Test Bank Finals

B) Smoking cessation

The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?

A) Monthly self-breast exams

B) Smoking cessation

C) Annual colonoscopies

D) Monthly testicular exams

A) Liver function tests (LFTs)

A nurse who works in an oncology clinic is assessing a patient who has arrived for a 2-month follow-up appointment following chemotherapy. The nurse notes that the patients skin appears yellow. Which blood tests should be done to further explore this clinical sign?

A) Liver function tests (LFTs)

B) Complete blood count (CBC)

C) Platelet count

D) Blood urea nitrogen and creatinine

C) Baked apricot chicken and steamed broccoli

The school nurse is teaching a nutrition class in the local high school. One student states that he has heard that certain foods can increase the incidence of cancer. The nurse responds, Research has shown that certain foods indeed appear to increase the risk of cancer. Which of the following menu selections would be the best choice for potentially reducing the risks of cancer?

A) Smoked salmon and green beans

B) Pork chops and fried green tomatoes

C) Baked apricot chicken and steamed broccoli

D) Liver, onions, and steamed peas

C) Teaching patients to wear sunscreen

Traditionally, nurses have been involved with tertiary cancer prevention. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention?

A) Yearly Pap tests

B) Testicular self-examination

C) Teaching patients to wear sunscreen

D) Screening mammograms

C) Prophylactic surgery

The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the patient is requesting a bilateral mastectomy. This surgery is an example of what type of oncologic surgery?

A) Salvage surgery

B) Palliative surgery

C) Prophylactic surgery

D) Reconstructive surgery

A) Impaired nutritional status

The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient?

A) Impaired nutritional status

B) Cognitive changes

C) Diarrhea

D) Alopecia

A) Stopping the administration of the drug immediately

While a patient is receiving IV doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize what action? A) Stopping the administration of the drug immediately

B) Notifying the patients physician

C) Continuing the infusion but decreasing the rate

D) Applying a warm compress to the infusion site

B) Nausea and vomiting

A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe?

A) Pruritis (itching)

B) Nausea and vomiting

C) Altered glucose metabolism

D) Confusion

C) Epistaxis (nose bleed)

A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia?

A) Interrupted sleep pattern

B) Hot flashes

C) Epistaxis (nose bleed)

D) Increased weight

B) Provide skin care to maintain skin integrity.

A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection-related death in oncology patients?

A) Encourage several small meals daily.

B) Provide skin care to maintain skin integrity.

C) Assist the patient with hygiene, as needed.

D) Assess the integrity of the patients oral mucosa regularly.

C) Risk for infection related to altered immunologic response

The nurse on a bone marrow transplant unit is caring for a patient with cancer who is preparing for HSCT. What is a priority nursing diagnosis for this patient?

A) Fatigue related to altered metabolic processes

B) Altered nutrition: less than body requirements related to anorexia

C) Risk for infection related to altered immunologic response

D) Body image disturbance related to weight loss and anorexia

D) Avoid using soap on the treatment area.

An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do?

A) Periodically apply ice to the area.

B) Keep the area cleanly shaven.

C) Apply petroleum jelly to the affected area.

D) Avoid using soap on the treatment area.

D) Discuss a referral for hospice care.

The nurse is caring for a patient has just been given a 6-month prognosis following a diagnosis of extensive stage small-cell lung cancer. The patient states that he would like to die at home, but the team believes that the patients care needs are unable to be met in a home environment. What might you suggest as an alternative?

A) Discuss a referral for rehabilitation hospital.

B) Panel the patient for a personal care home.

C) Discuss a referral for acute care.

D) Discuss a referral for hospice care.

A) These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and x-ray studies.

The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient?

A) These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and x-ray studies.

B) These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer.

C) Try not to be concerned about these symptoms. Every patient feels this way after having radiation therapy.

D) Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying

A) The patient requests that her family bring her makeup and wig.

A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem? A) The patient requests that her family bring her makeup and wig.

B) The patient begins to discuss the future with her family.

C) The patient reports less disruption from pain and discomfort.

D) The patient cries openly when discussing her disease.

A) Administer an antiemetic.

A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?

A) Administer an antiemetic.

B) Administer an antimetabolite.

C) Administer a tumor antibiotic.

D) Administer an anticoagulant.

B) Malignant cells contain proteins called tumor-specific antigens.

An oncology nurse educator is providing health education to a patient who has been diagnosed with skin cancer. The patients wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?

A) Malignant cells contain more fibronectin than normal body cells.

B) Malignant cells contain proteins called tumor-specific antigens.

C) Chromosomes contained in cancer cells are more durable and stable than those of normal cells.

D) The nuclei of cancer cells are unusually large, but regularly shaped.

B) Lymphatic circulation

A patients most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the patients cancer cells spread?

