PRE-TEST IN CELLULAR ABERRATION A. The client lies still.

1. The category "T" in the TNM system stands B. The client asks questions.
for: C. The client hears thumping sounds.
D. The client wears a watch and wedding band.
A. Time
B. Tumor (primary) 6. The community nurse is conducting a health
C. Tissue (primary) promotion program at a local school and is
D. Tumor (secondary) discussing the risk factors associated with cancer.
Which of the following, if identified by the client
2. True or False: All forms of cancer use the as a risk factor, indicates a need for further
same grading system. instructions?

True A. Viral factors

False B. Stress
C. Low-fat and high-fiber diets
3. Neoplasm can be classified as either benign or D. Exposure to radiation
malignant. The following are characteristics of
malignant tumor apart from? 7. A male client is in isolation after receiving an
internal radioactive implant to treat cancer. Two
A. Metastasis hours later, the nurse discovers the implant in the
B. Infiltrates surrounding tissues bed linens. What should the nurse do first?
C. Encapsulated
D. Poorly differentiated cells A. Stand as far away from the implant as
possible and call for help.
4. During chemotherapy, an oncology client has B. Pick up the implant with long-handled
a nursing diagnosis of impaired oral mucous forceps and place it in a lead-lined container.
membrane related to decreased nutrition and C. Leave the room and notify the radiation
immunosuppression secondary to the cytotoxic therapy department immediately.
effects of chemotherapy. Which nursing D. Put the implant back in place, using forceps
intervention is most likely to decrease the pain of and a shield for self-protection, and call for help.
stomatitis?
8. What should a male client over age 52 do to
A. Recommending that the client discontinue help ensure early identification of prostate
chemotherapy cancer?
B. Providing a solution of hydrogen peroxide
and water for use as a mouth rinse A. Have a digital rectal examination and
C. Monitoring the client’s platelet and leukocyte prostate-specific antigen (PSA) test done yearly.
counts B. Have a transrectal ultrasound every 5 years.
D. Checking regularly for signs and symptoms of C. Perform monthly testicular self-examinations,
stomatitis especially after age 50.
D. Have a complete blood count (CBC) and
5. The nurse is preparing for a female client for blood urea nitrogen (BUN) and creatinine levels
magnetic resonance imaging (MRI) to confirm or checked yearly.
rule out a spinal cord lesion. During the MRI scan,
which of the following would pose a threat to the
client?
9. A client is diagnosed with breast cancer. The A. Time, neoplasm, mode of growth
tumor size is up to 5 cm with axillary and neck B. Tumor, node, metastasis
lymph node involvement. The client is in what C. Tumor, neoplasm, mode of growth
stage of breast cancer? D. Time, node, metastasis

A. Stage I 14. A client, age 41, visits the gynecologist. After

B. Stage II examining her, the physician suspects cervical
C. Stage III cancer. The nurse reviews the client’s history for
D. Stage IV risk factors for this disease. Which history finding
is a risk factor for cervical cancer?
10. A tumor was shown to possess cells that were
moderately differentiated. This is considered a? A. Onset of sporadic sexual activity at age 17
B. Spontaneous abortion at age 19
A. Grade I C. Pregnancy complicated with eclampsia at age
B. Grade II 27
C. Grade III D. Human papillomavirus infection at age 32
D. Grade IV
15. A male client with a nagging cough makes an
11. Jeovina, with advanced breast cancer is appointment to see the physician after reading
prescribed tamoxifen (Nolvadex). When teaching that this symptom is one of the seven warning
the client about this drug, the nurse should signs of cancer. What is another warning sign of
emphasize the importance of reporting which cancer?
adverse reaction immediately?
A. Persistent nausea
A. Vision changes B. Rash
B. Hearing loss C. Indigestion
C. Headache D. Chronic ache or pain
D. Anorexia
16. A 35 years old client has been receiving
chemotherapy to treat cancer. Which
12. Which statement below is an incorrect assessment finding suggests that the client has
statement about can tumor staging? developed stomatitis (inflammation of the
mouth)?
A. Staging describes the main tumor’s location
and size, and if the cancer has spread to other A. White, cottage cheese–like patches on the
parts of the body like the lymph nodes or other tongue
organs. B. Yellow tooth discoloration
B. It’s useful in developing a treatment plan and C. Red, open sores on the oral mucosa
if the patient can participant in a clinical trial. D. Rust-colored sputum
C. A cancer stage designated at the time of the
cancer diagnosis can change overtime.
D. A CT scan, MRI, x-ray, and ultrasound can be
used to help stage a cancer.

