Nclex-Rn Practice Questions-Care of Adults Hematological and Oncological Management
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Question 1 |
Laboratory tests are prescribed for the client who has a smooth and reddened tongue and ulcers at the corners of the mouth. Which result would the nurse find if the client has iron-deficiency anemia?
A | Low hemoglobin and hematocrit |
B | Elevated red blood cells (RBCs) |
C | Prolonged prothrombin time (PT) |
D | Elevated white blood cells (WBCs) |
Question 2 |
The client receiving hospice care has cancer pain and requires treatment with a co-analgesic for pain control. Which medication should the nurse request an HCP to prescribe because it gives the best pain-relieving response when given with opioids?
A | Promethazine |
B | Gabapentin |
C | Diphenhydramine |
D | Droperidol |
Question 3 |
The client is experiencing pain due to cancer treatment- The client tells the nurse, “Methadone has always worked well for me in the past.” Which effects of methadone should the nurse consider when administering methadone?
A | Has a long half-life and high level of potency |
B | May cause an increase in BP and confusion |
C | Causes severe allergic reactions and liver failure |
D | Has active metabolites, but it is well tolerated |
Question 4 |
The nurse assesses that the client who is receiving radiation for cervical cancer continues to have diarrhea. Which nursing advice is most appropriate for this client?
A | Eat a low-residue diet and take sitz baths twice daily. |
B | Drink fluids low in potassium and take frequent tub baths. |
C | Consume more milk products and take frequent showers- |
D | Drink high-sodium fluids and apply hydrocolloid pads to rectum. |
Question 5 |
The nurse is assessing the client newly diagnosed with endometrial cancer. Which common findings would the nurse expect?
A | Abnormal vaginal bleeding and pain in the pelvic area |
B | Weight loss and profuse sweating, especially at night |
C | Anorexia and enlarged supraclavicular lymph nodes |
D | Unexplained spikes in temperature and splenomegaly |
Question 6 |
The client with a primary diagnosis of liver cancer with metastases to the lung is hospitalized with severe dyspnea. The nurse is preparing the client for radiation of the upper chest. Which nursing conclusion about the purpose of radiation therapy for this client is correct?
A | Radiation therapy is used to cure and control liver cancer. |
B | Radiation therapy is used to prevent future cancer development. |
C | Radiation therapy is used to cure and control lung cancer. |
D | Radiation therapy is used to prevent or relieve distressing symptoms- |
Question 7 |
The nurse is discussing prevention of liver cancer with the client. Which vaccine should the nurse recommend?
A | Varicella vaccine |
B | Hepatitis A vaccine |
C | Meningococcal vaccine |
D | Hepatitis B vaccine |
Question 8 |
The client diagnosed with esophageal cancer is having work-related problems that are interfering with the client's treatment. Which organization should the nurse advise the client to contact for assistance with these issues?
A | National Cancer Institute |
B | Leukemia Society of America |
C | Corporate Angel Network |
D | Patient Advocate Foundation |
Question 9 |
The client is admitted with a diagnosis of colon cancer. Which finding in the client’s admission information should prompt the nurse to consider that the cancer may be located in the client’s descending colon?
A | Pain in the lower abdomen |
B | Change in bowel habits |
C | Bright red blood in the stool |
D | Nausea and vomiting |
Question 10 |
The nurse is teaching the client who is to undergo diagnostic testing for possible gastric cancer. Teaching the client about which specific diagnostic test would be most helpful?
A | Bronchoscopy |
B | Sigmoid colonoscopy |
C | Esophagogastroduodcnoscopy |
D | Multigated acquisition (MUGA) scan |
Question 11 |
The client had basal cell carcinoma (BCC) lesions excised the day before at an outpatient clinic. The client telephones the nurse expressing concerns that the wounds are draining watery, pale pink fluid and that the small dressing is leaking. Which action should the nurse recommend?