A) Hematologic spread

B) Lymphatic circulation

C) Invasion

D) Angiogenesis

A) Rate of growth

B) Ability to cause death

E) Ability to spread

The nurse is describing some of the major characteristics of cancer to a patient who has recently received a diagnosis of malignant melanoma. When differentiating between benign and malignant cancer cells, the nurse should explain differences in which of the following aspects? Select all that apply.

A) Rate of growth

B) Ability to cause death

C) Size of cells

D) Cell contents

E) Ability to spread

B) Different proteins in the cell membrane

A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The patient states, They tell me my cancer is malignant, while my coworkers breast tumor was benign. I just dont understand at all. When preparing a response to this patient, the nurse should be cognizant of what characteristic that distinguishes malignant cells from benign cells of the same tissue type?

A) Slow rate of mitosis of cancer cells

B) Different proteins in the cell membrane

C) Differing size of the cells

D) Different molecular structure in the cells

D) Invading healthy host tissues

An oncology patient will begin a course of chemotherapy and radiation therapy for the treatment of bone metastases. What is one means by which malignant disease processes transfer cells from one place to another? A) Adhering to primary tumor cells

B) Inducing mutation of cells of another organ

C) Phagocytizing healthy cells

D) Invading healthy host tissues

C) Breast cancer

D) Esophageal cancer

E) Liver cancer

The nurse is performing an initial assessment of an older adult resident who has just relocated to the long-term care facility. During the nurses interview with the patient, she admits that she drinks around 20 ounces of vodka every evening. What types of cancer does this put her at risk for? Select all that apply.

A) Malignant melanoma

B) Brain cancer

C) Breast cancer

D) Esophageal cancer

E) Liver cancer

B) Research has shown that taking the drug tamoxifen can reduce your chance of breast cancer.

The clinic nurse is caring for a patient whose grandmother and sister have both had breast cancer. She requested a screening test to determine her risk of developing breast cancer and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response?

A) Research has shown that eating a healthy diet can provide all the protection you need against breast cancer.

B) Research has shown that taking the drug tamoxifen can reduce your chance of breast cancer.

C) Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer.

D) Research has shown that there is little you can do to reduce your risk of breast cancer if you have a genetic predisposition.

A) Palliative

You are caring for a patient who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the patient the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer?

A) Palliative

B) Reconstructive

C) Salvage

D) Prophylactic

A) Tumor lysis syndrome (TLS)

The home health nurse is performing a home visit for an oncology patient discharged 3 days ago after completing treatment for non-Hodgkin lymphoma. The nurses assessment should include examination for the signs and symptoms of what complication?

A) Tumor lysis syndrome (TLS)

B) Syndrome of inappropriate antiduretic hormone (SIADH)

C) Disseminated intravascular coagulation (DIC)

D) Hypercalcemia

B) Impaired wound healing

The nurse is admitting an oncology patient to the unit prior to surgery. The nurse reads in the electronic health record that the patient has just finished radiation therapy. With knowledge of the consequent health risks, the nurse should prioritize assessments related to what health problem?

A) Cognitive deficits

B) Impaired wound healing

C) Cardiac tamponade

D) Tumor lysis syndrome

B) TPN administered via a peripherally inserted central catheter

A patient with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location precludes the use of enteral feeding. What intervention should the nurse identify as best meeting this patients nutritional needs?

A) Administration of parenteral feeds via a peripheral IV

B) TPN administered via a peripherally inserted central catheter

C) Insertion of an NG tube for administration of feeds

D) Maintaining NPO status and IV hydration until treatment completion

D) Altering the immunologic relationship between the tumor and the patient

An oncology nurse is contributing to the care of a patient who has failed to respond appreciably to conventional cancer treatments. As a result, the care team is considering the possible use of biologic response modifiers (BRFs). The nurse should know that these achieve a therapeutic effect by what means?

A) Promoting the synthesis and release of leukocytes

B) Focusing the patients immune system exclusively on the tumor

C) Potentiating the effects of chemotherapeutic agents and radiation therapy

D) Altering the immunologic relationship between the tumor and the patient

C) Candidiasis

While taking a health history on a 20-year-old female patient, the nurse ascertains that this patient is taking miconazole (Monistat). The nurse is justified in presuming that this patient has what medical condition?

A) Bacterial vaginosis

B) Human papillomavirus (HPV)

C) Candidiasis

D) Toxic shock syndrome (TSS)

B) Human papillomavirus (HPV)

When teaching patients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor?

A) Late childbearing

B) Human papillomavirus (HPV)

C) Postmenopausal bleeding

D) Tobacco use

A) This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually.

A female patient with HIV has just been diagnosed with condylomata acuminata (genital warts). What information is most appropriate for the nurse to tell this patient?

A) This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually.

B) The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days.

C) The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.

