Download N1120 Test Blueprint-Oncology

Oncology Test Questions/Blueprint
Question
Course
Objective
1. Which statement regarding general cancer development is true?
a. The risk for cancer development increases with age.
b. Cancers usually develop in tissues that do not retain
their ability to divide.
c. Children born to older mothers have a greater risk for
cancer development.
d. Most mutations leading to cancer development occur in
structural genes
2. By which process does “initiation” assist in the development of
cancer?
a. Carcinogen inflicts mutations at specific sites on
the cell wall
b. The initial tumor increases in size and causes
metastasis
c. Exposure to carcinogen results in division of
mutated cells
d. Making cancer cells appear more normal in order
to escape immunosurveillance by the body
MODIFIED answer “A” 1120-VIII-3 By which process does
“initiation” assist in the development of cancer?
a. Carcinogen inflicts damage to the cell wall
b. The initial tumor increases in size and causes
metastasis
c. Exposure to carcinogen results in division of
mutated cells
d. Making cancer cells appear more normal in order
to escape immunosurveillance by the body
©2011 Keith Rischer/www.KeithRN.com
Step in the
Nursing
Process
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MODIFY
3. Seeking to prevent cancer, nurses frequently counsel patients on
lifestyle
choices related to dietary fat intake, tobacco use and
alcohol consumption. The
goal of behavioral changes is to:
a.
minimize or reverse the promotion of cancer
development
b.
prevent metastasis of cancerous tumors
c.
reverse cancer progression once it has been initiated
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d.
stimulate T cell production so the bodies immune
system can be more effective
4.
Your patient in clinic is a 61-year-old woman who is 5 feet, 4
inches tall and weighs 125 pounds. She works for the post
office and has a 5-mile daily walking mail-delivery route. This
is her first contact with the health care system in 20 years.
Which of these topics will the nurse plan to include in patient
teaching about cancer prevention for this patient?
a
Need to increase physical activity and weight loss
.
b
Evaluate use of sunscreen and yearly Pap testing
c.
d.
e.
Need for mammogram testing
b&c
a, b, c
.
5. Examples of carcinogens that can initiate or promote cancer
development include:
a.
b.
c.
d.
e.
Smoking
Ionizing and ultraviolet radiation
Diet high in fiber and low in fat
a&b
a,b,c
6. While she is being prepared for a biopsy of a lump in her right
breast, the patient asks the nurse what the difference is between a
benign tumor and a malignant tumor. The nurse explains that a
benign tumor differs from a malignant tumor in that benign tumors:
©2011 Keith Rischer/www.KeithRN.com
a.
are rapidly growing in size
b.
are undifferentiated and do not resemble the tissue
of origin
c.
do not metastasize to other tissues and organs
d.
metastasize to other tissues and organs
7. Which of the following diagnostic procedures can determine
whether a tumor is benign or malignant?
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a. Positive Emission Tomography (PET) scan
b. Needle aspirated biopsy
c. Computed tomography (CT) scan
d. Magnetic resonance imaging (MRI)
8.
A patient with breast cancer is told her cancer had
metastasized to her lung. Which
of the following
statements is correct?
a.
The patient now has breast and lung cancer.
b.
Breast cancer increases the risk of lung cancer.
c.
The patient has breast cancer with metastasis to the
d.
The patient has experienced benign tumor activity.
lung.
9.
Your patient with breast cancer has a small tumor with no
spread or lymph node involvement. Using clinical staging,
this would be:
a.
Stage I
b.
Stage II
c.
Stage III
d.
Stage IV
©2011 Keith Rischer/www.KeithRN.com
10.
The nurse closely monitors the CBC laboratory results of a
patient receiving chemotherapy. The drug regimen may
need to be discontinued or modified if the results include:
a.
Hemoglobin of 11 g/dl
b.
WBC count of 1200/mm3
c.
platelets of 120,000/mm3
d.
creatinine level of 1.2 mg/dl
11. Chemotherapy agents exert their physiologic influence to
destroy cancer cells by:
a. Damaging cellular DNA of only oncologic cells
b. Damaging cellular DNA of all cells in the human body,
especially those that are rapidly dividing
c. Damaging the cell wall of all cells in the human body,
especially those that are rapidly dividing
d. Damaging the cell wall of all cells in the human body,
especially those that are slow dividing
12.
