Take The Oncology NCLEX Practice Test Questions!

1. Nurse Amy is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society guidelines. the nurse should recommend that the women:

Perform breast self-examination annually.

Have a mammogram annually.

Have a hormonal receptor assay annually.

Have a physician conduct a clinical examination every 2 years.

The American Cancer Society guidelines state. “Women older than age 40 should have a mammogram annually and a clinical examination at least annually [not every 2 years]; all women should perform breast self-examination monthly [not annually].” The hormonal receptor assay is done on a known breast tumor to determine whether the tumor is estrogen– or progesterone-dependent.

Explanation

The American Cancer Society guidelines state. “Women older than age 40 should have a mammogram annually and a clinical examination at least annually [not every 2 years]; all women should perform breast self-examination monthly [not annually].” The hormonal receptor assay is done on a known breast tumor to determine whether the tumor is estrogen– or progesterone-dependent.

2. A client. age 41. visits the gynecologist. After examining her. the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer?

Onset of sporadic sexual activity at age 17

Spontaneous abortion at age 19

Pregnancy complicated with eclampsia at age 27

Human papillomavirus infection at age 32

Like other viral and bacterial venereal infections. human papillomavirus is a risk factor for cervical cancer. Other risk factors for this disease include frequent sexual intercourse before age 16. multiple sex partners. and multiple pregnancies. A spontaneous abortion and pregnancy complicated by eclampsia aren’t risk factors for cervical cancer.

Explanation

Like other viral and bacterial venereal infections. human papillomavirus is a risk factor for cervical cancer. Other risk factors for this disease include frequent sexual intercourse before age 16. multiple sex partners. and multiple pregnancies. A spontaneous abortion and pregnancy complicated by eclampsia aren’t risk factors for cervical cancer.

3. A female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy?

Urine output of 400 ml in 8 hours

Serum potassium level of 3.6 mEq/L

Blood pressure of 120/64 to 130/72 mm Hg

Dry oral mucous membranes and cracked lips

Chemotherapy commonly causes nausea and vomiting. which may lead to fluid and electrolyte imbalances. Signs of fluid loss include dry oral mucous membranes. cracked lips. decreased urine output (less than 40 ml/hour). abnormally low blood pressure. and a serum potassium level below 3.5 mEq/L.

Explanation

Chemotherapy commonly causes nausea and vomiting. which may lead to fluid and electrolyte imbalances. Signs of fluid loss include dry oral mucous membranes. cracked lips. decreased urine output (less than 40 ml/hour). abnormally low blood pressure. and a serum potassium level below 3.5 mEq/L.

4. Nurse April is teaching a client who suspects that she has a lump in her breast. The nurse instructs the client that a diagnosis of breast cancer is confirmed by:

Breast self-examination.

Mammography.

Fine needle aspiration.

Chest X-ray.

Fine needle aspiration and biopsy provide cells for histologic examination to confirm a diagnosis of cancer. A breast self-examination. if done regularly. is the most reliable method for detecting breast lumps early. Mammography is used to detect tumors that are too small to palpate. Chest X-rays can be used to pinpoint rib metastasis.

Explanation

Fine needle aspiration and biopsy provide cells for histologic examination to confirm a diagnosis of cancer. A breast self-examination. if done regularly. is the most reliable method for detecting breast lumps early. Mammography is used to detect tumors that are too small to palpate. Chest X-rays can be used to pinpoint rib metastasis.

5. The nurse is interviewing a male client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer?

Duodenal ulcers

Hemorrhoids

Weight gain

Polyps

Colorectal polyps are common with colon cancer. Duodenal ulcers and hemorrhoids aren’t preexisting conditions of colorectal cancer. Weight loss — not gain — is an indication of colorectal cancer.

Explanation

Colorectal polyps are common with colon cancer. Duodenal ulcers and hemorrhoids aren’t preexisting conditions of colorectal cancer. Weight loss — not gain — is an indication of colorectal cancer.

6. A female client is receiving methotrexate (Mexate). 12 g/m2 I.V.. to treat osteogenic carcinoma. During methotrexate therapy. the nurse expects the client to receive which other drug to protect normal cells?

