Nursing 240 Exam 2 (100+ Questions) – Colorectal, Skin & Lung Cancer, Bowel Obstruction, TPN, SIADH, Pleural Effusion, Thoracentesis & Oncology Labs

This advanced-level exam study guide features 100+ clinically accurate, up-to-date questions and answers for Nursing 240 – Oncology, Surgical, and Fluid Management Nursing, created for the 2025/2026 academic year at the University of Nursing Sciences. The document blends complex oncology pathophysiology, diagnostics, pharmacologic interventions, and surgical care with high-level nursing applications. It’s designed to help students prepare for unit exams, final evaluations, and licensure exams with a focus on critical care oncology, GI disorders, and thoracic conditions. Covered Topics: Colorectal Cancer (CRC): Risk factors: colon polyps, age 50, family history, African American ethnicity, high-fat diets, radiation, IBS ACS screening guidelines: FOBT, colonoscopy, sigmoidoscopy, stool DNA testing Early vs late signs: rectal bleeding, change in bowel habits, weight loss, palpable masses Diagnostics: colonoscopy with biopsy, CEA levels, CT/MRI Surgical interventions: local excision, fulguration, colectomy with lymph node sampling Bowel Obstruction: Types: mechanical (adhesions, volvulus, tumor) vs non-mechanical (paralytic ileus) Partial vs complete obstruction symptoms Clinical signs: high-pitched bowel sounds above obstruction, hypoactive below Diagnostics: X-ray, CT, electrolyte labs Small vs large bowel: dehydration risk, stool patterns Treatment: NG decompression, IV fluids, electrolyte correction Total Parenteral Nutrition (TPN): Indications: malnutrition, inability to use GI tract Administration: central line only via infusion pump Complications: infection, hyperglycemia, fluid overload Tubing changes: every 24 hours with micron filter Weaning: must be tapered to avoid hypoglycemia Skin Cancer: Risk factors: sun exposure, fair complexion, immunosuppression ABCDE rule for melanoma Cancer types: Basal cell carcinoma – slow growing, face/neck Squamous cell carcinoma – more invasive, lips/ears Superficial spreading melanoma – common in women 50 Diagnostic: biopsy, lymph node excisional biopsy Surgical options: Mohs surgery Lung Cancer: Risk factors: smoking, asbestos, radon, prior radiation ACS screening: annual low-dose CT for high-risk patients Diagnostic tests: chest X-ray, sputum culture, bronchoscopy, biopsy Surgeries: wedge resection, lobectomy, pneumonectomy – with post-op breath sound expectations SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion): Causes: cancer, CNS trauma, medications Symptoms: confusion, seizures, muscle cramps, oliguria Nursing care: seizure precautions, hypertonic 3% saline, sodium monitoring Pleural Effusion & Thoracentesis: Causes: malignancy, heart failure, infections Symptoms: decreased breath sounds, dyspnea Procedure risks: pneumothorax, hypoxemia, subcutaneous emphysema Post-procedure nursing care and patient monitoring This is a high-impact study tool that consolidates oncology diagnostics, surgical nursing, electrolyte imbalances, TPN safety, and thoracic interventions into one expertly organized reference. Ideal for exam preparation and clinical application. Courses this document may concern: Nursing 240: Oncology & Surgical Nursing Med-Surg II: Cancer & Critical Care Advanced Fluid & Electrolyte Management Adult Health Nursing NCLEX-RN Prep for Oncology and GI Students this document may benefit: BSN and ADN nursing students LPN/LVN students in bridge programs NCLEX-RN, ATI, or HESI candidates International nursing students preparing for U.S. clinical cancer care and fluid management Keywords: colorectal cancer, colonoscopy, CEA level, bowel obstruction, NG decompression, TPN administration, TPN risks, skin cancer ABCDE, basal cell, squamous cell, melanoma, lung cancer CT, wedge resection, lobectomy, SIADH, hyponatremia, thoracentesis, pleural effusion, nursing cancer care, Nursing 240, oncology review, NCLEX cancer questions