Test Bank for Lewis 's Medical -Surgical Nursing, 12th Edition by Mariann M. Harding, Jeffrey Kwong, Debra Hagler Chapter 16-20 Contents Chapter 16: Cancer ................................ ................................ ................................ .................... 2 Chapter 17: Fluid, Electrolyte, and Acid -Base Imbalances ................................ ..................... 20 Chapter 18: Preoperative Care ................................ ................................ ................................ . 36 Chapter 19: Intraoperative Care ................................ ................................ ............................... 44 Chapter 20: Postoperative Care ................................ ................................ ............................... 52 Chapter 16: Cancer Harding: Lewis’s Medical -Surgical Nursing, 12th Edition MULTIPLE CHOICE 1. A patient who is scheduled for a breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is accurate? a. “Benign tumors do not cause damage to other tissues.” b. “Benign tumors are likely to recur in the same location.” c. “Malignant tumors may spread to other tissues or organs.” d. “Malignant cells reproduce more rapidly than normal cells.” ANS: C The major difference between benign and malignant tumors is that malignant tumors invade adjacent tissues and spread to distant tissues and benign tumors do not metastasize. The other statements are inaccurate. Both types of tumors may cause damage to adjacent tissues. Malignant cells do not reproduce more rapidly than normal cells. Benign tumors do not usually recur. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 2. The nurse is caring for a patient receiving intravesical bladder chemotherapy. The nurse would monitor for which adverse effect? a. Nausea b. Alopecia c. Hematuria d. Xerostomia ANS: C Regional routes of chemotherapy delivery such as intravesical therapy confine adverse effects to the local area. The adverse effects of intravesical chemotherapy are confined to the bladder. The other adverse effects are associated with systemic chemotherapy. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity 3. A patient smokes 2 packs of cigarettes/day. Which action by the nurse could help the patient reduce the risk of lung cancer? a. Teach the patient about the seven warning signs of cancer. b. Plan to monitor the patient‘s carcinoembryonic antigen (CEA) level. c. Teach the patient about annual chest x-rays for lung cancer screening. d. Discuss dangers associated with cigarettes during each patient encounter. ANS: D Teaching about the risks associated with cigarette smoking is recommended at every patient encounter because cigarette smoking is associated with multiple health problems. The other options may detect lung cancer that is already present but do not reduce the risk. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 4. Which food choice would the nurse suggest for a patient scheduled to receive external -
beam radiation for abdominal cancer? a. Fruit salad b. Baked chicken c. Creamed broccoli d. Toasted wheat bread ANS: B Protein is needed for wound healing. To minimize the diarrhea that is associated with bowel radiation, the patient should avoid foods high in roughage, such as fruits and whole grains. A temporary lactose intolerance may develop secondary to radiation, so dairy products should also be avoided. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 5. During a routine health examination, a 40-yr-old patient tells the nurse about a family history of colon cancer. Which action would the nurse take first? a. Schedule a sigmoidoscopy to provide baseline data. b. Obtain more information about the patient‘s relatives. c. Teach the patient about the need for a colonoscopy at age 50. d. Teach the patient how to do home testing for fecal occult blood. ANS: B The patient may be at increased risk for colon cancer, but the nurse‘s first action should be further assessment. The other actions may be appropriate, depending on the information that is obtained from the patient with further questioning. DIF: Cognitive Level: Analyze (Analysis) TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 6. A patient who is diagnosed with cervical cancer classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is accurate? a. “The cancer involves only the cervix.” b. “The cancer cells look like normal cells.” c. “Further testing is needed to determine the spread of the cancer.” d. “It is difficult to determine the original site of the cervical cancer.” ANS: A Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time. Cell differentiation is not indicated by clinical staging. Because the cancer is in situ, the origin is the cervix. Further testing is not indicated given that the cancer has not spread. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 7. The nurse teaches a patient who is scheduled for a prostate needle biopsy about the procedure. Which statement by the patient indicates that teaching was effective? a. “The biopsy will remove the cancer in my prostate gland.” b. “The biopsy will determine how much longer I have to live.” c. “The biopsy will indicate whether the cancer has spread to other organs.” d. “The biopsy will help guide the treatment choices for my enlarged prostate.” ANS: D A biopsy is used to determine whether the prostate enlargement is benign or malignant and determines the type of treatment that will be needed. A biopsy does not give information about metastasis, life expectancy, or the impact of cancer on the patient‘s life. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity 8. The nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. Which patient statement indicates that the teaching has been effective? a. “After cancer has not recurred for 5 years, it is consid ered cured.” b. “The cancer will be cured if the entire tumor is surgically removed.” c. “I will need follow -up examinations for many years after treatment before I can be considered cured.” d. “Cancer is never cured, but the tumor can be controlled with surgery, chemotherapy, and radiation.” ANS: C The risk of recurrence varies by the type of cancer. Some cancers are considered cured after a shorter time span or after surgery, but stage III breast cancer will require additional therapies and ongoing follow -up. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process:
beam radiation for abdominal cancer? a. Fruit salad b. Baked chicken c. Creamed broccoli d. Toasted wheat bread ANS: B Protein is needed for wound healing. To minimize the diarrhea that is associated with bowel radiation, the patient should avoid foods high in roughage, such as fruits and whole grains. A temporary lactose intolerance may develop secondary to radiation, so dairy products should also be avoided. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 5. During a routine health examination, a 40-yr-old patient tells the nurse about a family history of colon cancer. Which action would the nurse take first? a. Schedule a sigmoidoscopy to provide baseline data. b. Obtain more information about the patient‘s relatives. c. Teach the patient about the need for a colonoscopy at age 50. d. Teach the patient how to do home testing for fecal occult blood. ANS: B The patient may be at increased risk for colon cancer, but the nurse‘s first action should be further assessment. The other actions may be appropriate, depending on the information that is obtained from the patient with further questioning. DIF: Cognitive Level: Analyze (Analysis) TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 6. A patient who is diagnosed with cervical cancer classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is accurate? a. “The cancer involves only the cervix.” b. “The cancer cells look like normal cells.” c. “Further testing is needed to determine the spread of the cancer.” d. “It is difficult to determine the original site of the cervical cancer.” ANS: A Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time. Cell differentiation is not indicated by clinical staging. Because the cancer is in situ, the origin is the cervix. Further testing is not indicated given that the cancer has not spread. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 7. The nurse teaches a patient who is scheduled for a prostate needle biopsy about the procedure. Which statement by the patient indicates that teaching was effective? a. “The biopsy will remove the cancer in my prostate gland.” b. “The biopsy will determine how much longer I have to live.” c. “The biopsy will indicate whether the cancer has spread to other organs.” d. “The biopsy will help guide the treatment choices for my enlarged prostate.” ANS: D A biopsy is used to determine whether the prostate enlargement is benign or malignant and determines the type of treatment that will be needed. A biopsy does not give information about metastasis, life expectancy, or the impact of cancer on the patient‘s life. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity 8. The nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. Which patient statement indicates that the teaching has been effective? a. “After cancer has not recurred for 5 years, it is consid ered cured.” b. “The cancer will be cured if the entire tumor is surgically removed.” c. “I will need follow -up examinations for many years after treatment before I can be considered cured.” d. “Cancer is never cured, but the tumor can be controlled with surgery, chemotherapy, and radiation.” ANS: C The risk of recurrence varies by the type of cancer. Some cancers are considered cured after a shorter time span or after surgery, but stage III breast cancer will require additional therapies and ongoing follow -up. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process:
