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COMPREHENSIVE PHASE WORKBOOK ONCOLOGY NOVEMBER 2024 Philippine Nurse Licensure Examination Review 1. Teresa came to the clinic for cancer screening. Which of the following reported signs/symptoms would indicate further assessment? A. Bowel movement twice a day for the past 5 years B. Mobile rounded breast mass occurring before menstruation C. Mole that has become larger in the past four weeks D. Lingering cough one week after a cold 2. You are currently preparing medications for Joanna, a patient with cancer. An alkylating agent was prescribed. Which of the following should you expect to be written in the medication order? A. Doxorubicin (Adriamycin) B. Methotrexate (Folex) C. Cyclophosphamide (Cytoxan) D. Tamoxifen (Nolvadex) 3. Regina shall undergo her chemotherapy session today. She is concerned about the nausea and vomiting after chemotherapy. When should the nurse administer anti-emetics? A. With the administration of chemotherapy B. 30 minutes before chemotherapy C. Immediately after nausea begins D. When therapy is completed 4. Greg shall receive chemotherapy tomorrow. As a part of the health teaching for post-chemo care, which of the following should not be included? A. Use of normal saline in buccal mucosa B. Minimizing intrusive procedures C. Using manual razor D. Avoiding crowds and contact sports 5. Carcinogenesis is irreversible in which stage? A. Progression B. Promotion C. Initiation D. Regression 6. The breast biopsy result of Karen, a 56 year old with a suspicious breast mass reveals dysplasia. Dysplasia is a pattern of cell growth that can best be defined as: A. Normal cell that occurs during skin regeneration B. Bizarre cell growth that results in different cell sizes and shapes C. Increased number of cells of a tissue, which then become enlarged D. Malignant and lacking in normal cellular characteristics 7. A testicular cancer screening program was launcheD. Which of these groups should be the target for the program? A. Day care providers B. Senior citizens C. Middle - aged men D. High - school students 8. Mariam had a breast biopsy performed due to a suspicious mass on the upper outer quadrant of her left breast. The biopsy classifies the lesion according to the TNM staging system as follows: TIS, N0, M0. What does this classification mean? A. No evidence of primary tumor, no abnormal regional lymph nodes, and no evidence of distant metastasis B. Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis C. Can’t assess tumor or regional lymph nodes and no evidence of metastasis D. Carcinoma in situ, no demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis 9. Helena is being treated with teletherapy. Immediately following the radiation therapy, Helena is: A. Given a complete bath B. Placed on isolation for 6 hours C. Considered radioactive for 24 hours D. Free from radiation 10. Helena complains of fatigue and body malaise. Which of the following nursing interventions would be most helpful for Helena? A. Refer her immediately. B. Reassure that these feelings are just normal and nothing to worry about C. Tell her that these feelings are brought about by her thoughts about her illness D. Help her plan her daily activities 11. After the radiation therapy, Helena developed thrombocytopeniA. As a nurse you should observe the following symptoms: A. Petechiae, ecchymosis, epistaxis B. Weakness, easy fatigability, pallor C. Headache, dizziness, blurred vision D. Severe sore throat, bacteremia, hepatomegaly 12. The nurse evaluates Helena’s understanding of the precaution she must take to avoid potential complications of having thrombocytopenia. Helena is correct when she states: A. “I will take rest periods to conserve my energy.” B. “I will brush my teeth frequently to prevent infection.” C. “I will avoid taking aspirin.”¬ D. “I will report to the nurse if I feel like I am having fever.” 13. You are currently supervising a student nurse in the cancer unit. You warned them about adverse events during chemo drug administration. One adverse event is when chemotherapeutic agents are deposited into the subcutaneous tissue and caused tissue necrosis and damage to underlying tendons, nerves, and blood vessels. This is termed as: A. Extravasation B. Infiltration C. Infection D. Tissue Ulceration 14. Morris just finished her chemotherapy session today. Which of the following side effects would you expect the most? A. Myelosuppression B. Stomatitis C. Nausea and vomiting D. Alopecia TOP RANK REVIEW ACADEMY, INC. Page 1 | 4
15. Nurse Paula is currently preparing for a 5-fluorouracil (5-FU) infusion. You know that this is under which of the following chemotherapeutic agent classification? A. Alkylating agents B. Antitumor antibiotics C. Plant Alkaloids D. Antimetabolites 16. Earliest sign of skin reaction to radiation therapy is: A. Erythema B. Melanoma C. Atrophy D. Vitiligo 17. You are an oncology nurse. During your rounds, a patient asked you why you are wearing a film badge. You answer that it is used to: A. Identify the nurse who is assigned to care for such a patient B. Prevent radiation-induced sterility C. Protect the nurse from radiation effects D. Measure the amount of exposure to radiation 18. Glenda is already in the maintenance phase of her chemotherapy. She is experiencing alopecia. Which of the following actions would best indicate that the client is meeting the goal of improved body image and self-esteem? A. The client requests that her family bring her makeup and wig B. The client begins to discuss the future with her family C. The client reports less disruption from pain and discomfort D. The client cries openly when discussing her disease 19. The procedure that involves the removal of the entire breast tissue including the nipple-areola complex and a portion of the axillary lymph nodes is termed as: A. Simple mastectomy B. Radical mastectomy C. Modified radical mastectomy D. Total mastectomy 20. Veronica came to an oncologist due to a suspicious breast mass. Which of the following signs indicate an advanced malignancy of the breast? A. Absence of nipple discharge B. Enlargement of the areola C. Engorgement of the breast D. Dimpling in the breast 21. Belinda asked you when should she perform a breast self examination. You reply that: A. BSE is performed same date each month B. BSE is performed monthly every morning after a warm bath or shower C. BSE is performed 7 days after menstruation D. BSE is performed when there is an urge 22. Which of the following is the recommended exercise after mastectomy? A. Bungee jumping B. Badminton C. Arm exercises D. Bowling 23. Tunying was diagnosed with laryngeal cancer. Which of the following factors most likely predisposed Tunying to this disease? A. Smoking and alcoholism B. Age C. Gender D. Familial predisposition 24. Tunying underwent laryngectomy, which of the following position should the nurse place the post-op patient? A. Semi-Fowler B. Supine with head flat on bed C. Supine with pillow D. Side lying 25. In order to communicate with Tunying, you would allow him to use: A. Magic Slate B. Picture board C. Call bell D. Hand gestures 26. Diana H sustained a broken right hip after slipping in the bathroom. She shall undergo an X-ray of broken right hip. To maintain patient’s position during radiation exposure which of the following is NOT recommended? A. Application of traction device B. Holding the patient in place during the exposure. C. Use of sling. D. Use of sandbag. 27. During personnel orientation, a new nurse asked you about radiation exposure. Which of the following parts of the body is at greatest risk of radiation exposure for personnel within with 6 feet range of radiation? A. neck, face and hands B. head, neck and hands C. hand, chest and abdomen D. head, neck and feet 28. You are currently orienting a new nurse. You remind her about the guidelines for radiation safety. These guidelines were based on: A. shielding, distance and time B. distance, time and sex C. clothing, distance and time D. Time, clothing and age. 29. Wellinson was admitted in the unit with a working diagnosis of Hodgkin’s Disease. Which of the following would you expect to occur first in the patient history? A. Cervical lymphadenopathy B. Inguinal lymphadenopathy C. Axillary lymphadenopathy D. Mediastinal lymphadenopathy 30. You would expect that Wellinson is in this age range because the highest incidence of the disease is in: A. Young adults B. Middle-aged adults C. Elderly D. Children 31. You are currently teaching a group of student nurses about Hodgkin's disease. The nurse determines that further education is needed if a nursing staff member states that which of the following is a characteristic of the disease? A. Presence of Reed Sternberg cells B. Involvement of lymph node, spleen and liver C. Occurs most often in older clients D. Prognosis depends on the stage of the disease 32. Upon reviewing Wellinson’s chart, you would expect which of the following? A. Night sweats B. Severe lymph node pain C. Weight gain of 2 kg D. Headache with minor visual changes 33. Marino S came to the clinic for colon cancer screening. Which of the following signs and symptoms would lead you to further assess the patient? A. constipation, ascites and mucus in the stool B. diarrhea, Heartburn and eructation C. blood in the stools, anemia, and "pencil-shaped" stools D. anorexia, hematemesis, and increased peristalsis 34. Xander D has an abdominoperineal resection and returns to the unit with a single-barreled sigmoid colostomy. Which of the following would the nurse expect following this surgical procedure? TOP RANK REVIEW ACADEMY, INC. Page 2 | 4
