MSN Exam for Bladder Cancer

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1) A client with bladder cancer is being treated with iridium seed implants. The nurse’s discharge teaching should include telling the client to:

  1. Strain his urine
  2. Increase his fluid intake
  3. Report urinary frequency
  4. Avoid prolonged sitting

2) Aniline dyes have been linked to cancer

  1. true
  2. false

3) Does not respond at all to radiation

  1. grade 2
  2. grade 3
  3. grade 1
  4. grade 4

4) Occupational exposure to pizza making has been linked to bladder cancer

  1. true
  2. false

5) Toxicity levels are unacceptable if the patient is worse off then before treatment

  1. true
  2. false

6) Superficial bladder cancer can be treated by direct instillation of the antineoplastic antibiotic agent mitomycin (Mutamycin). This process is termed:

  1. Intraventricular administration
  2. Intravesical administration
  3. Intravascular administration
  4. Intrathecal administration

7) very low degree of malignancy

  1. grade 2
  2. grade 3
  3. grade 1
  4. grade 4

8) A client has been diagnosed as having bladder cancer, and a cystectomy and an ileal conduit are scheduled. Preoperatively, the nurse plans to:

  1. Limit fluid intake for 24 hours
  2. Teach the procedure for irrigation of the stoma
  3. Teach muscle-tightening exercises
  4. Provide cleansing enemas and laxatives as ordered

9) anticholinergics

  1. drugs that decrease bladder outlet resistance
  2. drugs that simulate detrusor contractility and promote bladder emptying
  3. drugs that inhibit contractility and promote urine storage
  4. drugs that increase bladder outlet resistance

10) What is the most common type of Bladder Cancer?

  1. Squamous Cell Carcinoma
  2. Transistional cell carcinoma
  3. Epithelial hyperplasia

11) Can coffee cause bladder tumors?

  1. yes
  2. no

12) How does bladder cancer rate on the most commonly occurring GU cancer in adults list?

  1. 1st
  2. 2nd
  3. 4th
  4. 8th

13) Well differentiated but fully malignant

  1. grade 1
  2. grade 2
  3. grade 3
  4. grade 4

14) Recurring UTI, N/V and leukopenia are all adverse reactions to Chemotherapy and what else is one?

  1. fistula’s
  2. BPH
  3. Penile Prosthetic
  4. nephrotoxicity

15) Beta-adrenergics

  1. drugs that increase bladder outlet resistance
  2. drugs that inhibit contractility and promote urine storage
  3. drugs that simulate detrusor contractility and promote bladder emptying
  4. drugs that decrease bladder outlet resistance

16) Response is poor to radiation

  1. grade 3
  2. grade 1
  3. grade 2
  4. grade 4

17) The female client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing:

  1. Rupture of the bladder
  2. The development of a vesicovaginal fistula
  3. Extreme stress caused by the diagnosis of cancer
  4. Altered perineal sensation as a side effect of radiation therapy

18) What would be a indication to use Chemotherapy?

  1. complete resolution of abnormal serum tumor markers
  2. location of tumor
  3. chronic reflux
  4. N/V
  5. Recurring CIS

19) High degree of malignancy, usually anaplastic CA

  1. grade 2
  2. grade 1
  3. grade 4
  4. grade 3

20) Transitional cell carcinoma (TCC) is

  1. a poorly differentiated carcinoma often without any papillary growth
  2. a benign proliferation of urothelium in response to inflammation or irritation
  3. a type of malignancy that arises from the urothelial lining of the urinary tract
  4. a cancerous growth on the urothelium causing disintegration of the bladder wall and urothelium.

21) What is a random bladder biopsy done for?

