NCM 106

CARE OF CLIENTS WITH PROBLEMS IN CELLULAR ABERRATIONS,

ACUTE BIOLOGIC CRISIS, EMERGENCY AND DISASTER NURSING

LONG TEST
July 4, 2016 | 3:00-5:00pm

Name: ____________________________________________________________________

General Instructions
1.

2.
3.
4.
5.

This test is composed of 85 items, divided into 4 parts:

identification, multiple choice, enumeration, fill in the
blanks.
You have two hours to finish the whole test.
Use blue/black ballpen to write the best answer
of each item.
Erasures and/or retracing will not be tolerated.
Answer independently and quietly. Any form of cheating
is prohibited.

Part 1. Identification (1-20)

Write your answer on the space provided before the number.

__________________1. The radiation source is not confined

completely to one body area, and it enters body fluids
and eventually is eliminated via various excreta, which
are radioactive and harmful to others.
__________________2. How far will the nurse stand from
the patient with a radioactive implant?
__________________3. For how long will you stay with the
same client in a shift?
__________________4. Surgical procedure where breast
tissue and the nipple are removed. Lymph nodes
remain intact.
__________________5. When malignant cells produce
enzymes, hormones and other substances, this
phenomenon is termed as __.
__________________6. Platelets, RBCs, and some WBCs
arise from what group in the bone marrow?
__________________7. The term __ represents that period
of time when blood levels are at their lowest point.

__________________8. The donor of the bone marrow is the

clients identical twin.
__________________9. Generally, benign tumors are named
with a suffix -__.
__________________10. This theory suggests that failure of
the immune response system leads to inability to
destroy the cancer cells
__________________11. Most common type of cancer in
women
__________________12. Classification of tumor cells
__________________13. A diagnostic test that makes use of
a specimen that can be obtained from tumors that
tend to shed cells from their surface
__________________14. __ biopsy is done when the tumor is
small
__________________15. This refers to a group of complex
diseases characterized by uncontrolled growth and
spread of abnormal cells
__________________16. Reverse cellular development to a
more primitive or embryonic cell type

__________________17. Replacement of one adult type by a

different adult cell type
__________________18. Most common route of metastasis
__________________19. Usually a late sign of cancer
__________________20. A surgery done for relief of
distressing signs and symptoms or for retardation of
metastasis. This is an attempt to improve quality of
life.

Part 2. Multiple Choice (1-20)

Encircle the letter of the best answer.
1. Mr. Pablo, diagnosed with Bladder Cancer, is
scheduled for a cystectomy with the creation of an
ileal conduit in the morning. He is wringing his hands
and pacing the floor when the nurse enters his room.
What is the best approach?
A. "Good evening, Mr. Pablo. Wasn't it a pleasant
day, today?"
B. "Mr, Pablo, you must be so worried, I'll leave
you alone with your thoughts.
C. Mr. Pablo, you'll wear out the hospital floors
and yourself at this rate."
D. "Mr. Pablo, you appear anxious to me. How
are you feeling about tomorrow's surgery?"
2. Mr. Perez is in continuous pain from cancer. Pain
medication provides little relief and he refuses to
move. The nurse should plan to:
A. Reassure him that the nurses wont hurt him
B. Let him perform his own activities of daily
living
C. Handle him gently when assisting with
required care
D. Complete A.M. care quickly as possible when
necessary

3. The nurse is conducting an education session for a

group of smokers in a stop smoking class.
Which finding would the nurse state as a common
symptom of lung cancer?
A. Dyspnea on exertion
B. Foamy, blood-tinged sputum
C. Wheezing sound on inspiration
D. Cough or change in a chronic cough
4. A client is being evaluated for cancer of the colon. In
preparing the client for barium enema, the nurse
should:
A. Give laxative the night before and a cleansing
enema in the morning before the test
B. Render an oil retention enema and give
laxative the night before
C. Instruct the client to swallow 6 radiopaque
tablets the evening before the study
D. Place the client on CBR a day before the study
5. The client has a good understanding of the means to
reduce the chances of colon cancer when he says:
A. I will exercise daily.
B. I will include more red meat in my diet.
C. I will have an annual chest x-ray.
D. I will include more fresh fruits and
vegetables in my diet.

6. Maria Sison, 40 years old, single, was admitted to

the hospital with a diagnosis of Breast Cancer. She was
scheduled for radical mastectomy. Nursing care during
the preoperative period should consist of
A. assuring Maria that she will be cured of
cancer
B. assessing Maria's expectations and doubts
C. maintaining a cheerful and optimistic
environment
D. keeping Maria's visitors to a minimum so she
can have time for herself
7. A chemotherapeutic agent 5FU is ordered as an
adjunct measure to surgery. Which of the ff.
statements about chemotherapy is true?
A. it is a local treatment affecting only tumor
cells
B. it affects both normal and tumor cells
C. it has been proven as a complete cure for
cancer
D. it is often used as a palliative measure.

8. Which is an incorrect statement pertaining to the

following procedures for cancer diagnostics?
A. Biopsy is the removal of suspicious tissue and
the only definitive method to diagnose cancer
B. Ultrasonography detects tissue density
changes difficult to observe by X-ray via
sound waves.
C. CT scanning uses magnetic fields and radio
frequencies to provide cross-sectional view of
tumor
D. Endoscopy provides direct view of a body
cavity to detect abnormality.
9. Which statement by the client indicates to the nurse
that the patient understands precautions necessary
during internal radiation therapy for cancer of the
cervix?
A. I should get out of bed and walk around in
my room.
B. My 7 year old twins should not come to visit
me while Im receiving treatment.
C. I will try not to cough, because the force
might make me expel the application.
D. I know that my primary nurse has to wear
one of those badges like the people in the xray department, but they are not necessary
for anyone else who comes in here.

