Cancer
and
Oncology
Nursing
NCLEX
Challenge
Exam
(Quiz
#3:
20
Questions)
UPDATED ON OCTOBER 17, 2023
BY MATT VERA BSN, R.N.
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Angie
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Zild
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diday
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Petro
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jew
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Myra
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View Questions
1 point(s)
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?
1. Question
A. The client’s pain rating
B. The nurse’s impression of the client’s pain
C. Nonverbal cues from the client
D. Pain relief after appropriate nursing intervention
Correct
Correct Answer: A. The client’s pain rating
Option A: The client’s self-report is a critical component of pain
assessment. The nurse should ask the client about the description of the
pain and listen carefully to the client’s words used to describe the pain.
Option B: Nonverbal cues from the client are important but are not the
most appropriate pain assessment measure.
Option C: The nurse’s impression of the client’s pain is not appropriate in
determining the client’s level of pain.
Option D: Assessing pain relief is an important measure, but this option is
not related to the subject of the question.
2. Question
1 point(s)
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. Ability to ambulate
B. Urine specific gravity
C. Bowel sounds
D. Incision appearance
Correct
Correct Answer: C. Bowel sounds
Option C: The client is kept NPO until peristalsis returns, usually in 4 to 6
days. When signs of bowel function return, clear fluids are given to the
client. If no distention occurs, the diet is advanced as tolerated. The most
important assessment is to assess bowel sounds before feeding the client.
Options A, B, and D: These are unrelated to the subject of the question.
1 point(s)
A male client is admitted to the hospital with a suspected diagnosis of Hodgkin’s disease.
Which assessment findings would the nurse expect to note specifically in the client?
3. Question
A. Fatigue
B. Weakness
C. Weight gain
D. Enlarged lymph nodes
Correct
Correct Answer: D. Enlarged lymph nodes
Option D: Hodgkin’s disease is a chronic progressive neoplastic disorder of
lymphoid tissue characterized by the painless enlargement of lymph nodes
with progression to extra lymphatic sites, such as the spleen and liver.
Options A and B: Fatigue and weakness may occur but are not related
significantly to the disease.
Option C: Weight loss is most likely to be noted.
4. Question
1 point(s)
During the admission assessment of a 35 year old client with advanced ovarian cancer,
the nurse recognizes which symptom as typical of the disease?
A. Abdominal distention
B. Abdominal bleeding
C. Diarrhea
D. Hypermenorrhea
Incorrect
Correct Answer: A. Abdominal distention
Option A: Clinical manifestations of ovarian cancer include abdominal
distention, urinary frequency and urgency, pleural effusion, malnutrition,
pain from pressure caused by the growing tumor and the effects of urinary
or bowel obstruction, constipation, ascites with dyspnea, and ultimately
general severe pain.
Options B and D: Abnormal bleeding, often resulting in hypermenorrhea, is
associated with uterine and endometrial cancer.
Option C: Diarrhea is often related to colon cancer, lymphoma, carcinoid
syndrome, and pancreatic cancer.
5. Question
1 point(s)
Nurse Kate is reviewing the complications of colonization with a client who has
microinvasive cervical cancer. Which complication, if identified by the client, indicates a
need for further teaching?
A. Hemorrhage
B. Ruptured ovarian cyst
C. Infection
D. Cervical stenosis
Correct
Correct Answer: B. Ruptured ovarian cyst
Option B: Ruptured ovarian cyst is not a complication. This usually occurs
after a strenuous exercise and after sexual intercourse.
Options A, C, and D: Conization procedure involves the removal of a coneshaped area of the cervix. Complications of the procedure include
hemorrhage, infection, and cervical stenosis.
6. Question
1 point(s)
Mr. Miller has been diagnosed with bone cancer. You know this type of cancer is classified
as:
A. Carcinoma
B. Lymphoma
C. Melanoma
D. Sarcoma
Correct
Correct Answer: D. Sarcoma
Option D: Tumors that originate from bone, muscle, and other connective
tissue are called sarcomas.
Option A: Carcinoma is a malignancy that starts at the epithelial lining of an
organ, glands, or body structures.
Option B: Lymphoma is a cancer that begins in the nodes or glands of the
lymphatic system.
Option C: Melanoma is a type of skin cancer that originates in cells known
as melanocytes.
7. Question
1 point(s)
Sarah, a hospice nurse visits a client dying of ovarian cancer. During the 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 experiencing?
A. Anger
B. Denial
C. Bargaining
D. Depression
Correct
Correct Answer: C. Bargaining
Option C: Denial, bargaining, anger, depression, and acceptance are
recognized stages that a person facing a life-threatening illness experience.
Bargaining identifies a behavior in which the individual is willing to do
anything to avoid loss or change prognosis or fate.
Option A: Anger also may be the first response to upsetting news and the
predominant theme is “why me?” or the blaming of others.
Option B: Denial is expressed as shock and disbelief and may be the first
response to hearing bad news.
Option D: Depression may be manifested by hopelessness, weeping
openly, or remaining quiet or withdrawn.
8. Question
1 point(s)
The nurse is admitting a male client with laryngeal cancer to the nursing unit. The nurse
assesses for which most common risk factor for this type of cancer?
A. Alcohol abuse
B. Cigarette smoking
C. Use of chewing tobacco
D. Exposure to air pollutants
Incorrect
Correct Answer: B. Cigarette smoking
Option B: Cigarette use is the most common risk factor for head and neck
cancers such as laryngeal cancer. The smoke that comes from a cigarette
contains harmful chemicals such as nicotine, carbon monoxide, ammonia,
and hydrogen cyanide that passes through the larynx on its way to the
lungs.
Options A and C: Combined use of alcohol and tobacco enhances the risk.
Option D: Another risk factor is exposure to environmental pollutants (e.g.,
paint fumes, wood dust, coal dust) but cigarette smoking remains the most
common.
9. Question
1 point(s)
The female client who has been receiving radiation therapy for bladder cancer tells the
nurse that it feels as if she is voiding through the vagina. The nurse interprets that the
client may be experiencing:
A. Extreme stress caused by the diagnosis of cancer
B. Altered perineal sensation as a side effect of radiation therapy
C. Rupture of the bladder
D. The development of a vesicovaginal fistula
Incorrect
Correct Answer: D. The development of a vesicovaginal fistula
Option D: A vesicovaginal fistula is a genital fistula that occurs between the
bladder and vagina. The fistula is an abnormal opening between these two
body parts and, if this occurs, the client may experience drainage of urine
through the vagina.
Options A, B, and C: The client’s complaint is not associated.
10. Question
1 point(s)
The client with leukemia is receiving Myleran (busulfan) and Zyloprim (allopurinol). The
nurse tells the client that the purpose if the allopurinol is to prevent:
A. Mouth sores
B. Hyperuricemia
C. Nausea
D. Alopecia
Correct
Correct Answer: B. Hyperuricemia
Option B: Allopurinol decreases uric acid concentrations in serum and
urine. In the client receiving chemotherapy, uric acid levels increase as a
result of the massive cell destruction that occurs from the chemotherapy.
This medication prevents or treats hyperuricemia caused by chemotherapy.
Options A, C, and D: Allopurinol is not used to prevent alopecia, nausea, or
mouth sores.
11. Question
1 point(s)
A 25-year-old patient is inquiring about the methods or ways to detect cancer earlier. The
nurse least likely identifies this method by stating:
A. Yearly physical and blood examination
B. Annual digital rectal examination for persons over age 40
C. Annual Pap smear for sexually active women only
D. Annual chest x-ray
Correct
Correct Answer: C. Annual Pap smear for sexually active women only
Option C: Pap smear should be done yearly for sexually active women. All
women should have an annual pap smear by age 40 and up whether
sexually active or not.
Options A, B, and D: Early detection of cancer is promoted by annual oral
examination, monthly BSE from age 20, annual chest x-ray, yearly digital
rectal examination for persons over age 40, annual Pap smear from age 40
and annual physical and blood examination.
12. Question
1 point(s)
The removal of entire breast, pectoralis major and minor muscles and neck lymph nodes
which is followed by skin grafting is a procedure called:
A. Radiation therapy
B. Halstead surgery
C. Modified radical mastectomy
D. Simple mastectomy
Incorrect
Correct Answer: B. Halstead surgery
Option B: Halstead surgery also called radical mastectomy involves the
removal of the entire breast, pectoralis major and minor muscles, and neck
lymph nodes. It is followed by skin grafting.
Option A: Radiation therapy uses high doses radiation to kill cancer cells
and their ability to grow and divide.
Option C: Removal of the entire breast, pectoralis major muscle and the
axillary lymph nodes is a surgical procedure called modified radical
mastectomy.
Option D: Simple mastectomy is the removal of the entire breast but the
pectoralis muscles and nipples remain intact.
13. Question
1 point(s)
Chemotherapy is one of the therapeutic modalities for cancer. This treatment is
contraindicated to which of the following conditions?
A. Bone marrow depression
B. Recent surgery
C. Pregnancy
D. All of the above
Correct
Correct Answer: D. All of the above
Chemotherapy is contraindicated in cases of infection (chemotherapeutic
agents are immunosuppressive), recent surgery (chemotherapeutic agent
may retard the healing process), impaired renal and hepatic function (drugs
are nephrotoxic and hepatotoxic), recent radiation therapy
(immunosuppressive treatment), pregnancy (drugs can cause congenital
defects) and bone marrow depression (chemo. agents may aggravate the
condition).
14. Question
1 point(s)
The nurse is preparing Cytoxan (cyclophosphamide). Safe handling of the drug should be
implemented to protect the nurse from injury. Which of the following actions by the nurse
should be corrected?
A. The nurse should wear a mask and gloves
B. Air bubbles should be expelled on wet cotton
C. Review order to check the rate, solution, and frequency of the drug
D. Vent vials after mixing
Incorrect
Correct Answer: A. The nurse should wear a mask and gloves
Option A: The nurse should be corrected if she is only wearing a mask and
glove because additional protective equipment (gown, goggles, and face
shields) should also be worn in handling chemotherapeutic drugs.
Option B: Air bubbles are expelled on wet cotton to prevent the spread of
the chemotherapeutic agent particles.
Option C: Ensures the IV chemotherapy solution is correct and helps avoid
medication error.
Option D: The vials should be vent after mixing to reduce the internal
pressure.
15. Question
1 point(s)
Neoplasm can be classified as either benign or malignant. The following are
characteristics of malignant tumor apart from:
A. Encapsulated
B. Infiltrates surrounding tissues
C. Metastasis
D. Poorly differentiated cells
Incorrect
Correct Answer: A. Encapsulated
Option A: Benign: grows slowly, localized, encapsulated, well-differentiated
cells, no metastasis, not harmful to host.
Options B, C, and D: Malignant: Grows rapidly, infiltrate surrounding
tissues, not encapsulated, poorly differentiated, metastasis present, always
harmful.
16. Question
1 point(s)
On a clinic visit a client who has a relative with cancer, is asking about the warning signs
that may relate to cancer. The nurse correctly identifies the warning signs of cancer by
responding:
A. “A lump located only in the breast area may suggest the presence of
cancer.”
B. “Sudden weight loss of unexplained etiology can be a warning sign of
cancer.”
C. “Presence of dry cough is one of the warning signs of cancer.”
D. “If a sore healing took a month or more to heal, cancer should be
suspected.”
Correct
Correct Answer: B. “Sudden weight loss of unexplained etiology can be a
warning sign of cancer.”
Option B: Unexplained sudden weight loss of 10 pounds or more is a
warning signal of cancer. This is common among cancers of the esophagus,
stomach, and pancreas.
Option A: The presence of lump is not limited to the breast only; it can grow
elsewhere which is why this option is wrong.
Option C: Nagging cough not dry cough and hoarseness of voice is a sign
of cancer.
Option D: The sore in cancer does not heal.
17. Question
In staging and grading neoplasm TNM systems is used. TNM stands for:
A. Tumor, neoplasm, mode of growth
1 point(s)
B. Time, node, metastasis
C. Tumor, node, metastasis
D. Time, neoplasm, mode of growth
Correct
Correct Answer: C. Tumor, node, metastasis
TNM system is used to describe the amount and spread of cancer in a
client’s body. TNM stands for tumor (describes the original primary tumor),
node (describes whether the cancer has spread to the nearby lymph
nodes), and metastasis (describes whether the cancer has spread to other
parts of the body).
18. Question
1 point(s)
Breast self examination (BSE) is one of the ways to detect breast cancer earlier. The nurse
is conducting health teaching to female clients in a clinic. During evaluation the clients are
asked to state what they learned. Which of the following statements made by a client
needs further teaching about BSE?
A. “BSE is done after menstruation.”
B. “BSE palpation is done by starting at the center going to the periphery in a
circular motion.”
C. “BSE can be done in a lying position.”
D. “BSE should start from age 20.”
Incorrect
Correct Answer: B. “BSE palpation is done by starting at the center going to
the periphery in a circular motion.”
Option B: This client needs further teaching as palpation in BSE should
start at the periphery going to the center in a circular motion.
Option A: BSE is performed 7-10 days after menstruation when the breast
are less tender and lumpy.
Option C: The breast can be examined in a lying position since this position
flattens the breast and makes it easier to examine.
Option D: All women age 20 and older must do self-breast exams where
breast tumors can be easily detected at this age.
19. Question
1 point(s)
A client had undergone radiation therapy (external). The expected side effects include the
following apart from:
A. Hair loss
B. Ulceration of oral mucous membranes
C. Constipation
D. Headache
Correct
Correct Answer: C. Constipation
Option C: Diarrhea, not constipation is the side effect of radiation therapy
which usually starts during or right after the treatment and may last for
several weeks.
Options A, B, and D: These are common side effects of radiation therapy.
20. Question
1 point(s)
Nurse Janet is assigned in the oncology section of the hospital. Which of the following
orders should the nurse question if a client is on radiation therapy?
A. Bland diet
B. Aspirin every 4 hours
C. Saline rinses every 2 hours
D. Analgesics before meals
Incorrect
Correct Answer: B. Aspirin every 4 hours
Option B: Radiation therapy makes the platelet count decrease. Thus,
nursing responsibilities should be directed at promoting safety by avoiding
episodes of hemorrhage or bleeding such as physical trauma and aspirin
administration.
Options A and C: Bland diet and saline rinses every 2 hours should also be
done to manage stomatitis, a complication of radiation therapy.
Option D: Analgesics are given before meals to alleviate the pain caused by
stomatitis.
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