Cancer, Radiation, & Chemotherapy NCLEX-like Critical Thinking Questions

In the cancer unit, the nursing team consists of 1 RN, 2 LVN/LPNs, and 2 UAPs. Which of the following clients should the RN address?

A client with colon cancer who needs help with his colostomy irrigation.
A client with a mastectomy 2 days ago who needs help with bathing.
A stable client with brain cancer and left sided weakness who is demanding a bed bath.
A client with pancreatic cancer who is refusing chemotherapy.

The nurse receives report on 4 clients. The nurse should see which client FIRST?

A client with colon cancer admitted 4 days who reports a leaking colostomy bag.
A client receiving a chemotherapeutic drug who is on the call light stating "my IV is swelling."
A client with aplastic anemia who is receiving a blood transfusion.
A client who is having a mastectomy this morning and who still needs informed consent.

A client with pancreatic cancer tells the nurse “I just can’t do this anymore.” What is the best response by the nurse?

"You are doing so good. Why are you so worried?"
"Just imagine how your family must feel!"
"Tell me more about how are you feeling."
"We can go ahead and stop all treatments."

The radium implant of a client with cervical cancer client becomes dislodged. What is the priority action?

To use long-handled forceps to pick up the implant and place it in a lead container.
To reinsert it using sterile gloves.
To pick up the implant with gloves and place it in the lead container.
To notify the HCP.

Type/put an “X” to identify risk factors, early identification, or characteristics of each cancer. One answer relates to all 5 cancers.

Statement	Breast Cancer	Testicular Cancer	Cervical Cancer	Ovarian Cancer	Uterine Cancer
Self-examination is best after a shower
Risk factors: multiple sex partners, first intercourse before age 17, and smoking
Self-examination is best 7 days after menstruation
Findings include back pain, painless testicular swelling, and heavy sensation in the scrotum
Symptoms include abdominal distension, urinary frequency, pain from pressure caused by growing tumor, urinary and bowel obstruction, ascites and constipation
A symptom is Abnormal bleeding such as hypermenorrhea
After surgical treatment, the client should elevate affected arm on a pillow above heart level.
Treatment includes “debulking” to reduce the size of the tumor.
Lymphedema characterized by arm edema is a complication
Cervical radiation implant is a treatment and client must maintain bedrest
Biopsy is the definitive diagnosis

Match

Sort elements

Can prevent liver cancer
Assess in clients with SVC syndrome
Changes that happen in colon cancer
hyperuricemia, hyperkalemia, and hyperphosphatemia
Bleeding and clotting that leads to organ dysfunction
Tumor causes spinal column to collapse
Causes edema of upper body and dyspnea

Hepatitis B vaccine
Respiratory Status
Bowel habits
Tumor lysis syndrome
DIC
Spinal Cord Compression
Superior Vena Cava Syndrome

The experienced nurse is teaching the new nurse about the care of clients with internal radiation implants. Which of the following statements by the new nurse demonstrates that the new nurse requires further teaching? Only 1 Answer

"I should only spend 30 minutes per 8 hour shift in the client's room."
"I should wear my dosimeter badge when entering the room."
"Pregnant women and children under the age of 16 are not allowed in the room."
"Visitors should stay at least 6 feet away from the source and their visits should be limited to 30 minutes."
"Nurses should never care for more than one client with a radiation implant at one time."
"Pregnant nurses must wear a lead shield to reduce the transmission of radiation."
" I must put a caution sign on the client's door."
"The client must be in a private room with a private bathroom."

The nurse educates a client with cancer on the side effects of chemotherapy. Which of the following side effects should the nurse include in the plan of care? Select all that apply.

Alopecia
Anemia which causes shortness of breath
Neutropenia which places clients at risk for infection
Thrombocytopenia which places clients at a risk for bleeding
Excessive Hunger
Mucositis
Nausea and vomiting

The new graduate nurse asks the oncologist about the difference between a sealed radiation source and an unsealed radiation source. Which of the following woud NOT be a good response by the oncologist?

"An unsealed radiation source is given either orally or IV. It enters the client's body fluids, making them radioactive. It is usually excreted within 48 hours."
"A sealed radiation source is a solid implant that is inserted within the tumor or the tissues with cancer. It emits radiation while the implant is in place, but the client's body fluids are not radioactive."
"A unsealed radiation source is a solid implant that is inserted within the tumor or the tissues with cancer. It emits radiation while the implant is in place, but the client's body fluids are not radioactive."

The nurse is caring for a client with bladder cancer. Which of the following does the nurse anticipate as the presenting symptom of bladder cancer?

Oliguria
painless hematuria
Painful urination
Abdominal pain

Match the cancer with the risk factor. Choose the best answer. DRAG

Sort elements

Breast Cancer
Colon Cancer
Bladder cancer
skin Cancer
Cervical Cancer
Liver cancer

Prolonged exposure to estrogen
Eating red meats and foods high in fats
Smoking and exposure to harmful chemicals
Prolonged sun exposure or UV light
HPV
Hepatitis C and B

The nurse is caring for a client on chemotherapy who has developed stomatitis? Which of the following actions should the nurse NOT take?

Teach the client to avoid irritants such as spicy, acidic foods, and hot liquids
Teach client to choose foods with room air temperatures
Teach the client to use oral viscous lidocaine prior to meals.
Teach the client to assess his oral mucous membranes twice a month for possible infection
Teach the client to avoid alcohol-based mouth wash

Which of the following clients has the lowest risk for cervical cancer?

A client who has been smoking for 4 years.
A client who has had 5 sexual partners in the last 2 years.
A client on birth control pills
A client who has a history of gonorrhea
A client who always uses condoms when having sex
A client with a history of HPV