Which characteristic identifies a tumor as malignant rather than benign?
It invades nearby tissue and can spread to distant sites
✓
It grows slowly and stays within a defined area
It causes symptoms by pressing on nearby structures
It forms a mass that can be seen on imaging
Correct Answer
It invades nearby tissue and can spread to distant sites
A malignant tumor grows uncontrollably, invades surrounding tissue and can spread through the blood or lymphatic system, which makes it a threat wherever it is located. Growing slowly and staying within a defined area describes a benign tumor. Causing symptoms by pressing on nearby structures can happen with benign and malignant tumors alike. Forming a mass that can be seen on imaging is true of both types, so it does not tell them apart.
Category: Cancer Biology
Question 2
A patient treated for breast cancer develops a mass in the spine, and a biopsy of that mass shows breast cancer cells. How is this cancer described?
Primary bone cancer of the spine
Breast cancer that has metastasized to bone
✓
A new bone sarcoma unrelated to the breast
Bone cancer that has spread to the breast
Correct Answer
Breast cancer that has metastasized to bone
A cancer keeps the name of the site where it began, even after it spreads, so breast cancer cells found in the spine are metastatic breast cancer. Primary bone cancer of the spine would contain cells that arose from bone, not from breast tissue. A new bone sarcoma unrelated to the breast would arise from connective tissue cells rather than breast cells. Bone cancer that has spread to the breast reverses the direction of spread that the biopsy shows.
Category: Cancer Biology
Question 3
During a health-promotion visit, which of the patient's cancer risk factors can be reduced through teaching?
Older age
A family history of colon cancer
Heavy alcohol use
✓
Biological sex
Correct Answer
Heavy alcohol use
Alcohol use is a modifiable risk factor, so teaching that helps the patient cut back or stop lowers cancer risk. Older age is nonmodifiable, because DNA errors build up over a lifetime. A family history of colon cancer reflects inherited risk that cannot be changed, although it does guide screening. Biological sex is also a nonmodifiable factor.
Category: Detection and Staging
Question 4
A patient with neutropenia after chemotherapy develops a new fever, and the provider orders blood cultures and an intravenous antibiotic. Which approach is correct?
Waiting for the culture results before starting the antibiotic
Giving a fever reducer and rechecking the temperature before acting
Starting the antibiotic and drawing cultures at the next routine lab draw
Drawing the cultures and then giving the antibiotic without delay
✓
Correct Answer
Drawing the cultures and then giving the antibiotic without delay
Fever in a patient with neutropenia can signal an infection that quickly progresses to septic shock, so cultures are drawn first to identify the organism and the antibiotic is then started promptly. Waiting for the culture results before starting the antibiotic delays treatment of a possibly life-threatening infection. Giving a fever reducer and rechecking the temperature before acting also delays care and can mask the fever. Starting the antibiotic and drawing cultures at the next routine lab draw lowers the chance that the cultures will grow and identify the organism.
Category: Oncologic Emergencies
Question 5
Which finding in an adult should prompt the nurse to recommend an evaluation for cancer?
Unintentional weight loss with fatigue that rest does not relieve
✓
Muscle soreness the day after a hard workout
Tiredness after a single night of poor sleep
Weight gain over a holiday season
Correct Answer
Unintentional weight loss with fatigue that rest does not relieve
Sudden, unintentional weight loss and persistent fatigue that is out of proportion to activity are common nonspecific signs of cancer and call for further evaluation. Muscle soreness the day after a hard workout is an expected response to exercise. Tiredness after a single night of poor sleep has an obvious cause and resolves with rest. Weight gain over a holiday season reflects intake rather than an unexplained change.
Category: Detection and Staging
Question 6
Which adult is the best candidate for lung cancer screening with low-dose computed tomography?
A nonsmoker with seasonal allergies
A long-time heavy smoker
✓
A young adult with mild asthma
A person recovering from pneumonia
Correct Answer
A long-time heavy smoker
Low-dose CT screening is recommended for people at high risk because of a long smoking history or other long-term inhaled chemical exposure. It is not routine for a nonsmoker with seasonal allergies, who has no added lung cancer risk. A young adult with mild asthma does not meet the risk criteria for screening. A person recovering from pneumonia may need follow-up for the infection, but pneumonia alone is not a reason for lung cancer screening.
Category: Detection and Staging
Question 7
A patient receiving ordered treatment for spinal cord compression from a tumor still has the same back pain and leg weakness when improvement was expected. Which nursing action is appropriate?
Continuing to wait, since some patients improve slowly
Documenting the findings without further action
Verifying that every ordered treatment was given and reporting the lack of response
✓
Increasing the dose of the patient's current medication
Correct Answer
Verifying that every ordered treatment was given and reporting the lack of response
Evaluating outcomes includes asking why an expected response did not happen, which can uncover a missed or overlooked order, and the provider needs to know that treatment is not working. Continuing to wait, since some patients improve slowly, risks permanent nerve damage from an untreated emergency. Documenting the findings without further action leaves the problem unaddressed. Increasing the dose of the patient's current medication requires a new provider order and is outside nursing scope.