D) The human papillomavirus (HPV), which causes condylomata acuminata, cannot be transmitted during oral sex.

B) Increased abdominal girth

A patient with ovarian cancer is admitted to the hospital for surgery and the nurse is completing the patients health history. What clinical manifestation would the nurse expect to assess?

A) Fish-like vaginal odor

B) Increased abdominal girth

C) Fever and chills

D) Lower abdominal pelvic pain

C) Most cases of ovarian cancer are considered to be random, with no obvious causation.

A 30-year-old patient has come to the clinic for her yearly examination. The patient asks the nurse about ovarian cancer. What should the nurse state when describing risk factors for ovarian cancer?

A) Use of oral contraceptives increases the risk of ovarian cancer.

B) Most cases of ovarian cancer are attributed to tobacco use.

C) Most cases of ovarian cancer are considered to be random, with no obvious causation.

D) The majority of women who get ovarian cancer have a family history of the disease.

A) Provide emotional support to the patient and her family.

The nurse is caring for a patient who has just been told that her ovarian cancer is terminal and that no curative options remain. What would be the priority nursing care for this patient at this time?

A) Provide emotional support to the patient and her family.

B) Implement distraction and relaxation techniques.

C) Offer to inform the patients family of this diagnosis.

D) Teach the patient about the importance of maintaining a positive attitude.

A) Promotion of HPV immunization

B) Encouraging young women to delay first intercourse

C) Smoking cessation

E) Using safer sex practices

A public health nurse is participating in a campaign aimed at preventing cervical cancer. What strategies should the nurse include is this campaign? Select all that apply.

A) Promotion of HPV immunization

B) Encouraging young women to delay first intercourse

C) Smoking cessation

D) Vitamin D and calcium supplementation

E) Using safer sex practices

D) Reassure the patient that she will still be able to have intercourse with sexual satisfaction and orgasm.

A 27-year-old female patient is diagnosed with invasive cervical cancer and is told she needs to have a hysterectomy. One of the nursing diagnoses for this patient is disturbed body image related to perception of femininity. What intervention would be most appropriate for this patient?

A) Reassure the patient that she will still be able to have children.

B) Reassure the patient that she does not have to have sex to be feminine.

C) Reassure the patient that you know how she is feeling and that you feel her anxiety and pain.

D) Reassure the patient that she will still be able to have intercourse with sexual satisfaction and orgasm.

C) Protecting the safety of the patient, family, and staff

A patient diagnosed with cervical cancer will soon begin a round of radiation therapy. When planning the patients subsequent care, the nurse should prioritize actions with what goal?

A) Preventing hemorrhage

B) Ensuring the patient knows the treatment is palliative, not curative

C) Protecting the safety of the patient, family, and staff

D) Ensuring that the patient adheres to dietary restrictions during treatment

A) Leukopenia

The nurse is caring for a 63-year-old patient with ovarian cancer. The patient is to receive chemotherapy consisting of Taxol and Paraplatin. For what adverse effect of this treatment should the nurse monitor the patient?

A) Leukopenia

B) Metabolic acidosis

C) Hyperphosphatemia

D) Respiratory alkalosis

C) Brachytherapy

A 45-year-old woman has just undergone a radical hysterectomy for invasive cervical cancer. Prior to the surgery the physician explained to the patient that after the surgery a source of radiation would be placed near the tumor site to aid in reducing recurrence. What is the placement of the source of radiation called?

A) Internal beam radiation

B) Trachelectomy

C) Brachytherapy

D) External radiation

D) Radical trachelectomy

A 25-year-old patient diagnosed with invasive cervical cancer expresses a desire to have children. What procedure might the physician offer as treatment?

A) Radical hysterectomy

B) Radical culposcopy

C) Radical trabeculectomy

D) Radical trachelectomy

C) It will help to observe for dimpling more closely.

The nurse leading an educational session is describing self-examination of the breast. The nurse tells the womens group to raise their arms and inspect their breasts in a mirror. A member of the womens group asks the nurse why raising her arms is necessary. What is the nurses best response?

A) It helps to spread out the fat that makes up your breast.

B) It allows you to simultaneously assess for pain.

C) It will help to observe for dimpling more closely.

D) This is what the American Cancer Society recommends.

C) Age 38

A woman aged 48 years comes to the clinic because she has discovered a lump in her breast. After diagnostic testing, the woman receives a diagnosis of breast cancer. The woman asks the nurse when her teenage daughters should begin mammography. What is the nurses best advice?

A) Age 28

B) Age 35

C) Age 38

D) Age 48

C) Stop taking aspirin.

A woman scheduled for a simple mastectomy in one week is having her preoperative education provided by the clinic nurse. What educational intervention will be of primary importance to prevent hemorrhage in the postoperative period?

A) Limit her intake of green leafy vegetables.

B) Increase her water intake to 8 glasses per day.

C) Stop taking aspirin.

D) Have nothing by mouth for 6 hours before surgery.

D) Tamoxifen is known to be a highly effective protective measure.

The nurse is caring for a 52-year-old woman whose aunt and mother died of breast cancer. The patient states, My doctor and I talked about Tamoxifen to help prevent breast cancer. Do you think it will work? What would be the nurses best response?

A) Yes, its known to have a slight protective effect.

B) Yes, but studies also show an increased risk of osteoporosis.

C) You wont need to worry about getting cancer as long as you take Tamoxifen.

D) Tamoxifen is known to be a highly effective protective measure.

D) Bilateral mastectomy

A woman is being treated for a tumor of the left breast. If the patient and her physician opt for prophylactic treatment, the nurse should prepare the woman for what intervention?

A) More aggressive chemotherapy

B) Left mastectomy

C) Radiation therapy

D) Bilateral mastectomy

C) Pagets disease

During a recent visit to the clinic a woman presents with erythema of the nipple and areola on the right breast. She states this started several weeks ago and she was fearful of what would be found. The nurse should promptly refer the patient to her primary care provider because the patients signs and symptoms are suggestive of what health problem?

A) Peau dorange

B) Nipple inversion

C) Pagets disease

D) Acute mastitis

A) Acknowledge the fear the patient is likely experiencing.

A patient who came to the clinic after finding a mass in her breast is scheduled for a diagnostic breast biopsy. During the nurses admission assessment, the nurse observes that the patient is distracted and tense. What is it important for the nurse to do?

A) Acknowledge the fear the patient is likely experiencing.

B) Describe the support groups that exist in the community.

C) Assess the patients stress management skills.

D) Document a nursing diagnosis of ineffective coping.

A) Lumpectomy and radiation

A patient has been referred to the breast clinic after her most recent mammogram revealed the presence of a lump. The lump is found to be a small, well-defined nodule in the right breast. The oncology nurse should recognize the likelihood of what treatment?

A) Lumpectomy and radiation

B) Partial mastectomy and radiation

C) Partial mastectomy and chemotherapy

D) Total mastectomy and chemotherapy

C) Fine-needle aspiration

A 23-year-old woman comes to the free clinic stating I think I have a lump in my breast. Do I have cancer? The nurse instructs the patient that a diagnosis of breast cancer is confirmed by what?

A) Supervised breast self-examination

B) Mammography

C) Fine-needle aspiration

D) Chest x-ray

B) A nonmobile mass with irregular edges

A 42 year-old patient tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. She says that she is afraid that she has cancer. Which assessment finding would most strongly suggest that this patients lump is cancerous?

A) Eversion of the right nipple and mobile mass

B) A nonmobile mass with irregular edges

C) A mobile mass that is soft and easily delineated

D) Nonpalpable right axillary lymph nodes

D) Arrange a referral to a community-based support program.

A patient in her 30s has two young children and has just had a modified radical mastectomy with immediate reconstruction. The patient shares with the nurse that she is somewhat worried about her future, but she appears to be adjusting well to her diagnosis and surgery. What nursing intervention is most appropriate to support this patients coping?

A) Encourage the patients spouse or partner to be supportive while she recovers.

B) Encourage the patient to proceed with the next phase of treatment.

C) Recommend that the patient remain optimistic for the sake of her children.

D) Arrange a referral to a community-based support program.

D) Arrange a referral to a community-based support program.

A patient in her 30s has two young children and has just had a modified radical mastectomy with immediate reconstruction. The patient shares with the nurse that she is somewhat worried about her future, but she appears to be adjusting well to her diagnosis and surgery. What nursing intervention is most appropriate to support this patients coping?

A) Encourage the patients spouse or partner to be supportive while she recovers.

B) Encourage the patient to proceed with the next phase of treatment.

C) Recommend that the patient remain optimistic for the sake of her children.

D) Arrange a referral to a community-based support program.

C) Avoid lifting objects heavier than 10 pounds.

The nurse is caring for a patient who has just had a radical mastectomy and axillary node dissection. When providing patient education regarding rehabilitation, what should the nurse recommend?

A) Avoid exercise of the arm for next 2 months.

B) Keep cuticles clipped neatly.

C) Avoid lifting objects heavier than 10 pounds.

D) Use a sling until healing is complete.

A) Apply cold compresses as ordered.

A new mother who is breastfeeding calls the clinic to speak to a nurse. The patient is complaining of pain in her left breast and describes her breast as feeling doughy. The nurse tells her to come into the clinic and be checked. The patient is diagnosed with acute mastitis and placed on antibiotics. What comfort measure should the nurse recommend?

A) Apply cold compresses as ordered.

B) Avoid wearing a bra until the infection clears.