13.In staging and grading neoplasm TNM system

is used. TNM stands for?
17. Chemotherapeutic agents have different D. No cancer found in other body parts
specific classifications. The following
medications are antineoplastic antibiotics 22. What is the meaning of cancer is in situ?
except?
A. The tumor is found in its original place and
A. Doxorubicin has not spread from its original location.
B. Fluorouracil B. The tumor is formed outside its original place
C. Mitoxantrone and has spread within it localized site.
D. Bleomycin C. The tumor is cancerous and may spread.
D. The tumor is distant from its original place.
Feedback
18. The TNM staging system for cancer can be
used to help stage what type of cancer? 23. A male client with a cerebellar brain tumor is
admitted to an acute care facility. The nurse
A. Brain cancer formulates a nursing diagnosis of Risk for injury.
B. Spinal cord cancer Which “related-to” phrase should the nurse add
C. Leukemia to complete the nursing diagnosis statement?
D. Colon cancer
A. Related to visual field deficits
19. The category "N" in the TNM system stands B. Related to difficulty swallowing
for: C. Related to impaired balance
D. Related to psychomotor seizures
A. Number
B. Necrosis 24. A female client with cancer is scheduled for
C. Nodes radiation therapy. The nurse knows that
D. Normal radiation at any treatment site may cause a
certain adverse effect. Therefore, the nurse
20. For a female client with newly diagnosed should prepare the client to expect:
cancer, the nurse formulates a nursing diagnosis
of Anxiety related to the threat of death A. hair loss.
secondary to cancer diagnosis. Which expected B. stomatitis.
outcome would be appropriate for this client? C. fatigue.
D. vomiting.
A. “Client verbalizes feelings of anxiety.”
B. “Client doesn’t guess at prognosis.” 25. On a patient’s TNM classification you see a
C. “Client uses any effective method to reduce lowercase "p" (pT1) in front of the T on the
tension.” patient report. This means?
D. “Client stops seeking information.”
A. The cancer has been restaged.
21. The TNM staging system has been used to B. The cancer was staged based on the findings
stage your patient's cancer. The report says: after surgery.
T1N0M0 What is the meaning of N0? C. The cancer was staged before the treatment
began and was based on test results and
A. Cancer in regional lymph node can’t be assessment findings.
measured D. The cancer was staged after therapy was
B. No cancer present in regional lymph node administered.
C. Cancer in distant lymph node can’t be
measured
26. Nurse April is teaching a client who suspects A. probenecid (Benemid)
that she has a lump in her breast. The nurse B. cytarabine (ara-C, cytosine arabinoside
instructs the client that a diagnosis of breast [Cytosar-U])
cancer is confirmed by: C. thioguanine (6-thioguanine, 6-TG)
D. leucovorin (citrovorum factor or folinic acid
A. breast self-examination. [Wellcovorin])
B. mammography.
C. fine needle aspiration. 31. Specific classification of the
D. chest X-ray. chemotherapeutic agent, Vincristine is?

27. Nurse Brian is developing a plan of care for A. Hormone modulator

marrow suppression, the major dose-limiting B. Mitotic inhibitor
adverse reaction to floxuridine (FUDR). How long C. Antineoplastic antibiotic
after drug administration does bone marrow D. Antimetabolite
suppression become noticeable?
32. A female client has an abnormal result on a
A. 24 hours Papanicolaou test. After admitting, she read his
B. 2 to 4 days chart while the nurse was out of the room, the
C. 7 to 14 days client asks what dysplasia means. Which
D. 21 to 28 days definition should the nurse provide?

