Republic of the Philippines
SAMAR STATE UNIVERSITY
COLLEGE OF NURSING AND HEALTH SCIENCES
Catbalogan City, Samar
FINAL EXAMINATION IN NCM 106 (Care of Clients with Problems in
Cellular Aberrations- ONCOLOGY and Acute Biologic Crisis)
1. The nurse on duty is discussing the pathophysiology related to leukemia with a
class of nursing student. Which statement made by a nursing student indicates a
lack of understanding of the pathophysiology of this disease?
A. Normal bone marrow is replaced by blast cells
B. Red blood cell production is affected
C. The platelet count is decreased
D. The presence of Reed- Sternberg cell is found on biopsy
2. A 4-year old is admitted to the hospital for abdominal pain. The mother reports
that the child has been pale and excessively tired and bruising easily. On
physical examination, lymphadenopathy and hepatospenomegaly are noted.
Diagnostic studies are being performed on the child because acute lymphocytic
leukemia is suspected. The nurse understands that which diagnostic study will
confirm this diagnosis?
A. White blood cell count
B. A lumbar puncture
C. Bone marrow biopsy
D. A platelet count
3. A nurse instructs the parents of a child with leukemia regarding measures related
to monitoring for infection. Which statement if made by a parent indicates a need
for further instruction?
A. “I will perform proper hand washing techniques”
B. “I will take rectal temperature daily”
C. “I will inspect the skin daily for redness”
D. “I will inspect the mouth daily for lesions”
4. The nurse analyzes the laboratory values of a patient with leukemia who is
receiving chemotherapy. The nurse notes that the platelet count is 20, 000cell/ µl.
based on this laboratory result, which nursing intervention will the nurse
document in the plan of care?
A. Initiate protective isolation precautions
B. Monitor temperature every 4 hours
C. Monitor closely for signs of infection
D. Use of soft small toothbrush for mouth care
Republic of the Philippines
SAMAR STATE UNIVERSITY
COLLEGE OF NURSING AND HEALTH SCIENCES
Catbalogan City, Samar
FINAL EXAMINATION IN NCM 106 (Care of Clients with Problems in
Cellular Aberrations- ONCOLOGY and Acute Biologic Crisis)
5. The nurse is monitoring the laboratory results of a client preparing to receive
chemotherapy. The nurse would determine that the white blood cell is normal if
which of the following results were present?
A. 3000 to 8000 cells/mm3
B. 5000 to 10000 cells/mm3
C. 7000 to 15000 cells/mm3
D. 2000 to 5000 cells/mm3
6. A patient with leukemia is complaining of nausea. A nurse suspects that the
nausea is related to the chemotherapy. The nurse, concerned about the child’s
nutritional status, most appropriately would offer which of the following during the
episode of nausea?
A. The patient’s favorite food
B. Cool, clear liquid
C. Low- protein food
D. Low- calorie food
7. A client with cancer who is receiving chemotherapy tells the nurse that the food
on the meal tray “tastes funny”. Which intervention by the nurse is appropriate?
A. Keep the client NPO
B. Administer antiemetic as tolerated
C. Provide oral hygiene care
D. Obtain order for TPN
8. A nurse instructs a client about the procedure to perform the BSE. Which client
statement indicates a need for further instructions?
A. “I don’t need to do that. I’m too old for that”
B. “I do BSE 7 days after I get my period”
C. “I examine my breasts in the shower”
D. “I lie on my back to examine my breasts”
9. A client calls the ambulatory care clinic and tells the nurse that she found an area
that looks like the peel of an orange when performing BSE, but found other
changes. The nurse should:
A. Tell the client there is nothing to worry about
B. Arrange for the client to be seen at the clinic as soon as possible
C. Tell the client to take her temperature and call back if she has a fever
Republic of the Philippines
SAMAR STATE UNIVERSITY
COLLEGE OF NURSING AND HEALTH SCIENCES
Catbalogan City, Samar
FINAL EXAMINATION IN NCM 106 (Care of Clients with Problems in
Cellular Aberrations- ONCOLOGY and Acute Biologic Crisis)
D. Tell the client to point the area out to the physician at her next regularly
scheduled appointment
10. A nurse is performing an admission assessment on a client admitted with newly
diagnosed Hodgkin’s disease. Which of the following would the nurse expect the
client to report?