C) Avoid washing the breasts.

D) Perform gentle massage to stimulate neutrophil migration

D) The patient has a 15% chance of 5-year survival

A patient newly diagnosed with breast cancer states that her physician suspects regional lymph node involvement and told her that there are signs of metastatic disease. The nurse learns that the patient has been diagnosed with stage IV breast cancer. What is an implication of this diagnosis?

A) The patient is not a surgical candidate.

B) The patients breast cancer is considered highly treatable.

C) There is a 10% chance that the patients cancer will self-resolve.

D) The patient has a 15% chance of 5-year survival

B) The patient gave birth to her first child at age 38.

The nurse is performing a comprehensive health history of a patient who is in her 50s. The nurse should identify what risk factor that may increase this patients risk for breast cancer?

A) The patient breastfed each of her children.

B) The patient gave birth to her first child at age 38.

C) The patient experienced perimenopausal symptoms starting at age 46.

D) The patient experienced menarche at age 13.

A) Nontenderness

The nurse is reviewing the physicians notes from the patient who has just left the clinic. The nurse learns that the physician suspects a malignant breast tumor. On palpation, the mass most likely had what characteristic?

A) Nontenderness

B) A size of 5 mm

C) Softness and a regular shape

D) Mobility

C) Women over age 40

For which of the following population groups would an annual clinical breast examination be recommended?

A) Women over age 21

B) Women over age 25

C) Women over age 40

D) All post-pubescent females with a family history of breast cancer

B) Instructions about breast self-examination (BSE)

A 42-year-old man has come to the clinic for an annual physical. The nurse notes in the patients history that his father was treated for breast cancer. What should the nurse provide to the patient before he leaves the clinic?

A) A referral for a mammogram

B) Instructions about breast self-examination (BSE)

C) A referral to a surgeon

D) A referral to a support group

D) Between days 5 and 7 after menses

The nurse is teaching breast self-examination (BSE) to a group of women. The nurse should recommend that the women perform BSE at what time?

A) At the time of menses

B) At any convenient time, regardless of cycles

C) Weekly

D) Between days 5 and 7 after menses

A) Womens knowledge of how their breasts normally look and feel

A nurse is teaching a group of women about the potential benefits of breast self-examination (BSE). The nurse should teach the women that effective BSE is dependent on what factor?

A) Womens knowledge of how their breasts normally look and feel

B) The rapport that exists between the woman and her primary care provider

C) Synchronizing womens routines around BSE with the performance of mammograms

D) Womens knowledge of the pathophysiology of breast cancer

B) Medication adverse effects

A 60-year-old man presents at the clinic complaining that his breasts are tender and enlarging. The patient is subsequently diagnosed with gynecomastia. The patient should be assessed for the possibility of what causative factor?

A) Age-related physiologic changes

B) Medication adverse effects

C) Poor nutrition

D) Fluid overload

D) Decreased nipple sensation

A woman is considering breast reduction mammoplasty. When weighing the potential risks and benefits of this surgical procedure, the nurse should confirm that the patient is aware of what potential consequence?

A) Chronic breast pain

B) Unclear mammography results

C) Increased risk of breast cancer

D) Decreased nipple sensation

A) An ultrasound-guided core biopsy is faster, less expensive, and does not use radiation.

A patient is to undergo an ultrasound-guided core biopsy. The patient tells the nurse that a friend of hers had a stereotactic core biopsy. She wants to understand the differences between the two procedures. What would be the nurses best response?

A) An ultrasound-guided core biopsy is faster, less expensive, and does not use radiation.

B) An ultrasound-guided core biopsy is a little more expensive, but it doesnt use radiation and it is faster.

C) An ultrasound-guided core biopsy is a little more expensive, and it also uses radiation but it is faster.

D) An ultrasound-guided core biopsy takes more time, and it also uses radiation, but it is less expensive.

B) An incisional biopsy is performed to confirm a diagnosis and so that special studies can be done that will help determine the best treatment.

A patient at high risk for breast cancer is scheduled for an incisional biopsy in the outpatient surgery department. When the nurse is providing preoperative education, the patient asks why an incisional biopsy is being done instead of just removing the mass. What would be the nurses best response?

A) An incisional biopsy is performed because its known to be less painful and more accurate than other forms of testing.

B) An incisional biopsy is performed to confirm a diagnosis and so that special studies can be done that will help determine the best treatment.

C) An incisional biopsy is performed to assess the potential for recovery from a mastectomy.

D) An incisional biopsy is performed on patients who are younger than the age of 40 and who are otherwise healthy.

A) By encouraging her to verbalize her questions and concerns

A patient has just been told she needs to have an incisional biopsy of a right breast mass. During preoperative teaching, how could the nurse best assess this patient for specific educational, physical, or psychosocial needs she might have?

