MSN Exam for Colorectal Cancer

Practice Mode – Questions and choices are randomly arranged, the answer is revealed instantly after each question, and there is no time limit for the exam.

Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam.

Text Mode – Text version of the exam

1) Before discharge, the nurse scheduled the client who had a colostomy for colorectal cancer for discharge instruction about resuming activities. The nurse should plan to help the client understands that:

1. After surgery, changes in activities must be made to accommodate for the physiologic changes caused by the operation.
2. Most sports activities, except for swimming, can be resumed based on the client’s overall physical condition.
3. With counseling and medical guidance, a near normal lifestyle, including complete sexual function is possible.
4. Activities of daily living should be resumed as quickly as possible to avoid depression and further dependency.

2) A 37-year-old client with uterine cancer asks the nurse, “Which is the most common type of cancer in women?” The nurse replies that it’s breast cancer. Which type of cancer causes the most deaths in women?

1. Breast cancer
2. Lung cancer
3. Brain cancer
4. Colon and rectal cancer

3) Which of the following characteristics are risk factors for colorectal cancer?

1. Familial polyposis
2. Age younger than 40
3. Low fat, low protein, high fiber diet
4. History of skin cancer

4) A patient received surgery and chemotherapy for colon cancer, completing therapy 3 months previously, and she is now in remission. At a follow-up appointment, she complains of fatigue following activity and difficulty with concentration at her weekly bridge games. Which of the following explanations could account for her symptoms?

1. The symptoms may be the result of anemia caused by chemotherapy.
2. The patient may be immunosuppressed.
3. The patient may be depressed.
4. The patient may be dehydrated.

5) When teaching a client about the signs of colorectal cancer, Nurse Trish stresses that the most common complaint of persons with colorectal cancer is:

1. Abdominal pain
2. Hemorrhoids
3. Change in caliber of stools
4. Change in bowel habits

6) A nurse assigned to the emergency department evaluates a patient who underwent fiberoptic colonoscopy 18 hours previously. The patient reports increasing abdominal pain, fever, and chills. Which of the following conditions poses the most immediate concern?

1. Bowel perforation.
2. Viral gastroenteritis.
3. Colon cancer.
4. Diverticulitis.

7) The nurse is interviewing a male client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer?

1. Duodenal ulcers
2. Hemorrhoids
3. Weight gain
4. Polyps

8) A temporary colostomy is performed on the client with colon cancer. The nurse is aware that the proximal end of a double barrel colostomy:

1. Is the opening on the client’s left side
2. Is the opening on the distal end on the client’s left side
3. Is the opening on the client’s right side
4. Is the opening on the distal right side

9) A client is being evaluated for cancer of the colon. In preparing the client for barium enema, the nurse should:

1. Give laxative the night before and a cleansing enema in the morning before the test
2. Render an oil retention enema and give laxative the night before
3. Instruct the client to swallow 6 radiopaque tablets the evening before the study
4. Place the client on CBR a day before the study

10) When teaching a client about the signs of colorectal cancer, Nurse Trish stresses that the most common complaint of persons with colorectal cancer is:

1. Abdominal pain
2. Hemorrhoids
3. Change in caliber of stools
4. Change in bowel habits

11) The client has a good understanding of the means to reduce the chances of colon cancer when he states:

1. “I will exercise daily.”
2. “I will include more red meat in my diet.”
3. “I will have an annual chest x-ray.”
4. “I will include more fresh fruits and vegetables in my diet.”

12) Which of the follow statements provides accurate information regarding cancer of the colon and rectum?

1. Cancer of the colon and rectum is the second most common type of internal cancer in the United States.
2. Rectal cancer affects more than twice as many people as colon cancer.
3. The incidence of colon and rectal cancer decreases with age.
4. There is no hereditary component to colon cancer.

13) Which diet is associated with an increased risk of colorectal cancer?

1. Low protein, complex carbohydrates
2. High protein, simple carbohydrates
3. High fat, refined carbohydrates
4. Low carbohydrates, complex proteins

14) Discharge instructions for a patient who has been operated on for colorectal cancer include irrigating the colostomy. The nurse knows her teaching is effective when the patient states he’ll contact the doctor if:

1. He experiences abdominal cramping while the irrigant is infusing
2. He has difficulty inserting the irrigation tube into the stoma
3. He expels flatus while the return is running out
4. He’s unable to complete the procedure in 1 hour

15) You must rearrange the room assignment for several clients. Which two clients would best suited to put in the same room? (Choose the letter that applies).