A | Apply ice to the area |
B | Contact the surgeon |
C | Take pain medication |
D | Change the dressings |
Question 12 |
The client asks the nurse to look at a lesion on the client’s body. Which characteristics should prompt the nurse to consider that the client may have a basal cell carcinoma (BCC)?
A | Nodular in appearance, depression in the center, and has a “pearly” characteristic |
B | Irregular color, surface, and border, less than one centimeter, and appears eroded |
C | Dry, hyperkeratotic scaly-like papule and has the appearance similar to a wart |
D | Vesiculopustular lesion with a thick, honey- colored crust and pruritic in nature |
Question 13 |
The nurse is caring for the client receiving combination chemotherapy ofoxaliplatin, fluorouracil, and leucovorin. The nurse should assess the client for which common side effects of this chemotherapy regimen?
A | Neurotoxicities and diarrhea |
B | Cardiomyopathy and dysphagia |
C | Renal insufficiency and gastritis |
D | Photophobia and stomatitis |
Question 14 |
The client with Hodgkin’s lymphoma receives radiation treatments. The nurse should monitorthe client for which specific symptoms of radiation pneumonitis?
A | Tachypnea, hypotension, and fever |
B | Cough, elevated temperature, and dyspnea |
C | Bradypnea, cough, and decreased urine output |
D | Cough, tachycardia, and altered mental status |
Question 15 |
The nurse is caring for the client experiencing superior vena cava syndrome secondary to lung cancer. Which problem should be the nurse’s priority?
A | Ineffective breathing pattern |
B | Ineffective tissue perfusion |
C | Risk for infection |
D | Impaired skin integrity |
Question 16 |
The nurse is teaching the client who is a strict vegetarian how to decrease the risk of developing megaloblastic anemia. Which information should the nurse provide?
A | Undergo an annual Schilling test. |
B | Increase intake of foods high in iron. |
C | Supplement the diet with vitamin Biz- |
D | Have a hemoglobin level drawn monthly. |
Question 17 |
The nurse assesses that the client with hemolytic anemia has weakness, fatigue, malaise, and skin and mucous membrane pallor. Which finding should the nurse also associate with hemolytic anemia?
A | Scleral jaundice |
B | A smooth, red tongue |
C | A craving for ice to chew |
D | A poor intake of fresh vegetables |
Question 18 |
A coworker being oriented by another nurse states, “I’m confused; a physician told me that graft-versus—host disease (GVHD) symptoms were desirable for a particular client after a bone marrow transplant.” Which should be the nurse’s best response?
A | “GVHD isn’t desirable. Maybe you heard the physician wrong.” |
B | “That’s interesting. Did the client have a gastrointestinal tumor?” |
C | “That’s right if the transplant involved using autologous stem cells.” |
D | “GVHD is sometimes desirable with a hematological malignancy.” |
Question 19 |
The young adult, diagnosed with hemophilia A, is receiving a monthly scheduled dose of factor VIII cryoprecipitate. The client begins to cry during administration. Which response by the nurse is most appropriate?
A | “Why are you crying? You seem afraid when I am administering the drug.” |
B | “Is it painful While I’m giving this IV push? If so, I can give it by infusion.” |
C | “I know this is uncomfortable for you; this only takes a few minutes to give.” |
D | “If you want to talk to me about what you are feeling, I am here to listen.” |
Question 20 |
The female client, who has Hodgkin’s lymphoma with cervical and axillary node involvement, is to receive chemotherapy and radiation. The nurse evaluates that the client is coping positively when the client makes which statement?
A | “I’ve a wig that matches my hair color, but I’ll miss my own hair.” |
B | “I am so glad that the treatments won’t cause me to lose my hair.” |
C | “I’m happy that the drug-radiation combination prevents mucositis.” |
D | “I’ve faith that my doctor will cure me and I’ll never have cancer again.” |
Question 21 |
The nurse completed teaching the client who had a bone marrow transplant (BMT). Which statement by the client indicates the client misunderstood the expected changes following a BMT?