A hospitalized patient who has received chemotherapy for
leukemia develops neutropenia. Which observation by the
nurse caring for the patient indicates that they should
intervene?
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a.
Groups of the patients coworkers visit each lunch
hour.
b.
Dietary staff do not do hand hygiene upon entering
the room.
c.
Dietary staff do not wear a gown upon entering the
room.
d.
Dietary staff do not wear a mask upon entering the
room.
13.
.When assessing a patient’s needs for psychological support
after the patient has been diagnosed with stage IV cancer of
the colon, which question by the nurse will be the most
meaningful?
a.
“Can you tell me what has been helpful to you in the
past when coping
with stressful events?”
©2011 Keith Rischer/www.KeithRN.com
b.
cancer?”
“How long ago were you diagnosed with this
c.
“Are you familiar with the stages of grief related to a
diagnosis
of cancer?”
d.
“How do you feel about dying?”
14. What lab value will be elevated with your patient with lung
cancer who now has suspected metastasis to the spine?
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a. Potassium
b. Calcium
c. Lactate
d. Magnesium
15. A patient with metastatic cancer of the colon experiences severe
vomiting following each administration of chemotherapy.
The most important nursing intervention for this patient is to:
a.
increase fluid intake before each chemotherapy
treatment.
b.
have the patient eat full meals when nausea is not
present.
c.
administer Prochlorperazine (Compazine) prn one
hour before chemotherapy treatment.
d.
offer dry crackers and carbonated fluid immediately
following chemotherapy treatment.
16. Your patient is to receive Lorazepam (Ativan) to treat post
chemotherapy nausea. Because of your knowledge of the
mechanism of action of this drug after administration you
will need to closely assess for:
a.
b.
c.
d.
Drowsiness
Tachycardia
Insomnia
Hypertension
©2011 Keith Rischer/www.KeithRN.com
17. 1120- A patient receiving head and neck radiation and systemic
chemotherapy has ulcerations over the oral mucosa and tongue.
An appropriate intervention for the nurse to perform is to:
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a. remove food debris from the teeth and oral mucosa with a stiff toothbrush.
b. use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth.
c. gargle and rinse the mouth several times a day with an antiseptic mouthwash.
d. rinse the mouth before and after each meal and at bedtime with a saline solution.
18. In reviewing the labs and nursing assessment data for your
patient receiving chemotherapy for cancer, all of the following
results are listed. Which findings should alert the nurse to the
possibility of sepsis:
a. WBC 1000 mm3 and Neutrophils 50% for Absolute
Neutrophil Count (ANC) of 500
b. Oral temperature of 99.5 F
c.
Oral temperature of 100.5 F
d. a & b
e. a & c
19. Your patient has just had radiation therapy to a tumor in their
right lung. You will include the following nursing interventions in your
plan of care EXCEPT:
a. Assess skin integrity regularly for any breakdown
b. Keep chest covered and prevent exposure as much as
possible
c. Expose skin to air as much as possible
d. Cleanse skin with normal saline
20. Your patient with lung cancer has had recent radiation therapy,
and is now showing signs of sepsis/septic shock. You would expect
to see all of the following EXCEPT:
a.Decreasing blood pressure
©2011 Keith Rischer/www.KeithRN.com
b.Increased urine output
c.Increased heart rate
d.Anxiety-restlessness
21. Surgery to bypass an intestinal obstruction due to widespread
metastasis in the abdomen would have as its major aim the:
a.
cure of the cancer.
b.
palliation of symptoms.
c.
prevention of further metastatic spread.
d.
preparation of the patient for immunotherapy.
22. A 63-year-old man who has terminal cancer of the liver is cared
for by his wife at home. His abdominal pain has become
increasingly severe, and he now states that the pain is intense most
of the time. The nurse recognizes that patient/family teaching
regarding pain management with Oxycodone has been effective
when the patient:
a.
addiction.
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limits the use of opiate analgesics to prevent
b.
resigns himself to the fact that pain is an inevitable
consequence of cancer.
c.
uses pain medication only when the pain becomes
more than he can tolerate.
d.
takes analgesics around the clock on a regular
schedule, using additional
doses for breakthrough pain.
