1. Question B.

Involvement of two or more lymph node regions or

structures
A diagnosis of Hodgkin’s disease was made to a 58-
C. Involvement of single lymph node region or structure
year old man and is admitted for the initial cycle of
chemotherapy. During the hospitalization, the nurse D. Involvement of extralymphatic organs or tissues
should watch out for the following
complication, except?
5. Question

Angela, a clinical instructor is conducting a lecture

A. Fertility problems
about chemotherapy. Which of the following
B. Benign prostatic hyperplasia statements is correct about the rate of cell growth in
C. Secondary cancer relation to chemotherapy?

D. Infection
A. Faster growing cells are more susceptible to
chemotherapy
2. Question
B. Faster growing cells are less susceptible to
The nurse is reviewing the chart of a client who is newly chemotherapy
diagnosed with chronic lymphocytic leukemia. Which of
C. Slower growing cells are more susceptible to
the following laboratory values is expected to be seen?
chemotherapy
D. Non-dividing cells are more susceptible to
A. Elevated aspartate aminotransferase and alanine chemotherapy
aminotransferase levels
B. Thrombocytopenia and increased lymphocytes
6. Question
C. Elevated sedimentation rate
A 40-year-old male diagnosed with acute lymphocytic
D. Uncontrolled proliferation of granulocytes
leukemia finished his first cycle of chemotherapy. Which
of the following statements by the nurse is wrong?
3. Question

Maria was recently diagnosed with Hodgkin’s A. “You can eat soft cheeses from pasteurized milk”
lymphoma. Upon the early diagnosis, the nurse will B. “You can enjoy the turkey on the day of thanksgiving
expect which of the following areas is often involved? party”
C. “Try eating sashimi in one of the famous
A. Chest Japanese restaurants around the city”

B. Neck D. “ A medium well steak is a good idea of a sumptuous

meal”
C. Groin
7. Question
D. Pelvis
A client with leukemia has neutropenia. Which of the
following functions must be frequently assessed?
4. Question

According to a standard staging classification of

 A. Heart sounds
Hodgkin’s disease, which of the following criteria
reflects stage III?  B. Bowel sounds
 C. Breath sounds
A. Involvement of lymph node regions or structures on D. Blood pressure
both sides of the diaphragm
 8. Question 12. Question

Which of the following clients is most at risk for During a routine physical examination, a firm mass is
developing multiple myeloma? palpated in the right breast of a 35-year-old woman.
Which of the following findings or client history would
suggest cancer of the breast as opposed to fibrocystic
A. A 60-year-old African-American man disease?
B. A 52-year-old Hispanic woman
C. A 35-year-old White man A. Increased vascularity of the breast
D. A 25-year-old Asian woman B. History of anovulatory cycles
C. Cyclic changes in mass size
9. Question D. History of early menarche
Which of the following substances has abnormal values
early in the course of multiple myeloma (MM)?
13. Question

The client with which of the following types of lung

A. Red blood cells cancer has the best prognosis?
B. Immunoglobulins
C. White blood cells  A. Squamous cell
D. Platelets  B. Oat cell
 C. Small cell
10. Question  D. Adenocarcinoma
Nurse Andrei is caring for a client with multiple
myeloma. During the review of the laboratory results.
14. Question
The nurse will monitor the client for which of the
following conditions? Warning signs and symptoms of lung cancer include
persistent cough, bloody sputum, dyspnea, and which
of the other following symptoms?
A. Hypermagnesemia
B. Hyperkalemia
 A. Generalized weakness
C. Hypernatremia
 B. Recurrent pleural effusion
D. Hypercalcemia
 C. Dizziness
 D. Hypotension
11. Question

Giving instructions for breast self-examination is

15. Question
particularly important for clients with which of the
following medical problems? A centrally located tumor would produce which of the
following symptoms?

A. Ovarian cancer
 A. Shoulder pain
B. Endometrial polyps
C. Cervical dysplasia  B. Pleuritic pain

D. A dermoid cyst  C. Coughing

 D. Hemoptysis
 C. To remove the tumor and as little surrounding
16. Question tissue as possible
D. To remove the tumor and all surrounding tissue
Which of the following interventions is the key to
increasing the survival rates of clients with lung cancer?
20. Question
A. High-dose chemotherapy If the client with lung cancer also has preexisting
B. Early bronchoscopy pulmonary disease, which of the following
statements best describes the extent of a surgery that
C. Smoking cessation
can be performed?
D. Early detection

A. It doesn’t affect it
17. Question
B. It may require a whole lung to be removed
A client has been diagnosed with lung cancer and C. The entire tumor may not be able to be removed
requires a wedge resection. How much of the lung is
removed? D. It may prevent surgery if the client can’t tolerate
lung tissue removal

