngeal cancer who needs oral care
before breakfast
52. The outpatient client is receiving photodynamic therapy. Which environmental
factor is a priority for the client to adjust for protection?
A. Storing drugs in dark locations at room temperature
B. Wearing soft clothing
C. Wearing a hat and sunglasses when going outside
D. Reducing all direct and indirect sources of light
53. Which manifestation of an oncologic emergency requires the nurse to contact the
health care provider immediately?
A. New onset of fatigue
B. Edema of arms and hands
30
C. Dry cough
D. Weight gain
54. The nurse is caring for a patient receiving an initial dose of chemotherapy to treat
a rapidly growing metastatic colon cancer. The nurse is aware that this patient is at
risk for tumor lysis syndrome (TLS) and will monitor the patient closely for which of
the following abnormalities associated with this oncologic emergency?
A. Hypokalemia
B. Hypocalcemia
C. Hypouricemia
D. Hypophosphatemia
55. The nurse is caring for a patient suffering from anorexia secondary to
chemotherapy. Which of the following strategies would be most appropriate for the
nurse to use to increase the patient's nutritional intake?
A. Increase intake of liquids at mealtime to stimulate the appetite.
B. Serve three large meals per day plus snacks between each meal.
C. Avoid the use of liquid protein supplements to encourage eating at mealtime.
D. Add items such as skim milk powder, cheese, honey, or peanut butter to
selected foods.
56. Which of the following items would be most beneficial when providing oral care
to a patient with metastatic cancer who is at risk for oral tissue injury secondary to
chemotherapy?
A. Firm-bristle toothbrush
B. Hydrogen peroxide rinse
C. Alcohol-based mouthwash
D. 1 tsp salt in 1 L water mouth rinse
57. Which of the following nursing diagnoses is most appropriate for a patient
experiencing myelosuppression secondary to chemotherapy for cancer treatment?
A. Acute pain
B. Hypothermia

C. Powerlessness
D. Risk for infection
58. Previous administrations of chemotherapy agents to a cancer patient have resulted
in diarrhea. Which of the following dietary modifications should the nurse
recommend?
A. A bland, low-fiber diet
B. A high-protein, high-calorie diet
C. A diet high in fresh fruits and vegetables
D. A diet emphasizing whole and organic foods
59. A 33-year-old patient has recently been diagnosed with stage II cervical cancer.
The nurse would understand that the patient's cancer
A. Is in situ.
B. Has metastasized.
C. Has spread locally.
D. Has spread extensively.
60. A client newly diagnosed with acute leukemia asks why he is at such extreme risk
for infection when his white blood cell count is so high. What is the nurse's best
response?
A. "Even though you have many white blood cells, they are too immature to
fight infection."
B. "For now, your risk is low; however, when the chemotherapy begins, your risk
for infection will be high."
C. "These white blood cells are cancerous and live longer than normal white
blood cells, so they are too old to fight infection."
D. "It is not the white blood cells that provide protection; it is the red blood cells,
which are very low in your blood right now."
61. Which precaution is most important for the nurse to teach a client with leukemia
to prevent an infection by auto contamination?
A. Take antibiotics exactly as prescribed.
31
B. Perform mouth care three times daily.
C. Avoid the use of pepper and raw foods.
D. Report any burning on urination immediately.
62. Six weeks after hematopoietic stem cell transplantation for leukemia, the client's
white blood cell (WBC) count is 8200/mm3. What is the nurse's best action in view of
this laboratory result?
A. Notify the health care provider immediately.
B. Assess the client for other symptoms of infection.
C. Document the laboratory report as the only action.
D. Remind the client to avoid crowds and people who are ill.
63. Which assessment is most important for the nurse to perform for the client
receiving one unit of packed red blood cells from an autologous donation?
A. Temperature
B. Blood pressure
C. Oxygen saturation
D. IV site for hives
64. When teaching women about the risk of breast cancer, which risk factor does the
nurse know is the most common for the development of the disease?
A. Having an aunt with breast cancer
B. Being an older adult
C. Being a Euro-American
D. Consuming a low-fat diet
65. The nurse is assigned to care for a client immediately after breast-conserving
surgery for cancer. What is the priority for care of the client at this time?
A. Teach the client to sleep in the prone position each night.
B. Empty wound drains and record the output amount.
C. Remind the client how to perform breast self-examination.
D. Monitor the incision and flap for adequate tissue perfusion.

