Chapter 17: Care of the Patient with Cancer
MULTIPLE CHOICE
1. A patient has developed stomatitis from chemotherapy. What should the appropriate
intervention for this condition include?
a. Instruction in the following of a liquid diet
b. Using a commercial mouthwash after each meal
c. Cleaning teeth with a cotton swab dipped in hydrogen peroxide
d. Using a soft toothbrush
ANS: D
The use of a soft toothbrush to clean the teeth and rinsing with normal saline or soda will
prevent added discomfort and bleeding.
DIF: Cognitive Level: Comprehension REF: Page 804 OBJ: 13
TOP: Stomatitis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
2. Which of the following men should be highest priority for referral for a prostate-specific
antigen (PSA)?
a. 43-year-old Hispanic man
b. 45-year-old African American man
c. 49-year-old Korean man
d. 50-year-old Native American man
ANS: B
African American men are a high-risk population for prostate cancer. Orientals and Native
Americans have a relatively low incidence of prostate cancer.
DIF: Cognitive Level: Analysis REF: Page 795 OBJ: 3
TOP: PSA testing KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
3. A patient, age 56, has been advised that his prostate-specific antigen (PSA) level is elevated.
The physician then performed a digital rectal examination (DRE). What should the next
definitive diagnostic test be?
a. CA-125 test
b. Transrectal ultrasound
c. Needle biopsy of the prostate
d. MRI
ANS: B
Men over the age of 50 should be advised to have a prostate-specific antigen (PSA) test and
rectal examination once a year. Two other screening methods—DRE and transrectal
ultrasonography (TRUS)—are used alone and in combination in the early detection of prostate
cancer.
DIF: Cognitive Level: Analysis REF: Page 800 OBJ: 11
TOP: Prostate cancer KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity
, 4. How would the nurse explain to the patient who is taking cyclophosphamide (Cytoxan), an
alkylating agent, about how the medication works?
a. It inhibits DNA and RNA synthesis
b. It interferes with DNA replication
c. It damages the cell in S phase of replication
d. It alters the hormonal environment that promotes cancer growth
ANS: B
Most chemotherapeutic agents work by interfering with the cell’s ability to multiply or
reproduce. Cytoxan interferes with DNA replication.
DIF: Cognitive Level: Analysis REF: Page 803 OBJ: 13
TOP: Chemotherapy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
5. After an elevation of his PSA, the patient has blood drawn for a CA-19-9. When he asks the
nurses the purpose of this new test, what is the most appropriate response?
a. It tests for hepatobiliary cancer
b. It tests for colorectal cancer
c. It tests for bladder cancer
d. It tests for lung cancer
ANS: A
The CA-19-9 is a tumor marker for tumors in the hepatobiliary system.
DIF: Cognitive Level: Comprehension REF: Page 800 OBJ: 11
TOP: CA-19-9 KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
6. A patient, age 39, receiving chemotherapy for treatment of her cancer has a white blood cell
count of 1600/mm3. This finding requires nursing interventions to provide which of the
following?
a. Adequate fluid intake
b. Protection from falls
c. Protection against infection
d. Frequent small nutritious snacks
ANS: C
The nurse needs to protect the patient against pathogens, monitor the patient for signs of
infections, and respond aggressively if an infection occurs.
DIF: Cognitive Level: Analysis REF: Page 803 OBJ: 13
TOP: Leukopenia KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment
7. What should the home health nurse advise the patient who found a lump in her breast a week
ago during breast self-examination?
a. Arrange for an examination by her physician
b. Wait until her next ovulatory cycle and check the lump again
c. Postpone appointment until the lump enlarges
d. Apply warm, moist compresses
MULTIPLE CHOICE
1. A patient has developed stomatitis from chemotherapy. What should the appropriate
intervention for this condition include?
a. Instruction in the following of a liquid diet
b. Using a commercial mouthwash after each meal
c. Cleaning teeth with a cotton swab dipped in hydrogen peroxide
d. Using a soft toothbrush
ANS: D
The use of a soft toothbrush to clean the teeth and rinsing with normal saline or soda will
prevent added discomfort and bleeding.
DIF: Cognitive Level: Comprehension REF: Page 804 OBJ: 13
TOP: Stomatitis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
2. Which of the following men should be highest priority for referral for a prostate-specific
antigen (PSA)?
a. 43-year-old Hispanic man
b. 45-year-old African American man
c. 49-year-old Korean man
d. 50-year-old Native American man
ANS: B
African American men are a high-risk population for prostate cancer. Orientals and Native
Americans have a relatively low incidence of prostate cancer.
DIF: Cognitive Level: Analysis REF: Page 795 OBJ: 3
TOP: PSA testing KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
3. A patient, age 56, has been advised that his prostate-specific antigen (PSA) level is elevated.
The physician then performed a digital rectal examination (DRE). What should the next
definitive diagnostic test be?
a. CA-125 test
b. Transrectal ultrasound
c. Needle biopsy of the prostate
d. MRI
ANS: B
Men over the age of 50 should be advised to have a prostate-specific antigen (PSA) test and
rectal examination once a year. Two other screening methods—DRE and transrectal
ultrasonography (TRUS)—are used alone and in combination in the early detection of prostate
cancer.
DIF: Cognitive Level: Analysis REF: Page 800 OBJ: 11
TOP: Prostate cancer KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity
, 4. How would the nurse explain to the patient who is taking cyclophosphamide (Cytoxan), an
alkylating agent, about how the medication works?
a. It inhibits DNA and RNA synthesis
b. It interferes with DNA replication
c. It damages the cell in S phase of replication
d. It alters the hormonal environment that promotes cancer growth
ANS: B
Most chemotherapeutic agents work by interfering with the cell’s ability to multiply or
reproduce. Cytoxan interferes with DNA replication.
DIF: Cognitive Level: Analysis REF: Page 803 OBJ: 13
TOP: Chemotherapy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
5. After an elevation of his PSA, the patient has blood drawn for a CA-19-9. When he asks the
nurses the purpose of this new test, what is the most appropriate response?
a. It tests for hepatobiliary cancer
b. It tests for colorectal cancer
c. It tests for bladder cancer
d. It tests for lung cancer
ANS: A
The CA-19-9 is a tumor marker for tumors in the hepatobiliary system.
DIF: Cognitive Level: Comprehension REF: Page 800 OBJ: 11
TOP: CA-19-9 KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
6. A patient, age 39, receiving chemotherapy for treatment of her cancer has a white blood cell
count of 1600/mm3. This finding requires nursing interventions to provide which of the
following?
a. Adequate fluid intake
b. Protection from falls
c. Protection against infection
d. Frequent small nutritious snacks
ANS: C
The nurse needs to protect the patient against pathogens, monitor the patient for signs of
infections, and respond aggressively if an infection occurs.
DIF: Cognitive Level: Analysis REF: Page 803 OBJ: 13
TOP: Leukopenia KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment
7. What should the home health nurse advise the patient who found a lump in her breast a week
ago during breast self-examination?
a. Arrange for an examination by her physician
b. Wait until her next ovulatory cycle and check the lump again
c. Postpone appointment until the lump enlarges
d. Apply warm, moist compresses