A. A segment of the lung, including a bronchiole and its

alveoli 21. Question

B. One entire lung The client with a benign lung tumor is treated in which
of the following ways?
C. A lobe of the lung
D. A small, localized area near the surface of the lung
A. The tumor is removed, involving the least possible
amount of tissue
18. Question
B. The tumor is left alone unless symptoms are present
When a client has a lobectomy, what fills the space C. The tumor is treated with radiation only
where the lobe was?
D. The tumor is treated with chemotherapy only

A. The remaining lobe or lobes over expand to fill the

space 22. Question

B. The lung space fills up with serous fluid In the client with terminal lung cancer, the focus of
nursing care is on which of the following nursing
C. The space stays empty
interventions?
D. The surgeon fills the space with gel

A. Prepare the client’s will

B. Provide pain control
19. Question
C. Provide nutritional support
Which of the following is the primary goal for surgical D. Provide emotional support
resection of lung cancer?

A. To remove all of the tumor and any collapsed alveoli in

the same region
B. To remove as much as the tumor as possible, without
removing any alveoli
 23. Question 27. Question

What are the three most important prognostic factors Which of the following types of leukemia carries
in determining long-term survival for children with the best prognosis?
acute leukemia?

 A. Basophilic leukemia
A. Histologic type of disease, initial WBC count, and
 B. Acute lymphoblastic leukemia
client’s age at diagnosis
 C. Acute myelogenous leukemia
B. Progression of illness, WBC at the time of diagnosis, and
client’s age at the time of diagnosis  D. Eosinophilic leukemia

C. Histologic type of disease, initial platelet count, and type 28. Question
of treatment Which of the following is the reason to perform a spinal
D. Type of treatment and client’s sex tap on a client newly diagnosed with leukemia?

24. Question  A. To assess for central nervous system

infiltration
Which of the following complications are three main
consequences of leukemia?  B. To aid in classification of the leukemia
 C. To rule out meningitis

A. Anemia, infection, and bleeding tendencies  D. To decrease intracranial pressure

B. Bone deformities, spherocytosis, and infection 29. Question

C. Polycythemia, decreased clotting time, and infection Joseph who had a history of long-term smoking and
alcoholism is diagnosed with oropharyngeal cancer. He
D. Lymphocytopoiesis, growth delays, and hirsutism
is admitted into the chemo unit for the initiation of
chemotherapy. Which of the following tests is
25. Question performed before the infusion of chemotherapeutic
agents?
A child is seen in the pediatrician’s office for complaints
of bone and joint pain. Which of the following other
assessment findings may suggest leukemia?  A. Complete blood count (CBC)
 B. Peripheral blood smear
A. Increased activity level  C. Lumbar puncture
B. Increased appetite  D. Liver function test
C. Petechiae 30. Question
D. Abdominal pain Which of the following immunizations should not be
26. Question given to a 4-month-old sibling of a client with leukemia?

Which of the following assessment findings in a client

with leukemia would indicate that cancer has invaded  A. Oral poliovirus vaccine (OPV)
the brain?  B. Hepatitis B vaccine
 C. Diphtheria and tetanus and pertussis (DPT)
A. Hypervigilant and anxious behavior vaccine
B. Increased heart rate and decreased blood pressure  D. Haemophilus influenzae type b vaccines (Hib)
C. Headache and vomiting
D. Hypervigilant and anxious behavior
 31. Question 35. Question

Which of the following medications usually is given to a Parents of pediatric clients who undergo irradiation
client with leukemia as prophylaxis against P. carinii involving the central nervous system should be warned
pneumonia? about postirradiation somnolence. When does this
neurologic syndrome usually occur?

A. Vincristine (Oncovin)
 A. Immediately
B. Prednisone (Deltasone)
 B. Within 1 to 2 weeks
C. Oral nystatin suspension
 C. Within 5 to 8 weeks
D. Sulfamethoxazole and trimethoprim (Bactrim)
 D. Within 3 to 6 months
36. Question
32. Question

In which of the following diseases would bone marrow The nurse is instructing the client to perform a testicular
self-examination. The nurse tells the client:
transplantation not be indicated in a newly diagnosed
client?
 A. That testicular examination should be done
at least every 6 months
A. Severe aplastic anemia
 B. To gently feel the testicle with one finger to
B. Severe combined immunodeficiency
feel for a growth
C. Acute lymphocytic leukemia
 C. To examine the testicles while lying down
D. Chronic myeloid leukemia
 D. The best time for the examination is after
a shower
33. Question