28. What TNM classification below best A. Presence of completely undifferentiated

describes this finding: very large tumor with 1 tumor cells that don’t resemble cells of the
regional lymph node involvement, and spread to tissues of their origin
two regional organs? B. Increase in the number of normal cells in a
normal arrangement in a tissue or an organ
A. T1N1M2 C. Replacement of one type of fully
B. T4N1M1 differentiated cell by another in tissues where
C. T1N1M1 the second type normally isn’t found
D. T4N1M2 D. Alteration in the size, shape, and organization
of differentiated cells
29. Skin reactions are common in radiation
therapy. Nursing responsibilities on promoting
skin integrity should be promoted apart from? 33. Which of the following statements is correct
about the rate of cell growth in relation to
A. Avoiding the use of ointments, powders and chemotherapy?
lotion to the area
B. Using soft cotton fabrics for clothing A. Faster growing cells are less susceptible to
C. Washing the area with a mild soap and water chemotherapy.
and patting it dry, not rubbing it B. Non-dividing cells are more susceptible to
D. Avoiding direct sunlight or cold chemotherapy
C. Faster growing cells are more susceptible to
30. A female client is receiving methotrexate chemotherapy
(Mexate), 12 g/m2 I.V., to treat osteogenic D. Slower growing cells are more susceptible to
carcinoma. During methotrexate therapy, the chemotherapy
nurse expects the client to receive which other
drug to protect normal cells?
34. A 25-year-old patient is inquiring about the 38. Which statements best describe tumor
methods or ways to detect cancer earlier. The grading? Select all that apply:
nurse least likely identify this method by stating?
A. Tumor grading provides information on how
A. Annual chest x ray tumor cells look under a microscope.
B. Annual Pap smear for sexually active women B. Cancer can be graded using the TNM
only classification system.
C. Annual digital rectal examination for persons C. Tumor grading describes the location and size
over age 40 of the main tumor, and if the cancer has spread
D. Yearly physical and blood examination to other parts of the body like the lymph nodes
or other organs.
35. Your patient's tumor grading report stated D. A biopsy is used to help grade a tumor.
"well differentiated, Grade I". You know that this
means? 39. A male client complains of sporadic epigastric
pain, yellow skin, nausea, vomiting, weight loss,
A. The patient's tumor cells were different in and fatigue. Suspecting gallbladder disease, the
appearance and arrangement compared to physician orders a diagnostic workup, which
what normal cells possess. reveals gallbladder cancer. Which nursing
B. This type of cancer is considered high grade. diagnosis may be appropriate for this client?
C. This type of cancer is low grade because the
tumor cells have an appearance and A. Anticipatory grieving
arrangement that is similar to normal cells. B. Impaired swallowing
D. This grade of cancer tends to spread and C. Disturbed body image
grow quickly. D. Chronic low self-esteem

36. Which stage of cancer is called metastatic 40. The nurse is interviewing a male client about
cancer and means the cancer has spread to other his past medical history. Which preexisting
parts of the body beyond where the cancer condition may lead the nurse to suspect that a
started? client has colorectal cancer?

