42: Oncological Disorders
. A client is diagnosed as having a bowel tumor and several diagnostic tests are
prescribed. The nurse understands that which test will confirm the diagnosis of
malignancy?
1. Magnetic resonance imaging (MRI)
2. Computerized tomography (CT) scan
3. Abdominal ultrasound
4. Biopsy of the
tumor Answer: 4
Rationale: A biopsy is done to determine whether a tumor is malignant or benign.
An MRI, CT scan, and ultrasound will visualize the presence of a mass but will
not confirm a diagnosis of malignancy.
Test-Taking Strategy: Use the process of elimination and note the key word,
confirm. This key word will direct you to option 4. Review the purpose of the
tests if you had difficulty with this question.
Level of Cognitive Ability:
Comprehension Client Needs:
Physiological Integrity
Integrated Process: Nursing Process/Data
Collection Content Area: Adult
Health/Oncology
Reference: Christensen, B., & Kockrow, E. (2003). Adult health nursing (4th ed).
St. Louis: Mosby, p. 720.
. A client is diagnosed with multiple myeloma and the client asks the nurse about
the diagnosis. The nurse bases the response on which characteristic of the
disorder?
1. Malignant exacerbation in the number of leukocytes
,2. Altered red blood cell production
3. Altered production of lymph nodes
4. Malignant proliferation of plasma cells and tumors
within the bone Answer: 4
Rationale: Multiple myeloma is a neoplastic condition characterized by abnormal
malignant proliferation of plasma cells and the accumulation of mature plasma
cells in the bone marrow. Option 1 describes the leukemic process. Options 2 and
3 are not characteristics of multiple myeloma.
Test-Taking Strategy: Use the process of elimination and knowledge regarding
the pathophysiology associated with this disorder to answer the question.
Focusing on the name of the diagnosis will assist in directing you to option 4.
Review this information if you are unfamiliar with this oncological disorder.
Level of Cognitive Ability:
Comprehension Client Needs:
Physiological Integrity Integrated
Process: Nursing Process/Planning
Content Area: Adult Health/Oncology
Reference: Linton, A., & Maebius, N. (2003). Introduction to medical-surgical
nursing (3rd ed.). Philadelphia: W.B. Saunders, p. 552.
,. A nurse is reviewing the laboratory results of a client diagnosed with multiple
myeloma. Which of the following would the nurse expect to specifically note with
this diagnosis?
1. Decreased number of plasma cells in the bone marrow
2. Increased white blood cells
3. Increased calcium level
4. Decreased blood urea nitrogen
(BUN) level Answer: 3
Rationale: Findings indicative of multiple myeloma are an increased number of
plasma cells in the bone marrow, anemia, hypercalcemia as a result of the release
of calcium from the deteriorating bone tissue, and an elevated BUN level. An
increased white blood cell count may or may not be present and is not specifically
related to multiple myeloma.
Test-Taking Strategy: Knowledge regarding the pathophysiology associated with
this disorder and the effects it produces on the body is required to answer the
question. Remember, hypercalcemia occurs as a result of the release of calcium
from the deteriorating bone tissue. Review this information if you are unfamiliar
with this oncological disorder.
Level of Cognitive Ability:
Comprehension Client Needs:
Physiological Integrity
Integrated Process: Nursing Process/Data
Collection Content Area: Adult
Health/Oncology
Reference: Lewis, S., Heitkemper, M., & Dirksen, S. (2004). Medical-surgical
nursing: Assessment and management of clinical problems (6th ed.). St. Louis:
Mosby, p. 745.
, . A nurse is assisting in developing a plan of care for the client with multiple
myeloma. A priority nursing intervention for a client with multiple myeloma is
which of the following?
1. Coughing and deep breathing
2. Encouraging fluids
3. Monitoring the red blood cell count
4. Providing frequent oral
care Answer: 2
Rationale: Hypercalcemia secondary to bone destruction is a priority concern in
the client with multiple myeloma. The nurse should encourage fluids in adequate
amounts to maintain an output of 1.5 to 2.0 L/day. Clients require about 3 L of
fluid per day. The fluid is needed not only to dilute the calcium, but also to
prevent protein from precipitating in the renal tubules.
Options 1, 3, and 4 may be a component of the plan of care, but are not the
priority in this client. Test-Taking Strategy: Knowledge regarding the clinical
manifestations that occur in multiple myeloma is required to answer the question.
Recalling that encouraging fluids is specific to the care of a client with this
disorder will direct you to option 2. Review the specific manifestations of this
disorder if you had difficulty with this question.
Level of Cognitive Ability:
Application Client Needs:
Physiological Integrity Integrated
Process: Nursing Process/Planning
Content Area: Adult Health/Oncology
Reference: Lewis, S., Heitkemper, M., & Dirksen, S. (2004). Medical-surgical
nursing: Assessment and management of clinical problems (6th ed.). St. Louis:
Mosby, p. 746.