Which of the following treatment measures should be 37. Question

implemented for a child with leukemia who has been
The community nurse is conducting a health promotion
exposed to the chickenpox?
program at a local school and is discussing the risk
factors associated with cancer. Which of the following, if
A. Acyclovir (Zovirax) should be started on exposure identified by the client as a risk factor, indicates a need
for further instructions?
B. VZIG should be given within 72 hours of exposure
C. No treatment is indicated
 A. Stress
D. Varicella-zoster immunoglobulin (VZIG) should be given
with the evidence of disease  B. Exposure to radiation
 C. Viral factors

34. Question  D. Low-fat and high-fiber diet

Nausea and vomiting are common adverse effects of 38. Question

radiation and chemotherapy. When should a nurse The client with cancer is receiving chemotherapy and
administer antiemetics? develops thrombocytopenia. The nurse identifies which
intervention is the highest priority in the nursing plan of
care?
A. When therapy is completed
B. Immediately after nausea begins
 A. Monitoring temperature
C. With the administration of therapy
 B. Monitoring for pathological factors
D. 30 minutes before the initiation of therapy
C. Ambulation three times a day 42. Question
D. Monitoring the platelet count The oncology nurse specialist provides an educational
session to nursing staff regarding the characteristics of
Hodgkin’s disease. The nurse determines that further
39. Question
education is needed if a nursing staff member states which
A client is diagnosed with multiple myeloma. The client of the following is characteristic of the disease?
asks the nurse about the diagnosis. The nurse bases the
response on which of the following descriptions of this
disorder?  A. Prognosis depends on the stage of the disease
 B. Occurs most often in the older client

A. Altered red blood cell production  C. Presence of Reed-Sternberg cells

B. Malignant proliferation of plasma cells and tumors  D. Involvement of lymph nodes, spleen, and liver
within the bone 43. Question
C. Altered production of lymph The nurse is reviewing the laboratory results of a client
D. Malignant exacerbation in the number of leukocytes receiving chemotherapy. The platelet count is 10,000
cells/mm. Based on this laboratory value,
the priority nursing assessment is which of the following?
40. Question

The nurse is reviewing the laboratory results of a client  A. Assess skin turgor
diagnosed with multiple myeloma. Which of the following
would the nurse expect to note specifically in this disorder?  B. Assess bowel sounds
 C. Assess temperature

A. Increased WBC’s  D. Assess level of consciousness

B. Increased calcium levels 44. Question

C. Decreased blood urea nitrogen Nurse Donald is caring for a client following a modified
radical mastectomy. Which assessment finding would
D. Decreased number of plasma cells in the bone marrow.
indicate that the client is experiencing a complication
related to this surgery?
41. Question

The nurse is developing a plan of care for the client with  A. Pain at the incisional site
multiple myeloma. The nurse includes which priority  B. Complaints of decreased sensation near the
intervention in the plan of care? operative site
 C. Arm edema on the operative side
A. Encouraging fluids
 D. Sanguineous drainage in the Jackson-Pratt
B. Providing frequent oral care drain
C. Coughing and deep breathing
D. Monitoring red blood cell count
 45. Question 48. Question

A nurse is providing education in a community setting A 58-year-old man is going to have chemotherapy for
about general measures to avoid excessive sun exposure. lung cancer. He asks the nurse how the chemotherapeutic
Which of the following recommendations is appropriate? drugs will work. The most accurate explanation the nurse
can give is which of the following?

A. Wear loosely woven clothing for added ventilation

 A. “Cancer cells are susceptible to drug toxins.”
B. Apply sunscreen only after going in the water
 B. “Chemotherapy affects all rapidly dividing
C. Apply sunscreen with a sun protection factor (SPF) of
cells.”
30 or more before sun exposure
 C. “Chemotherapy encourages cancer cells to
D. Avoid peak exposure hours from 9am to 1pm
divide.”
 D. “The molecular structure of the DNA is altered.”
46. Question
49. Question
Which of the following nursing interventions would be
A client with stomach cancer is admitted to the oncology
most helpful in making the respiratory effort of a client
unit after vomiting for 3 days. Physical assessment findings
with metastatic lung cancer more efficient?
include irregular pulse, muscle twitching, and complaints
of prickling sensations in the fingers and hands.
A. Teaching the client diaphragmatic breathing techniques Laboratory results include a potassium level of 2.9 mEq/L,
a pH of 7.46, and a bicarbonate level of 29 mEq/L. The
B. Administering cough suppressants as ordered
client is experiencing:
C. Teaching and encouraging pursed-lip breathing
D. Placing the client in a low semi-Fowlers position
 A. Metabolic alkalosis
 B. Respiratory acidosis
47. Question
 C. Metabolic acidosis
The nurse is teaching a 17-year old client and the client’s  D.Respiratory alkalosis
family about what to expect with high-dose chemotherapy
and the effects of neutropenia. What should the nurse
teach as the most reliable early indicator of infection in a
neutropenic client?

A. Dyspnea
B. Fever
C. Tachycardia
D. Chills