Category: Oncologic Emergencies
Question 8
A patient in a long hospital stay for leukemia treatment snaps at staff and says, "Everything is just done to me." Which nursing approach addresses this concern?
Limiting conversation to required care tasks
Asking the provider for a sedative
Assigning a different nurse each shift
Involving the patient in planning care and explaining each procedure beforehand
✓
Correct Answer
Involving the patient in planning care and explaining each procedure beforehand
Feeling that care is done to them rather than with them threatens a patient's dignity and sense of control, so including the patient in decisions and explaining care before it happens restores respect and boundaries. Limiting conversation to required care tasks deepens the sense of being processed rather than cared for. Asking the provider for a sedative treats a reasonable frustration as behavior to suppress. Assigning a different nurse each shift removes continuity and makes trust harder to build.
Category: Survivorship and Support
Question 9
A biopsy report describes a cervical lesion as carcinoma in situ. What does this mean?
Abnormal cells remain in the layer where they began and have not invaded
✓
The cancer has spread to nearby lymph nodes
The cancer has spread to distant organs
The lesion is benign and needs no follow-up
Correct Answer
Abnormal cells remain in the layer where they began and have not invaded
Carcinoma in situ describes abnormal cells found only in their place of origin, without invasion of the surrounding tissue. Spread to nearby lymph nodes means the cancer has moved beyond its original layer, so it is no longer in situ. Spread to distant organs is metastasis, a much more advanced stage. Calling the lesion benign and in no need of follow-up is wrong, because in situ cells are abnormal and need treatment and monitoring.
Category: Detection and Staging
Question 10
A patient receiving chemotherapy reports constant tiredness that sleep does not relieve. Which intervention has the strongest evidence for reducing cancer-related fatigue?
Strict bed rest until treatment ends
Regular physical activity balanced with rest
✓
Extra caffeinated drinks during the day
Long naps throughout the afternoon
Correct Answer
Regular physical activity balanced with rest
Regular physical activity is the intervention with consistent evidence for reducing cancer-related fatigue, and it is balanced with rest and planned with safety in mind. Strict bed rest until treatment ends causes deconditioning that makes fatigue worse. Extra caffeinated drinks during the day can disrupt sleep and do not treat the underlying fatigue. Long naps throughout the afternoon can interfere with nighttime sleep without addressing the cause.
Category: Symptom Management
Question 11
A patient receiving chemotherapy becomes nauseated at mealtimes. Which nursing action helps?
Serving foods steaming hot to boost appetite
Offering one large meal instead of several small ones
Removing the tray cover before bringing the meal into the room
✓
Having the patient lie flat right after eating
Correct Answer
Removing the tray cover before bringing the meal into the room
Steam trapped under a tray cover carries strong food odors that can trigger nausea, so the cover is taken off before the tray is brought into the room. Serving foods steaming hot to boost appetite intensifies odors, and cold foods are often better tolerated. Offering one large meal instead of several small ones overfills the stomach and worsens nausea. Having the patient lie flat right after eating raises the risk of vomiting and aspiration.
Category: Symptom Management
Question 12
What is the goal of platelet transfusion for a patient with chemotherapy-induced thrombocytopenia?
Returning the platelet count to normal
Preventing infection while counts are low
Correcting the patient's anemia
Preventing or controlling bleeding
✓
Correct Answer
Preventing or controlling bleeding
Platelets are transfused to raise the count only enough to prevent serious bleeding or to stop active bleeding, not to bring it back into the reference range. Returning the platelet count to normal is therefore not the target of the transfusion. Preventing infection while counts are low depends on neutrophils, not platelets. Correcting the patient's anemia requires red blood cells.
Category: Symptom Management
Question 13
A patient who recently finished chemotherapy says, "I keep losing track of what I'm doing, and last week I left a pan burning on the stove." Which nursing action is appropriate?
Planning memory aids and safer cooking habits for treatment-related memory changes
✓
Explaining that these changes prove the cancer has spread to the brain
Telling the patient that memory problems do not follow chemotherapy
Advising the patient to avoid friends until thinking becomes clearer
Correct Answer
Planning memory aids and safer cooking habits for treatment-related memory changes
Chemotherapy can cause cognitive changes, sometimes called chemo brain, that affect memory and attention, and they become a safety issue during tasks such as cooking or driving, so the nurse helps the patient build a plan with memory aids and safer routines. Explaining that the changes prove the cancer has spread to the brain is wrong, because treatment itself commonly causes them, although new or worsening symptoms are still reported for evaluation. Telling the patient that memory problems do not follow chemotherapy dismisses a recognized side effect. Advising the patient to avoid friends deepens the social isolation that memory difficulty can already cause.
Category: Symptom Management
Question 14
A patient with acute leukemia is starting induction chemotherapy and is at risk for tumor lysis syndrome. Which nursing measure is a priority?