66. A client had a transurethral resection of the prostate (TURP) yesterday. The staff
nurse notes that the hemoglobin is 8.2 g/dL. What is the nurse's best action?
A. Notify the charge nurse as soon as possible.
B. Irrigate the catheter with 30 mL normal saline.
C. Document the assessment in the medical record.
D. Prepare for a blood transfusion.
67. A nurse is caring for a client with neutropenia. Which clinical manifestation
indicates that an infection is present or should be ruled out?
A. Coughing and deep breathing
B. Evidence of pus
C. Fever of 102 deg. F or higher
D. Wheezes or crackles
68. A nurse is caring for a client with neutropenia who has a suspected infection.
Which intervention does the nurse implement first?
A. Hydrates the client with 1000 mL of IV normal saline
B. Initiates the administration of prescribed antibiotics
C. Obtains requested cultures
D. Places the client on Bleeding Precautions
69. The client who has recently had breast cancer surgery requests a volunteer to visit
her home to help with recovery. Which community resource will the nurse
recommend?
A. National Breast Cancer Coalition
B. Reach for Recovery
C. Susan G. Komen for the Cure
D. Young Survival Coalition
70. The client has been diagnosed with breast cancer. Which treatment option chosen
by the client requires the nurse to discuss with the client the necessity of considering
additional therapy?
A. Chemotherapy
32
B. Complementary and alternative therapy (CAM)
C. Hormonal therapy
D. Neoadjuvant therapy
71. A client asks the nurse about early detection of breast masses. Which statement by
the nurse about early detection of breast masses is correct?
A. "A yearly breast examination by a health care provider can substitute for
breast self-examination (BSE)."
B. "Detection of breast cancer before axillary node invasion yields the same
survival rate."
C. "Mammography as a baseline screening is recommended by the American
Cancer Society at 30 years of age."
D. "The goal of screening for breast cancer is early detection because BSE
does not prevent breast cancer."
72. The nurse is instructing a client on how to perform breast self-examination (BSE).
Which techniques will the nurse include in teaching the client about BSE? Select all
that apply.
A. Instruct the client to keep her arm by her side while performing the
examination.
B. Ensure that the setting in which BSE is demonstrated is private and
comfortable.
C. Ask the client to remove her shirt. The bra may be left in place.
D. Ask the client to demonstrate her own method of BSE.
E. Use the fingertips, which are more sensitive than the finger pads, to palpate
the breasts.
73. A client with a high genetic risk for breast cancer asks the nurse about options for
prevention and early detection. Which option for prevention and early detection is the
option of choice?
A. Breast self-examination (BSE) beginning at 20 years of age
B. Hormone replacement therapy combining estrogen and progesterone

C. Magnetic resonance imaging (MRI) and mammography every year
beginning at age 30
D. Prophylactic mastectomy
74. The nurse suspects that which client has the highest risk for breast cancer?
A. Older adult woman with high breast density
B. Nullipara older adult woman
C. Obese older adult male with gynecomastia
D. Middle-aged woman with high breast density
75. The nurse is instructing a client with breast cancer who will be undergoing
chemotherapy about side effects of doxorubicin (Adriamycin). Which side effect will
the nurse instruct the client to report to the physician?
A. Diaphoresis
B. Dysphagia
C. Edema
D. Hearing loss
76. The client who has undergone breast surgery is struggling with issues concerning
her sexuality. What is the best way for the nurse to address the client's concerns?
A. Allow the client to bring up the topic first.
B. Remind the client to avoid sexual intercourse for 2 months after the surgery.
C. Suggest that the client wear a bra during intercourse.
D. Teach the client that birth control is a priority.
77. The client is struggling with body image after breast cancer surgery. Which
behavior indicates to the nurse that the client is maladaptive?
A. Avoiding eye contact with staff
B. Saying, "I feel like less of a woman"
C. Requesting a temporary prosthesis immediately
D. Saying, "This is the ugliest scar ever"
33
78. Which assessment finding indicates to the nurse that the client is at high risk for a
malignant breast lesion?
A. 1-cm freely mobile rubbery mass discovered by the client
B. Ill-defined painful rubbery lump in the outer breast quadrant
C. Backache and breast fungal infection
D. Nipple discharge and dimpling
79. The large-breasted client reports discomfort, backaches, and fungal infections
because of her excessive breast size. The nurse plans to provide information to the
client about which breast treatment option?
A. Augmentation
B. Compression
C. Reconstruction
D. Reduction mammoplasty
80. The nurse is teaching postmastectomy exercises to the client. Which statement
made by the client indicates that teaching has been effective?
A. "For the pulley exercise, I'll drape a 6-foot-long rope over a shower
curtain rod or over the top of a door."
B. "In rope turning, I'll hold the rope with my arms flexed."
C. "In rope turning, I'll start by making large circles."
D. "With hand wall climbing, I'll walk my hands up the wall and back down until
they are at waist level."
81. The nurse is discussing treatment options with the client newly diagnosed with
breast cancer. Which statement by the client indicates a need for further teaching?
A. "Hormonal therapy is only used to prevent the growth of cancer. It won't get
rid of it."
B. "I might have chemotherapy before surgery."
C. "If I get radiation, I am not radioactive to others."
D. "Radiation will remove the cancer, so I might not need surgery."