A. Stage II A. Duodenal ulcers

B. Stage 0 B. Hemorrhoids
C. Stage III C. Weight gain
D. Stage I D. Polyps
E. Stage IV
41. Which statement below is an incorrect
37. Radiation protection is very important to statement about can tumor staging?
implement when performing nursing
procedures. When the nurse is not performing A. Staging describes the main tumor's location
any nursing procedures what distance should be and size, and if the cancer has spread to other
maintained from the client? parts of the body like the lymph nodes or other
organs.
A. 1 feet B. It's useful in developing a treatment plan and
B. 2 feet if the patient can participant in a clinical trial.
C. 2.5 feet C. A cancer stage designated at the time of the
D. 3 feet cancer diagnosis can change overtime.
D. A CT scan, MRI, x-ray, and ultrasound can be
used to help stage a cancer.
 46. A 35 years old client with ovarian cancer is
prescribed hydroxyurea (Hydrea), an
42. Chemotherapy is one the therapeutic antimetabolite drug. Antimetabolites are a
modalities for cancer. This treatment is diverse group of antineoplastic agents that
contraindicated to which of the following interfere with various metabolic actions of the
conditions? cell. The mechanism of action of antimetabolites
interferes with:
A. Recent surgery
B. Pregnancy A. cell division or mitosis during the M phase of
C. Bone marrow depression the cell cycle.
D. All the above B. normal cellular processes during the S phase
of the cell cycle.
C. the chemical structure of deoxyribonucleic
43. Which of the following interventions is the acid (DNA) and chemical binding between DNA
key to increasing the survival rates of clients with molecules (cell cycle–nonspecific).
lung cancer? D. one or more stages of ribonucleic acid (RNA)
synthesis, DNA synthesis, or both (cell cycle–
A. Early bronchoscopy nonspecific).
B. Early detection
C. High dose chemotherapy 47. The ABCD method offers one way to assess
D. Smoking cessation skin lesions for possible skin cancer. What does
the A stand for?
44. Nurse Amy is speaking to a group of women
about early detection of breast cancer. The A. Actinic
average age of the women in the group is 47. B. Asymmetry
Following the American Cancer Society C. Arcus
guidelines, the nurse should recommend that D. Assessment
the women:

A. perform breast self-examination annually. 48. A female client with cancer is being evaluated
B. have a mammogram annually. for possible metastasis. Which of the following is
C. have a hormonal receptor assay annually. one of the most common metastasis sites for
D. have a physician conduct a clinical cancer cells?
examination every 2 years.
A. Liver
45. Nurse April is teaching a group of women to B. Colon
perform breast self-examination. The nurse C. Reproductive tract
should explain that the purpose of performing D. White blood cells (WBCs)
the examination is to discover:
49. For a female client newly diagnosed with
A. cancerous lumps. radiation-induced thrombocytopenia, the nurse
B. areas of thickness or fullness. should include which intervention in the plan of
C. changes from previous self-examinations. care?
D. fibrocystic masses.
A. Administering aspirin if the temperature
exceeds 102° F (38.8° C)
B. Inspecting the skin for petechiae once every
shift
C. Providing for frequent rest periods 54. The category "M" in the TNM system gives
D. Placing the client in strict isolation detail about:

50. A client had undergone radiation A. if the cancer has spread to other parts of the
therapy(external). The expected side effects body and if this is the case, how much and the
include the following apart from? location of it
B. the number and location of the lymph nodes
A. Hair loss that have cancer
B. Ulceration of oral mucous membranes C. the size of the tumor that is growing into
C. Constipation other tissues
D. Headache D. if the cancer cells appear abnormal

51. Nurse Lucia is providing breast cancer 55. Which TNM classification has the poorest
education at a community facility. The American prognosis?
Cancer Society recommends that women get
mammograms: A. T0N0M0
B. T2N2M1
A. yearly after age 40. C. T4N1M0
B. after the birth of the first child and every 2 D. T4N3M1
years thereafter.
C. after the first menstrual period and annually
thereafter.
D. every 3 years between ages 20 and 40 and
annually thereafter.

52. A female client is receiving chemotherapy to

treat breast cancer. Which assessment finding
indicates a fluid and electrolyte imbalance
induced by chemotherapy?

A. Urine output of 400 ml in 8 hours

B. Serum potassium level of 3.6 mEq/L
C. Blood pressure of 120/64 to 130/72 mm Hg
D. Dry oral mucous membranes and cracked lips

53. Contact of the client on radiation therapy

should be limited only to how many minutes to
promote safety of the therapy personnel?

A. 1 minute
B. 3 minutes
C. 5 minutes
D. 10 minutes