POST-TEST: Cellular Aberration

1. A tissue sample shows increased number of normal cells in response to hormonal stimulation.
This cellular adaptation is known as:

A. Metaplasia
B. Hyperplasia
C. Dysplasia
D. Anaplasia

Answer: B
Rationale: Hyperplasia = increased number of cells from normal stimulus (e.g., hormones).
Bloom’s Level: Understand
Reference: Suddarth 15th Ed., Cellular Growth and Adaptation

2. Remaining kidney enlarges after nephrectomy. This adaptation is:

A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Neoplasia

Answer: A
Hypertrophy = cell size increases due to increased workload.
Analyze
Suddarth Cellular Adaptations

3. Best distinction between benign and malignant tumors:

A. Benign tumors invade aggressively

B. Malignant tumors are well differentiated
C. Benign tumors do not metastasize
D. Malignant tumors grow slowly

Answer: C
Benign tumors grow locally; metastasis = hallmark of malignancy.
Evaluate
Suddarth Neoplasia Characteristics

4. Which is a warning sign in CAUTION?

A. Sudden fever
B. Nagging cough or hoarseness
C. Headaches
D. Decreased appetite

Answer: B
Persistent cough may indicate lung cancer.
Understand
Early Cancer Detection Guidelines – Suddarth

5. Tumor is G3:
A. Well differentiated
B. Poorly differentiated
C. Localized only
D. Has metastasis

Answer: B
Higher grade = less differentiated = more aggressive.
Analyze
Suddarth Cancer Grading

6. Cancer cells spreading to new locations:

A. Initiation
B. Promotion
C. Metastasis
D. Angiogenesis

Answer: C
Metastasis = invasion + spread + secondary tumors.
Understand
Suddarth Metastatic Mechanisms

7. Tumor marker for prostate cancer:

A. CEA
B. PSA
C. AFP
D. CA 19-9

Answer: B
PSA used for detection & monitoring of prostate cancer.
Remember
Oncology Diagnostics – Suddarth

8. Highest risk factor for lung cancer:

A. UV exposure
B. Radon
C. Benzene
D. Tobacco smoke

Answer: D
Smoking accounts for majority of lung cancer cases.
Understand
Environmental Cancer Risks – Suddarth

9. DNA damage becomes permanent in what phase?

A. Promotion
B. Initiation
C. Progression
D. Angiogenesis

Answer: B
Mutations occur → irreversible genetic changes.
Understand
Carcinogenesis Phases – Suddarth

10. Most characteristic malignant feature:

A. Normal adhesion
B. Contact inhibition
C. High mitotic index
D. Encapsulation

Answer: C
Malignant cells divide rapidly and uncontrollably.
Analyze
Cell Growth Properties – Suddarth

11. CA-125 elevation is suggestive of:

A. Liver cancer
B. Colorectal cancer
C. Ovarian cancer
D. Pancreatic cancer

Answer: C
CA 125 = biomarker for ovarian malignancy.
Remember
Tumor Markers Table – Suddarth

12. TNM: T2 N1 M0 means:

A. No tumor present
B. Large tumor with metastasis
C. Tumor + regional lymph nodes involved, no distant metastasis
D. Small tumor, localized only

Answer: C
N1 = nodal involvement; M0 = no metastasis.
Apply
TNM Cancer Staging – Suddarth

13. Vitamin supporting cell regulation & immune defense:

A. Vitamin C
B. Vitamin D
C. Vitamin K
D. B12
 Answer: B
Vitamin D reduces cancer risk via cell regulation & apoptosis support.
Understand
Nutritional Oncology – Suddarth

14. Lost process leading to tumor survival:

A. Differentiation
B. Apoptosis
C. Angiogenesis
D. Adhesion

Answer: B
Cancer cells evade programmed cell death.
Analyze
Cancer Cell Biology – Suddarth

15. Oncogenes arise from mutation in:

A. Proto-oncogenes
B. Tumor suppressor genes
C. Oncofetal genes
D. Telomerase genes

Answer: A
Proto-oncogenes → oncogenes when mutated → cancer activation.
Understand
Genetic Factors in Cancer – Suddarth

16. Malignant tumor from epithelial tissue:

A. Carcinoma
B. Sarcoma
C. Lymphoma
D. Myeloma

Answer: A
Carcinomas originate from skin or mucosal linings.
Remember
Neoplasm Classification – Suddarth

17. Most important lifestyle change to reduce colorectal cancer:

A. Exercise
B. Stop smoking
C. Increase fiber intake
D. Limit alcohol

Answer: C
High fiber → faster transit → less carcinogen exposure.
 Evaluate
GI Cancer Prevention – Suddarth

18. A client with cervical cancer asks why Pap smear is important. The nurse’s BEST response is:

A. “It treats early cervical cancer.”

B. “It detects premalignant cervical cell changes.”
C. “It identifies HPV strains causing cancer.”
D. “It confirms cancer spread to the uterus.”
Answer: B
Rationale: Pap smear allows early detection of dysplasia before cancer occurs.
Bloom’s Level: Understand

19. Which hallmark feature differentiates malignant tumors from benign tumors?

A. Slow growth
B. Encapsulation
C. Metastasis
D. Well-differentiated cells
Answer: C
Rationale: Only malignant cells invade and metastasize to distant sites.
Bloom: Remember

20. A patient with breast cancer reports a family history of the disease. This mainly suggests:

A. Viral infection
B. Inherited gene mutation (BRCA)
C. Radiation exposure
D. Low immune response
Answer: B
Rationale: BRCA mutations contribute to hereditary breast cancer.
Bloom: Apply

21. Which finding indicates malignant cell growth?

A. Defined edges
B. Differentiated appearance
C. Localized compression to tissue
D. Rapid, uncontrolled division
Answer: D
Rationale: Malignant cells proliferate rapidly disregarding normal regulation.
Bloom: Understand

22. Cachexia in cancer patients is primarily related to:

A. High carbohydrate intake

B. Tumor secreting TNF-alpha
C. Increased mobility
D. Radiation side effects only
Answer: B
Rationale: TNF-alpha causes anorexia, muscle wasting, metabolic disturbances.
Bloom: Apply
23. A smoker develops lung cancer. This is an example of:

A. Primary prevention
B. Secondary prevention
C. Carcinogenesis related to chemical agents
D. Hormonal carcinogenesis
Answer: C
Rationale: Tobacco contains carcinogenic hydrocarbons.
Bloom: Understand

24. Which is a role of proto-oncogenes in normal cells?

A. Suppress tumor growth

B. Initiate apoptosis
C. Regulate normal cell growth
D. Promote metastasis
Answer: C
Rationale: Proto-oncogenes control cell proliferation; mutation → oncogene.
Bloom: Remember

25. A client asks what metastasis means. The nurse replies:

A. “Cancer is non-cancerous.”
B. “Cancer has spread to distant organs.”
C. “Tumor is slow-growing.”
D. “Surgery will fully remove the cancer.”
Answer: B
Rationale: Metastasis indicates distant spread beyond primary tumor.
Bloom: Understand

26. PSA testing is used primarily for which cancer?

A. Prostate
B. Liver
C. Thyroid
D. Colon
Answer: A
Rationale: PSA is a biomarker for prostate cancer screening and monitoring.
Bloom: Remember

27. A cancer patient develops frequent infections. This is due to:

A. Medications improving immunity

B. Bone marrow suppression
C. Hyperactive WBCs
D. High neutrophil count
Answer: B
Rationale: Myelosuppression → decreased WBCs → infection risk.
Bloom: Apply

28. Mutation of tumor suppressor gene p53 leads to:

A. Enhanced apoptosis
B. Loss of control over cell cycle
C. Improved cell differentiation
D. Halt in carcinogenesis
Answer: B
Rationale: p53 normally stops abnormal cell growth and repairs DNA.
Bloom: Analyze

29. A nurse teaches about cancer staging. Stage IV means:

A. Localized tumor
B. Limited regional spread
C. In situ carcinoma
D. Distant metastasis
Answer: D
Rationale: Stage IV indicates the worst prognosis with widespread metastasis.
Bloom: Understand

30. Carcinoma originates from:

A. Connective tissue
B. Epithelial tissue
C. Bone marrow
D. Neural tissue
Answer: B
Rationale: Carcinomas are epithelial origin; sarcomas from connective tissue.
Bloom: Remember

31. A nurse explains hyperplasia as:

A. Increase in cell size

B. Increase in number of cells
C. Change in cell type
D. Total loss of function
Answer: B
Rationale: Hyperplasia = ↑ cell number; hypertrophy = ↑ cell size.
Bloom: Understand

32. Which cell characteristic would suggest benign tumor?

A. Poorly differentiated
B. Non-encapsulated
C. Slow rate of growth
D. Frequent metastasis
Answer: C
Rationale: Benign tumors grow slowly and are usually localized.
Bloom: Remember

33. The nurse identifies the promotion stage of carcinogenesis as:

A. Permanent DNA mutation

B. Reversible proliferation of mutated cells
C. Metastasis to lymph nodes
D. Immune response elimination
Answer: B
Rationale: Promotion can still be halted by removing carcinogens.
Bloom: Understand

34. The nurse identifies carcinogenesis initiation phase as:

A. DNA mutation due to carcinogen exposure

B. Reversible cell proliferation
C. Clinical cancer detection stage
D. Cancer cell death
Answer: A
Rationale: Initiation is the first, irreversible genetic change.
Bloom: Remember

35. A female with BRCA1 mutation asks how mutation causes cancer. Nurse explains:

A. “It improves immune system surveillance.”

B. “It increases DNA repair efficiency.”
C. “It impairs tumor suppressor function.”
D. “It reverses metastasis.”
Answer: C
Rationale: BRCA mutation → defective tumor suppression → ↑ risk.
Bloom: Apply

36. Which cancer warning sign matches “Change in bowel or bladder habits”?

A. Colon cancer
B. Leukemia
C. Brain tumor
D. Bone sarcoma
Answer: A
Rationale: Colorectal tumors alter elimination patterns.
Bloom: Understand

37. A patient undergoing chemotherapy reports fatigue and pale skin. Which lab result supports
bone marrow suppression?

A. RBC 2.8 M/µL

B. Platelets 300,000/µL
C. WBC 10,000/µL
D. Hgb 15 g/dL
Answer: A
Rationale: Low RBC → anemia common in chemo.
Bloom: Apply

38. The nurse anticipates metastasis primarily through:

A. Digestive tract
B. Urinary excretion
C. Lymphatic and blood vessels
D. Nerve pathways
Answer: C
Rationale: Most cancers spread hematogenous and lymphatic routes.
Bloom: Remember

39. Which is a tumor marker used in ovarian cancer?

A. AFP
B. CA-125
C. CEA
D. PSA
Answer: B
Rationale: CA-125 is elevated with ovarian malignancy.
Bloom: Remember

40. Which immune cells destroy tumor cells via apoptosis?

A. B cells
B. T-killer cells
C. Eosinophils
D. Basophils
Answer: B
Rationale: Cytotoxic T cells target malignant cells.
Bloom: Understand

41. Which lifestyle change MOST reduces cancer risk?

A. Increasing red meat intake

B. Smoking cessation
C. Avoiding fruits and vegetables
D. Routine tanning
Answer: B
Rationale: Smoking contributes to 30% of cancer deaths.
Bloom: Apply

42. The primary purpose of cancer screening tests is to:

A. Cure advanced cancer

B. Detect early and precancerous changes
C. Increase metastasis
D. Replace treatment
Answer: B
Rationale: Early detection improves outcomes.
Bloom: Understand

43. The nurse notes leukopenia. The priority action:

A. Encourage group gatherings

B. Monitor for fever and infection
C. Provide NSAIDs
D. Give live vaccines
Answer: B
Rationale: ↑ infection risk → frequent monitoring needed.
Bloom: Apply

44. A tumor described as “carcinoma in situ” means:

A. Fully metastasized
B. Invasive into distant organs
C. Confined to original location
D. Benign only
Answer: C
Rationale: Pre-invasive localized stage.
Bloom: Understand

45. A patient with a suspicious breast lump undergoes needle biopsy. This is:

A. Tertiary prevention
B. Secondary prevention
C. Primary prevention
D. No prevention stage
Answer: B
Rationale: Detecting disease at early stage.
Bloom: Understand

46. Which is an early warning sign of leukemia?

A. New skin lesion changes

B. Painless breast lump
C. Frequent infections and bruising
D. Difficulty swallowing
Answer: C
Rationale: Bone marrow failure → ↓ RBC/WBC/platelets.
Bloom: Apply

47. A tumor that arises from connective tissue is:

A. Leukemia
B. Carcinoma
C. Sarcoma
D. Melanoma
Answer: C
Rationale: Sarcomas = malignant tumors of connective tissue.
Bloom: Remember

48. Oncogenesis is BEST defined as:

A. Programmed cell death

B. Normal cellular repair
C. Process of tumor development
D. Immune surveillance failure
Answer: C
Rationale: Involves mutation → proliferation → invasion.
Bloom: Remember
49. A modifiable risk factor for lung cancer is:

A. Age
B. Genetic history
C. Smoking
D. Gender
Answer: C
Rationale: Lifestyle risk factor.
Bloom: Apply

50. A poorly differentiated tumor means:

A. Good prognosis
B. Cells resemble normal cells
C. Aggressive and malignant behavior
D. Localized tumor
Answer: C
Rationale: Dedifferentiation = ↑ malignancy.
Bloom: Understand

51. The TNM classification “T3 N1 M0” indicates:

A. Distant metastasis present

B. Small tumor, no lymph involvement
C. Large tumor with regional nodes, no metastasis
D. No evidence of cancer
Answer: C
Rationale: M0 means no metastasis.
Bloom: Analyze

52. In cancer pain management, the MOST important nursing consideration is:

A. Pain is subjective and must be believed and treated

B. Avoid opioid use
C. Wait until pain is severe
D. Focus only on non-pharmacologic interventions
Answer: A
Rationale: Pain control is priority in oncology care.
Bloom: Apply

53. Which finding supports tumor lysis syndrome?

A. Hypokalemia
B. Hyperuricemia
C. Hypophosphatemia
D. Low potassium and phosphate
Answer: B
Rationale: Cell destruction → ↑ uric acid, K+, phosphate.
Bloom: Analyze

54. A cancer patient says, “I caused this cancer myself.” Which response is MOST therapeutic?
A. “You shouldn’t think that way.”
B. “What makes you feel responsible?”
C. “Focus on treatment instead.”
D. “You need to stay positive.”
Answer: B
Rationale: Open-ended assessment supports emotional coping.
Bloom: Apply

55. A biopsy reveals mild dysplasia in the cervix. Nursing action:

A. Immediate chemotherapy
B. Surgical removal of uterus
C. Regular Pap smear follow-up
D. No further care needed
Answer: C
Rationale: Dysplasia = reversible with monitoring.
Bloom: Apply

56. Which cancer is MOST linked to HPV infection?

A. Prostate
B. Cervical
C. Brain
D. Melanoma
Answer: B
Rationale: HPV 16 & 18 major cervical carcinogens.
Bloom: Remember

57. Which condition results from DNA damage and uncontrolled growth?

A. Neoplasm
B. Normal apoptosis
C. Normal mitosis
D. Atrophy
Answer: A
Rationale: Neoplasia = abnormal proliferation due to mutations.
Bloom: Understand

58. Which assessment requires urgent reporting in neutropenic patient?

A. Fatigue
B. Fever 38°C (100.4°F)
C. Decreased appetite
D. Alopecia
Answer: B
Rationale: Fever → sepsis risk due to low immunity. PRIORITY
Bloom: Apply

59. Which is consistent with cachexia?

A. Sudden weight gain

B. Increased appetite
C. Muscle wasting and weight loss
D. Improved strength
Answer: C
Rationale: Wasting due to metabolic changes and tumor factors.
Bloom: Understand

60. A benign tumor characteristic:

A. Non-encapsulated
B. Spreads via blood
C. Similar to normal cells
D. Poor prognosis
Answer: C
Rationale: Well-differentiated, non-metastatic.
Bloom: Remember

61. A client on chemotherapy has platelets 15,000/µL. Which is priority?

A. Encourage brushing teeth hard

B. Avoid invasive procedures
C. Provide anticoagulants
D. Allow contact sports
Answer: B
Rationale: Severe thrombocytopenia → high bleeding risk. PRIORITY
Bloom: Apply

62. Which carcinogen is linked to hepatocellular carcinoma?

A. UV light
B. Aflatoxin (mold-contaminated food)
C. HPV
D. Asbestos
Answer: B
Rationale: Aflatoxins cause liver cancer.
Bloom: Understand

63. Which individualized factor increases cancer risk the MOST?

A. Gender
B. Age > 65
C. Shoe size
D. Eye color
Answer: B
Rationale: Cancer incidence increases with aging.
Bloom: Remember

64. Most effective teaching to prevent skin cancer:

A. UV exposure daily
B. Avoid sunscreen
C. Wear protective clothing outdoors
D. Increase tanning bed use
Answer: C
Rationale: UV radiation is major skin cancer risk factor.
Bloom: Apply

65. Which is a hallmark of cancer cells?

A. Contact inhibition
B. Controlled proliferation
C. Ability to evade apoptosis
D. Normal differentiation
Answer: C
Rationale: Cancer cells avoid programmed death → survival advantage.
Bloom: Analyze

67. Early warning sign of colorectal cancer:

A. Heavy menstrual bleeding

B. Change in stool characteristics
C. Jaw pain
D. Decreased urination
Answer: B
Rationale: Bowel habit change is a classic symptom.
Bloom: Understand

68. Which is TRUE about metastasis?

A. Always slow
B. Malignant cells invade distant tissues
C. Localized only
D. Occurs in benign tumors
Answer: B
Rationale: Defines malignancy progression.
Bloom: Remember

69. Cancer cells’ uncontrolled growth is mainly due to:

A. Balanced cell cycle

B. Tumor suppressor genes activation
C. Oncogene activation
D. Lack of telomerase
Answer: C
Rationale: Mutated proto-oncogenes → uncontrolled proliferation.
Bloom: Analyze

70. Example of tertiary cancer prevention:

A. HPV vaccination
B. Chemotherapy and radiation therapy
C. PSA screening
D. Smoking cessation counseling
Answer: B
Rationale: Tertiary = treatment and prevention of complications.
Bloom: Understand

71. A nurse is educating on carcinogens. Which statement is correct?

A. “Only chemicals can cause cancer.”

B. “Radiation and viruses can be carcinogenic too.”
C. “Bacteria cause most cancers.”
D. “Carcinogens cannot be prevented.”
Answer: B
Rationale: Carcinogenesis may come from chemicals, radiation, viruses.
Bloom: Understand