A | “I may gain weight from my immunosuppressant medication.” |
B | “Sterility can occur from the chemotherapy and radiation.” |
C | “I may have vision changes from the total body irradiation.” |
D | “Changes to my mouth could include a white, patchy tongue.” |
Question 22 |
Tire nurse teaches a coworker about the treatment for hemophilia. The nurse instructs that the treatment will likely include periodic self- administration of which component?
A | Platelets |
B | Whole blood |
C | Factor concentrates |
D | Fresh frozen plasma |
Question 23 |
The client undergoing intensive chemotherapy for Hodgkin’s lymphoma (l-IL) is hospitalized with fever and depressed immune system functioning. The nurse is administering filgrastim subcutaneously daily. Which laboratory value should the nurse monitor to determine the medication’s effectiveness?
A | Hemoglobin |
B | Platelet count |
C | Absolute neutrophil count (ANC) |
D | Reed-Sternberg cells |
Question 24 |
The client has undergone a lymph node biopsy to differentiate between Hodgkin’s and non-Hodgkin’s lymphoma. After reviewing the client’s lymph node biopsy results, which revealed that the client has Hodgkin’s lymphoma, the nurse should obtain which educational brochure?
A | The brochure that includes an explanation of an elevated reticulocyte count |
B | The brochure that includes an explanation of CA-125 tumor markers |
C | The brochure that includes an explanation of an elevated WBC count |
D | The brochure that includes an explanation about Reed-Sternberg cells |
Question 25 |
The client diagnosed with acute myeloid leukemia receives a bone marrow transplant. Which medication to prevent grafiversus-host disease (GVHD) should the nurse plan to administer?
A | A cephalosporin antibiotic, such as ceftazidime |
B | An immunosuppressant, such as cyclosporine |
C | A chemotherapeutic agent, such as cisplatin |
D | Peginterferon alfa-2a for prevention and treatment of hepatitis |
Question 26 |
The client who is receiving doxorubicin for the first time to treat multiple myelorna develops flushing, facial swelling, headache, chills, and back pain- Which statement made by the nurse is best?
A | “These symptoms usually resolve in 1 day and are limited to the first dose.” |
B | “These are signs of toxicity; you may want to consider refusing treatment.” |
C | “I can give you ondansetron prescribed prn now to alleviate these symptoms.” |
D | “Side effects occur with chemotherapy, but focus on your cancer being cured.” |
Question 27 |
The nurse receives orders after notifying an HCP about the client who has tachycardia, diaphoresis, and an elevated temperature after treatments for ALL. Which order should be the nurse’s priority?
A | Portable chest x-ray in the client’s room |
B | Urine culture, and blood cultures x 2 |
C | Vancomycin 500 mg IV q6h |
D | Filgrastim 0.3 mg subcut daily |
Question 28 |
A home-care nurse is following up with the client who was diagnosed with liver cancer 3 months ago. Which assessment information should the nurse communicate to the HCP?
A | Client is weak and pale and remained in bed throughout the visit |
B | Client’s weight has remained unchanged since the previous visit. |
C | Client reports itching is relieved with diphenhy- dramine cream. |
D | Client’s pain level averages a 7 on a 0 to 10 scale with scheduled opioids. |
Question 29 |
When reviewing the client’s medical record, the experienced nurse discovers that the client’s breast cancer is staged as T4 N3 M1. Which comment made by the experienced nurse to the new nurse is correct?
A | “This client has a 3-cm breast tumor that has spread to only one lymph node.” |
B | “The TNM system is used to classify solid tumors by size and degree of spread.” |
C | “The higher the number in the TNM system, the better the chances are for a cure.” |
D | “This TNM system helps to classify tumors as either well- or poorly differentiated.” |
Question 30 |
Following morning shift report, the nurse identities care needs for four clients. Which client should be the nurse’s priority?
A | The client with lung cancer who is to receive ondansetron 8 mg IV 30 minutes prior to chemotherapy |
B | The client with an absolute neutrophil count of 98/mm3 who needs to be placed on neutropenic precautions |
C | The client who is stable but has breast cancer and is scheduled for external beam radiation in 15 minutes |
D | The client with stomatitis from radiation for tonsillar cancer who is to receive a gastrostomy tube feeding |
Question 31 |
The client who has renal cancer that has metastasized rates pain at a 9 on a 0 to 10 pain scale. Which medication should the nurse plan to administer now and then schedule to be administered at the prescribed dosing interval?
A | Meperidine |
B | Propoxyphene |
C | Pentazocine |
D | Oxycodone |
Question 32 |
The cheat who was recently admitted with gastric cancer appears pale and weak and states feeling fatigued. In reviewing the client’s laboratory results, which component of the CBC should the nurse most associate with the client’s gastric cancer and identify as the causative factor for the fatigue?
A | White blood cell 12,200/mm3 |
B | Hemoglobin 7.9 g/dL |
C | Serum protein 5.9 g/dL |
D | Blood urea nitrogen 22 mg/dL |
Question 33 |
The nurse is caring for the client who had a left modified radical mastectomy (a total mastectomy with axillary node dissection and removal of the lining over the pectoralis major muscle). Which action by the nurse is appropriate?
A | Have the client elevate the left arm above the head |
B | Ensure that [V access sites are only on the right side |
C | Have the client View the incision site as soon as possible |
D | Initiate left arm strengthening within 24 hours of surgery |
Question 34 |
When assessing the client who is recovering from a radical hysterectomy with vulvectomy, the nurse notes lymphedema of the lower extremities. Which intervention should be implemented by the nurse?
A | Elevate the head of the client’s bed to 45 degrees. |
B | Increase the client’s intake of fluids high in sodium. |
C | Encourage the client to exercise the lower extremities- |
D | Apply splints to both of the client’s lower extremities. |
Question 35 |
The client who received 50 mL from a unit of whole blood has low back pain. In response to this client’s symptom, which action should be taken by the nurse first?
A | Reposition the client. |
B | Assess the pain further. |
C | Administer an analgesic. |
D | Stop the blood transfusion. |
Question 36 |
The nurse explains “watchful waiting” (ongoing visits to a physician for observation of signs and symptoms without treatment) to the client with prostate cancer. Which client is a candidate for “watchful waiting”?
A | 50-year—old with prostate cancer that has metastasized to the bone |
B | 75-year—old expected to live 5 years and has low-grade disease |
C | 45-year-old who has extension of the tumor outside of the prostate |
D | 59-year-old who is asymptomatic with an elevated prostate-specific antigen |
Question 37 |
The client, who underwent a right mastectomy with lymph node dissection, is being admitted to a nursing unit from the PACU. When settling the client in bed, which action by the NA requires the nurse to intervene?
A | Placing a blood pressure cuff on the left arm for vital signs |
B | Taping a sign to the side rail stating no le or lab draws on the right |
C | Elevating the bed to 90 degrees and keeping the right arm dependent |
D | Asking if the client feels ready to allow family to enter the room |
Question 38 |
The nurse assesses the client diagnosed with acute myeloid leukemia. Which finding should be the nurse’s priority for implementing interventions?
A | Pain from mucositis and oral tissue injury |
B | Weakness and fatigue with slight activity |
C | T 99°F, P 100, R 22, BP 132/64 mm Hg |
D | Ecchymosis and petechiae noted on arms |
Question 39 |
The client diagnosed with von Willebrand’s disease calls a clinic after experiencing hemarthrosis. The client states that factor concentrate is infusing. Which intervention should the nurse recommend now?
A | “Take two 325-mg aspirin tablets every 4 hours for pain.” |
B | “Apply a cold pack to the area for 30 minutes every 1 to 2 hours.” |
C | “Come to the clinic; you need an infusion of fresh frozen plasma.” |
D | “If wearing a splint, remove it to avoid compartment syndrome.” |
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