82. The client is receiving chemotherapy treatment for breast cancer and asks for
additional support for managing the associated nausea and vomiting. Which
complementary therapy will the nurse suggest?
A. Ginger
B. Journaling
C. Meditation
D. Yoga
83. The client who has had a mastectomy asks the nurse about breast reconstructive
surgery. Which statement by the nurse about breast reconstruction is true?
A. "Many women want breast reconstruction using their own tissue
immediately after mastectomy."
B. "Placement of saline- or gel-filled prostheses is not recommended because of
the nature of the surgery."
C. "Reconstruction of the nipple-areola complex is the first stage in the
reconstruction of the breast."
D. "The surgeon should offer the option of breast reconstruction surgery once
healing has occurred after the mastectomy."
84. Which client being cared for on the medical-surgical unit will be best to assign to
a nurse who has floated from the intensive care unit (ICU)?
A. Recent radical mastectomy client who requires chemotherapy administration
B. Modified radical mastectomy client who needs discharge teaching
C. Stage III breast cancer client who is requesting information about radiation
and chemotherapy
D. A client with a Jackson-Pratt drain in place who has just arrived from
the post-anesthesia care unit (PACU) after a quadrantectomy
85. Which action can the same-day surgery charge nurse delegate to an experienced
unlicensed assistive personnel (UAP) who is helping with the care of a client who is
having a breast biopsy?
A. Assess anxiety level about the surgery.
B. Monitor the vital signs after surgery.
34
C. Obtain data about breast cancer risk factors.
D. Teach about postoperative routine care.
86. A client who has just been discharged from the hospital after a modified radical
mastectomy is referred to a home health agency. Which nursing action will be most
appropriate to delegate to an experienced home health aide?
A. Assessing the safety of the home environment
B. Developing a plan to decrease lymphedema risk
C. Monitoring pain level and analgesic effectiveness
D. Reinforcing the guidelines for hand and arm care
87. A client who has just been notified that the breast biopsy indicates a malignancy
tells the nurse, "I just don't know how this could have happened to me." Which of
these responses by the nurse will be most appropriate?
A. "Tell me what you mean when you say you don't know how this could
have happened to you."
B. "Do you have a family history that might make you more likely to develop
breast cancer?"
C. "Would you like me to help you find more information about how breast
cancer develops?"
D. "Many risk factors for breast cancer have been identified, so it is difficult to
determine what might have caused it."
88. A premenopausal client diagnosed with breast cancer will be receiving hormonal
therapy. The nurse anticipates that the physician will request which medication for
this client?
A. Anastrazole (Arimdex)
B. Fulvestrant (Faslodex)
C. Leuprolide (Lupron)
D. C. Trastuzumab (Herceptin)
89. The client with prostate cancer asks the nurse for more information and
counseling. Which resources will the nurse suggest? Select all that apply.
 35

A. American Cancer Society's Man to Man program. C. Keep all appointments for follow-up laboratory testing.
B. Us TOO International. D. Hearing tests will need to be conducted periodically.
C. American Prostate Cancer Society. E. Take the medication in the afternoon.
D. National Prostate Cancer Coalition.
E. The client's church, synagogue, or place of worship. 94. The client has undergone transurethral resection of the prostate (TURP). Which
intervention will the nurse incorporate in this client's postoperative care?
90. The client with prostate cancer asks why he must have surgery instead of A. Administer antispasmodic medications.
radiation, even if it is the least invasive type. What is the nurse's best response? B. Encourage the client to urinate around the catheter if pressure is felt.
A. "It is because your cancer growth is large." C. Perform intermittent urinary catheterization every 4 to 6 hours.
B. "Surgery is the most common intervention to cure the disease." D. Place the client in a supine position, with his knees flexed.
C. "Surgery slows the spread of cancer."
D. "The surgery is to promote urination." 95. The nurse understands that hormone treatment for prostate cancer works by which
action?
91. With which male client will the nurse conduct prostate screening and education? A. Decreases blood flow to the tumor.
A. Young adult with a history of urinary tract infections. B. Destroys the tumor.
B. Client who has sustained an injury to the external genitalia. C. Shrinks the tumor.
C. Adult who is older than 50 years. D. Suppresses growth of the tumor.
D. Sexually active client.
1. A nurse is caring for a client who has developed mucositis of the oral membrane.
92. The issue that is often foremost in the minds of men who have been diagnosed The client is being discharged. The nurse should teach the client to:
with prostate cancer and must be addressed by the nurse is the alteration of which A. The client should drink iced liquids before each meal.
factor? A. The client should rinse his/her mouth with commercial mouth wash after
A. Comfort because of surgical pain. every meal.
B. Mobility because of treatment. B. The client should rinse his/her mouth with a solution of saline and water
C. Nutrition because of radiation treatment. after each meal.
D. Sexual function after treatment. C. The client should firmly brush his/her teeth after each meal.