A) By encouraging her to verbalize her questions and concerns

B) By discussing the possible findings of the biopsy

C) By discussing possible treatment options if the diagnosis is cancer

D) By reviewing her medical history

A) Acute pain related to tissue manipulation and incision

A patient has just returned to the postsurgical unit from post-anesthetic recovery after breast surgery for removal of a malignancy. What is the most likely major nursing diagnosis to include in this patients immediate plan of care?

A) Acute pain related to tissue manipulation and incision

B) Ineffective coping related to surgery

C) Risk for trauma related to post-surgical injury

D) Chronic sorrow related to change in body image

B) Provide the patient with relevant information about expected recovery.

A 52-year-old woman has just been told she has breast cancer and is scheduled for a modified mastectomy the following week. The nurse caring for this patient knows that she is anxious and fearful about the upcoming procedure and the newly diagnosed malignancy. How can the nurse most likely alleviate this patients fears?

A) Provide written material on the procedure that has been scheduled for the patient.

B) Provide the patient with relevant information about expected recovery.

C) Give the patient current information on breast cancer survival rates.

D) Offer the patient alternative treatment options.

C) Lobules and ducts

A nurse is explaining that each breast contains 12 to 20 cone-shaped lobes. The nurse should explain that each lobe consists of what elements?

A) Modified tendons and ligaments

B) Connective tissue and smooth muscle

C) Lobules and ducts

D) Endocrine glands and sebaceous glands

D) Provide the patient with encouragement in an empathic and thoughtful manner.

A nurse has assessed that a patient is not yet willing to view her mastectomy site. How should the nurse best assist the patient is developing a positive body image?

A) Ask the woman to describe the current appearance of her breast.

B) Help the patient to understand that many women have gone through the same unpleasant experience.

C) Explain to the patient that her body image does not have to depend on her physical appearance.

D) Provide the patient with encouragement in an empathic and thoughtful manner.

A) Not until the drain is removed

A patient has had a total mastectomy with immediate reconstruction. The patient asks the nurse when she can take a shower. What should the nurse respond?

A) Not until the drain is removed

B) On the second postoperative day

C) Now, if you wash gently with soap and water

D) Seven days after your surgery

A) Adherence to the exercise plan

B) Overall psychological functioning

C) Integrity of surgical drains

A patient has been discharged home after a total mastectomy without reconstruction. The patient lives alone and has a home health referral. When the home care nurse performs the first scheduled visit this patient, what should the nurse assess? Select all that apply.

A) Adherence to the exercise plan

B) Overall psychological functioning

C) Integrity of surgical drains

D) Understanding of cancer

E) Use of the breast prosthesis

C) Is there someone you trust to help you make treatment choices?

A patient has just been diagnosed with breast cancer and the nurse is performing a patient interview. In assessing this patients ability to cope with this diagnosis, what would be an appropriate question for the nurse to ask this patient?

A) What is your level of education?

B) Are you feeling alright these days?

C) Is there someone you trust to help you make treatment choices?

D) Are you concerned about receiving this diagnosis?

D) According to current guidelines, breast conservation combined with radiation is as effective as a modified radical mastectomy.

A 35-year-old mother of three young children has been diagnosed with stage II breast cancer. After discussing treatment options with her physician, the woman goes home to talk to her husband, later calling the nurse for clarification of some points. The patient tells the nurse that the physician has recommended breast conservation surgery followed by radiation. The patients husband has done some online research and is asking why his wife does not have a modified radical mastectomy to be sure all the cancer is gone. What would be the nurses best response?

A) Modified radical mastectomies are very hard on a patient, both physically and emotionally and they really arent necessary anymore.

B) According to current guidelines, having a modified radical mastectomy is no longer seen as beneficial.

C) Modified radical mastectomies have a poor survival rate because of the risk of cancer recurrence.

D) According to current guidelines, breast conservation combined with radiation is as effective as a modified radical mastectomy.

D) It is highly responsive to treatment

A public health nurse has been asked to provide a health promotion session for men at a wellness center. What should the nurse inform the participants about testicular cancer?

A) It is most common among men over 55.

B) It is one of the least curable solid tumors.

C) It typically does not metastasize.

D) It is highly responsive to treatment

D) The patient should avoid close contact with his daughter for 2 months

A patient has just been diagnosed with prostate cancer and is scheduled for brachytherapy next week. The patient and his wife are unsure of having the procedure because their daughter is 3 months pregnant. What is the most appropriate teaching the nurse should provide to this family?

A) The patient should not be in contact with the baby after delivery.

B) The patients treatment poses no risk to his daughter or her infant.

C) The patients brachytherapy may be contraindicated for safety reasons.

D) The patient should avoid close contact with his daughter for 2 months

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

A nurse is teaching a 53-year-old man about prostate cancer. What information should the nurse provide to best facilitate the early identification of prostate cancer?