  1. stage and grade verification
  2. invasive
  3. noninvasive
  4. smaller tumors
  5. stages T1-T4

22) From below what are symptoms of bladder cancer? (Choose answer that apply)

  1. painful hematuria
  2. frequency and urgency
  3. dysuria
  4. flank pain
  5. abdominal pain

23) estrogens

  1. drugs that simulate detrusor contractility and promote bladder emptying
  2. drugs that increase bladder outlet resistance
  3. drugs that decrease bladder outlet resistance
  4. drugs that inhibit contractility and promote urine storage

24) drugs that decrease bladder outlet resistance

  1. alpha-adrenergics blockers
  2. Estrogens
  3. beta-adrenergics
  4. alpa-adrenergics

25) The health of the patient is a factor in deciding to use or not to use Chemo

  1. true
  2. false

26) Does respond to radiation

  1. grade 3
  2. grade 4
  3. grade 2
  4. grade 1

27) Beta-adrenergic blockers

  1. drugs that increase bladder outlet resistance
  2. drugs that decrease bladder outlet resistance
  3. drugs that simulate detrusor contractility and promote bladder emptying
  4. drugs that inhibit contractility and promote urine storage

28) Alpha-adrenergics

  1. drugs that inhibit contractility and promote urine storage
  2. drugs that decrease bladder outlet resistance
  3. drugs that simulate detrusor contractility and promote bladder emptying
  4. drugs that increase bladder outlet resistance

29) A male client is being transferred to the nursing unit for admission after receiving a radium implant for bladder cancer. The nurse in-charge would take which priority action in the care of this client?

  1. Place client on reverse isolation.
  2. Admit the client into a private room.
  3. Encourage the client to take frequent rest periods.
  4. Encourage family and friends to visit.

30) lowest degree of malignancy

  1. grade 1
  2. grade 2
  3. grade 3
  4. grade 4

31) Resistant

  1. grade 1
  2. grade 2
  3. grade 3
  4. grade 4

32) Cigarette smoking can cause bladder cancer, but at what ratio to non-smokers?

  1. 3 times greater
  2. 4 times greater
  3. 5 times greater
  4. 2 times greater

33) most frequent presenting symptom is?

  1. painless hematuria
  2. flank pain due to ureteral obstruction or pelvic mass
  3. frequency
  4. constipation

34) Occupational exposure to aromatic amines cannot cause cancer

  1. true
  2. false

35) How many grades of cancer are there?

  1. 5
  2. 4
  3. 3
  4. 6
  5. 8

36) What percentage of bladder cancers does squamous cell carcinoma account for?

  1. 3%
  2. 5%
  3. 50%
  4. 95%
  5. 75%

37) Mr. Pablo, diagnosed with Bladder Cancer, is scheduled for a cystectomy with the creation of an ileal conduit in the morning. He is wringing his hands and pacing the floor when the nurse enters his room. What is the best approach?

  1. “Good evening, Mr. Pablo. Wasn’t it a pleasant day, today?”
  2. “Mr, Pablo, you must be so worried, I’ll leave you alone with your thoughts.
  3. “Mr. Pablo, you’ll wear out the hospital floors and yourself at this rate.”
  4. “Mr. Pablo, you appear anxious to me. How are you feeling about tomorrow’s surgery?”

38) Tricyclic antidepressants

  1. drugs that inhibit contractility and promote urine storage
  2. drugs that increase bladder outlet resistance
  3. drugs that simulate detrusor contractility and promote bladder emptying
  4. drugs that decrease bladder outlet resistance

39) A male client with bladder cancer has had the bladder removed and an ileal conduit created for urine diversion. While changing this client’s pouch, the nurse observes that the area around the stoma is red, weeping, and painful. What should nurse Katrina conclude?

  1. The skin wasn’t lubricated before the pouch was applied.
  2. The pouch faceplate doesn’t fit the stoma.
  3. A skin barrier was applied properly.
  4. Stoma dilation wasn’t performed.

40) cholinergics

  1. drugs that increase bladder outlet resistance
  2. drugs that inhibit contractility and promote urine storage
  3. drugs that simulate detrusor contractility and promote bladder emptying
  4. drugs that decrease bladder outlet resistance

41) Drugs that inhibit contractility and promote urine storage

  1. antispasmodics
  2. alpa-adrenergics
  3. cholinergics
  4. external sphincter/striated muscle relaxent

42) A male client is receiving the cell cycle–nonspecific alkylating agent thiotepa (Thioplex), 60 mg weekly for 4 weeks by bladder instillation as part of a chemotherapeutic regimen to treat bladder cancer. The client asks the nurse how the drug works. How does thiotepa exert its therapeutic effects?

