WorksheetsCancer – Cellular Regulation Concept
Total questions: 90
Worksheet time: 48mins
Which characteristic best describes malignant cells?
Well differentiated
Controlled growth
Ability to invade and metastasize
Programmed cell death (apoptosis)
The process by which cancer spreads to other parts of the body is called:
Initiation
Promotion
Progression
Metastasis
The TNM classification system is used to:
Identify cancer cell type
Determine nutritional needs
Stage cancer based on tumor size, node, and metastasis
Describe genetic mutations
A client has a grade IV tumor. This indicates:
Tumor cells resemble normal cells
Tumor is benign
Tumor cells are undifferentiated and aggressive
Cancer is in situ only
Which term describes new, uncontrolled growth of abnormal tissue?
Neoplasm
Metaplasia
Dysplasia
Apoptosis
Common side effects of chemotherapy include:
Hypertension and edema
Alopecia, mucositis, bone marrow suppression
Weight gain and bradycardia
Constipation and urinary retention
The most serious hematologic complication of chemotherapy is:
Constipation
Fatigue
Myelosuppression
Hair loss
A patient receiving external radiation should be taught to:
Wash treatment area with soap and scrub brush
Apply heating pads
Avoid applying lotions or creams to marked area
Cover site tightly with adhesive dressings
The nurse should wear gloves when handling the linens of a patient who:
Has oral ulcers
Has neutropenia
The underlying problem in leukemia is:
Decreased RBC production
Overproduction of immature WBCs
Overproduction of platelets
Bone marrow fibrosis only
Which type of leukemia is most common in children?
CLL
ALL
AML
CML
Which leukemia is most common in adults?
AML
ALL
CML
CLL
A hallmark of Chronic Myeloid Leukemia (CML) is:
A. Philadelphia chromosome
B. Pancytopenia
C. Reed–Sternberg cells
D. Blast crisis
Chronic Lymphocytic Leukemia (CLL) primarily affects:
Children
Adults over 60 years old
Middle-aged women
Teenagers
Common symptoms of leukemia include:
Weight gain and edema
Fatigue, bruising, recurrent infections
Bradycardia and hypertension
Constipation and jaundice
The definitive diagnosis of leukemia is made by:
CBC only
Bone marrow biopsy
CT scan
Lymph node biopsy
The priority nursing concern in a patient with leukemia is:
Pain control
Infection prevention
Fluid restriction
Weight monitoring
Which finding is characteristic of Hodgkin lymphoma?
Bence–Jones proteins
Reed–Sternberg cells
Philadelphia chromosome
Lymphocytosis
Hodgkin lymphoma typically begins in:
The spleen
One localized group of lymph nodes
Bone marrow
Multiple distant sites simultaneously
Non-Hodgkin lymphoma differs from Hodgkin in that it:
Is localized to one node group
Has Reed–Sternberg cells
Spreads widely and unpredictably
Occurs mostly in young adults only
Common symptom of both Hodgkin and Non-Hodgkin lymphoma:
Painless lymph node enlargement
Painful swollen nodes
Petechiae
Weight gain
Which factor is associated with development of Non-Hodgkin lymphoma?
Epstein-Barr virus and immunosuppression
Elevated calcium
High-protein diet
Dehydration
The best diet teaching for a patient with lymphoma receiving chemo:
Avoid all protein
Eat small frequent high-calorie, high-protein meals
Only eat soft, bland foods
Avoid fluids during meals
A neutropenic patient’s absolute neutrophil count (ANC) is 400. The nurse should:
Continue regular diet
Place on protective isolation
Encourage raw fruits and vegetables
Give live vaccines
The nurse should teach a neutropenic patient to:
A neutropenic client develops a fever of 100.6°F (38.1°C). The nurse’s first action is:
Notify provider immediately
Recheck in 4 hours
Give acetaminophen only
Encourage fluids
A platelet count of 40,000/mm³ indicates:
Normal
Mild thrombocytopenia
Risk for bleeding
Critical anemia
The nurse teaches a patient with thrombocytopenia to:
Use a soft toothbrush
Take aspirin for pain
Floss vigorously
Receive IM injections
Which finding requires immediate reporting in thrombocytopenia?
Mild fatigue
Small bruise on arm
New petechiae or bleeding gums
Loss of appetite
Platelet transfusion is typically indicated when counts fall below:
100,000
50,000
The nurse recognizes spontaneous bleeding risk when platelets are:
< 150,000
< 100,000
< 50,000
< 20,000
A common side effect of radiation to the head and neck is:
Alopecia
Mucositis
Constipation
Urinary retention
The nurse should instruct a patient undergoing chemotherapy to:
Avoid crowds and sick contacts
Eat raw vegetables for vitamins
Receive live vaccines
Use tampons for menstrual hygiene
The primary reason to avoid rectal suppositories in patients with leukemia or thrombocytopenia is:
They cause constipation
They increase risk for bleeding and infection
They interfere with absorption
They cause mucositis
Filgrastim (Neupogen) is used to:
Increase platelet count
Stimulate neutrophil production (Correct)
Epoetin alfa (Epogen) is used to:
Stimulate platelet production
Increase RBC production
Replace plasma proteins
Treat infection
The nurse knows that pancytopenia means:
Low RBCs only
Low WBCs only
Low RBCs, WBCs, and platelets
High platelets and low WBCs
Which lab finding would the nurse expect with bone marrow suppression?
Hgb 14, Platelets 200,000
Hgb 8.2, WBC 2,500, Platelets 60,000
Hgb 15, WBC 8,000, Platelets 300,000
Hgb 12, WBC 12,000, Platelets 400,000
Which symptom most strongly suggests leukemia relapse?
Weight gain
Fever and recurrent infections
Constipation
Bradycardia
Which is the priority nursing diagnosis for a patient with bone marrow suppression?
Risk for infection
Risk for injury
Disturbed body image
Imbalanced nutrition
A client receiving chemotherapy reports mouth pain and white patches on the tongue. Which action should the nurse take first?
Encourage citrus juices for vitamin C
Obtain a culture of the lesions
Apply an alcohol-based mouth rinse
Give a hard toothbrush for plaque removal
The nurse provides teaching for a client starting chemotherapy. Which statement indicates understanding?
I’ll avoid large crowds while my counts are low.
I’ll use aspirin if I get a headache.
I should floss twice daily to prevent gum bleeding.
I’ll schedule my flu shot next week if I feel well.
A patient with metastatic breast cancer is receiving doxorubicin. Which finding is most concerning?
(a)
During chemotherapy, a client's WBC drops to 2,000 /μL. What is the priority nursing action?
Encourage oral fluids
Hold chemotherapy and implement neutropenic precautions
Offer fresh fruit snacks
Give acetaminophen for fever
A patient receiving radiation therapy to the neck reports dry mouth. Which teaching is most appropriate?
Rinse with alcohol-based mouthwash
Suck on sugar-free candy or chew gum
Increase salt intake
Limit fluids
Which lab result indicates the greatest need for platelet transfusion?
Platelets 120,000 /μL
Platelets 60,000 /μL
Platelets 25,000 /μL
Platelets 180,000 /μL
The nurse is caring for a client 10 days post-chemotherapy who presents with a fever of 100.9°F (38.3°C). What should the nurse do first?
Administer acetaminophen and reassess
Notify the provider immediately
Encourage oral fluids
Document and monitor
A client with lung cancer has developed SIADH. Which finding does the nurse expect?
Serum sodium 150 mEq/L
Serum sodium 128 mEq/L
Polyuria
Dry mucous membranes
A client undergoing chemotherapy has an absolute neutrophil count of 400. Which meal selection is safest?
Fresh fruit salad
Yogurt parfait
Canned peaches and pasteurized milk
Spinach salad with vinaigrette
A client with thrombocytopenia states, “I cut myself shaving this morning.” Which instruction is appropriate?
Use an electric razor instead.
Apply ice to stop the bleeding.
Apply a tourniquet until it stops.
