NURS 202 EVALUATION EXAM TEST QUESTIONS AND
ANSWERS GRADED A+
✔✔A client is undergoing a left modified radical mastectomy for breast cancer.
Postoperatively, blood pressure should be obtained from the right arm, and the client's
left arm and hand should be elevated as much as possible to prevent:
A. carpal tunnel syndrome.
B. peripheral neuropathy.
C. contractures.
D. lymphedema. - ✔✔D. lymphedema.
Lymphedema is a common postoperative effect of modified radical mastectomy and
lymph node dissection. Elevation of the left arm and hand will allow gravity to assist
lymph drainage. Other preventive measures include exercises in which the arms are
elevated. Peripheral neuropathy is not associated with postoperative complications, nor
are contractures. Although muscle atrophy is a potential adverse effect if the client does
not exercise the left arm, it would not be prevented by elevation.
✔✔The nurse is speaking to a group of women about early detection of breast cancer.
Which screening does the nurse recommend to women age 50 and older?
A. annual self breast examination
B. annual mammogram
C. annual test for hormonal receptor assay
D. biennial clinical breast examination by a healthcare provider - ✔✔B. annual
mammogram
The Canadian Cancer Society states at 50 years that women should have a
mammogram annually and a clinical examination at least annually (not every 2 years).
The American Cancer Society recommends mammography yearly beginning at age 40.
All women should perform breast self-examination monthly (not annually). The
hormonal receptor assay is done on a known breast tumor to determine whether the
tumor is estrogen or progesterone dependent. An annual breast exam by a healthcare
provider should be performed.
✔✔The nurse is conducting a health history for a client at risk for cancer. Which lifestyle
factor is considered a risk for colorectal cancer?
A. a diet low in vitamin C
B. a high dietary intake of artificial sweeteners
C. a high-fat, low-fiber diet
D. multiple sex partners - ✔✔C. a high-fat, low-fiber diet
,A high-fat, low-fiber diet is a risk factor for colorectal cancer. A diet low in vitamin C, use
of artificial sweeteners, and multiple sex partners are not considered risk factors for
colorectal cancer.
✔✔A nurse is speaking to a group of women about early detection of breast cancer.
The average age of the women in the group is 47. Following the American Cancer
Society (Canadian Cancer Society) guidelines, the nurse should recommend that the
women
A. perform breast self-examination annually.
B. have a mammogram annually.
C. have a hormonal receptor assay annually.
D. have a physician conduct a clinical examination every 2 years. - ✔✔B. have a
mammogram annually.
The American Cancer Society (Canadian Cancer Society) guidelines state that women
age 40 and older should have a mammogram annually and a clinical examination at
least annually (not every 2 years). All women should perform breast self-examination
monthly (not annually). The hormonal receptor assay is done on a known breast tumor
to determine whether the tumor is estrogen- or progesterone-dependent.
✔✔A nurse is caring for a client who is receiving chemotherapy for lung cancer. During
the hand-off report, the nurse from the previous shift states that the client has been
placed on neutropenic precautions. Which laboratory value supports this nursing
action?
A. a red blood cell count of 3.5 million/mm3
B. a platelet count of 90,000 per microliter
C. a retculocyte count of 1%
D. a white blood cell count of 2200/mm3 - ✔✔D. a white blood cell count of 2200/mm3
The normal number of WBCs in the blood is 4,500-10,000 white blood cells per
microliter (mcL). Less than 4,500 is considered neutropenia and places the client at risk
for infection. The platelet count ranges from 150,000 to 450,000/mcL. Platelets are
responsible for blood clotting. The nurse needs to institute bleeding precautions for this,
not neutropenic precautions. Red blood cells are responsible for oxygen transport. The
reticulocyte count is normal.
✔✔The care of which client can be assigned to an unlicensed assistive personnel
(UAP)?
