N218 Final Exam Review Questions with Correct Answers
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Course
Nur 218
Institution
Nur 218
A patient has a tissue growth that was diagnosed as cancer. Which of the following terms best describes this growth?
a. Neoplasm
b. Lipoma
c. Meningioma
d. Hypertrophy - Answer-a. Neoplasm - this is the only term that describes a possible cancer; all others are benign findings.
A 45-year...
N218 Final Exam Review Questions with
Correct Answers
A patient has a tissue growth that was diagnosed as cancer. Which of the following
terms best describes this growth?
a. Neoplasm
b. Lipoma
c. Meningioma
d. Hypertrophy - Answer-a. Neoplasm - this is the only term that describes a possible
cancer; all others are benign findings.
A 45-year old male presents with persistent, severe stomach pain. Testing reveals a
peptic ulcer. Further laboratory tests reveal the presence of Helicobacter pylori. Which
of the following is of concern for this patient?
a. Gastric cancer
b. Leukemia
c. Lung cancer
d. Adenocarcinoma of the colon - Answer-a. Gastric Cancer - The presence of H.pylori
is associated with gastric cancer, not with leukemia, lung cancer or colorectal cancer.
Some tumours initially described as benign can progress to malignancy.
a. True
b. False - Answer-a. True
Direct invasion may be a part of the mechanism of local tumour spreading.
a. True
b. False - Answer-a. True
Invasion is a prerequisite for metastasis.
a. True
b. False - Answer-a. True - Direct invasion is a prerequisite (1st step) for metastasis;
may occur by direct tumour extension.
Cells with TP53 genes escape apoptosis.
a. True
b. False - Answer-b. False - May escape
All tumour cells that are released into the blood eventually find a compatible tissue to
multiply in and create a tumour.
a. True
b. False - Answer-b. False - Because metastasis requires successful completion of
each and every step, there may be numerous opportunities to interrupt this lethal
activity.
,Infection is the most significant cause of complications and death in individuals with
cancer.
a. True
b. False - Answer-a. True - Immunosuppression from cancer or therapies used
contribute.
Carcinoma refers to abnormal cell proliferation originating from which tissues?
a. Blood vessels
b. Epithelial cells
c. Connective tissue
d. Glandular tissue - Answer-b. Epithelial cells
When teaching a client who smokes about the relationship of smoking to the
development of cancer, how should the nurse explain tobacco smoke as a "complete
carcinogen"?
a. Exposure to the smoke always causes cellular changes
b. Tobacco smoke is capable of both initiating and promoting cancer growth
c. Cancer will always develop in people who smoke who are exposed to other
carcinogens
d. Tobacco smoke serves as a vehicle for the spread of cancer cells during the
progression stage of cancer. - Answer-b. Tobacco smoke is capable of both initiating
and promoting cancer.
Following a client with lung cancer, the nurse identifies the nursing diagnosis of
ineffective airway clearance. On which if the following data would the nurse base this
diagnosis?
a. Oxygen saturation of 85%
b. Respiratory rate of 28 breaths per minute
c. Presence of yellow/bloody thick sputum
d. Weak, non-productive cough - Answer-d. Weak, non-productive cough - client is
unable to clear the airway effectively.
A pathology report stages a tumour as T2 N1 M0. What is the meaning of this finding?
a. There is a tumour without spread to the surrounding lymph nodes, and no metastasis
b. There are two malignant tumours and one involved lymph node without metastasis
c. There is a measurable tumour with spread to the surrounding lymph nodes, without
metastasis
d. There is no tumour after two biopsies and one lymph node biopsy, without metastasis
- Answer-c. There is a measurable tumour with spread to the surrounding lymph nodes,
without metastasis - T2 = 2-5cm, N1=Mobile node involvement M0= no metastasis
A 58-year old woman has breast cancer that has metastasized to the liver. Which fact
about metastatic cells does the nurse understand that the treatment plan for the client is
based on?
a. They are identical to the cells in the breast, having been passively spread through the
blood and lymph tissues
,b. They become more unlike the cells of the primary site as mutations occur in the
tumour cells at both sites
c. They do not proliferate as rapidly as malignant cells in the primary site and are
therefore less sensitive to treatment
d. They retain the characteristics of the malignant cells in the breast and have the same
response to treatment as the primary tumour does. - Answer-b. They become more
unlike the cells of the primary site as mutations occur in the tumour cells at both sites -
As the primary and metastatic sites develop, the cells become more heterogeneous as
they repeatedly undergo spontaneous genetic mutations
Which cancers are associated with alterations in the BRCA1 gene?
a. Endometrial and ovarian
b. Endometrial and cervical
c. Cervical and breast
d. Breast and ovarian - Answer-d. Breast and ovarian
During examination of a 33-year old client's breasts, the nurse feels several movable,
tender nodules. The client tells the nurse that she has fibrocystic breasts, but reducing
her sodium and caffeine intake has not made a difference in her breast lumps or
tenderness. What is an appropriate client outcome for the nurse to establish with the
client?
a. Performance of daily breast self exam
b. Arranges for immediate examination and biopsy of any new lumps
c. Patient monitors changes in the size and tenderness of all lumps related to her
menstrual cycle
d. Patient consults with her physician about having a bilateral simple mastectomy to
prevent the cysts from becoming malignant - Answer-c. Patient monitors changes in the
size and tenderness of all lumps related to her menstrual cycle - Because fibrocystic
breast lumps may increase in size and tenderness during the premenstrual phase, the
client should be taught to monitor for this change and to call the MD if changes persist
after her menstrual cycle is over.
A 20-year old university BSN nursing student from VIU comes to the student health
center on campus because she has discovered a small lump in her right breast. She is
very worried that she has breast cancer because she has learned about breast cancer
in her Health Sciences course. Her mother had cervical cancer. The nurse's response to
this individual is based on the knowledge of the most common cause of breast lumps in
women her age are likely to be:
a. Breast cysts
b. Fibroadenoma
c. Breast abscesses
d. Adenocarcinoma - Answer-b. Fibroadenoma (Most frequent cause of breast lumps in
women under 25 yrs of age).
, When counseling a client about breast cancer prevention, the nurse considers that the
client has a significant family history of breast cancer with which of the following? (select
all that apply)
a. A sister who died from ovarian cancer at age of 29
b. A paternal grandmother who died from breast cancer at age 79
c. A cousin who was diagnosed with breast cancer at age 60 and ovarian cancer at age
68
d. A mother who was diagnosed with breast cancer at age of 42
e. A maternal grandmother diagnosed with breast cancer at age 65 - Answer-a. A sister
who died from ovarian cancer at age of 29
d. A mother who was diagnosed with breast cancer at age of 42.
A client with a breast biopsy positive for cancer is to undergo lymphatic mapping and
sentinel lymph node biopsy. What should the nurse explain about this procedure?
a. It reduces the need for extensive lymph node dissection for pathological examination
b. It can identify specific lymph nodes that have malignant cells, so only involve nodes
need to be excised
c. It eliminates the need for excision of more than one lymph node for staging of the
breast cancer
d. It will confirm the absence of tumour spread if the sentinel lymph node is negative for
malignant changes - Answer-a. It reduces the need for extensive lymph node dissection
for pathological examination.
A 34-year old woman has undergone a modified radical mastectomy for a breast
tumour. The pathology report identified the tumour as stage II, estrogen receptor-
positive adenocarcinoma. What would the nurse expect the first choice treatment for
this client to be after mastectomy?
a. Chemotherapy
b. Biological therapy
c. Radiation therapy
d. Hormone therapy with tamoxifen - Answer-d. Hormone therapy with tamoxifen - used
for estrogen-dependent breast tumours in premenopausal women.
A client returns to the post surgical unit following a right modified radical mastectomy
with dissection of axillary lymph nodes. Post op orders include diet as tolerated, up to
ad lib. Hemovac drain and patient-controlled anesthesia (PCA) at 1mg morphine sulfate
every 10 minutes. What is an appropriate nursing intervention for the nurse to include in
the post op care of this patient?
a. Teaching the client to use the PCA every 10 minutes for the best surgical pain relief
b. Insisting that the client examine the surgical incision when the dressings are removed
c. Posting a sign at the bedside warning against blood pressures or Venipuncture on the
right arm
d. Encouraging the client to obtain a permanent breast prosthesis as soon as she is
discharged from the hospital - Answer-c. Posting a sign at the bedside warning against
blood pressures or Venipuncture on the right arm.
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