NCLEX : Symptoms and Tests for Tumors

Study concepts, example questions & explanations for NCLEX

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Example Questions

Example Question #1 : Symptoms And Tests For Tumors

Which leukemia is linked to the Philadelphia chromosome? 

Possible Answers:

Acute myelogenous leukemia (AML)

Chronic myelogenous leukemia (CML)

Acute lymphocytic leukemia (ALL)

Chronic lymphocytic leukemia (CLL) 

Correct answer:

Chronic myelogenous leukemia (CML)

Explanation:

The Philadelphia chromosome, which is an abnormality in chromosome 22, is most often found in bone marrow cells of patients with chronic myelogenous leukemia. It may also occasionally be found in acute lymphocytic leukemia, though this is rare.

Example Question #41 : Conditions And Treatments

Reed-Sternberg cells are pathognomonic in what type of cancer?

Possible Answers:

Acute myeloblastic leukemia

Non-Hodgkin's lymphoma

Acute lymphocytic leukemia

Hodgkin's lymphoma

Correct answer:

Hodgkin's lymphoma

Explanation:

Reed-Sternberg cells are the pathognomonic cells of Hodgkin's lymphoma. These are mutated multinucleated B cells with a large amount of cytoplasm. These cells can be present in other pathologies - the diagnosis of Hodgkin's lymphoma can only be made if the Reed-Sternberg cells are in the presence of non-neoplastic inflammatory cells such as lymphocytes, plasma cells, and eosinophils.

Example Question #42 : Conditions And Treatments

What protein is found in the urine of patients with multiple myeloma?

Possible Answers:

Tau 64

Albumin

Alpha-synuclein

Bence-Jones protein

Correct answer:

Bence-Jones protein

Explanation:

Bence-Jones proteins are present in the urine of over 60% of multiple myeloma patients.Albumin may be present in the urine of these patients, but it is not pathognomonic for multiple myeloma. Alpha-synuclein is associated with neurodegenerative conditions, and tau 64 is a protein present in the neurons of patients with Alzheimer's disease.

Example Question #43 : Conditions And Treatments

What is the most common symptom of Hodgkin's lymphoma?

Possible Answers:

Bone pain

Easy bruising

Prolonged enlargement of one or more lymph nodes

Fatigue and weight loss

Correct answer:

Prolonged enlargement of one or more lymph nodes

Explanation:

The most common symptom of Hodgkin's lymphoma is the painless enlargement of one or more lymph nodes. 

Unexplained weight loss and fatigue may also be present, but are more likely to present later than lymph node enlargement. Bone pain and easy bruising are not typically seen.

Example Question #44 : Conditions And Treatments

What tumor antigen will be elevated in prostate cancer?

Possible Answers:

Tyrosinase

Prostate specific antigen (PSA)

Cancer antigen 125 (CA 125)

Alpha-fetoprotein (AFP)

Correct answer:

Prostate specific antigen (PSA)

Explanation:

In prostate cancer, patients will have elevated levels of prostate specific antigen (PSA). Cancer antigen 125 (CA 125) is elevated in ovarian cancer, alpha-fetoprotein (AFP) is elevated in hepatocellular carcinoma, and tyrosinase is an enzyme that is often highly elevated in malignant melanoma.

Example Question #45 : Conditions And Treatments

The oncology nurse cares for a patient who has been newly diagnosed with leukemia. Which of the following sets of symptoms would the nurse not expect during the initial physical assessment?

Possible Answers:

Headache, ecchymosis, retinal hemorrhages

Throat ulcers, pneumonia, anemia

Weight gain, high red blood cell count, flushing

Lethargy, bleeding gums, petechiae

Mouth ulcers, low leukocyte count, weakness

Correct answer:

Weight gain, high red blood cell count, flushing

Explanation:

Leukemia is a cancer of white blood cells, limiting the ability of the body to fight infection. Patients with leukemia exhibit altered leukocyte counts (less than ), as well as ulcerations of the mouth and throat, pneumonia, septicemia, anemia, fatigue, lethargy, weakness, pallor, weight loss, headache, disorientation, and forms of bleeding, including bleeding gums, ecchymosis, petechiae, and retinal hemorrhaging. Patients with leukemia do not usually exhibit weight gain (usually loss), high red blood cell counts (usually anemic), and flushing (usually pallor).

Example Question #46 : Conditions And Treatments

The oncology nurse cares for a patient newly diagnosed with breast cancer. What are common risk factors for this type of cancer? 

Possible Answers:

Stress, advancing age, chronic irritation

Immunosuppression, advancing age, genetic predisposition

Radiation, chronic irritation, smoking

Smoking, advanced age, genetic disposition

Pharmaceutical use, alcohol, radiation

Correct answer:

Immunosuppression, advancing age, genetic predisposition

Explanation:

All of these may be factors in the diagnosis of cancer. The operative word in the question is ‘risk.’ Common risk factors for breast cancer include previous immunosuppression, advancing age, and genetic predisposition. Common causative factors include smoking, alcohol use, radiation,  chronic irritation, consumption of food additives, exposure to industrial chemicals such as asbestos, exposure to dangerous pharmaceuticals such as stillbesterol, previous viral infection such as Epstein-Barr, and stress (when combined with other causative factors).

Example Question #47 : Conditions And Treatments

You are the nurse taking care of a patient newly diagnosed with ovarian cancer. Which of the following biomarkers is typically followed to assess the progress of disease (or response to treatment) in ovarian cancer patients?

Possible Answers:

Cancer antigen 19-9 (CA 19-9)

Prostate specific antigen (PSA)

c-KIT

Cancer antigen 125 (CA-125)

BCR/ABL

Correct answer:

Cancer antigen 125 (CA-125)

Explanation:

The correct answer is "Cancer antigen (CA-125)" because CA-125, also known as mucin 16, is a glycoprotein that is found to have elevated serum levels in patients with a variety of cancers (including ovarian cancer) and benign conditions, as compared to patients without such conditions. As a result, monitoring CA-125 levels can be used as a method of tracking disease progression or response to treatment based upon what the initial CA-125 level is at the time of diagnosis. 

On the other hand, the other choices are incorrect. Cancer antigen 19-9 (CA 19-9) is incorrect as this is a biomarker in pancreatic cancer, not ovarian cancer.Prostate specific antigen (PSA) is incorrect as this is a biomarker in prostate cancer (and other prostate conditions), not ovarian cancer. c-KIT is incorrect as this is a biomarker in gastrointestinal stromal tumors, not ovarian cancer. BCR/ABL is incorrect as this is the translocation found in the Philadelphia Chromosome implicated in chronic myelogenous leukemia, not ovarian cancer.

Example Question #48 : Conditions And Treatments

You are the nurse taking care of a patient newly diagnosed with pancreatic cancer. Which of the following biomarkers is typically followed to assess the progress of disease (or response to treatment) in pancreatic cancer patients?

Possible Answers:

BRAF

CD30

Cancer antigen 125 (CA-125)

Cancer antigen 19-9 (CA 19-9)

CD20 antigen

Correct answer:

Cancer antigen 19-9 (CA 19-9)

Explanation:

The correct answer is "Cancer antigen 19-9 (CA 19-9)" because CA 19-9 is often elevated in patients who have pancreatic cancer (or certain types of colon cancers), and can be used to assess response to treatment and/or disease progression. 

On the other hand, the other choices are incorrect. Cancer antigen-125 (CA-125) is incorrect as this is a tumor marker used to track ovarian cancer, not pancreatic cancer. CD20 antigen is a tumor marker for B-cell lymphomas and leukemias, not pancreatic cancer. CD30 antigen is a tumor marker for anaplastic large cell lymphoma, not pancreatic cancer. BRAF is a tumor marker for melanoma, not pancreatic cancer.

Example Question #49 : Conditions And Treatments

Which of the following image modalities would be best suited to diagnose a suspected lung cancer?

Possible Answers:

EKG

CT scan

Chest x-ray

EEG

Correct answer:

CT scan

Explanation:

A CT scan is the preferred imaging modality to view a tumor in the lung tissue. A chest x-ray might initially find a nodule or abnormal marking in the lungs, but it must be followed up with a CT scan to be diagnostic. EKG looks at the heart and EEG looks at the brain. 

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