A. Night sweats
B. Severe lymph node pain
C. Weight gain
D. Headache with minor visual changes
11. Mr. Ramos with leukemia is hospitalized and is receiving combination therapy.
Laboratory results indicate that he is neutropenic, and protective isolation
procedures are initiated. The child of the patient visits and brings a fresh bouquet
of flowers picked from their garden and asks the nurse for a vase for the flowers.
The nurse responds to the grandmother by telling her:
A. “I have a vase in the utility room, and I will get it for you”
B. “The flowers from your garden are beautiful but should not be placed in your
father’s room at this time”
C. “I will get a vase and wash it well before you put the flowers in”
D. “When you bring the flowers into the room, place them on the bedside stand
as far away from your child as possible”
12. A nurse is caring for a patient after surgical removal of one entire lung. Which
nursing intervention would the nurse give highest priority?
A. Monitor vital signs
B. Maintain the chest tube drainage system, which will drain air and blood that
accumulate in the pleural space
C. Assess cardiac and respiratory status, monitor for the absence and presence
of lung sounds
D. Monitor neurovital signs every 10-15 minutes
13. The nurse is caring for a client experiencing hematologic toxicity as a result of
chemotherapy. The nurse develops a plan of care for the client. The nurse plans
to:
A. Restrict all visitors
B. Restrict fluid intake
C. Insert an indwelling urinary catheter to prevent skin breakdown
Republic of the Philippines
SAMAR STATE UNIVERSITY
COLLEGE OF NURSING AND HEALTH SCIENCES
Catbalogan City, Samar
FINAL EXAMINATION IN NCM 106 (Care of Clients with Problems in
Cellular Aberrations- ONCOLOGY and Acute Biologic Crisis)
D. Restrict fresh and vegetable diet
14. The nurse is reviewing the laboratory results of the client receiving
chemotherapy. The platelet count is 10, 000 cells/mm3. Based on the laboratory
value, the priority nursing assessment is which of the following?
A. Assess level of consciousness
B. Assess temperature
C. Assess bowel sounds
D. Assess skin turgor
15. The nurse is caring for a client following a modified radical mastectomy. Which
assessment finding would indicate that the client is experiencing a complication
related to surgery?
A. Sanguineous drainage in the Jackson- Pratt drain
B. Pain at the incisional site
C. Complaints of decreased sensation near the operative site
D. Arm edema on the operative site
16. Betsy is performing an arm exercise 2 days after surgery (radical mastectomy).
Which of the following performance would alert the nurse?
A. Maintaining adduction position of the arm
B. Deep breathing
C. Lifting clasped hands
D. Pulley or rope pulling
17. A nurse is caring for a client admitted to the surgical nursing unit following right
modified radical mastectomy. The nurse includes which of the following in the
nursing plan of care for this client?
A. Position the client supine with right arm elevated on a pillow
B. Take BP in the right arm only
C. Draw serum laboratory samples from the right arm only
D. Check the right posterior axilla area when assessing the surgical dressing
18. Which family member should not be permitted to visit a patient with newly
diagnosed leukemia?
A. The one who has a new baby at home
B. The one with history of asthma
C. The one who has received recent radiation treatment for cancer
D. The one who has a runny nose
Republic of the Philippines
SAMAR STATE UNIVERSITY
COLLEGE OF NURSING AND HEALTH SCIENCES
Catbalogan City, Samar
FINAL EXAMINATION IN NCM 106 (Care of Clients with Problems in
Cellular Aberrations- ONCOLOGY and Acute Biologic Crisis)
19. A client has had a left mastectomy with axillary lymph node dissection. The nurse
determines that the client understands postoperative restrictions and arm care if
the client states to:
A. Use straight razor to shave under the arms
B. Allow blood pressure to be taken only on the left arm
C. Carry a handbag and heavy objects on the left arm
D. Use gloves when working in the garden
20. A nurse is developing a plan of care for a client being admitted to the hospital
who is immunosupressed and will be placed on neutropenic precautions. With
regard to neutropenic precautions, which intervention is incorrect?
A. Placing a mask on the client if the client leaves the room
B. Removing a vase with fresh flowers left by a previous client
C. Admitting the client to a semi- private room
D. Placing a precaution sign on the door to the room
21. A nurse receives a telephone call from the hospital admission office and is
informed that the client is being admitted who will undergo implantation of sealed
internal radiation source. The nurse asks the admission office clerk if which of the
following rooms is selected for the client?
A. A single room at the distant end of the hall
B. A single room near the nurse’s station
C. A semiprivate room between two isolation rooms
D. A semiprivate room near the nurse’s station
22. A nurse is caring for a client with cervical cancer who has an internal radiation
implant. Which of the following required items would the nurse ensure is kept in
the client’s room during the treatment?
A. A bedside commode
B. A lead apron
C. Long- handled forceps and a lead container
D. A number 16 Foley catheter
23. A client is receiving a course of chemotherapy on an outpatient basis for the
diagnosis of lung cancer. Which home care instruction would the nurse provide to
the client?
A. A bathroom can be shared with any member of the family
Republic of the Philippines
SAMAR STATE UNIVERSITY
COLLEGE OF NURSING AND HEALTH SCIENCES
Catbalogan City, Samar
FINAL EXAMINATION IN NCM 106 (Care of Clients with Problems in
Cellular Aberrations- ONCOLOGY and Acute Biologic Crisis)
B. Urinary and bowel excreta is not considered contaminated
C. Disposable plates and plastic utensils must be used during the entire course
of chemotherapy
D. Contaminated linens should be washed separately and washed a second
time if necessary
24. A nurse reviews the record of a client receiving external radiation therapy and
notes documentation of a skin finding noted as moist desquamation. The nurse
expects to note which of the following on assessment of the client?
A. Reddened skin
B. A rash
C. Weeping of the skin
D. Dermatitis
25. A nurse is providing care to a client following a bone biopsy. Which action would
the nurse take as part of aftercare for this procedure?
A. Keep the area in dependent position
B. Monitor VS once per day
C. Monitor the site for swelling, bleeding or hematoma formation
D. Administer IM narcotic analgesic
Test II. MULTIPLE RESPONSE: (2 points each number)
26. The following are risk factors of breast cancer, EXCEPT:
A. Multiparity
B. Family history of breast cancer
C. Late menarche
D. Obesity
E. High dose radiation exposure to chest
27. The following assessments are true to breast cancer.
A. Mass felt in the upper inner quadrant
B. Nipple retraction or elevation
C. Skin dropsy
D. Symmetry of the breast
E. Clear nipple discharges
F. Presence of the lesion on mammography
Republic of the Philippines
SAMAR STATE UNIVERSITY
COLLEGE OF NURSING AND HEALTH SCIENCES
Catbalogan City, Samar
FINAL EXAMINATION IN NCM 106 (Care of Clients with Problems in
Cellular Aberrations- ONCOLOGY and Acute Biologic Crisis)
28. Risk factors of leukemia are the following, EXCEPT:
A. Medications
B. Chemicals
C. Bacterial
D. Genetic
E. Exposure to radiation
F. Immunological
29. The following are preoperative interventions to lung cancer patient, EXCEPT:
A. Assess tracheal deviation
B. Place in supine position to help ease breathing
C. Administer 1-2 L/min oxygen as prescribed
D. Monitor for breathing patterns
E. Provide a high calorie, high protein and high vitamin diet
30. A nurse is providing home care instructions to the spouse of a client who is
confused and will be cared for at home. Select all instructions that the nurse
provides to the spouse:
A. Display a calendar and a clock around the client’s room
B. Encourage frequent visits from family and friends
C. Limit the number of choices given to the client
D. Turn the lights off at dusk
E. Maintain a predictable routine
F. Use simple, clear communication
Republic of the Philippines
SAMAR STATE UNIVERSITY
COLLEGE OF NURSING AND HEALTH SCIENCES
Catbalogan City, Samar
FINAL EXAMINATION IN NCM 106 (Care of Clients with Problems in
Cellular Aberrations- ONCOLOGY and Acute Biologic Crisis)
Prepared by: Maricel M. Tizon, MAN, RN
Name: _____________________ December 28, 2020
1. 11. 21.
2. 12. 22.
3. 13. 23.
4. 14. 24.
5. 15. 25.
6. 16. 26.
7. 17. 27.
8. 18. 28.
9. 19. 29.
10. 20. 30.
“work+time+faith= RESULTS. YOU MUST NOT GIVE UP YOUR FAITH. BELIEVING IS
SEEING!”