10. Papanicolaou smear is usually done to determine

cancer of
A. Cervix
B. Ovaries
C. Fallopian tubes
D. Breast
11. Larry is diagnosed as having CML and is admitted
to the hospital for chemotherapy. Larry discusses his
recent diagnosis of leukemia by referring to statistical
facts and figures. The nurse recognizes that Larry is
using the defense mechanism known as:
A. Reaction formation
B. Sublimation
C. Intellectualization
D. Projection
12. The laboratory results of the client with leukemia
indicate bone marrow depression. The nurse should
encourage the client to:
A. Increase his activity level and ambulate
frequently
B. Sleep with the head of his bed slightly
elevated
C. Drink citrus juices frequently for nourishment
D. Use a soft toothbrush and electric razor

13. A client jokes about his leukemia even though hes

becoming sicker. The nurses reply should be:
A. Your laugher is a cover for your fear.
B. He who laughs on the outside, cries on the
inside.
C. Why are you always laughing?
D. Does it help you to joke about your illness?
14. Dennis receives a blood transfusion and develops
flank pain, chills, fever and hematuria. The nurse
recognizes that Dennis is probably experiencing:
A. An anaphylactic transfusion reaction
B. An allergic transfusion reaction
C. A hemolytic transfusion reaction
D. A pyrogenic transfusion reaction
15. A client is in her third month of her first
pregnancy. During the interview, she tells the nurse
that she has several sex partners and is unsure of the
identity of the baby's father. Which of the following
nursing interventions is a priority?
A. Counsel the woman to consent to HIV
screening
B. Perform tests for sexually transmitted
diseases
C. Discuss her high risk for cervical cancer
D. Refer the client to a family planning clinic

16. The nurse is planning care for a client during the

acute phase of a sickle cell vaso-occlusive crisis. Which
of the following actions would be most appropriate?
A. Fluid restriction 1000cc per day
B. Ambulate in hallway 4 times a day
C. Administer analgesic therapy as ordered
D. Encourage increased caloric intake
17. Which contraindication should the nurse assess for
prior to giving a child immunization?
A. Mild cold symptoms
B. Chronic asthma
C. Depressed immune system
D. Allergy to eggs
18. A 65-year-old Hispanic-Latino client with prostate
cancer rates his pain as a 6 on a 0-to-10 scale. The
client refuses all pain medication other than Motrin,
which does not relieve his pain. The next action for the
nurse to take is to
A. Ask the client about the refusal of certain pain
medications
B. Talk with the client's family about the
situation
C. Report the situation to the health care
provider
D. Document the situation in the notes

19. A 24 year-old male is admitted with a diagnosis of

testicular cancer. The nurse would expect the client to
have
A. Scrotal discoloration
B. Sustained painful erection
C. Inability to achieve erection
D. Heaviness in the affected testicle
20. A nurse aide is taking care of a 2 year-old child
with Wilm's tumor. The nurse aide asks the nurse why
there is a sign above the bed that says DO NOT
PALPATE THE ABDOMEN? The best response by the
nurse would be which of these statements?
A. "Touching the abdomen could cause cancer
cells to spread."
B. "Examining the area would cause difficulty to
the child."
C. "Pushing on the stomach might lead to the
spread of infection."
D. "Placing any pressure on the abdomen may
cause an abnormal experience."

Part 3. Enumeration (1-25)

Warning signals of cancer
1.
2.
3.
4.
5.
6.
7.
8.
9.
Sequence of carcinogenesis
10.
11.
12.
Process of metastasis
13.
14.
15.
16.

Undesirable effects of chemo drugs

17.
18.
19.
20.
21.
Classification of leukemia according to stem cell
involved
22.
23.
24.
25.

Part 4. Fill in the blanks (1-20)

LUNG CANCER
1. Removal of the whole lung is termed as
______________________.
2. The number 1 cause of lung cancer is
_______________________.
3. ________________ carcinoma usually grows in the
central part of the lungs.
4. Small cell lung cancer is also termed as
_______________________.

LYMPHOMA
1. The difference between Hodgkins and NonHodgkins Lymphoma is the presence of
______________________________________.
2. CML usually affects the middle age group and
those with ________________ chromosome which
enhances the replicability of cancer cells.
3. The preferred site for bone marrow aspiration
and biopsy is _____________________________________,
because it houses lesser blood vessels as
compared to other bones.
4. _________________ reaction occurs when the
donors and recipients blood are
incompatible.
BREAST CANCER
1. 50% of tumors arise from _____________________
quadrant of the breast.
2. Post operatively, the affected arm of the
patient must be elevated on pillow and
slightly _____________.

CERVICAL CANCER
1. Management of choice for cervical cancer is
_________________/internal radiation therapy.
2. Those who had their first intercourse at ___
years are at greater risk.
PROSTATE CANCER
1. ___________________________________ (no acronym
please) is elevated if the tumor has not yet
metastasized.
2. For the first 24 hours of CBI, _______ urine is
expected.
LARYNGEAL CANCER
1. ________________ laryngectomy retains voice.
2. The most common early warning sign for
laryngeal cancer is
_______________________________________.
SKIN CANCER
1. _________________________ with prominent dilated
subepidermal blood vessels are commonly
seen in patients with basal cell carcinoma.
2. _________________________ arises from the
epidermal cell that produces melanin.

COLON CANCER
1. Familial _____________ is one of the risk factors
associated with this type of cancer.
2. The preferred treatment modality for Stage 0
colorectal cancer is __________________, a
procedure involving the removal of polyp/s.