4th

College of Nursing Unit Exam Cellular Aberration Sept 20 , 2007

Name: _____________________
Answer in CAPITAL LETTERS only. You are allowed to erase only once. Superimposed answers will be marked incorrect

A.

Provide a high fiber diet

Score: ________________ B. administer allopurinol 2 hours before chemotherapy session C. encourage increased fluid intake. D. Administer an antieemetic 30 to 60 minutes before a chemotherapy session ____9. Liza, aged 5 is hospitalized with a diagnosis of acute lymphocytic leukemia. Admission assessment reveals a pale, listless child with multiple petechiae and fever. Lizas fever most likely is related to: A. Anemia C. meningeal irritation B. Thrombocytopenia D. neutrophenia ____10. The patient who is suffering from alopecia as a side effect of chemotherapy is instructed that: A. The hair loss is permanent B. The hair will grow back after treatment C. Drugs will be necessary to stimulate hair growth D. There is no known remedy for hair loss ___11. The cancer patient is prescribed a course of chemotherapy. Patient teaching includes information that radiation therapy works on the premise that A. Malignant cells are more sensitive to radiation B. X-rays are strong enough to eliminate malignant cells C. Therapeutic doses kill only cancer and not normal cells D. X-rays are selective enough to destroy only malignant cells ____12. For the patient undergoing a course of external radiation treatments, the nurse should be alert for: A. Impairment of skin integrity B. Decreased mobility C. Constipation D. Ulceration of mucous membranes ____13. Which of the following is contraindicated for a client with ALL who is under remission of his/her disease? A. Antibiotics C. corticosteroids B. Immunizations D. bronchodilators ____14. Guidelines for early detection of cancer include the following except A. Monthly BSE for women 20 years of age & B. Guaiac stool exam on yearly basis for adults 50 years C. Pap smear only among sexually active women D. Baseline mammogram for women over 40 ____15. Which of the following laboratory data indicates bone marrow depression in the client receiving chemotherapy? A. RBC 4.8 million/cu.mm B. Platelets 95,000/cu.mm C. WBC 8,000/cu. Mm D. Neutrophils 65% Situation: JP, who has Hodgkins disease, is admitted to the hospital for staging (16-20) ____16. The purpose of staging is A. Identify treatment modality for a confirmed neoplastic disease

____1. Which of the following would be the nurses best response when a 28 year old woman asks the nurse, What can I do to make sure that I dont get breast cancer like my mother and sister? A. There is nothing you can do to so you dont get breast cancer. B. You can detect the cancer early with monthly breast self examination C. Youre frightened that you may get breast cancer like your mother and sister D. You should get a CBE every year and a yearly Pap smear ____2. Which of the following client statements would indicate to the nurse that teaching about decreasing the risk of skin cancer has been effective? A. It is all right for me to stay in the sun as long as I use a sun block with SPF 15. B. I should avoid excessive sun exposure between the hours of 10:00 am-3:00 pm . C. I should wear sleeveless shirts and caps when I am out in the sun. D. Because I have no history of skin cancer in my family, I dont have to worry. ___3. Which of the following is recommended for early detection of colorectal cancer? A. yearly digital rectal examinations after age 40 and stool examinations after age 50 B. Monthly testicular self examinations and yearly proctosigmoidoscopy C. DRE yearly after age 25 and monitoring for changes in bladder habits D. Yearly PE in conjunction with yearly KUB radiographs ____4. When discussing preventive dietary measures for cancer, which of the following would be appropriate to include? A. Foods low in vitamin A and C B. Increased total dietary fat intake C. low fiber diet D. cruciferous vegetable ____5. What is the most common form of childhood cancer? A. Lymphoma C. Leukemia B. Brain tumor D. osteosarcoma ____6. Side effects of leukemia chemotherapy associated with initial remission include all the following except A. Bone marrow suppression C. Pneumonitis B. Alopecia D. nausea & vomiting ____7. When caring for a child awaiting surgery for Wilms tumor, which of the following nursing interventions would be most important? A. Handle the child with care, particularly during bathing B. Place the child on low blood count precautions C. Monitor bowel sounds to detect chemotherapy induced adynamic ileus D. Place the child in high fowlers position to facilitate lung expansion ____8. Which of the following nursing interventions can help prevent or reduce nausea and vomiting during chemotherapy?

B. Identifying the cell causing the patients disease C. Ascertain adjunct therapy with surgery D. Determine the extent of a confirmed neoplastic disease ____17. the physician stages cancer as T4, N3, M1. the nurse recognizes this as A. No metastasis B. Small tumor, no lymph involvement, no metastasis C. Large tumor, some lymph involvement, minimal metastasis D. Large tumor, advanced lymph enlargement with metastasis ____18. JPs illness was diagnosed early in its course. Which one of the following symptoms most likely first brought JP to seek health care? A. Difficulty with swallowing B. Swollen cervical lymph nodes C. Difficult with breathing and excessive expectoration D. Discomfort and a feeling of fullness over the area of his liver ____19. Which one of the following symptoms will JP very likely present upon admission that will require special nursing care measures A. Sore tongue C. diaphoresis B. Itching skin D. painful joints ____20. JP will undergo chemotherapy. Which statement is incorrect regarding chemotherapy? A. It destroys all malignant tumor cells without excessive destruction of normal cells B. It removes precancerous lesions or benign tumors C. It controls tumor growth if cure is no longer possible D. It is used as an adjuvant therapy ____21. The nurse can anticipate that a bone marrow specimen is most likely to be obtained from JPs sternum or A. Rib C. vertebra B. Femur D. Iliac crest ____22. The nurse should teach women that the best time in the menstrual cycle to examine the breasts is during the A. Week ovulation occurs B. 1st week after menstruation C. Week menstruation occurs D. last week before menstruation ____23. A client during a mothers class asked the nurse where the usual location of breast cancer? The nurses best response is A. Upper Outer Quadrant C. inner upper quadrant B. Lower Outer Quadrant D. inner lower quadrant ____24. During the mothers class questions concerning the nature of malignancies and the cells that cause cancerous tumors were raised. The nurse explains correctly that a characteristic of malignant cells is that they A. Grow slowly C. recur after removal B. Are encapsulated D. resemble original tissue ____25. The nurse assesses a cancer patient who is receiving chemotherapy and has developed diffuse petechiae. The lab results reveal very low RBCs. Which side effect of

chemotherapy accounts for this assessment data? A. Low WBC C. lymphocytes B. Bone marrow suppression D. platelets ____26. The most common presenting symptom of colon and rectal cancer is A. Hematochesia B. Change in bowel habits C. Crampy abdominal pain D. Blood in stool ____27. Which of the following assessment data is an early manifestation of gastric cancer? A. Anemia C. progressive loss of appetite B. Weight loss D. palpable gastric mass ____28. Which of the following statements about chemotherapy is true? A. It is a local treatment affecting only tumor cells B. It is a systemic treatment affecting both tumor and normal cells C. It has not yet been proven an effective treatment for cancer D. It causes few if any side effects ____29. Which of the following is Not a predisposing factor for cervical cancer? A. Early sexual experience with multiple partners B. HX of genital herpes, chronic cervicitis or VD C. Family Hx of cervical cancer D. Multiple pregnancies at an early age ____30. Which of the following is the surgical intervention for the treatment of testicular cancer? A. Testectomy C. scrotumectomy B. Epididymectomy D. orchiectomy ____31. For clients with cancer of the prostate the treatment include all of the following except A. Estrogen therapy C. Chemotherapy B. Androgen therapy D. Radiation therapy ____32 Chemotherapeutic agents are contraindicated during pregnancy as they A. are teratogenic B. suppress the immune system C. suppress cell miosis D. have ill effects Situation : a 32 years old client with stage II breast cancer is scheduled for radical mastectomy(32-35) ____33. Immediate postoperative care will include the following except A. Elevate and abduct the arm on the affected side B. Compress the hemovac suction after emptying the drainage C. Check the dressings at the back D. Advise the client not to wear bra until after the first follow up check up ____34. Lymphedema is the most common complication following radical mastectomy with axillary lymph resection. Which of the following nursing interventions will not minimize the problem? A. Elevate arm with pillow support B. Keep arm abducted C. Take the B/P from the arm of the affected side

D.