Probenecid (Benemid)

Cytarabine (ara-C. cytosine arabinoside [Cytosar-U])

Thioguanine (6-thioguanine. 6-TG)

Leucovorin (citrovorum factor or folinic acid [Wellcovorin])

Leucovorin is administered with methotrexate to protect normal cells. which methotrexate could destroy if given alone. Probenecid should be avoided in clients receiving methotrexate because it reduces renal elimination of methotrexate. increasing the risk of methotrexate toxicity. Cytarabine and thioguanine aren’t used to treat osteogenic carcinoma.

Explanation

Leucovorin is administered with methotrexate to protect normal cells. which methotrexate could destroy if given alone. Probenecid should be avoided in clients receiving methotrexate because it reduces renal elimination of methotrexate. increasing the risk of methotrexate toxicity. Cytarabine and thioguanine aren’t used to treat osteogenic carcinoma.

7. Nurse April is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover:

Cancerous lumps.

Areas of thickness or fullness.

Changes from previous self-examinations.

Fibrocystic masses.

Women are instructed to examine themselves to discover changes that have occurred in the breast. Only a physician can diagnose lumps that are cancerous. areas of thickness or fullness that signal the presence of a malignancy. or masses that are fibrocystic as opposed to malignant.

Explanation

Women are instructed to examine themselves to discover changes that have occurred in the breast. Only a physician can diagnose lumps that are cancerous. areas of thickness or fullness that signal the presence of a malignancy. or masses that are fibrocystic as opposed to malignant.

8. A male client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer?

Persistent nausea

Rash

Indigestion

Chronic ache or pain

Indigestion. or difficulty swallowing. is one of the seven warning signs of cancer. The other six are a change in bowel or bladder habits. a sore that does not heal. unusual bleeding or discharge. a thickening or lump in the breast or elsewhere. an obvious change in a wart or mole. and a nagging cough or hoarseness. Persistent nausea may signal stomach cancer but isn’t one of the seven major warning signs. Rash and chronic ache or pain seldom indicate cancer.

Explanation

Indigestion. or difficulty swallowing. is one of the seven warning signs of cancer. The other six are a change in bowel or bladder habits. a sore that does not heal. unusual bleeding or discharge. a thickening or lump in the breast or elsewhere. an obvious change in a wart or mole. and a nagging cough or hoarseness. Persistent nausea may signal stomach cancer but isn’t one of the seven major warning signs. Rash and chronic ache or pain seldom indicate cancer.

9. For a female client newly diagnosed with radiation-induced thrombocytopenia. the nurse should include which intervention in the plan of care?

Administering aspirin if the temperature exceeds 102° F (38.8° C)

Inspecting the skin for petechiae once every shift

Providing for frequent rest periods

Placing the client in strict isolation

Because thrombocytopenia impairs blood clotting. the nurse should inspect the client regularly for signs of bleeding. such as petechiae. purpura. epistaxis. and bleeding gums. The nurse should avoid administering aspirin because it may increase the risk of bleeding. Frequent rest periods are indicated for clients with anemia. not thrombocytopenia. Strict isolation is indicated only for clients who have highly contagious or virulent infections that are spread by air or physical contact.

Explanation

Because thrombocytopenia impairs blood clotting. the nurse should inspect the client regularly for signs of bleeding. such as petechiae. purpura. epistaxis. and bleeding gums. The nurse should avoid administering aspirin because it may increase the risk of bleeding. Frequent rest periods are indicated for clients with anemia. not thrombocytopenia. Strict isolation is indicated only for clients who have highly contagious or virulent infections that are spread by air or physical contact.

10. A male client undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma. the nurse should include which instruction?

“Keep the stoma uncovered.”

“Keep the stoma dry.”

“Have a family member perform stoma care initially until you get used to the procedure.”

“Keep the stoma moist.”

The nurse should instruct the client to keep the stoma moist. such as by applying a thin layer of petroleum jelly around the edges. because a dry stoma may become irritated. The nurse should recommend placing a stoma bib over the stoma to filter and warm air before it enters the stoma. The client should begin performing stoma care without assistance as soon as possible to gain independence in self-care activities.

Explanation

The nurse should instruct the client to keep the stoma moist. such as by applying a thin layer of petroleum jelly around the edges. because a dry stoma may become irritated. The nurse should recommend placing a stoma bib over the stoma to filter and warm air before it enters the stoma. The client should begin performing stoma care without assistance as soon as possible to gain independence in self-care activities.