23. Your patient with breast cancer says that she is now having
sudden onset of increased pain in her lower back. What problem
should the nurse suspect is related to this symptom?
a. Arthritis
b. Urinary retention
c. Metastasis to the bone
©2011 Keith Rischer/www.KeithRN.com
d. Muscle atrophy from inactivity
24. 1124.MODIFIED N1120-VIII-4 The nurse is teaching a colon cancer
patient about the expected outcomes of her cancer treatment.
The nurse evaluates that the teaching has been effective when
the patient states:
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a. “After cancer has not recurred for 5 years, it is considered cured.”
b. “I will need to have follow-up examinations for ten years after I have treatment
before I can be considered cured.”
c. “Cancer is considered cured if the entire tumor is surgically removed.”
d. “Cancer is never considered cured, but the tumor can be controlled with surgery,
chemotherapy, and radiation.”
.
25. 1125. A patient returns to the surgical unit following a right
mastectomy with removal of axillary lymph nodes. The most
appropriate intervention for the nurse to include in implementing
postoperative care for the patient includes:
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a. teaching the patient to use the ordered patient-controlled analgesia (PCA) every
10 minutes and to use a timer to help her remember.
b. posting a sign at the bedside warning against blood pressures or venipunctures in
the left arm.
c. posting a sign at the bedside warning against blood pressures or venipunctures in
the right arm.
d. encouraging the patient to obtain a permanent breast prosthesis as soon as she is
discharged from the hospital.
KEY:
Cognitive Level:
Remembering
Understanding
Applying
Analyzing
Item Discrimination = how well an item distinguishes between high and low scoring students.
 0 is OK if it’s info that everyone absolutely needs to know, i.e. key content.
 .2 to .3 is desirable for most
 .4 or higher is OK for just a few questions. If all were .4, most of our students would fail the test.
 Negative discrimination means a problem, like a poorly written question, mis-speaking in lecture, not fully clarifying a
©2011 Keith Rischer/www.KeithRN.com
Evaluating
Creating
topic, or an error on the answer key.
Add the item analysis statistics to the blueprint after you administer the test. Use these stats for improving you test items.
©2011 Keith Rischer/www.KeithRN.com
FINAL EXAM
ALTERATION IN CELLULAR GROWTH (7)
1.
What is the most effective intervention to teach
your patient to decrease their likelihood of
developing cancer?
a.
Monthly self-breast exams
b.
Smoking cessation
c.
Annual PAP exams
d.
Monthly testicular exams
2.
Your oncology patient who just started
chemotherapy spiked a temperature to 103 F,
what labs ordered by the physician will be
relevant to closely monitor and trend:
a.
Total white blood cell count (WBC)
b.
Neutrophil differential percentage
c.
Serum lactate
d.
a&b
e.
a, b, c
The side effects commonly seen in a patient
receiving chemotherapy are due to:
a.
impact on rapidly dividing cells in the
body
b.
impact on only the cancerous cells in the
tumor
c.
release of intracellular breakdown
products
d.
a&c
When asked by a patient “how does someone
get cancer?” the nurse’s reply is based on their
knowledge that cancer can be associated with:
a.
genetic and hormonal factors
b.
environmental and dietary factors
c.
viruses
d.
a&b
e.
a, b & c
Your patient is newly diagnosed with cancer
and is scheduled to begin chemotherapy
treatment. As part of your education plan, what
3.
4.
5.
©2011 Keith Rischer/www.KeithRN.com
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6.
7.
is the most common side effect that you will
prepare her for:
a.
Hyperkalemia
b.
Nausea and vomiting
c.
Altered glucose metabolism
d.
Increased appetite
Your oncology patient develops erythema
following radiation therapy. What should the
nurse instruct the patient to do?
a.
Apply ice to the area.
b.
Keep the area cleanly shaven.
c.
Apply petroleum ointment to the affected
area.
d.
Expose skin to air as much as possible
You are admitting an oncology patient to your
unit prior to surgery. The patient has just
finished radiation therapy. What is the most
serious complication that this puts your patient
at increased risk for?
a.
Nutritional deficit
b.
Infection/sepsis
c.
Cardiac tamponade
d.
Hypercalcemia
©2011 Keith Rischer/www.KeithRN.com
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