Shave less often but continue using blades.
Which statement by a patient receiving chemotherapy for leukemia indicates a need for further teaching?
I will take my temperature every day.
I should avoid people who are sick.
I will use a rectal thermometer for accuracy.
I will report any bleeding gums.
A nurse caring for a patient with cancer notes facial swelling, distended neck veins, and shortness of breath. Which complication should the nurse suspect?
Cardiac tamponade
Superior vena cava syndrome
Tumor lysis syndrome
Spinal cord compression
Which finding indicates possible spinal cord compression in a client with metastatic bone cancer?
Nausea and vomiting
Urinary retention and back pain
Chest tightness
Constipation only
Which laboratory change suggests tumor lysis syndrome after chemotherapy?
↓ Potassium, ↓ Uric acid
↑ Potassium, ↑ Phosphorus
↑ Calcium
↓ Phosphorus
The nurse anticipates which medication for prevention of tumor lysis syndrome?
Filgrastim (Neupogen)
Allopurinol (Zyloprim)
Epoetin alfa (Epogen)
Ondansetron (Zofran)
Which side effect of vincristine (Oncovin) requires immediate reporting?
Numbness or tingling of fingers
Hair loss
Fatigue
Nausea
The nurse should explain to a client receiving cisplatin that the major toxicity is:
Hepatotoxicity
Nephrotoxicity
Ototoxicity only
Cardiotoxicity
Which nursing action is priority for a client with internal radiation implants?
Limit visitors to 30 minutes/day
Keep lead apron 10 ft away
Allow pregnant visitors
Re-position frequently
The nurse recognizes which lab as most consistent with bone marrow suppression from chemotherapy?
Hgb 14 g/dL, WBC 8,000, Plt 250,000
Hgb 8 g/dL, WBC 2,000, Plt 40,000
Hgb 12 g/dL, WBC 5,000, Plt 200,000
Hgb 10 g/dL, WBC 10,000, Plt 400,000
The nurse is reinforcing teaching about the purpose of combination chemotherapy. Which statement is correct?
It increases the chance of resistance.
It allows smaller doses with better results.
It prevents all side effects.
It works only on one phase of the cell cycle.
A client with prostate cancer reports new bone pain and fatigue. The nurse interprets this as possible:
Local invasion
Metastasis
Remission
Side effect of treatment
Which is the most important nursing action for a patient with myelosuppression and a platelet count of 30,000/μL?
Monitor for constipation
Use stool softeners and avoid IM injections
Encourage hard-bristled toothbrush use
Administer iron supplements
A nurse caring for a patient with leukemia explains the goal of bone marrow transplantation is to:
Replace malignant cells with healthy stem cells
Eliminate infection risk
Provide temporary relief
Cure anemia
Which statement best explains the purpose of adjuvant therapy after tumor resection?
It’s used to prevent regrowth or metastasis.
It shrinks the tumor before surgery.
It’s given instead of surgery.
It reverses all side effects.
Which clinical finding indicates superior vena cava syndrome is worsening?
Decreased facial swelling
Increased cyanosis and difficulty breathing
Lower extremity edema only
Improved urine output
The nurse notes a patient with laryngeal cancer has hoarseness and difficulty swallowing. These symptoms most likely indicate:
Metastasis to the brain
Tumor obstruction of the airway
Bone metastasis
Radiation toxicity
Which patient statement suggests radiation skin care teaching was effective?
I’ll use mild soap and pat the area dry.
I’ll use my usual perfume on the site.
I’ll apply heating pads to sore spots.
I’ll scrub the markings off after therapy.
A nurse is evaluating lab results for a client with multiple myeloma. Which result is expected?
Hypercalcemia
Hypokalemia
Hyponatremia
Hypocalcemia
The nurse should include which instruction for a client with bone metastasis–related hypercalcemia?
Limit fluid intake
Increase weight-bearing activity
Eat more dairy products
Restrict sodium
The most appropriate goal for a client with fatigue due to cancer and anemia is:
Maintain activity without rest
Balance rest and activity periods
A client receiving chemotherapy reports bleeding gums and numerous bruises. Which lab value should the nurse check first?
