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P&R REVIEW

Total questions: 20

Worksheet time: 15mins

Name
Class
Date
1.

The nurse is performing a breast

assessment. Which statement made

by the client indicates a risk of

breast cancer? Select all that apply.

One, some, or all responses may

be correct.

a)

'I had a late onset of menarche.'

b)

"My first child was born when I was

32'

c)

- 'I noticed a slight discharge from a

nipple.

d)

"I perform breast self-examinations

frequently.

e)

"I consume two to four glasses of

alcohol a day.'

2.

What information from a client's

history would the nurse identify as

risk factors for the development of

colon cancer? Select all that apply.

One, some, or all responses may

be correct.

a)

Hemorrhoids

b)

Increased age

c)

High-fiber diet

d)

Ulcerative colitis

e)

Low hemoglobin level

3.

Which clinical manifestations does

the nurse expect the client to report

when admitted for surgical

resection of a rectosigmoid colon

cancer? Select all that apply. One,

some, or all responses may be

correct.

a)

Feeling tired

b)

Rectal bleeding

c)

Change in the shape of stools

d)

Feeling of abdominal bloating

e)

Stools float and are clay-colored

4.

A client is admitted for a biopsy of a

tumor in her left breast. The client

states, 'I know it can't be cancer.

because it doesn't hurt.!' Which

response by the nurse is most

therapeutic?

a)

'Let's hope that it isn't malignant.'

b)

"What do you know about breast

cancer?'

c)

'Most lumps in the breast are not

malignant.

d)

Has your primary health care

provider told you that it wasn't

cancer?'

5.

When a client who has seemed

cheerful after a diagnosis of lung

cancer and pneumonectomy

becomes withdrawn after being

discharged home, which action by

the home health nurse will be best?

A. Suggest that an antidepressant may be helpful.

B. Ask the client to describe the current emotional state.

C. Reassure the client that depression is a normal reaction.

D. Ask the health care provider to make a mental health referral.

(a)  

6.

Which information about malignant

tumors of the colon would the

nurse consider when providing care

for a client with an obstruction of

the colon?

A. Detection of the malignant tumors is easy.

B. Malignant tumors usually localize to one area.

C. Women are more at risk than men.

D. Colon obstructions are usually malignant.

(a)  

7.

Laboratory results for a client with

small cell lung cancer reflect urine

with a high specific gravity and a

serum sodium level of 127 mEg/L.

The client has gained 7 pounds in 3

days, has decreased urine output,

and no edema is noted. Which

nursing interventions are

appropriate for this client? Select all

that apply. One, some, or all

responses may be correct.

a)

Initiate furosemide (Lasix).

b)

Introduce a potassium-restricted diet.

c)

Start an IV of hypertonic saline solution.

d)

Institute a fluid restriction of 800 to 1000 mL/day.

e)

Set a goal of increasing sodium by 15 to 20 mEg/L in the next 24

hours.

8.

Which signs would the nurse expect

to observe in a client with small cell

carcinoma of the lung who develops

syndrome of inappropriate

antidiuretic hormone (SIADH)?

Select all that apply. One, some, or

all responses may be correct.

a)

oliguria

b)

Seizures

c)

Vomiting

d)

Polydipsia

e)

Polyphagia

9.

Oral contraceptives are prescribed

for a client who smokes heavily.

Which side effect would the nurse

warn the client might occur?

a)

Blood clots

b)

Cervical cancer

c)

Ovarian cancer

d)

Risk of coronary heart disease later in life

10.

Which discharge instructions would

the nurse include for a woman who

has undergone breast-conserving

surgery (lumpectomy) for breast

cancer?

a)

Assuring her that a supportive

brassiere is unnecessary

b)

Emphasizing the importance of

breast self-examination

c)

Instructing her to return the next

day for removal of the drain

d)

Explaining why it is unnecessary to

exercise the arm on the unaffected

side

11.

The client's cervical biopsy reveals a

stage 0 lesion. Which statement

explains this finding?

a)

The lesion is carcinoma in situ.

b)

There is early stromal invasion.

c)

There is parametrial involvement.

d)

The cancer is confined to the

cervix.

12.

The nurse is teaching a client about

different prevention and detection

practices to ensure breast health.

Which statement made by the client

indicates the need for further

teaching?

a)

'I will increase my meat

consumption.

b)

"I will perform a self-breast

examination every week.'

c)

'I will schedule routine

mammograms.

d)

“I will reduce my caffeine and

theophylline intake”

13.

Which topic is most important for

the nurse to teach in a community

health promotion class for middle-

aged adults?

a)

Tobacco cessation

b)

Infection prevention

c)

Alcohol abstinence

d)

Pain management

14.

After a hysterosalpingo-

oophorectomy, a client wants to

know whether it would be wise for

her to take hormones right away to

prevent symptoms of menopause.

Which response would the nurse

give?

a)

'It's best to wait until a few months

after surgery because you may not

have any symptoms.

b)

'Hormone replacement therapy has

been associated with increased risk

of breast cancer, so it would not be

recommended.

c)

'You have to wait until symptoms

are severe; otherwise the hormones

will have no effect.'

d)

'There are pros and cons to

hormone replacement therapy. I

will let your primary health care

provider know you would like to

diccuce thial

15.

A client develops severe bone

marrow suppression related to

cancer treatment. Which instruction

is important for the nurse to include

in the client's teaching?

A. Be prepared to experience alopecia.

B. Increase fluids to at least 3 liters

per day.

C. Use a soft toothbrush for oral

hygiene.

D. Monitor your intake and output of

fluids.

(a)  

16.

Which activities reflect secondary

prevention interventions in relation

to health promotion? Select all that

apply. One, some, or all responses

may be correct.

A. Encouraging regular dental checkups

B. Facilitating smoking cessation programs

C. Administering influenza vaccines to older adults

D. Teaching the procedure for breast self-examination

E. Referring clients with a chronic

illness to a support group

a)

Encouraging regular dental checkups

b)

Facilitating smoking cessation programs

c)

Administering influenza vaccines to older adults

d)

Teaching the procedure for breast self-examination

e)

Referring clients with a chronic

illness to a support group

17.

Which nursing intervention would

be recommended for a client after a

radiation implant is inserted as part

of internal radiation therapy for

cervical cancer?

A. Ensuring that the client's diet is low residue

B. Placing the client in the high- Fowler position

C. Checking the client's voiding and catheterizing if needed

D. Staying with the client for half an hour and assessing her for signs of radiation sickness

(a)  

18.

A client receiving cancer

chemotherapy asks the nurse why

an antibiotic was prescribed. Which

tissue affected by chemotherapy will

the nurse consider when

formulating a response?

A. Liver

B. Blood

C. Bone marrow

D. Lymph nodes

(a)  

19.

Which concept is most important to

teach a client in relation to why

medication cocktails are more

effective than a single medication in

cancer therapy?

A. Medication resistance

B. Tumor doubling time

C. Cellular growth cycle

D. Retained radioactive particles

(a)  

20.

A client receiving cisplatin therapy

developed tumor lysis syndrome

(TLS). Which medication would the

nurse anticipate administering to

this client for treatment of the TLS?

A. Mesna

B. Flavoxate

C. Allopurinol

D. Aprepitant

(a)