Oncology Test Bank :Questions and Answers
A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing
diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best
indicate that she is meeting the goal of improved body image and self-esteem?
A)The patient requests that her family bring her makeup and wig.
B)The patient begins to discuss the future with her family.
C)The patient reports less disruption from pain and discomfort.
D)The patient cries openly when discussing her disease. - ansA - Requesting her wig and makeup indicates that
the patient with alopecia is becoming interested in looking her best and that her body image and self-esteem
may be improving. The other options may indicate that other nursing goals are being met, but they do not
necessarily indicate improved body image and self-esteem.
A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain.
His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of
immature cells. The nurse caring for this patient suspects a diagnosis of what?
A)AML - acute myeloid leukemia
B)CML - chronic myeloid leukemia
C)MDS - myelodysplastic syndromes
D)ALL - acute lymphocytic leukemia - ansD - In (ALL), manifestations of leukemic cell infiltration into other
organs are more common than with other forms of leukemia, and include pain from an enlarged liver or spleen,
as well as bone pain. The central nervous system is frequently a site for leukemic cells; thus, patients may
exhibit headache and vomiting because of meningeal involvement. Other extranodal sites include the testes
and breasts. This particular presentation is not closely associated with (AML), (CML), or (MDS).
A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the
most common adverse effects of chemotherapy?
A)Administer an antiemetic.
B)Administer an antimetabolite.
C)Administer a tumor antibiotic.
D)Administer an anticoagulant. - ansA - Antiemetics are used to treat nausea and vomiting, the most common
adverse effects of chemotherapy. Antihistamines and certain steroids are also used to treat nausea and
vomiting. Antimetabolites and tumor antibiotics are classes of chemotherapeutic medications. Anticoagulants
,slow blood clotting time, thereby helping to prevent thrombi and emboli.
A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The
patient states, They tell me my cancer is malignant, while my coworkers breast tumor was benign. I just dont
understand at all. When preparing a response to this patient, the nurse should be cognizant of what
characteristic that distinguishes malignant cells from benign cells of the same tissue type?
A)Slow rate of mitosis of cancer cells
B)Different proteins in the cell membrane
C)Differing size of the cells
D)Different molecular structure in the cells - ansB - The cell membrane of malignant cells also contains proteins
called tumor-specific antigens (e.g., carcinoembryonic antigen [CEA] and prostate-specific antigen [PSA]), which
develop over time as the cells become less differentiated (mature). These proteins distinguish malignant cells
from benign cells of the same tissue type.
A 54-year-old man has just been diagnosed with small cell lung cancer. The patient asks the nurse why the
doctor is not offering surgery as a treatment for his cancer. What fact about lung cancer treatment should
inform the nurses response?
A)The cells in small cell cancer of the lung are not large enough to visualize in surgery.
B)Small cell lung cancer is self-limiting in many patients and surgery should be delayed.
C)Patients with small cell lung cancer are not normally stable enough to survive surgery.
D)Small cell cancer of the lung grows rapidly and metastasizes early and extensively. - ansD - Surgery is
primarily used for NSCLCs, because small cell cancer of the lung grows rapidly and metastasizes early and
extensively. Difficult visualization and a patients medical instability are not the limiting factors. Lung cancer is
not a self-limiting disease.
A 58-year-old male patient has been hospitalized for a wedge resection of the left lower lung lobe after a
routine chest x-ray shows carcinoma. The patient is anxious and asks if he can smoke. Which statement by the
nurse would be most therapeutic?
A)Smoking is the reason you are here.
B)The doctor left orders for you not to smoke.
C)You are anxious about the surgery. Do you see smoking as helping?
D)Smoking is OK right now, but after your surgery it is contraindicated. - ansC - Stating You are anxious about
,the surgery. Do you see smoking as helping? acknowledges the patients feelings and encourages him to assess
his previous behavior. Saying Smoking is the reason you are here belittles the patient. Citing the doctors orders
does not address the patients anxiety. Sanctioning smoking would be highly detrimental to this patient.
A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-
dose radiation (HDR). What safety measure should the nurse include in this patients subsequent plan of care?
A)Limit the time that visitors spend at the patients bedside.
B)Teach the patient to perform all aspects of basic care independently.
C)Assign male nurses to the patients care whenever possible.
D)Situate the patient in a shared room with other patients receiving brachytherapy. - ansA - To limit radiation
exposure, visitors should generally not spend more than 30 minutes with the patient. Pregnant nurses or
visitors should not be near the patient, but there is no reason to limit care to nurses who are male. All
necessary care should be provided to the patient and a single room should be used.
A 62-year-old woman diagnosed with breast cancer is scheduled for a partial mastectomy. The oncology nurse
explained that the surgeon will want to take tissue samples to ensure the disease has not spread to adjacent
axillary lymph nodes. The patient has asked if she will have her lymph nodes dissected, like her mother did
several years ago. What alternative to lymph node dissection will this patient most likely undergo?
A)Lymphadenectomy
B)Needle biopsy
C)Open biopsy
D)Sentinel node biopsy - ansD - Sentinel lymph node biopsy (SLNB), also known as sentinel lymph node
mapping, is a minimally invasive surgical approach that, in some instances, has replaced more invasive lymph
node dissections (lymphadenectomy) and their associated complications such as lymphedema and delayed
healing. SLNB has been widely adopted for regional lymph node staging in selected cases of melanoma and
breast cancer.
A 74-year-old male patient has recently been diagnosed with a Glioblastoma. The patient complains of having a
headache that is 8 out of 10 on a 0-10 scale. The nurse can expect to administer which of the following
medications? (Select all that apply)
a) Zofran
b) Gabapentin
c) Mannitol
, d) Ciprofloxacin - ansB, C - Gabapentin will prevent seizures. Mannitol will decrease fluid content of the brain
which will decrease ICP. Zofran and Cipro will not aid in decreasing headache or ICP.
A 77-year-old male is admitted to a unit with a suspected diagnosis of acute myeloid leukemia (AML). When
planning this patients care, the nurse should be aware of what epidemiologic fact?
A)Early diagnosis is associated with good outcomes.
B)Five-year survival for older adults is approximately 50%.
C)Five-year survival for patients over 75 years old is less than 2%.
D)Survival rates are wholly dependent on the patients pre-illness level of health. - ansC - The 5-year survival
rate for patients with AML who are 50 years of age or younger is 43%; it drops to 19% for those between 50
and 64 years, and drops to1.6% for those older than 75 years. Early diagnosis is beneficial, but is nonetheless
not associated with good outcomes or high survival rates. Preillness health is significant, but not the most
important variable.
A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should
the nurse prioritize when addressing the patients severe bone pain?
A)Implementing distraction techniques
B)Educating the patient about the effective use of hot and cold packs
C)Teaching the patient to use NSAIDs effectively
D)Helping the patient manage the opioid analgesic regimen - ansD - For severe pain resulting from multiple
myeloma, opioids are likely necessary. NSAIDs would likely be ineffective and are associated with significant
adverse effects. Hot and cold packs as well as distraction would be insufficient for severe pain.
A nurse is addressing the prevention of esophageal cancer in response to a question posed by a participant in a
health promotion workshop. What action has the greatest potential to prevent esophageal cancer?
A)Promotion of a nutrient-dense, low-fat diet
B)Annual screening endoscopy for patients over 50 with a family history of esophageal cancer
C)Early diagnosis and treatment of gastroesophageal reflux disease
D)Adequate fluid intake and avoidance of spicy foods - ansC - There are numerous risk factors for esophageal
cancer but chronic esophageal irritation or GERD is among the most significant. This is a more significant risk
factor than dietary habits. Screening endoscopies are not recommended solely on the basis of family history.