A. Continuous liquid stool until the client is discharged from the hospital B. Regulation of the colostomy C. Sanguinous drainage from the stoma mixed with feces. D. Reconnection of the bowel after a short time. 35. You inspect the colostomy stoma and finds the tissue is moist with a slight bluish color. This would best be interpreted as which of the following? A. Early sign of necrosis. B. Normal tissue (postoperative trauma). C. Infection. D. Internal hemorrhage. 36. Yuri was diagnosed to have bladder cancer. Which of the following parts of the patient history most likely contributed to its development? A. family history B. cigarette smoking C. low-bulk diet D. stress 37. Which of the following clinical findings would you expect the MOST from Yuri? A. Dysuria with hematuria B. Gross painless hematuria C. Palpable tumor D. Melena 38. Mayang G develops myelosuppression after the intensive phase of her chemotherapy. Which instructions should the nurse not include in the client’s discharge teaching plan? I. Avoid people who have recently received MMR. II. Avoid activities that may cause bleeding III. Increase intake of fresh fruits and vegetables IV. Avoid crowded places A. 1 and 3 B. 3 only C. 1, 2 and 4 D. 2 and 4 only 39. Vico B who is receiving 5 - Fluorouracil develops stomatitis. Which of the following nursing interventions for the client should be excluded? A. Normal saline gargle every 2 hours B. Taking hot liquids C. Soft, bland diet D. Topical anesthetics before meals 40. Rogelio A underwent cystectomy with ileal conduit. The nurse is correct that the normal urine from the stoma of the patient contains: A. pus B. oil C. Mucus D. Gas 41. You are currently conducting a cancer awareness program in a barangay. You include the following key messages for early detection of cancer except: A. Monthly BSE for women as early as adolescence B. Guaiac stool examination on yearly basis for adults over 50 years C. Pap smear only among sexually - active women D. Mammogram taken for women over 40 years of age 42. Leonardo A came in due to difficulty urinating. A prostate exam is warranted. What equipment will be necessary for the exam? A. Tongue depressor and specimen cup B. Lubricant and gloves C. Penlight and stethoscope D. Tuning fork and reflex hammer 43. Charla F underwent sealed radiation therapy for cancer of the cervix. Which statement by the client indicates to the nurse that the patient understands the precautions necessary? A. “I should be ambulating every 2h.” B. “My 4 year old child should not come to visit me while I’m receiving treatment.” C. “I will try not to sneeze, because the force might make me expel the application.” D. “I know that my primary nurse has to wear dosimeter badge but they are not necessary for anyone else who comes in here.” 44. Cass just received an internal radioactive implant. 2 hours later, the nurse discovers the implant in the bed linens. What should the nurse do first? A. Stand as far away as possible and call for help B. Pick up the implant with long handled forceps and place it in a lead-lined container C. Leave the room and notify the radiation therapy department immediately D. Put the implant back in place using forceps and shield for protection and call for help 45. Pia will undergo teletherapy. She verbalized her many concerns to the nurse. Which of the following is a correct response to her concerns? A. “You will be placed on low protein diet.” B. “You will not be radioactive because of the treatment.” C. “An implant will be inserted in your body cavity” D. “Only your body fluids are radioactive.” 46. Benedict was prescribed with hydroxyureA. Hydroxyurea is a known antimetabolite. The mechanism of action of anti-metabolites interferes with: A. Cell division or mitosis during the M phase of the cell cycle B. Cellular processes during the S phase of the cell cycle C. Non-specific phase of the cell cycle D. One or more stages of RNA synthesis, DNA synthesis or both 47. Queenie C was prescribed with doxorubicin. What is important to tell the client? A. Report symptoms of hematuria B. Increase oral fluids C. Observe patient for staggering balance D. Report symptoms of dyspnea 48. A client with cancer is receiving Methotrexate. The rationale for administering Leucovorin to a client receiving Methotrexate is to: I. Treat anemia II. Create a synergistic effect III. Increase the number of white blood cells IV. Reduces fatigue and weakness A. Except 4 B. 1 and 2 only C. 1 and 4 only D. 1 only 49. Loyda was worried about her upcoming chemotherapy session. She asks the nurse if chemotherapy affects all cells equally. Which of the following statements is correct? A. Faster growing cells are less susceptible to chemotherapy B. Non-dividing cells are more susceptible to chemotherapy C. Faster growing cells are more susceptible to chemotherapy D. Slower growing cells are more susceptible to chemotherapy 50. Maya X complains of extreme fatigue and weakness after her 1st week of Vinblastine therapy. Which of the following responses by the nurse would best reassure him? A. "These symptoms usually result from the therapy; however, we will continue to monitor your laboratory and clinical status." B. "These symptoms are part of your disease and can't be helped." C. "Don't be concerned about these symptoms. Everybody feels this way after having chemotherapy." TOP RANK REVIEW ACADEMY, INC. Page 3 | 4

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