NURS 202 COMPREHENSIVE EXAM UPDATED QUESTIONS
AND ANSWERS GRADED A+
✔✔The nurse teaches the client with chronic cancer pain about optimal pain control.
Which recommendation is most effective for pain control?
A. Get used to some pain, and use a little less medication than needed to keep from
being addicted.
B. Take prescribed analgesics on an around-the-clock schedule to prevent recurrent
pain.
C. Take analgesics only when pain returns.
D. Take enough analgesics around the clock so that you can sleep 12 to 16 hours a day
to block the pain. - ✔✔B. Take prescribed analgesics on an around-the-clock schedule
to prevent recurrent pain.
The regular administration of analgesics provides a consistent serum level of
medication, which can help prevent breakthrough pain. Therefore, taking the prescribed
analgesics on a regular schedule is the best way to manage chronic cancer-related
pain. There is little risk for the client with cancer-related pain to become addicted.
Sleeping 12 to 16 hours a day would not allow the client to participate in usual daily
activities or preferred activities.
✔✔Which strategy will be most effective in improving transcultural communications with
oncology clients and their families?
A. Use touch to show concern and caring for the client.
B. Focus attention on verbal communication skills only.
C. Establish a rapport and listen to their concerns.
D. Maintain eye contact at all times. - ✔✔C. Establish a rapport and listen to their
concerns.
It is important to establish rapport with the client and family by listening to verbal and
nonverbal concern and showing respect for cultural differences. The use of touch or eye
contact is culture-specific and cannot be generalized as an intervention for all
individuals with cancer. Miscommunication between individuals of different cultures is
often caused by language differences, rules of communication, age, and gender.
✔✔he nurse is teaching the client who is receiving chemotherapy and the family how to
manage possible nausea and vomiting at home. What information should the nurse
include in the teaching plan?
A. Eating frequent, small meals.
B. Include soft foods in the diet.
C. Drink a milkshake made with fruit every day.
D. Limit the amount of fluid intake. - ✔✔A. Eating frequent, small meals.
,To reduce the adverse effects of chemotherapy such as nausea and vomiting, the nurse
can suggest that the client eat small meals more frequently, which will be better
tolerated while maintaining adequate nutrition. It is not necessary to eat soft food or
milkshakes blended with fruit. Fluid intake should be encouraged to avoid dehydration.
✔✔A client with chronic cancer pain has been receiving opiates for 4 months. She rated
the pain as an 8 on a 10-point scale before starting the opioid medication. Following a
thorough examination, there is no new evidence of increased disease, yet the pain is
close to 8 again. What is the most likely explanation for the increasing pain?
A. development of an addiction to the opioids
B. tolerance to the opioid
C. withdrawal from the opioid
D. placebo effect has decreased - ✔✔B. tolerance to the opioid
Tolerance to an opioid occurs when a larger dose of the analgesic is needed to provide
the same level of pain control. The risk of addiction is low with opioids to treat cancer
pain. There are no data to support that this client is experiencing withdrawal. Although
the client may have experienced a placebo effect at one time, placebo effects tend to
diminish over time, especially in regard to chronic cancer pain.
✔✔A nurse is conducting a cancer risk screening program. Which client is at greatest
risk for skin cancer?
A. 45-year-old health care worker
B. 15-year-old high school student
C. 30-year-old butcher
D. 60-year-old mountain biker - ✔✔D. 60-year-old mountain biker
Basal cell carcinoma occurs most commonly in sun-exposed areas of the body. The
incidence of skin cancer is highest in older people who live in the mountains or spend
outdoor leisure time at higher altitudes.
✔✔A client with brown hair is concerned about losing hair as a result of chemotherapy.
What should the nurse tell the client?
A. "The new growth of hair will be gray."
B. "The hair loss is temporary."
C. "New hair growth will always be the same texture and color as it was before
chemotherapy."
D. "Avoid use of wigs when possible." - ✔✔B. "The hair loss is temporary."
Alopecia from chemotherapy is temporary. The new hair will not be necessarily gray,
but the texture and color of new hair growth may be different. Clients who will be
receiving chemotherapy should be encouraged to purchase a wig while they still have
,hair so that they can match the color and texture of their hair. Loss of hair, or alopecia,
is a serious threat to self-esteem and should be addressed quickly before treatment.
✔✔The nurse is witnessing the client's signature on the informed surgical consent for an
abdominal hysterectomy. The nurse should be certain the client understands that what
will be the outcome of this surgery?
A. decreased libido.
B. infertility.
C. depression.
D. weight gain. - ✔✔B. infertility.
The client needs to understand that with removal of the uterus she will no longer be able
to bear children or have menstrual periods. The surgical procedure should not change
her libido or sexual functioning. Research does not support the idea that hysterectomy
contributes to depression or weight gain. Research demonstrates that women who have
managed health problems for some time before the hysterectomy may actually have a
more positive effect, with less worry about their health condition, contraception, or
pregnancy.
✔✔A nurse is caring for a client who had a prostatectomy for prostate cancer. The
nurse is reviewing the client's vital signs and intake and output as documented by a
nursing assistant. (BP: 110/64, HR: 78, RR: 14, T: 99.4, Intake: 1420mL, Output:
330mL) Which documented finding requires immediate action?
A. blood pressure
B. heart rate
C. intake and output
D. temperature - ✔✔C. intake and output
The client has a significantly greater intake than output. This finding may indicate that
the catheter is blocked and causing urine retention. The nurse should immediately
irrigate the catheter and try to determine if clots are blocking the catheter. If the nurse is
unable to irrigate the catheter, the healthcare provider should be notified immediately.
The client's heart rate and blood pressure are normal. Although the temperature is
slightly elevated, this finding is not a priority at this time.
✔✔A client with stage II ovarian cancer undergoes a total abdominal hysterectomy and
bilateral salpingo-oophorectomy with tumor resection, omentectomy, appendectomy,
and lymphadenectomy. During the second postoperative day, which assessment finding
requires immediate intervention?
A. abdominal pain
B. hypoactive bowel sounds
C. serous drainage from the incision
, D. shallow breathing and increasing lethargy - ✔✔D. shallow breathing and increasing
lethargy
Shallow breathing and a change in the level of consciousness, such as increasing
lethargy requires immediate intervention because they may indicate a respiratory
complication — for example, atelectasis or carbon dioxide retention. To avoid
respiratory complications, the nurse should encourage turning, coughing, deep
breathing, and ambulation during the early postoperative period. Abdominal pain,
hypoactive bowel sounds, and serous drainage from the incision are expected findings
during the first few days after this type of surgery.
✔✔A client asks the nurse what PSA is. The nurse should reply that it stands for
A. prostate-specific antigen, which is used to screen for prostate cancer.
B. protein serum antigen, which is used to determine protein levels.
C. pneumococcal strep antigen, which is a bacteria that causes pneumonia.
D. papanicolaou-specific antigen, which is used to screen for cervical cancer. - ✔✔A.
prostate-specific antigen, which is used to screen for prostate cancer.
PSA stands for prostate-specific antigen, which is used to screen for prostate cancer.
✔✔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
AND ANSWERS GRADED A+
✔✔The nurse teaches the client with chronic cancer pain about optimal pain control.
Which recommendation is most effective for pain control?
A. Get used to some pain, and use a little less medication than needed to keep from
being addicted.
B. Take prescribed analgesics on an around-the-clock schedule to prevent recurrent
pain.
C. Take analgesics only when pain returns.
D. Take enough analgesics around the clock so that you can sleep 12 to 16 hours a day
to block the pain. - ✔✔B. Take prescribed analgesics on an around-the-clock schedule
to prevent recurrent pain.
The regular administration of analgesics provides a consistent serum level of
medication, which can help prevent breakthrough pain. Therefore, taking the prescribed
analgesics on a regular schedule is the best way to manage chronic cancer-related
pain. There is little risk for the client with cancer-related pain to become addicted.
Sleeping 12 to 16 hours a day would not allow the client to participate in usual daily
activities or preferred activities.
✔✔Which strategy will be most effective in improving transcultural communications with
oncology clients and their families?
A. Use touch to show concern and caring for the client.
B. Focus attention on verbal communication skills only.
C. Establish a rapport and listen to their concerns.
D. Maintain eye contact at all times. - ✔✔C. Establish a rapport and listen to their
concerns.
It is important to establish rapport with the client and family by listening to verbal and
nonverbal concern and showing respect for cultural differences. The use of touch or eye
contact is culture-specific and cannot be generalized as an intervention for all
individuals with cancer. Miscommunication between individuals of different cultures is
often caused by language differences, rules of communication, age, and gender.
✔✔he nurse is teaching the client who is receiving chemotherapy and the family how to
manage possible nausea and vomiting at home. What information should the nurse
include in the teaching plan?
A. Eating frequent, small meals.
B. Include soft foods in the diet.
C. Drink a milkshake made with fruit every day.
D. Limit the amount of fluid intake. - ✔✔A. Eating frequent, small meals.
,To reduce the adverse effects of chemotherapy such as nausea and vomiting, the nurse
can suggest that the client eat small meals more frequently, which will be better
tolerated while maintaining adequate nutrition. It is not necessary to eat soft food or
milkshakes blended with fruit. Fluid intake should be encouraged to avoid dehydration.
✔✔A client with chronic cancer pain has been receiving opiates for 4 months. She rated
the pain as an 8 on a 10-point scale before starting the opioid medication. Following a
thorough examination, there is no new evidence of increased disease, yet the pain is
close to 8 again. What is the most likely explanation for the increasing pain?
A. development of an addiction to the opioids
B. tolerance to the opioid
C. withdrawal from the opioid
D. placebo effect has decreased - ✔✔B. tolerance to the opioid
Tolerance to an opioid occurs when a larger dose of the analgesic is needed to provide
the same level of pain control. The risk of addiction is low with opioids to treat cancer
pain. There are no data to support that this client is experiencing withdrawal. Although
the client may have experienced a placebo effect at one time, placebo effects tend to
diminish over time, especially in regard to chronic cancer pain.
✔✔A nurse is conducting a cancer risk screening program. Which client is at greatest
risk for skin cancer?
A. 45-year-old health care worker
B. 15-year-old high school student
C. 30-year-old butcher
D. 60-year-old mountain biker - ✔✔D. 60-year-old mountain biker
Basal cell carcinoma occurs most commonly in sun-exposed areas of the body. The
incidence of skin cancer is highest in older people who live in the mountains or spend
outdoor leisure time at higher altitudes.
✔✔A client with brown hair is concerned about losing hair as a result of chemotherapy.
What should the nurse tell the client?
A. "The new growth of hair will be gray."
B. "The hair loss is temporary."
C. "New hair growth will always be the same texture and color as it was before
chemotherapy."
D. "Avoid use of wigs when possible." - ✔✔B. "The hair loss is temporary."
Alopecia from chemotherapy is temporary. The new hair will not be necessarily gray,
but the texture and color of new hair growth may be different. Clients who will be
receiving chemotherapy should be encouraged to purchase a wig while they still have
,hair so that they can match the color and texture of their hair. Loss of hair, or alopecia,
is a serious threat to self-esteem and should be addressed quickly before treatment.
✔✔The nurse is witnessing the client's signature on the informed surgical consent for an
abdominal hysterectomy. The nurse should be certain the client understands that what
will be the outcome of this surgery?
A. decreased libido.
B. infertility.
C. depression.
D. weight gain. - ✔✔B. infertility.
The client needs to understand that with removal of the uterus she will no longer be able
to bear children or have menstrual periods. The surgical procedure should not change
her libido or sexual functioning. Research does not support the idea that hysterectomy
contributes to depression or weight gain. Research demonstrates that women who have
managed health problems for some time before the hysterectomy may actually have a
more positive effect, with less worry about their health condition, contraception, or
pregnancy.
✔✔A nurse is caring for a client who had a prostatectomy for prostate cancer. The
nurse is reviewing the client's vital signs and intake and output as documented by a
nursing assistant. (BP: 110/64, HR: 78, RR: 14, T: 99.4, Intake: 1420mL, Output:
330mL) Which documented finding requires immediate action?
A. blood pressure
B. heart rate
C. intake and output
D. temperature - ✔✔C. intake and output
The client has a significantly greater intake than output. This finding may indicate that
the catheter is blocked and causing urine retention. The nurse should immediately
irrigate the catheter and try to determine if clots are blocking the catheter. If the nurse is
unable to irrigate the catheter, the healthcare provider should be notified immediately.
The client's heart rate and blood pressure are normal. Although the temperature is
slightly elevated, this finding is not a priority at this time.
✔✔A client with stage II ovarian cancer undergoes a total abdominal hysterectomy and
bilateral salpingo-oophorectomy with tumor resection, omentectomy, appendectomy,
and lymphadenectomy. During the second postoperative day, which assessment finding
requires immediate intervention?
A. abdominal pain
B. hypoactive bowel sounds
C. serous drainage from the incision
, D. shallow breathing and increasing lethargy - ✔✔D. shallow breathing and increasing
lethargy
Shallow breathing and a change in the level of consciousness, such as increasing
lethargy requires immediate intervention because they may indicate a respiratory
complication — for example, atelectasis or carbon dioxide retention. To avoid
respiratory complications, the nurse should encourage turning, coughing, deep
breathing, and ambulation during the early postoperative period. Abdominal pain,
hypoactive bowel sounds, and serous drainage from the incision are expected findings
during the first few days after this type of surgery.
✔✔A client asks the nurse what PSA is. The nurse should reply that it stands for
A. prostate-specific antigen, which is used to screen for prostate cancer.
B. protein serum antigen, which is used to determine protein levels.
C. pneumococcal strep antigen, which is a bacteria that causes pneumonia.
D. papanicolaou-specific antigen, which is used to screen for cervical cancer. - ✔✔A.
prostate-specific antigen, which is used to screen for prostate cancer.
PSA stands for prostate-specific antigen, which is used to screen for prostate cancer.
✔✔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