A. a client with stomatitis who requires instruction about mouth care before discharge
B. a client who is having radiation for cancer of the stomach and is to have the radiation
site bathed with warm water, followed by an application of a moisturizer
C. a client who had a gastric resection and has a nasogastric tube draining bright red
blood
,D. a client who had abdominal surgery and requires wet-to-dry dressing changes -
✔✔B. a client who is having radiation for cancer of the stomach and is to have the
radiation site bathed with warm water, followed by an application of a moisturizer
The care of the client who is having radiation treatments and requires skin care at the
site that involves bathing and application of a nonmedicated moisturizer is within the
scope of practice for the UAP. Discharge planning, assessing drainage, and changing
wet-to-dry dressings are nursing care activities that must be performed by a licensed
nurse.
✔✔A client with suspected gastric cancer undergoes an endoscopy of the stomach.
Which assessment made after the procedure would indicate the development of a
potential complication?
A. The client has a sore throat.
B. The client displays signs of sedation.
C. The client experiences a sudden increase in temperature.
D. The client demonstrates a lack of appetite. - ✔✔C. The client experiences a sudden
increase in temperature.
The most likely complication of an endoscopic procedure is perforation. A sudden
temperature spike within 1 to 2 hours after the procedure is indicative of a perforation
and should be reported immediately to the health care provider. A sore throat is to be
anticipated after an endoscopy. Clients are given sedatives during the procedure, so it
is expected that they will display signs of sedation after the procedure is completed. A
lack of appetite could be the result of many factors, including the disease process.
✔✔Which expected outcome about nutrition would be appropriate for a client who has
had a total gastrectomy for gastric cancer? The client will:
A. regain any weight lost within 4 weeks of the surgical procedure.
B. eat three full meals a day without experiencing gastric complications.
C. learn to self-administer enteral feedings every 4 hours.
D. maintain adequate nutrition through oral or parenteral feedings. - ✔✔D. maintain
adequate nutrition through oral or parenteral feedings.
An appropriate expected outcome is for the client to maintain nutrition either through
oral or total parenteral feedings. Oral and total parenteral nutrition may also be used
concurrently. It is not realistic to expect the client to regain weight loss within 4 weeks of
surgery. After surgery, it is recommended that the client eat six small meals a day rather
than three full meals to decrease symptoms of dumping syndrome. Enteral feedings are
not part of the expected outcome for gastric surgery.
✔✔A client with colon cancer is having a barium enema. The nurse should instruct the
client to take which type of medication after the procedure is completed?
, A. laxative
B. anticholinergic
C. antacid
D. demulcent - ✔✔A. laxative
After a barium enema, a laxative is ordinarily prescribed. This is done to promote
elimination of the barium. Retained barium predisposes the client to constipation and
fecal impaction. Anticholinergic drugs decrease gastrointestinal motility. Antacids
decrease gastric acid secretion. Demulcents soothe mucous membranes of the
gastrointestinal tract and are used to treat diarrhea.
✔✔A nurse is interviewing a client about their past medical history. Which preexisting
condition may lead the nurse to suspect that a client has colorectal cancer?
A. duodenal ulcers
B. hemorrhoids
C. weight gain
D. polyps - ✔✔D. polyps
Colorectal polyps are common with colon cancer. Duodenal ulcers and hemorrhoids
aren't preexisting conditions of colorectal cancer. Weight loss — not gain — is an
indication of colorectal cancer.
✔✔A client is admitted to the hospital for diagnostic testing to rule out colorectal cancer.
Which intervention should the nurse include on the plan of care?
A. Test all stools for occult blood.
B. Administer topical ointment to the rectal area to decrease bleeding.
C. Prepare the client for a gastrostomy tube placement.
D. Administer morphine routinely, as ordered. - ✔✔A. Test all stools for occult blood.
Blood in the stools is one of the warning signs of colorectal cancer. The nurse should
plan on checking all stools for both frank and occult blood. The blood in the stool is
coming from the colon or rectum; administering an ointment wouldn't help decrease the
bleeding. Preparing a client for a gastrostomy tube isn't appropriate when diagnosing
colorectal cancer. Colorectal cancer is usually painless; administering opioid pain
medication isn't needed
✔✔Which client is at highest risk for colorectal cancer?
A. the client who smoked 1 pack a day for 30 years
B. the client who follows a vegetarian diet
C. the client who has been treated for Crohn's disease for 20 years
D. the client with a family history of lung cancer - ✔✔C. the client who has been treated
for Crohn's disease for 20 years
ANSWERS GRADED A+
✔✔A client is undergoing a left modified radical mastectomy for breast cancer.