1. A 35-year-old female with copious, intractable diarrhea and vomiting
2. A 43-year-old female second day post-operative cholecystectomy
3. A 53-year-old female with pain related to alcohol-associated pancreatitis
4. A 62-year-old female with colon cancer receiving chemotherapy and radiation

Answers and Rationales

1. C. With counseling and medical guidance, a near normal lifestyle, including complete sexual function is possible.There are few physical restraints on activity postoperatively, but the client may have emotional problems resulting from the body image changes.
2. B. Lung cancer . Lung cancer is the most deadly type of cancer in both women and men. Breast cancer ranks second in women, followed (in descending order) by colon and rectal cancer, pancreatic cancer, ovarian cancer, uterine cancer, lymphoma, leukemia, liver cancer, brain cancer, stomach cancer, and multiple myeloma.
3. A. Familial polyposis . Family history of colon cancer or familial polyposis is a risk factor for colorectal cancer.
4. A. The symptoms may be the result of anemia caused by chemotherapy. Three months after surgery and chemotherapy the patient is likely to be feeling the after-effects, which often includes anemia because of bone-marrow suppression. There is no evidence that the patient is immunosuppressed, and fatigue is not a typical symptom of immunosuppression. The information given does not indicate that depression or dehydration is a cause of her symptoms.
5. D. Change in bowel habits . Constipation, diarrhea, and/or constipation alternating with diarrhea are the most common symptoms of colorectal cancer.
6. A. Bowel perforation. Bowel perforation is the most serious complication of fiberoptic colonoscopy. Important signs include progressive abdominal pain, fever, chills, and tachycardia, which indicate advancing peritonitis. Viral gastroenteritis and colon cancer do not cause these symptoms. Diverticulitis may cause pain, fever, and chills, but is far less serious than perforation and peritonitis.
7. D. Polyps . Colorectal polyps are common with colon cancer. Duodenal ulcers and hemorrhoids aren’t preexisting conditions of colorectal cancer. Weight loss — not gain — is an indication of colorectal cancer.
8. C. Is the opening on the client’s right side . The proximal end of the double-barrel colostomy is the end toward the small intestines. This end is on the client’s right side.
9. A. Give laxative the night before and a cleansing enema in the morning before the test. Barium enema is the radiologic visualization of the colon using a die. To obtain accurate results in this procedure, the bowels must be emptied of fecal material thus the need for laxative and enema.
10. D. Change in bowel habits. Constipation, diarrhea, and/or constipation alternating with diarrhea are the most common symptoms of colorectal cancer.
11. D. “I will include more fresh fruits and vegetables in my diet.” Numerous aspects of diet and nutrition may contribute to the development of cancer. A low-fiber diet, such as when fresh fruits and vegetables are minimal or lacking in the diet, slows transport of materials through the gut which has been linked to colorectal cancer.
12. A. Cancer of the colon and rectum is the second most common type of internal cancer in the United States. Cancer of the colon and rectum is the second most common type of internal cancer in the United States.
13. C. High fat, refined carbohydrates. A diet that is high in fat and refined carbohydrates increases the risk of colorectal cancer. High fat content results in an increase in fecal bile acids, which facilitate carcinogenic changes. Refined carbohydrates increase the transit time of food through the gastrointestinal tract and increase the exposure time of the intestinal mucosa to cancer-causing substances.
14. B. He has difficulty inserting the irrigation tube into the stoma . The patient should notify the doctor if he has difficulty inserting the irrigation tube into the stoma. Difficulty with insertion may indicate stenosis of the bowel. Abdominal cramping and expulsion of flatus may normally occur with irrigation. The procedure will often take an hour to complete.
15. B. A 43-year-old female second day post-operative cholecystectomy , C. A 53-year-old female with pain related to alcohol-associated pancreatitis. Both clients will need frequent pain assessments and medications. Clients with copious diarrhea or vomiting will frequently need enteric isolation. Cancer clients receiving chemotherapy are at risk for immunosuppression and are likely to need reverse isolation. Focus: Assignment