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

B) Have a transrectal ultrasound every 5 years.

C) Perform monthly testicular self-examinations, especially after age 60.

D) Have a complete blood count (CBC), blood urea nitrogen (BUN) and creatinine assessment performed annually.

A) Testicular cancer is a highly curable type of cancer.

A public health nurse is teaching a health class for the male students at the local high school. The nurse is teaching the boys to perform monthly testicular self-examinations. What point would be appropriate to emphasize?

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.

C) African Americans

A nurse is providing an educational event to a local mens group about prostate cancer. The nurse should cite an increased risk of prostate cancer in what ethnic group?

A) Native Americans

B) Caucasian Americans

C) African Americans

D) Asian Americans

A) A number of studies have identified an association of BRCA-2 mutation with an increased risk of prostate cancer.

A man tells the nurse that his father died of prostate cancer and he is concerned about his own risk of developing the disease, having heard that prostate cancer has a genetic link. What aspect of the pathophysiology of prostate cancer would underlie the nurses response?

A) A number of studies have identified an association of BRCA-2 mutation with an increased risk of prostate cancer.

B) HNPCC is a mutation of two genes that causes prostate cancer in men and it is autosomal dominant.

C) Studies have shown that the presence of the TP53 gene strongly influences the incidence of prostate cancer.

D) Recent research has demonstrated that prostate cancer is the result of lifestyle factors and that genetics are unrelated.

C) The patient should have PSA levels drawn regularly.

A nurse is performing an admission assessment on a 40-year-old man who has been admitted for outpatient surgery on his right knee. While taking the patients family history, he states, My father died of prostate cancer at age 48. The nurse should instruct him on which of the following health promotion activities?

A) The patient will need PSA levels drawn starting at age 55.

B) The patient should have testing for presence of the CDH1 and STK11 genes.

C) The patient should have PSA levels drawn regularly.

D) The patient should limit alcohol use due to the risk of malignancy

C) Evidence of a more advanced lesion

A nurse is caring for a 33-year-old male who has come to the clinic for a physical examination. He states that he has not had a routine physical in 5 years. During the examination, the physician finds that digital rectal examination (DRE) reveals stoney hardening in the posterior lobe of the prostate gland that is not mobile. The nurse recognizes that the observation typically indicates what?

A) A normal finding

B) A sign of early prostate cancer

C) Evidence of a more advanced lesion

D) Metastatic disease

A) Disturbed Body Image Related to Effects of Surgery

A 29-year-old patient has just been told that he has testicular cancer and needs to have surgery. During a presurgical appointment, the patient admits to feeling devastated that he requires surgery, stating that it will leave him emasculated and a shell of a man. The nurse should identify what nursing diagnosis when planning the patients subsequent care?

A) Disturbed Body Image Related to Effects of Surgery

B) Spiritual Distress Related to Effects of Cancer Surgery

C) Social Isolation Related to Effects of Surgery

D) Risk for Loneliness Related to Change in Self-Concept

A) Closely monitoring the input and output of the bladder irrigation system

A nurse is providing care for a patient who has recently been admitted to the postsurgical unit from PACU following a transuretheral resection of the prostate. The nurse is aware of the nursing diagnosis of Risk for Imbalanced Fluid Volume. In order to assess for this risk, the nurse should prioritize what action?

A) Closely monitoring the input and output of the bladder irrigation system

B) Administering parenteral nutrition and fluids as ordered

C) Monitoring the patients level of consciousness and skin turgor

D) Scanning the patients bladder for retention every 2 hours

A) Provide empathy and encouragement in an effort to foster a positive outlook.

A 22-year-old male is being discharged home after surgery for testicular cancer. The patient is scheduled to begin chemotherapy in 2 weeks. The patient tells the nurse that he doesnt think he can take weeks or months of chemotherapy, stating that he has researched the adverse effects online. What is the most appropriate nursing action for this patient at this time?

A) Provide empathy and encouragement in an effort to foster a positive outlook.

B) Tell the patient it is his decision whether to accept or reject chemotherapy.

C) Report the patients statement to members of his support system.

D) Refer the patient to social work.

A) The different leukemias all involve unregulated proliferation of white blood cells.

An oncology nurse is providing health education for a patient who has recently been diagnosed with leukemia. What should the nurse explain about commonalities between all of the different subtypes of leukemia?

A) The different leukemias all involve unregulated proliferation of white blood cells.

B) The different leukemias all have unregulated proliferation of red blood cells and decreased bone marrow function.

C) The different leukemias all result in a decrease in the production of white blood cells.

D) The different leukemias all involve the development of cancer in the lymphatic system.

A) Monitoring for infection

A nurse is caring for a patient who has a diagnosis of acute leukemia. What assessment most directly addresses the most common cause of death among patients with leukemia?