Postoperatively, blood pressure should be obtained from the right arm, and the client's
left arm and hand should be elevated as much as possible to prevent:
A. carpal tunnel syndrome.
B. peripheral neuropathy.
C. contractures.
D. lymphedema. - ✔✔D. lymphedema.
Lymphedema is a common postoperative effect of modified radical mastectomy and
lymph node dissection. Elevation of the left arm and hand will allow gravity to assist
lymph drainage. Other preventive measures include exercises in which the arms are
elevated. Peripheral neuropathy is not associated with postoperative complications, nor
are contractures. Although muscle atrophy is a potential adverse effect if the client does
not exercise the left arm, it would not be prevented by elevation.
✔✔The nurse is speaking to a group of women about early detection of breast cancer.
Which screening does the nurse recommend to women age 50 and older?
A. annual self breast examination
B. annual mammogram
C. annual test for hormonal receptor assay
D. biennial clinical breast examination by a healthcare provider - ✔✔B. annual
mammogram
The Canadian Cancer Society states at 50 years that women should have a
mammogram annually and a clinical examination at least annually (not every 2 years).
The American Cancer Society recommends mammography yearly beginning at age 40.
All women should perform breast self-examination monthly (not annually). The
hormonal receptor assay is done on a known breast tumor to determine whether the
tumor is estrogen or progesterone dependent. An annual breast exam by a healthcare
provider should be performed.
✔✔The nurse is conducting a health history for a client at risk for cancer. Which lifestyle
factor is considered a risk for colorectal cancer?
A. a diet low in vitamin C
B. a high dietary intake of artificial sweeteners
C. a high-fat, low-fiber diet
D. multiple sex partners - ✔✔C. a high-fat, low-fiber diet
,A high-fat, low-fiber diet is a risk factor for colorectal cancer. A diet low in vitamin C, use
of artificial sweeteners, and multiple sex partners are not considered risk factors for
colorectal cancer.
✔✔A nurse is speaking to a group of women about early detection of breast cancer.
The average age of the women in the group is 47. Following the American Cancer
Society (Canadian Cancer Society) guidelines, the nurse should recommend that the
women
A. perform breast self-examination annually.
B. have a mammogram annually.
C. have a hormonal receptor assay annually.
D. have a physician conduct a clinical examination every 2 years. - ✔✔B. have a
mammogram annually.
The American Cancer Society (Canadian Cancer Society) guidelines state that women
age 40 and older should have a mammogram annually and a clinical examination at
least annually (not every 2 years). All women should perform breast self-examination
monthly (not annually). The hormonal receptor assay is done on a known breast tumor
to determine whether the tumor is estrogen- or progesterone-dependent.
✔✔A nurse is caring for a client who is receiving chemotherapy for lung cancer. During
the hand-off report, the nurse from the previous shift states that the client has been
placed on neutropenic precautions. Which laboratory value supports this nursing
action?
A. a red blood cell count of 3.5 million/mm3
B. a platelet count of 90,000 per microliter
C. a retculocyte count of 1%
D. a white blood cell count of 2200/mm3 - ✔✔D. a white blood cell count of 2200/mm3
The normal number of WBCs in the blood is 4,500-10,000 white blood cells per
microliter (mcL). Less than 4,500 is considered neutropenia and places the client at risk
for infection. The platelet count ranges from 150,000 to 450,000/mcL. Platelets are
responsible for blood clotting. The nurse needs to institute bleeding precautions for this,
not neutropenic precautions. Red blood cells are responsible for oxygen transport. The
reticulocyte count is normal.
✔✔The care of which client can be assigned to an unlicensed assistive personnel
(UAP)?