Hemoglobin
White blood cell count
Platelet count
Serum calcium
A client with acute myeloid leukemia (AML) has an absolute neutrophil count (ANC) of 400. Which nursing action is most important?
Provide a high-protein diet
Initiate neutropenic precautions
Encourage daily weights
Administer platelet transfusion
Which clinical manifestation is expected in a client with anemia secondary to chemotherapy?
Bradycardia
Fatigue and pallor
Hypertension
Petechiae
The nurse reviews labs for a client receiving chemotherapy: Hgb 7.8 g/dL, WBC 2,200/μL, Platelets 90,000/μL. Which order should the nurse question?
Administer epoetin alfa
Provide bleeding precautions
Administer intramuscular vitamin B12
Encourage rest periods
A client receiving radiation to the chest reports difficulty swallowing and heartburn. The nurse recognizes these symptoms are due to:
Mucositis of the esophagus
Spinal cord compression
Tumor lysis syndrome
Anemia
The nurse is caring for a client with multiple myeloma. Which finding requires immediate intervention?
Serum calcium 11.8 mg/dL
Hemoglobin 10.5 g/dL
Fatigue
Mild back pain
A patient receiving doxorubicin (Adriamycin) reports shortness of breath and new swelling in the ankles. Which action should the nurse take?
Hold the medication and notify the provider
Administer antiemetic
Encourage deep breathing
Elevate the legs
Which statement by a client receiving chemotherapy indicates the need for further teaching?
I will avoid large crowds.
I can take ibuprofen if I get a headache.
I’ll wash my hands frequently.
I’ll call if I have a fever.
The nurse explains to a client that combination chemotherapy is used primarily to:
Reduce toxicity and drug resistance
Lower costs
Shorten treatment time
Minimize alopecia
A client with bone metastasis reports new onset of confusion and muscle weakness. Which lab result explains this finding?
Calcium 7.0 mg/dL
Calcium 11.6 mg/dL
Sodium 138 mEq/L
Potassium 4.1 mEq/L
A patient with leukemia develops petechiae and bleeding gums. What is the priority nursing diagnosis?
Impaired skin integrity
Risk for bleeding
Risk for infection
Disturbed body image
A client with Non-Hodgkin lymphoma is receiving chemotherapy and develops severe nausea. Which nursing intervention is most appropriate?
Provide clear liquids and administer ondansetron
Encourage carbonated beverages
Offer high-fat foods
Restrict oral intake
The nurse is caring for a patient with Hodgkin lymphoma. Which finding is expected?
Night sweats and painless enlarged lymph nodes
Petechiae and nosebleeds
Polyuria and thirst
Painful lymph nodes and rash
Which client is at greatest risk for developing infection after chemotherapy?
WBC 8,000/μL
WBC 4,000/μL
A client receiving chemotherapy asks why hair loss occurs. The nurse’s best response is:
Chemotherapy damages rapidly dividing cells, including hair follicles.
It happens only in people with low protein intake.
It’s due to a vitamin deficiency.
It’s a sign of infection.
A nurse cares for a patient with breast cancer taking tamoxifen. Which adverse effect should be reported immediately?
Hot flashes
Calf pain and swelling
Nausea
Headache
A patient with small cell lung cancer develops hyponatremia and concentrated urine. The nurse recognizes this as:
Diabetes insipidus
SIADH
Addison’s disease
Cushing’s syndrome
A nurse prepares to administer filgrastim (Neupogen). This medication is given to:
Stimulate RBC production
Increase neutrophil count
Raise platelet count
Replace plasma proteins
A client with pancytopenia should avoid which activity?
Eating cooked vegetables
Using a soft toothbrush
Receiving live vaccines
Taking acetaminophen
A patient with advanced cancer reports constant pain unrelieved by current medications. Which nursing action has the highest priority?
Contact provider to reassess pain management plan
Encourage distraction and deep breathing
Increase rest periods
Offer warm compresses