93. The client with benign prostatic hyperplasia (BPH) is being discharged with
alpha-adrenergic blockers. Which information is important for the nurse to include
when teaching the client about this type of pharmacologic management? Select all
that apply.
A. Avoid drugs used to treat erection problems.
B. Be careful when changing positions.
2. The nurse is about to access a client's implanted vascular port to administer
medication. What nursing action should be implemented first?
A. Apply warm compresses to the port site.
B. Have the client hang their arm over the side of the bed.
C. Have the client perform the val salva maneuver.
D. Inspect the port site for redness or swelling

3. After a liver biopsy which position is the client assisted to assume?
A. Right lying with a folded towel under the puncture site.
B. Left lying with a folded towel under the puncture site.
C. Supine with the head of the bed elevated.
D. Prone with a small pillow under the head.
4. The nurse is teaching a client proper skin care for external radiation treatments.
The nurse knows the client understands when the client states:
A. I will wash the area daily with betadine solution.
B. I will keep the area covered with an occlusive dressing
C. I will wear clothing that does not place pressure on the area.
D. I will apply my usual dry skin lotion to the area.
5. A nurse is discharging a client to home after the client received a round of
chemotherapy. The client states "I am glad to be going home so that I can continue
my herbal remedy for nausea." The best response by the nurse is:
A. Tell me what herbal remedies you are planning on taking. Then we can
discuss their safety with your physician.
B. I think herbal therapies are an excellent way to control nausea related to
chemotherapy.
C. Be sure to research the herbal therapies with the salesperson at the health food
store before you start taking them.
D. Herbal therapies are safe and effective for everyone. I do not know why
physicians do not use them more.
6. A nurse is caring for a client who states they have sudden pain at the IV site when
receiving Vincristine. The nurse's first action should be to:
A. Call the physician.
B. Apply cool compresses to the site.
C. Apply warm compresses to the site.
D. Stop the infusion immediately
36
7. A client is to start chemotherapy next week for ovarian cancer. The nurse knows
the client understands teaching concerning alopecia when the client states:
A. I can't wait to get a tan on the top of my head.
B. I know my hair will fall out but, it will grow back just as it is now after the
chemotherapy.
C. I know my hair will not fall out, because I have been using a mild shampoo.
D. I have decided to have my hair cut short tomorrow. I already bought my
wig.
8. A client receiving chemotherapy states that everything she tries to eat does not taste
good. The nurse explains that this is a side effect of chemotherapy and the client can
perform which of the following to decrease this symptom.
A. Eat spicy foods to camouflage the taste.
B. Frequently perform mouth care.
C. Drink sips of water between every mouth of food.
D. Use commercial mouth wash before each meal.
9. A client with a diagnosis of terminal cancer is being cared for at home. The nurse
is teaching the client how to control pain. The nurse teaches the client to:
A. Start with the lower dosage of a medication then gradually increase the
dose until pain relief is obtained.
B. Start with the higher dosage of medication then gradually decrease the dosage
until pain relief is maintained.
C. Adjunct therapies such as relaxation exercises are useless for cancer pain
relief.
D. Monitor medication dosage carefully in order to prevent addiction.
10. A client is being admitted to the hospital for a radiation implant for cervical
cancer. The nurse teaches the client that:
A. It is fine for the client's school age children to visit as long as they limit the
visit to less than one hour.
B. The client will be radioactive for one month after the radiation implant is
removed.
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C. Visitors should be limited. Small children and pregnant women should 15. A nurse is caring for a client with thrombocytopenia. Which of the following
not visit. should be included in the client's plan of care? Check all that apply.
D. The client's urine and stool will be not be radioactive while the implant is in 1. Monitor platelet counts
place. 2. Assess the patient for melena
3. Monitor WBC counts.
11. The goal of each chemotherapy treatment is to: 4. Monitor the patient for hematemesis
A. Eradicate all of the cancer cells
B. Eradicate all the actively proliferating cells in the body
C. Eradicate the wall of the cancerous tumor
D. Eradicate a percentage of the cancer cells

12. A client with cancer undergoing surgery to relieve symptoms. Which type of
surgery is the client undergoing ?
A. Palliative
B. Reconstructive
C. Prophylactic
D. Diagnostic

13. The nurse is caring for a client who received an allogenic bone marrow transplant.
This type of transplant involves receiving cells from which type of donor?
A. An identical twin
B. The donor
C. A donor other than the client
D. A mixture of the client's cells with another donor

14. A client who is receiving chemotherapy for lung cancer has a neutrophil count of
600/mm. Which of the following statements should be included in teaching for this
client:
A. Avoid using a manual razor to shave
B. Avoid eating raw fruits and vegetables
C. Avoid using power tools
D. Avoid eating spicy foods