Reinforce arm exercises

____35. Before discharging the patient the nurse encourages her to look at the incision. The patient refuses and cries It is so horrible. What is the best response of the nurse in this situation? A. I know it is awful, but it its not that terrible B. Your feelings are normal; its alright to cry C. Its ok. You can look at it in the mirror when you youre home D. I understand how you feel. Id feel the same way too. ____36. Which of the following is the priority nursing diagnosis after mastectomy? A. Disturbance in self concept B. Activity intolerance C. Self care deficit D. Altered mobility ____37. For the patient undergoing a course of external radiation treatment the nurse should be alert for A. Impairment of skin integrity B. Decreased mobility C. Constipation D. Ulceration of mucous membranes ____38. A surgical client newly diagnosed with cancer tells a nurse she knows the laboratory made a mistake about her diagnosis, Which of the following terms describes this reaction? A. Denial C. Regression B. Intellectualization D. repression ____39. which of the following is not one of the seven warning signs of cancer cited by the American Cancer Society A. Indigestion or difficulty of swallowing B. Unusually slow healing sore C. Unusual bleeding or discharge D. Unusual tenderness in breast tissue ____40. In a health education class, guidelines for early detection of cancer are discussed. Which response from a group member indicates correct understanding of these guidelines? A. I should have a cancer related checkup every 5 years after I reach 50. B. Women should have a baseline mammogram taken between the ages 45 and 50 C. Adults over the age of 50 should have a guiac test done on a yearly basis D. A pap smar needs to be done on sexually active women. ____41. Which of the following is not a predisposing factor for cervical cancer? A. Early sexual experience with multiple partners B. History of genital herpes, chronic cervicitis or venereal disease C. Family history of cervical cancer D. Multiple pregnancies at an early age ____42. patient who begins a regimen of chemotherapy shows a platelet count of 98,000. which action is not necessary at this time? A. Test all stools for occult blood B. Use soft toothbrush or foam cleaner for oral hygiene

C. Implement reverse isolation D. Avoid IM injection ____43. Which of the following sttements is correct concerning Hodgkins disease? A. It is a malignancy of the lymphoid system B. It is a malignant neoplasm of the plasma cells C. It is a syndrome characterized by a defect to cell mediated immunity D. It is a malignant disease associated with diffuse abnormal growth of leukocyte precursor in the bone marrow ____44. A diagnostic symptom for bladder cancer is A. Inability to urinate C. Dysuria B. painless hematuria D. painful hematuria ____45. Which one is not is an example of brachytherapy? A. Cobalt therapy C. interstitial therapy B. Intracavitary therapy D. 131 Iodine Test II. Modified True & False. Write T if the answer is True and F if the answer is False. If the answer is False underline the word(s) that makes the statement false and supply the correct word(s) to make it true _____________1. The mode of treatment for carcinoma in situ stage is chemotherapy _____________2. Malignant liver cancer is almost always fatal. _____________3. The pathognomonic sign for laryngeal cancer is dysphagia. _____________4. Recognizing early signs & seeking prompt treatment is the goal of primary prevention. _____________5. The N in CAUTION stands for nodal infiltration _____________6. Palliative treatment is given to relieve or diminish distressing symptoms such as pain or obstruction _____________7. Metaplasia refers to a change in size, shape or arrangement of normal cells into bizarre cells _____________8. Metaplasia is reversible. _____________9. Benign cells resemble normal cells of the tissue from which the tumor originated _____________10. Uterine myomas are benign tumors of smooth muscles Good Luck Prepared by: MFYOSORES 07