The nurse would instruct the clients to perform the examination:
. A client is diagnosed as having a bowel tumor and several diagnostic tests are
prescribed. The nurse understands that which test will confirm the diagnosis of
malignancy?
1. Magnetic resonance imaging (MRI)
2. Computerized tomography (CT) scan
3. Abdominal ultrasound
4. Biopsy of the
tumor Answer: 4
Rationale: A biopsy is done to determine whether a tumor is malignant or benign.
An MRI, CT scan, and ultrasound will visualize the presence of a mass but will
not confirm a diagnosis of malignancy.
Test-Taking Strategy: Use the process of elimination and note the key word,
confirm. This key word will direct you to option 4. Review the purpose of the
tests if you had difficulty with this question.
Level of Cognitive Ability:
Comprehension Client Needs:
Physiological Integrity
Integrated Process: Nursing Process/Data
Collection Content Area: Adult
Health/Oncology
Reference: Christensen, B., & Kockrow, E. (2003). Adult health nursing (4th ed).
St. Louis: Mosby, p. 720.
. A client is diagnosed with multiple myeloma and the client asks the nurse about
the diagnosis. The nurse bases the response on which characteristic of the
disorder?
1. Malignant exacerbation in the number of leukocytes
,2. Altered red blood cell production
3. Altered production of lymph nodes
4. Malignant proliferation of plasma cells and tumors
within the bone Answer: 4
Rationale: Multiple myeloma is a neoplastic condition characterized by abnormal
malignant proliferation of plasma cells and the accumulation of mature plasma
cells in the bone marrow. Option 1 describes the leukemic process. Options 2 and
3 are not characteristics of multiple myeloma.
Test-Taking Strategy: Use the process of elimination and knowledge regarding
the pathophysiology associated with this disorder to answer the question.
Focusing on the name of the diagnosis will assist in directing you to option 4.
Review this information if you are unfamiliar with this oncological disorder.
Level of Cognitive Ability:
Comprehension Client Needs:
Physiological Integrity Integrated
Process: Nursing Process/Planning
Content Area: Adult Health/Oncology
Reference: Linton, A., & Maebius, N. (2003). Introduction to medical-surgical
nursing (3rd ed.). Philadelphia: W.B. Saunders, p. 552.
,. A nurse is reviewing the laboratory results of a client diagnosed with multiple
myeloma. Which of the following would the nurse expect to specifically note with
this diagnosis?
1. Decreased number of plasma cells in the bone marrow
2. Increased white blood cells
3. Increased calcium level
4. Decreased blood urea nitrogen
(BUN) level Answer: 3
Rationale: Findings indicative of multiple myeloma are an increased number of
plasma cells in the bone marrow, anemia, hypercalcemia as a result of the release
of calcium from the deteriorating bone tissue, and an elevated BUN level. An
increased white blood cell count may or may not be present and is not specifically
related to multiple myeloma.
Test-Taking Strategy: Knowledge regarding the pathophysiology associated with
this disorder and the effects it produces on the body is required to answer the
question. Remember, hypercalcemia occurs as a result of the release of calcium
from the deteriorating bone tissue. Review this information if you are unfamiliar
with this oncological disorder.
Level of Cognitive Ability:
Comprehension Client Needs:
Physiological Integrity
Integrated Process: Nursing Process/Data
Collection Content Area: Adult
Health/Oncology
Reference: Lewis, S., Heitkemper, M., & Dirksen, S. (2004). Medical-surgical
nursing: Assessment and management of clinical problems (6th ed.). St. Louis:
Mosby, p. 745.
, . A nurse is assisting in developing a plan of care for the client with multiple
myeloma. A priority nursing intervention for a client with multiple myeloma is
which of the following?
1. Coughing and deep breathing
2. Encouraging fluids
3. Monitoring the red blood cell count
4. Providing frequent oral
care Answer: 2
Rationale: Hypercalcemia secondary to bone destruction is a priority concern in
the client with multiple myeloma. The nurse should encourage fluids in adequate
amounts to maintain an output of 1.5 to 2.0 L/day. Clients require about 3 L of
fluid per day. The fluid is needed not only to dilute the calcium, but also to
prevent protein from precipitating in the renal tubules.
Options 1, 3, and 4 may be a component of the plan of care, but are not the
priority in this client. Test-Taking Strategy: Knowledge regarding the clinical
manifestations that occur in multiple myeloma is required to answer the question.
Recalling that encouraging fluids is specific to the care of a client with this
disorder will direct you to option 2. Review the specific manifestations of this
disorder if you had difficulty with this question.
Level of Cognitive Ability:
Application Client Needs:
Physiological Integrity Integrated
Process: Nursing Process/Planning
Content Area: Adult Health/Oncology
Reference: Lewis, S., Heitkemper, M., & Dirksen, S. (2004). Medical-surgical
nursing: Assessment and management of clinical problems (6th ed.). St. Louis:
Mosby, p. 746.
The nurse would instruct the clients to perform the examination:
