2024 ONCOLOGY EXAM WITH
CORRECT ANSWERS
Which risk factor is most significant for developing cancer?
a) advancing age
b) smoking tobacco
c) drinking alcohol
d) fam h/o cancer - CORRECT-ANSWERSa (advancing age)
Which demonstrates the nurse's correct understanding of *neutropenic
precautions*?
a) moving client to semi-private room
b) encouraging fam to visit often
c) having room dusted/cleaned frequently
d) encouraging fam members to bring fresh flowers - CORRECT-ANSWERSc
(clean/dust frequently)
For the client receiving external radiation therapy, which nursing diagnosis is
the highest priority?
a) altered oral mucuous membrane
b) pain
c) self-care deficit
d) risk for impaired skin integrity - CORRECT-ANSWERSd (impaired skin
integrity)
What is a correct statement by a participant regarding a testicular exam?
a) "The best time to perform a self exam is after a shower."
b) "The testicle should feel hard but firm."
c) "The testicle may have minor lumps or swelling due to monthly hormonal
changes."
d) "I perform a self testicular exam once every 6 months." - CORRECT-
ANSWERSa (the best time to perform a self testicular exam is *after a
shower* when the scrotum is descended and the tissue is soft --> makes it
easier to feel for lumps or masses.)
A patient with leukemia is entering the period known as "the nadir". As the
nurse, you know the following about this period:
,a) the pt is at greatest risk for bleeding and the patient can experience a
platelet count of *50,000 or less* during this period.
b) the pt is at greatest risk for blood clots and the patient may experience a
platelet count of *500,000 or more*
c) the pt is at risk for *elevated* hgb and hct, therefore, are at risk for stroke
d) the pt will need to be placed in reverse isolation due to *low* WBC count. -
CORRECT-ANSWERSa (during this period, *bone marrow suppression is the
greatest*, therefore, the platelet count may be extremely *low*)
On assessment of a patient with *leukemia*, how would the patient present
clinically?
a) elevated hgb and hct, decreased platelets, decreased WBCs, and
bradycardia.
b) normal hgb and hct, normal platelets, and increased WBCs.
c) decreased hgb and hct, decreased platelets, and elevated or normal WBCs
with enlarged lymph nodes.
d) decreased hgb and hct, increased platelets, and elevated WBCs -
CORRECT-ANSWERSc (leukemia effects the bone marrow-responsible for
production of platelets, WBCs, and RBCs - leukemia pts will have *decreased
RBCs, decreased H&H, decreased platelets, elevated/normal WBC, and
enlarged lymph nodes)
"This disease always presents with hallmark signs of *bone pain in the ribs,
spine, and pelvis*" --> this is true for which type of cancer?
a) Hodgkin's
b) multiple myeloma
c) lung cancer
d) cervical cancer - CORRECT-ANSWERSb (multiple myeloma affects plasma
cells --> causes increased uric acid & calcium levels which *increases risk for
renal issues & bone fractures*)
---> encourage fluids to keep the kidneys "flushed" and skeletal support for
the bones helps with further complications
Which patient is at highest risk for cervical cancer?
a) A 21 year old who reports first sexual partner at the age of 14 and that
she has had at least 10 sex partners.
b) A 60 year old with a history of syphillis and cigarette smoking.
c) A 32 year old in a monogamous relationship who declined the HPV
vaccine.
d) None of the patients are at risk for cervical cancer. - CORRECT-ANSWERSa
(risk factors = first intercourse at younger than 18, multiple sex partners,
,STDs/HPV, family history, multiparity, smoking, oral contraceptive use,
obesity/poor diet, HIV/AIDS, sex partner's previous partner had cervical
cancer)
What type of treatment is normally the focus for a patient with lung cancer?
a) curative
b) palliation
c) exploratory
d) there is no Tx - CORRECT-ANSWERSb (palliation - symptom relief b/c lung
cancer is usually found in late stages when metastasis has already occurred)
-surgery for *stage 1&2 = higher cure rate* than if stage 3 or 4
What are paraneoplastic syndromes? - CORRECT-ANSWERShormones
secreted by tumor cells that complicate SCLC (ACTH, ADH, FSH, PH, ectopic
insulin)
What is the leading cause of all lung cancer deaths? - CORRECT-
ANSWERSsmoking (85%)
--- risk for LC determined by *# yrs smoking* & *#PPD smoked*
(primary prevention = reduce tobacco smoking /// secondary prevention =
screening high-risk people)
Which of the following are S/S of lung cancer that are not associated with the
pulmonary system? (SATA)
a) muffled heart sounds due to tumor/fluid around heart (*cardiac
tamponade*)
b) significant weight gain
c) increased risk for osteoporosis & pathologic fractures
d) cyanosis of lips/fingers & clubbing of fingers
e) increased vaginal discharge - CORRECT-ANSWERSa, c, d (cardiac
tamponade, dysrhythmias, cyanosis/clubbing, weight *loss*/anorexia, bone
density loss, fatigue, dysphagia, confusion/personality changes, NV, SVC
syndrome, decreased bowel/bladder function --> all S/S of lung cancer &
metastatic lung cancer that are not associated with the pulm system)
What diagnostic tests/labs are involved with diagnosing lung cancer? -
CORRECT-ANSWERS-early morning sputum cultures & thoracentesis if pleural
effusion (*cytologic testing of sputum & fluid* --> but cancer cells may not
be present in these substances)
-chest x-rays first identify lung lesions then further identified by CT
, -thoracoscopy directly views lung tissue
*to determine metastasis:*
-needly biopsy of lymph nodes
-direct surgical biopsy
-thoracentesis w/ pleural effusion
-MRI/scans of liver, spleen, brain, bone
-positron emission tomography (PET) scans (most thorough way to locate
metastasis)
-pulmonary function tests/ABGs determine overall respiratory status
What are the different treatment options involved with lung cancer? -
CORRECT-ANSWERS-chemotherapy (especially for SCLC)
-targeted therapy (EGFRIs & VEGFRIs)
-radiation - typically daily for 5-6 wks (if confined to chest) (higher doses for
shorter periods ---> relieves hemoptysis, obstruction, dysphagia, & bone
pain)
-PDT
-surgery (mainly for stage 1&2) (open thoracotomy or thoracoscopy w/ MIS)
How is dyspnea managed in the patient with lung cancer? - CORRECT-
ANSWERS-oxygen therapy
-continuous morphine infusion
-position for comfort (*semi-fowler's*)
*LC pt tires easily*
How are premalignant changes associated with cervical cells described? -
CORRECT-ANSWERSon a scale from *atypia* (suspicious) to cervical
intraepithelial neoplasia (*CIN/ dysplasia*) to carcinoma in situ (*CIS*)
--> *CIN graded on scale 1-3*
CIN1: mild (not much abnormal)
CIN2: moderate (some abnormal tissue)
CIN3: severe w/ CIS (most tissue is abnormal - most serious)
What is the most common cause of cervical cancer? - CORRECT-
ANSWERSHPV (HPV is most common cause of STDs)
*strain 16 & 18*-- cervical cancer/anal cancer
*strain 6 & 11* -- genital warts
Describe the vaccinations associated with cervical cancer prevention. -
CORRECT-ANSWERS-3 injections over 6 months
-ideally before first intercourse to protect from HPV infection