A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing
diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best
indicate that she is meeting the goal of improved body image and self-esteem?
A)The patient requests that her family bring her makeup and wig.
B)The patient begins to discuss the future with her family.
C)The patient reports less disruption from pain and discomfort.
D)The patient cries openly when discussing her disease. - ansA - Requesting her wig and makeup indicates that
the patient with alopecia is becoming interested in looking her best and that her body image and self-esteem
may be improving. The other options may indicate that other nursing goals are being met, but they do not
necessarily indicate improved body image and self-esteem.
A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain.
His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of
immature cells. The nurse caring for this patient suspects a diagnosis of what?
A)AML - acute myeloid leukemia
B)CML - chronic myeloid leukemia
C)MDS - myelodysplastic syndromes
D)ALL - acute lymphocytic leukemia - ansD - In (ALL), manifestations of leukemic cell infiltration into other
organs are more common than with other forms of leukemia, and include pain from an enlarged liver or spleen,
as well as bone pain. The central nervous system is frequently a site for leukemic cells; thus, patients may
exhibit headache and vomiting because of meningeal involvement. Other extranodal sites include the testes
and breasts. This particular presentation is not closely associated with (AML), (CML), or (MDS).
A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the
most common adverse effects of chemotherapy?
A)Administer an antiemetic.
B)Administer an antimetabolite.
C)Administer a tumor antibiotic.
D)Administer an anticoagulant. - ansA - Antiemetics are used to treat nausea and vomiting, the most common
adverse effects of chemotherapy. Antihistamines and certain steroids are also used to treat nausea and
vomiting. Antimetabolites and tumor antibiotics are classes of chemotherapeutic medications. Anticoagulants
,slow blood clotting time, thereby helping to prevent thrombi and emboli.
A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The
patient states, They tell me my cancer is malignant, while my coworkers breast tumor was benign. I just dont
understand at all. When preparing a response to this patient, the nurse should be cognizant of what
characteristic that distinguishes malignant cells from benign cells of the same tissue type?
A)Slow rate of mitosis of cancer cells
B)Different proteins in the cell membrane
C)Differing size of the cells
D)Different molecular structure in the cells - ansB - The cell membrane of malignant cells also contains proteins
called tumor-specific antigens (e.g., carcinoembryonic antigen [CEA] and prostate-specific antigen [PSA]), which
develop over time as the cells become less differentiated (mature). These proteins distinguish malignant cells
from benign cells of the same tissue type.
A 54-year-old man has just been diagnosed with small cell lung cancer. The patient asks the nurse why the
doctor is not offering surgery as a treatment for his cancer. What fact about lung cancer treatment should
inform the nurses response?
A)The cells in small cell cancer of the lung are not large enough to visualize in surgery.
B)Small cell lung cancer is self-limiting in many patients and surgery should be delayed.
C)Patients with small cell lung cancer are not normally stable enough to survive surgery.
D)Small cell cancer of the lung grows rapidly and metastasizes early and extensively. - ansD - Surgery is
primarily used for NSCLCs, because small cell cancer of the lung grows rapidly and metastasizes early and
extensively. Difficult visualization and a patients medical instability are not the limiting factors. Lung cancer is
not a self-limiting disease.
A 58-year-old male patient has been hospitalized for a wedge resection of the left lower lung lobe after a
routine chest x-ray shows carcinoma. The patient is anxious and asks if he can smoke. Which statement by the
nurse would be most therapeutic?
A)Smoking is the reason you are here.
B)The doctor left orders for you not to smoke.
C)You are anxious about the surgery. Do you see smoking as helping?
D)Smoking is OK right now, but after your surgery it is contraindicated. - ansC - Stating You are anxious about
,the surgery. Do you see smoking as helping? acknowledges the patients feelings and encourages him to assess
his previous behavior. Saying Smoking is the reason you are here belittles the patient. Citing the doctors orders
does not address the patients anxiety. Sanctioning smoking would be highly detrimental to this patient.
