JH CERILLES STATE COLLEGEPagadian City

NCM 106- PRELIM EXAM

NAME: __________________________ SCORE:_____________DATE:__________

TEST I. MULTIPLE CHOICE. Encircle the letter of the BEST correct answer. Erasures, alterations and superimpositions will automatically render that item incorrect.

1. Which of these is not a stage of cancer development?A. InitiationB. MetastasisC. PromotionD. Progression

2. Which of the following is not considered carcinogens?A. TobaccoB. sun raysC. flourescent lightsD. alcoholE. unhealthy dietary habits

3. Stage I cancer is:A. cancer in situB. metastasisC. limited local spreadD. tumor limited to the tissue of

origin, localized tumor growth4. __________ are normal cellular genes

that are important regulators of normal cellular processes.A. OncogenesB. NeoplasmsC. NadirD. Protooncogenes

5. _______ are tumor inducing genes.A. NeoplasmsB. OncogenesC. ProtooncogenesD. Malignancies

6. Which of the following is a correct statement about Metaplasia?A. increased density or number of cellsB. dividing cells differentiate into cell

types not normally found in that part of the body

C. cells are abnormal in size, shape, appearance, and arrangement because the DNA has lost control of the differentiation process

D. regression of a cell to an immature or undifferentiated cell type.

7. What is Anaplasia?A. increased density or number of cells

B. dividing cells differentiate into cell types not normally found in that part of the body

C. cells are abnormal in size, shape, appearance, and arrangement because the DNA has lost control of the differentiation process

D. regression of a cell to an immature or undifferentiated cell type.

8. Which of these is NOT one of the 5 things that determines the effectiveness of chemotherapy?A. mitotic rate of the tissueB. size of the tumorC. age of the tumorD. fat deposits surrounding the tumorE. location of the tumorF. presence of resistant tumor cells

Situation 1– As a nurse in the Oncology Unit, you have to be prepared to provide safe, efficient and effective care to your patients.

9. Which one of the following nursing interventions would be most helpful in preparing the patient for radiation therapy?A. Offer tranquilizers and antiemeticsB. Instruct the patient of the possibility of radiation burnC. Emphasis on the therapeutic value of the treatmentD. Map out the precise course of treatment

10. What side effects are most apt to occur the patient during radiation therapy to the pelvis?A. Urinary retentionB. Abnormal vaginal or perineal

dischargeC. Paresthesia of the lower

extremitiesD. Nausea and vomiting and diarrhea

11. Which of the following can be used on the irradiated skin during a course of radiation therapy?A. Adhesive tapeB. Mineral oilC. Talcum powder

D. Zinc oxide ointment12. Earliest sign of skin reaction to radiation

therapy is:A. DesquamationB. ErythemaC. AtrophyD. pigmentation

13. What is the purpose of wearing a film badge while caring for the patient who is radioactive?A. Identify the nurse who is assigned to care for such a patientB. Prevent radiation-induced sterilityC. Protect the nurse from radiation effectsD. Measure the amount of exposure to radiation

Situation 2 – You are going to participate in a Cancer Consciousness Week. You are assigned to take charge of the women to make them aware of cervical cancer. You reviewed its manifestations andmanagement,14. The following are risk factors for cervical

cancer EXCEPT:A. immunosuppressive therapyB. sex at an early age, multiple

partners, exposure to socially transmitted disease, male partner’s sexual habits

C. viral agents like the Human Papilloma Virus

D. smoking15. Late signs and symptoms of cervical

cancer include the following EXCEPT:A. urinary/bowel changesB. pain in pelvis, leg or flankC. uterine bleedingD. lymph edema of lower extremities

16. When a panhysterectomy is performed due to cancer of the cervix, which of the following organs are removed?

A. the uterus, cervix, and one ovary

B. the uterus, cervix, and two-thirds of the vagina

C. the uterus, cervix, tubes D. the uterus and cervix

17. The primary modalities of treatment for Stage 1 and IIA cervical cancer include the following:A. surgery, radiation therapy and

hormone therapyB. surgeryC. radiation therapyD. surgery and radiation therapy

18. A common complication of hysterectomy is

A. thrombophelbitis of the pelvic and thigh vessels

B. diarrhea due to over stimulationC. atelectasisD. wound dehiscence

19. A client is being admitted to the hospital after receiving a radiation implant for cervical cancer. The nurse takes which priority action in the care of this client?A. encourages the family to visitB. admits the client to a private roomC. places the client on reverse isolationD. encourages the client to take frequent rest periods

20. A client is to undergo weekly intravesical chemotherapy for bladder cancer for the next 8 weeks. The nurse interprets that the client understands how to manage the urine as a biohazard if the client states to:A. void into a bedpan and then empty the urine into the toiletB. disinfect the urine and toilet with bleach for 6 hours following a treatmentC. purchase extra bottles of scented disinfectant for daily bathroom cleansingD. have one bathroom strictly set aside for the client's use for the 8 weeks

21. The nurse is developing a plan of care for a client being admitted to the hospital who is immunosuppressed and will be placed on neutropenic precautions. With regard to neutropenic precautions, which intervention is incorrect?