Restricting fluids to prevent overload
Giving intravenous fluids and closely measuring urine output
✓
Giving potassium supplements with meals
Delaying lab checks until the treatment course ends
Correct Answer
Giving intravenous fluids and closely measuring urine output
When chemotherapy destroys large numbers of cancer cells at once, potassium, phosphate and uric acid flood the blood, so aggressive IV hydration and strict monitoring of urine output help the kidneys clear them. Restricting fluids to prevent overload would concentrate these substances and raise the risk of kidney injury. Giving potassium supplements with meals is dangerous because tumor lysis already raises serum potassium. Delaying lab checks until the treatment course ends would miss electrolyte changes that need frequent monitoring.
Category: Oncologic Emergencies
Question 15
A patient with lung cancer develops swelling of the face and neck, a cough and shortness of breath at rest. Which oncologic emergency does the nurse suspect?
Spinal cord compression
Tumor lysis syndrome
Superior vena cava syndrome
✓
Hyperviscosity syndrome
Correct Answer
Superior vena cava syndrome
A tumor pressing on the superior vena cava blocks blood returning from the head, neck and arms, causing facial and neck swelling, cough and dyspnea at rest, and lung cancer is a common cause. Spinal cord compression presents with back pain and later weakness, sensory changes and bladder or bowel problems. Tumor lysis syndrome causes electrolyte imbalances after cancer cells break down, not facial swelling. Hyperviscosity syndrome causes headache and dizziness from thickened blood.
Category: Oncologic Emergencies
Question 16
A patient with prostate cancer that has spread to the spine is at risk for spinal cord compression. Which symptom is often the earliest sign?
Loss of bladder control
Weakness of both legs
Numbness in the feet
New or worsening back pain
✓
Correct Answer
New or worsening back pain
Back pain is typically the first sign of spinal cord compression, and recognizing it early allows treatment before nerve damage becomes permanent. Loss of bladder control appears later as the compression progresses. Weakness of both legs is a later finding that signals advancing compression. Numbness in the feet also develops after pain, as sensory pathways become affected.
Category: Oncologic Emergencies
Question 17
How should the nurse handle linens and waste from the room of a patient with a sealed radioactive implant?
Keeping them in the room until the radiation safety team clears them
✓
Sending them directly to the regular hospital laundry
Double-bagging them and leaving them in the hallway
Discarding them with the regular trash
Correct Answer
Keeping them in the room until the radiation safety team clears them
A sealed source can become dislodged and end up in bedding or waste, so linens and trash stay in the room until radiation safety staff check them. Sending them directly to the regular hospital laundry could carry a radioactive source out of the controlled area. Double-bagging them and leaving them in the hallway exposes people outside the room. Discarding them with the regular trash risks losing the source and exposing others.
Category: Radiation and Treatment Care
Question 18
During an immunotherapy infusion, a patient develops hives, low blood pressure and wheezing. What does the nurse recognize?
Expected flu-like effects that need no action
A hypersensitivity reaction
✓
Tumor lysis syndrome
Fluid volume overload
Correct Answer
A hypersensitivity reaction
Urticaria, hypotension and bronchospasm during an immunotherapy infusion signal a hypersensitivity reaction, which calls for the facility's reaction protocol. Labeling these as expected flu-like effects that need no action is wrong, because flu-like effects do not include hives, falling blood pressure and wheezing. Tumor lysis syndrome produces electrolyte disturbances rather than hives. Fluid volume overload causes crackles and edema, not urticaria.
Category: Radiation and Treatment Care
Question 19
After a stem cell transplant from a donor, a patient develops a skin rash, diarrhea and abnormal liver tests. Which complication does the nurse suspect?
Radiation dermatitis
Tumor lysis syndrome
Graft-versus-host disease
✓
Febrile neutropenia
Correct Answer
Graft-versus-host disease
In graft-versus-host disease, immune cells from the donor attack the recipient's tissues, commonly the skin, the gut and the liver, so this pattern after a donor transplant is a warning sign. Radiation dermatitis is limited to the skin in a treatment field and does not cause diarrhea or liver changes. Tumor lysis syndrome causes electrolyte imbalances after cancer cells break down. Febrile neutropenia is a fever with a low neutrophil count and does not explain diarrhea with abnormal liver tests.
Category: Radiation and Treatment Care
Question 20
A survivor who had chest radiation and chemotherapy for lymphoma long ago now has heart muscle damage. How is this problem classified?
An acute side effect of radiation
A recurrence of the original cancer
A hypersensitivity reaction
A late effect of cancer treatment
✓
Correct Answer
A late effect of cancer treatment
A late effect is a health problem that appears long after cancer treatment has ended, and cardiomyopathy is a known example after chest radiation and some chemotherapy. An acute side effect of radiation appears during or soon after treatment. A recurrence of the original cancer means the lymphoma has returned, not that the heart muscle is damaged. A hypersensitivity reaction is an immediate immune response, not delayed organ damage.
Category: Survivorship and Support