A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-
dose radiation (HDR). What safety measure should the nurse include in this patients subsequent plan of care?
A)Limit the time that visitors spend at the patients bedside.
B)Teach the patient to perform all aspects of basic care independently.
C)Assign male nurses to the patients care whenever possible.
D)Situate the patient in a shared room with other patients receiving brachytherapy. - ansA - To limit radiation
exposure, visitors should generally not spend more than 30 minutes with the patient. Pregnant nurses or
visitors should not be near the patient, but there is no reason to limit care to nurses who are male. All
necessary care should be provided to the patient and a single room should be used.
A 62-year-old woman diagnosed with breast cancer is scheduled for a partial mastectomy. The oncology nurse
explained that the surgeon will want to take tissue samples to ensure the disease has not spread to adjacent
axillary lymph nodes. The patient has asked if she will have her lymph nodes dissected, like her mother did
several years ago. What alternative to lymph node dissection will this patient most likely undergo?
A)Lymphadenectomy
B)Needle biopsy
C)Open biopsy
D)Sentinel node biopsy - ansD - Sentinel lymph node biopsy (SLNB), also known as sentinel lymph node
mapping, is a minimally invasive surgical approach that, in some instances, has replaced more invasive lymph
node dissections (lymphadenectomy) and their associated complications such as lymphedema and delayed
healing. SLNB has been widely adopted for regional lymph node staging in selected cases of melanoma and
breast cancer.
A 74-year-old male patient has recently been diagnosed with a Glioblastoma. The patient complains of having a
headache that is 8 out of 10 on a 0-10 scale. The nurse can expect to administer which of the following
medications? (Select all that apply)
a) Zofran
b) Gabapentin
c) Mannitol
, d) Ciprofloxacin - ansB, C - Gabapentin will prevent seizures. Mannitol will decrease fluid content of the brain
which will decrease ICP. Zofran and Cipro will not aid in decreasing headache or ICP.
A 77-year-old male is admitted to a unit with a suspected diagnosis of acute myeloid leukemia (AML). When
planning this patients care, the nurse should be aware of what epidemiologic fact?
A)Early diagnosis is associated with good outcomes.
B)Five-year survival for older adults is approximately 50%.
C)Five-year survival for patients over 75 years old is less than 2%.
D)Survival rates are wholly dependent on the patients pre-illness level of health. - ansC - The 5-year survival
rate for patients with AML who are 50 years of age or younger is 43%; it drops to 19% for those between 50
and 64 years, and drops to1.6% for those older than 75 years. Early diagnosis is beneficial, but is nonetheless
not associated with good outcomes or high survival rates. Preillness health is significant, but not the most
important variable.
A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should
the nurse prioritize when addressing the patients severe bone pain?
A)Implementing distraction techniques
B)Educating the patient about the effective use of hot and cold packs
C)Teaching the patient to use NSAIDs effectively
D)Helping the patient manage the opioid analgesic regimen - ansD - For severe pain resulting from multiple
myeloma, opioids are likely necessary. NSAIDs would likely be ineffective and are associated with significant
adverse effects. Hot and cold packs as well as distraction would be insufficient for severe pain.
A nurse is addressing the prevention of esophageal cancer in response to a question posed by a participant in a
health promotion workshop. What action has the greatest potential to prevent esophageal cancer?
A)Promotion of a nutrient-dense, low-fat diet
B)Annual screening endoscopy for patients over 50 with a family history of esophageal cancer
C)Early diagnosis and treatment of gastroesophageal reflux disease
D)Adequate fluid intake and avoidance of spicy foods - ansC - There are numerous risk factors for esophageal
cancer but chronic esophageal irritation or GERD is among the most significant. This is a more significant risk
factor than dietary habits. Screening endoscopies are not recommended solely on the basis of family history.