A. a client with stomatitis who requires instruction about mouth care before discharge
B. a client who is having radiation for cancer of the stomach and is to have the radiation
site bathed with warm water, followed by an application of a moisturizer
C. a client who had a gastric resection and has a nasogastric tube draining bright red
blood
,D. a client who had abdominal surgery and requires wet-to-dry dressing changes -
✔✔B. a client who is having radiation for cancer of the stomach and is to have the
radiation site bathed with warm water, followed by an application of a moisturizer
The care of the client who is having radiation treatments and requires skin care at the
site that involves bathing and application of a nonmedicated moisturizer is within the
scope of practice for the UAP. Discharge planning, assessing drainage, and changing
wet-to-dry dressings are nursing care activities that must be performed by a licensed
nurse.
✔✔A client with suspected gastric cancer undergoes an endoscopy of the stomach.
Which assessment made after the procedure would indicate the development of a
potential complication?
A. The client has a sore throat.
B. The client displays signs of sedation.
C. The client experiences a sudden increase in temperature.
D. The client demonstrates a lack of appetite. - ✔✔C. The client experiences a sudden
increase in temperature.
The most likely complication of an endoscopic procedure is perforation. A sudden
temperature spike within 1 to 2 hours after the procedure is indicative of a perforation
and should be reported immediately to the health care provider. A sore throat is to be
anticipated after an endoscopy. Clients are given sedatives during the procedure, so it
is expected that they will display signs of sedation after the procedure is completed. A
lack of appetite could be the result of many factors, including the disease process.
✔✔Which expected outcome about nutrition would be appropriate for a client who has
had a total gastrectomy for gastric cancer? The client will:
A. regain any weight lost within 4 weeks of the surgical procedure.
B. eat three full meals a day without experiencing gastric complications.
C. learn to self-administer enteral feedings every 4 hours.
D. maintain adequate nutrition through oral or parenteral feedings. - ✔✔D. maintain
adequate nutrition through oral or parenteral feedings.
An appropriate expected outcome is for the client to maintain nutrition either through
oral or total parenteral feedings. Oral and total parenteral nutrition may also be used
concurrently. It is not realistic to expect the client to regain weight loss within 4 weeks of
surgery. After surgery, it is recommended that the client eat six small meals a day rather
than three full meals to decrease symptoms of dumping syndrome. Enteral feedings are
not part of the expected outcome for gastric surgery.
✔✔A client with colon cancer is having a barium enema. The nurse should instruct the
client to take which type of medication after the procedure is completed?
, A. laxative
B. anticholinergic
C. antacid
D. demulcent - ✔✔A. laxative
After a barium enema, a laxative is ordinarily prescribed. This is done to promote
elimination of the barium. Retained barium predisposes the client to constipation and
fecal impaction. Anticholinergic drugs decrease gastrointestinal motility. Antacids
decrease gastric acid secretion. Demulcents soothe mucous membranes of the
gastrointestinal tract and are used to treat diarrhea.
✔✔A nurse is interviewing a client about their past medical history. Which preexisting
condition may lead the nurse to suspect that a client has colorectal cancer?
A. duodenal ulcers
B. hemorrhoids
C. weight gain
D. polyps - ✔✔D. polyps
Colorectal polyps are common with colon cancer. Duodenal ulcers and hemorrhoids
aren't preexisting conditions of colorectal cancer. Weight loss — not gain — is an
indication of colorectal cancer.
✔✔A client is admitted to the hospital for diagnostic testing to rule out colorectal cancer.
Which intervention should the nurse include on the plan of care?
A. Test all stools for occult blood.
B. Administer topical ointment to the rectal area to decrease bleeding.
C. Prepare the client for a gastrostomy tube placement.
D. Administer morphine routinely, as ordered. - ✔✔A. Test all stools for occult blood.
Blood in the stools is one of the warning signs of colorectal cancer. The nurse should
plan on checking all stools for both frank and occult blood. The blood in the stool is
coming from the colon or rectum; administering an ointment wouldn't help decrease the
bleeding. Preparing a client for a gastrostomy tube isn't appropriate when diagnosing
colorectal cancer. Colorectal cancer is usually painless; administering opioid pain
medication isn't needed
✔✔Which client is at highest risk for colorectal cancer?
A. the client who smoked 1 pack a day for 30 years
B. the client who follows a vegetarian diet
C. the client who has been treated for Crohn's disease for 20 years
D. the client with a family history of lung cancer - ✔✔C. the client who has been treated
for Crohn's disease for 20 years