  1. It interferes with deoxyribonucleic acid (DNA) replication only.
  2. It interferes with ribonucleic acid (RNA) transcription only.
  3. It interferes with DNA replication and RNA transcription.
  4. It destroys the cell membrane, causing lysis.

43) artificial sweeteners, pelvic irradiation and chronic cystitis can’t cause cancer

  1. true
  2. false

44) higher levels of toxicity are acceptable if the cure can be achieved?

  1. true
  2. false
Answers and Rationales
  1. A. Strain his urine . Iridium seeds can be expelled during urination, so the client should be taught to strain his urine and report to the doctor if any of the seeds are expelled. Increasing fluids, reporting urinary frequency, and avoiding prolonged sitting are not necessary
  2. A. true 
  3. D. grade 4 
  4.  B. false 
  5. A. true 
  6. B. Intravesical administration. Medications administered intravesically are instilled into the bladder. Intraventricular administration involves the ventricles of the brain. Intravascular administration involves blood vessels. Intrathecal administration involves the fluid surrounding the brain and spinal cord.
  7. A. grade 2 
  8. D. Provide cleansing enemas and laxatives as ordered 
  9. C. drugs that inhibit contractility and promote urine storage 
  10. B. Transistional cell carcinoma 
  11. A. yes 
  12. B. 2nd
  13. C. grade 3 
  14. D. nephrotoxicity 
  15. B. drugs that inhibit contractility and promote urine storage 
  16. C. grade 2 
  17. B. The development of a vesicovaginal fistula. A vesicovaginal fistula is a genital fistula that occurs between the bladder and vagina. The fistula is an abnormal opening between these two body parts and, if this occurs, the client may experience drainage of urine through the vagina.
  18. A. complete resolution of abnormal serum tumor markers, B. location of tumor 
  19. C. grade 4 
  20. C. a type of malignancy that arises from the urothelial lining of the urinary tract
  21. A. stage and grade verification 
  22. B. frequency and urgency, C. dysuria, D. flank pain
  23. B. drugs that increase bladder outlet resistance 
  24. A. alpha-adrenergics blockers 
  25. A. true 
  26. A. grade 3 
  27. A. drugs that increase bladder outlet resistance 
  28. D. drugs that increase bladder outlet resistance
  29. B. Admit the client into a private room. The client who has a radiation implant is placed in a private room and has a limited number of visitors. This reduces the exposure of others to the radiation.
  30. A. grade 1 
  31. A. grade 1 
  32. B. 4 times greater
  33. A. painless hematuria 
  34. B. false 
  35. B. 4 
  36. A. 3% 
  37. D. “Mr. Pablo, you appear anxious to me. How are you feeling about tomorrow’s surgery?”  The client is showing signs of anxiety reaction to a stressful event. Recognizing the client’s anxiety conveys acceptance of his behavior and will allow for verbalization of feelings and concerns.
  38. A. drugs that inhibit contractility and promote urine storage
  39. B. The pouch faceplate doesn’t fit the stoma. If the pouch faceplate doesn’t fit the stoma properly, the skin around the stoma will be exposed to continuous urine flow from the stoma, causing excoriation and red, weeping, and painful skin. A lubricant shouldn’t be used because it would prevent the pouch from adhering to the skin. When properly applied, a skin barrier prevents skin excoriation. Stoma dilation isn’t performed with an ileal conduit, although it may be done with a colostomy if ordered.
  40. C. drugs that simulate detrusor contractility and promote bladder emptying 
  41. A. antispasmodics
  42. C. It interferes with DNA replication and RNA transcription.Thiotepa interferes with DNA replication and RNA transcription. It doesn’t destroy the cell membrane.
  43. B. false
  44. A. true 

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