A. admitting the client to a semiprivate room

B. placing a precaution sign on the door to the room

C. placing a mask on the client if the client leaves the room

D. removing a vase with fresh flowers left by a previous client

22. The nurse is preparing to change the linens and gown of a client who was incontinent of urine. The client had received an unsealed radiation source earlier in the day for treatment of thyroid cancer. The nurse wears which of the following protective items?

A. mask and glovesB. gown and glovesC. mask, gown, and glovesD. gown, gloves, and eyewear

23. The nurse receives a telephone call from the hospital admission office and is informed that a client is being admitted who will undergo implantation of a sealed internal radiation source. The nurse asks the admission office clerk if which of the following rooms is selected for the client?

A. a single room near the nurse's station

B. a single room at the distant end of the hall

C. a semiprivate room near the nurse's station

D. a semiprivate room between two isolation rooms

Situation 3 - Colorectal cancer can affect old and younger people. Surgical procedures and other modes of treatment are done to ensure quality of life. You are assigned in the cancer institute to care of patients with this type of cancer.24. Larry, 55 years old, who is suspected of

having colorectal cancer, is admitted After taking the history and vital signs the physician does which test as a screening test for colorectal cancer.

A. Barium enemaB. Carcinoembryonic antigenC. Annual digital rectal

examinationD. Proctosigmoidoscopy

25. To confirm his impression of colorectal cancer, Larry will require which diagnostic study?

A. Carcinoembryonic antigenB. ProctosigmoidoscopyC. Stool hematologic testD. Abdominal computed

tomography (CT) test26. The following are risk factors for

colorectal cancer, EXCEPT:A. Inflammatory bowelsB. High fat, high fiber dietC. SmokingD. Geneticfactors-familial

adenomatous polyposis27. Symptoms associated with cancer of the

colon include:A. constipation, ascites and mucus

in the stoolB. diarrhea, heart burn and

eructationC. blood in the stools, anemia,

and “pencil shaped” stoolsD. anorexia, hematemesis, and

increased peristalasis

28. Several days prior to bowel surgery, Larry may be given sulfasuxidine and neomycin primarily to:

A. promote rest of the bowel by minimizing peristalsis

B. reduce the bacterial content of the colon

C. empty the bowel of solid wasteD. soften the stool by retaining

water in the colon29. A client has developed oral mucositis as

a result of radiation to the head and neck. The nurse shouls teach the client to incorporate which of the following measures in his or her daily home care routine?

A. oral hygiene should be performed in the morning and evening

B. high-protein foods, such as peanut butter, should be incorporated in the diet

C. a glass of wine per day will not pose any further harm to the oral cavity

D. a combination of a weak saline and water solution should be used to rinse the mouth before and after each meal

30. A client with renal cancer is being treated preoperatively with radiation therapy. The nurse evaluates that the client has an understanding of proper care of the skin over the treatment field if the client states to:

A. wash the ink marks off the skinB. avoid skin exposure to direct

sunlightC. apply perfumed lotion to the

affected skinD. wear tight clothing over the skin

site to provide support31. The nurse is caring for a client admitted

to the surgical nursing unit following right modified radical mastectomy. The nurse includes which of the following in the nursing plan of care for this client?

A. take blood pressures in the right arm only

B. draw serum laboratory samples from the right arm only

C. position the client supine with right arm elevated on a pillow

D. check the right posterior axilla area when assessing the surgical dressing

32. A nurse provides discharge instructions to a client with testicular cancer who

had testicular surgery. The nurse tells the clients:

A. to avoid driving a car for at least 8 weeks

B. not to be fitted for a prosthesis for at least 6 months

C. to avoid sitting for long periods for at least 6 weeks

D. to report any elevation in temperature to the physician

33. A client calls the ambulatory care clinic and tells the nurse that she found an area that looks like the peel of an orange when performing a breast self-examination (BSE), but found no other changes. The nurse should:

A. tell the client there is nothing to worry about

B. arrange for the client to be seen at the clinic as soon as possible

C. tell the client to take her temperature and call back if she has a fever

D. tell the client to point the area out to the physician at her next regularly scheduled appointment

34. A client with cancer who is receiving chemotherapy tells the nurse that the food on the meal tray "tastes funny." Which intervention by the nurse is appropriate?

A. keep the client NPOB. provide oral hygiene careC. administer an antiemetic as

orderedD. obtain an order for parenteral

nutrition (PN)35. A client receiving chemotherapy has an

infiltrated intravenous line and extravasation at the site. The nurse avoids doing which of the following in the management of this situation?