A) Monitoring for infection

B) Monitoring nutritional status

C) Monitor electrolyte levels

D) Monitoring liver function

Hypercalcemia

An oncology nurse is caring for a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patients most recent blood tests, the nurse should anticipate what imbalance?

A) Hypercalcemia

B) Hyperproteinemia

C) Elevated serum viscosity

D) Elevated RBC count

C) Decreased bone density

A nurse is planning the care of a patient who has been admitted to the medical unit with a diagnosis of multiple myeloma. In the patients care plan, the nurse has identified a diagnosis of Risk for Injury. What pathophysiologic effect of multiple myeloma most contributes to this risk?

A) Labyrinthitis

B) Left ventricular hypertrophy

C) Decreased bone density

D) Hypercoagulation

A) Tell him that you will give him privacy and leave the room.

A patient with advanced leukemia is responding poorly to treatment. The nurse finds the patient tearful and trying to express his feelings, but he is clearly having difficulty. What is the nurses most appropriate action? A) Tell him that you will give him privacy and leave the room.

B) Offer to call pastoral care.

C) Ask if he would like you to sit with him while he collects his thoughts.

D) Tell him that you can understand how he’s feeling.

B) Risk for Infection

A nursing student is caring for a patient with acute myeloid leukemia who is preparing to undergo induction therapy. In preparing a plan of care for this patient, the student should assign the highest priority to which nursing diagnoses?

A) Activity Intolerance

B) Risk for Infection

C) Acute Confusion

D) Risk for Spiritual Distress

C) Five-year survival for patients over 75 years old is less than 2%.

A 77-year-old male is admitted to a unit with a suspected diagnosis of acute myeloid leukemia (AML). When planning this patients care, the nurse should be aware of what epidemiologic fact?

A) Early diagnosis is associated with good outcomes.

B) Five-year survival for older adults is approximately 50%.

C) Five-year survival for patients over 75 years old is less than 2%.

D) Survival rates are wholly dependent on the patients pre-illness level of health

D) ALL

A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain. His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of immature cells. The nurse caring for this patient suspects a diagnosis of what?

A) AML

B) CML

C) MDS

D) ALL

A) Chew with care to avoid inadvertently biting the tongue.

A patient with leukemia has developed stomatitis and is experiencing a nutritional deficit. An oral anesthetic has consequently been prescribed. What health education should the nurse provide to the patient?

A) Chew with care to avoid inadvertently biting the tongue.

B) Use the oral anesthetic 1 hour prior to meal time.

C) Brush teeth before and after eating.

D) Swallow slowly and deliberately.

B) Hemorrhage

A patient diagnosed with acute myelogenous leukemia has just been admitted to the oncology unit. When writing this patients care plan, what potential complication should the nurse address?

A) Pancreatitis

B) Hemorrhage

C) Arteritis

D) Liver dysfunction

C) Multiple myeloma

An emergency department nurse is triaging a 77-year-old man who presents with uncharacteristic fatigue as well as back and rib pain. The patient denies any recent injuries. The nurse should recognize the need for this patient to be assessed for what health problem?

A) Hodgkin disease

B) Non-Hodgkin lymphoma

C) Multiple myeloma

D) Acute thrombocythemia

D) Helping the patient manage the opioid analgesic regimen

A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should the nurse prioritize when addressing the patients severe bone pain?

A) Implementing distraction techniques

B) Educating the patient about the effective use of hot and cold packs

C) Teaching the patient to use NSAIDs effectively

D) Helping the patient manage the opioid analgesic regimen

A) Cure of the disease

13\. A nurse is caring for a patient with Hodgkin lymphoma at the oncology clinic. The nurse should be aware of what main goal of care?

A) Cure of the disease

B) Enhancing quality of life

C) Controlling symptoms

D) Palliation

D) Its important to reduce other factors that increase the risk of second cancers.

A patient with non-Hodgkins lymphoma is receiving information from the oncology nurse. The patient asks the nurse why she should stop drinking and smoking and stay out of the sun. What would be the nurses best response?

A) Everyone should do these things because theyre health promotion activities that apply to everyone.

B) You dont want to develop a second cancer, do you?

C) You need to do this just to be on the safe side.

D) Its important to reduce other factors that increase the risk of second cancers.

B) Promptly refer the patient for medical assessment.

An adult patient has presented to the health clinic with a complaint of a firm, painless cervical lymph node. The patient denies any recent infectious diseases. What is the nurses most appropriate response to the patients complaint?

A) Call 911.

B) Promptly refer the patient for medical assessment.

C) Facilitate a radiograph of the patients neck and have the results forwarded to the patients primary care provider.

D) Encourage the patient to track the size of the lymph node and seek care in 1 week