A. applying direct manual pressure to the site

B. stopping the administration of the medication

C. administering an available antidote as prescribedd) leaving the needle in place and aspirating any residual medication

36. The home care nurse is assisting a client in managing cancer pain. To ensure that the client has adequate ans safe pain control, the nurse plans to:

A. rely totally on prescription and over-the-counter medication to relieve pain

B. keep a baseline level of pain so that the client does not become sedated or addicted

C. try multiple medication modalities for pain relief to get the maximum pain relief effect

D. start with low doses of medication and gradually increase to a dose that relieves pain, not exceeding he maximum daily dose

37. The nurse has provided home-care instructions to a client recovering from a radial vulvectomy. Which statement by the client indicates the need for further instructions?

A. I need to take showers rather than tub baths

B. I need to monitor for foul-smelling perineal discharge

C. I need to wipe from front to back after a bowel movement

D. I need to notify the physician if swelling of the groin or genital area persists for longer than 1 week

38. The community health nurse provides an educational session regarding the risk factors for cervical cancer to women in the local community. The nurse determines that further teaching is needed if a woman attending the session identifies which of the following as a risk factor for this type of cancer?

A. smoking tobaccoB. low socioeconomic classC. early age of first intercourseD. white race

39. The nurse has completed discharge teaching with a client who has had surgery for lung cancer. The nurse determines that the client has misunderstood essential elements of home management if the client verbalizes the need to:

A. avoid exposure to crowdsB. deal with any increases in

pain independentlyC. sit up and lean forward to

breathe more easily

D. call the physician in case of increased temperature or shortness of breath

40. The nurse is taking a history from a client who is suspected of having testicular cancer. Which of the following data will be most helpful for determining the client's risk factors for this type of cancer?

A. age and raceB. marital statusC. number of childrenD. number of sexual partners

41. The community health nurse provides an educational session to members of the local community regarding the breast self-examination (BSE). Which statement by a member indicates the need for further education?

A. I need to perform a BSE every month

B. I should perform a BSE when I have my period

C. It is easiest to perform a BSE when I am in the shower when my hands are soapy

D. I'll use the finger pads of my three middle fingers to feel for lumps and thickening

42. The nurse provides discharge instructions to the client who had a mastectomy and axillary lymph node dissection. The nurse teaches the client to:

A. avoid use of insect repellentB. wear protective gloves

when doing the dishesC. avoid the use of lanolin hand

cream on the affected armD. cut the cuticles on the nails

carefully using clean cuticle scissors

43. A client is receiving a course of chemotherapy on an outpatient basis for the diagnosis of lung cancer. Which home-care instruction should the nurse provide to the client?

A. a bathroom can be shared with any member of the family

B. urinary and bowel excreta are not considered contaminated

C. disposable plates and plastic utensils must be used during the entire course of chemotherapy

D. contaminated linens should be washed separately and then washed a second time, if necessary

44. The home-care nurse visits a client with bowel cancer who recently received a course of chemotherapy . The client has developed stomatitis, and the nurse provides instructions to the client about the care of the mouth. The nurse determines that the client needs further instructions if the client states the need to:

A. eat foods without spicesB. maintain a diet of soft foodsC. drink juices that are not citrusD. drink foods and liquids that

are hot45. A client with leukemia receives a

course of chemotherapy. The home-care nurse who is scheduled to visit the client receives a telephone call from the client's physician. The physician informs the nurse that the client's neutrophil count is 600/mm3. On the basis of this laboratory value, the home-care nurse tells the client to avoid doing which of the following?

A. straining at bowel movements

B. using a straight razor for shaving

C. eating any raw fruits or vegetables

D. taking aspirin or medications that contain aspirin

46. A client in the final stages of terminal cancer tells his nurse: "I wish I could just be allowed to die. I'm tired of fighting this illness. I have lived a good life. I only continue my chemotherapy and radiation treatments because my family wants me to." What is the nurse's best response?

A. "Would you like to talk to a psychologist about your thoughts and feelings?"

B. "Would you like to talk to your minister about the significance of death?"

C. "Would you like to meet with your family and your physician about this matter?"

D. "I know you are tired of fighting this illness, but death will come in due time."

47. Which client has the highest risk of ovarian cancer?

A. 30-year-old woman taking oral contraceptives

B. 45-year-old woman who has never been pregnant

C. 40-year-old woman with three children

D. 36-year-old woman who had her first child at age 22

48. An oncology nurse educator is speaking to a women's group about breast cancer. Nurse test 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.

49. During a breast examination, which finding most strongly suggests that the client has breast cancer?

A. Slight asymmetry of the breastsB. A fixed nodular mass with

dimpling of the overlying skinC. Bloody discharge from the

nippleD. Multiple firm, round, freely

movable masses that change with the menstrual cycle

50. The nurse 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:

A. breast self-examination.B. mammography.C. fine needle aspiration.D. chest X-ray.

51.