The following sample questions are representative of actual test content, difficulty level, and question format. The answer key follows the set of questions.
Directions: Each question or incomplete statement below is followed by four suggested answers or completions. Select the one that is best in each case.
A significant contributing factor to the lower five-year cancer survival rates among African Americans is:
- poor compliance with treatment.
- greater prevalence of genetic mutations.
- diagnosis at a later stage of disease.
- presence of primary resistant disease.
The APN palpates an abdominal mass in a patient with a chief complaint of flank pain and gross hematuria. The APN recommends a
- CA-125 level.
- prostate-specific antigen level.
- computer tomography of the abdomen and pelvis.
To reduce hematologic and gastrointestinal toxicities in a patient receiving pemetrexed and cisplatin, the APN recommends:
- folic acid supplements.
- calcium supplements.
The APN assesses a patient receiving prophylactic cranial radiation for small cell lung cancer, a patient receiving interferon for melanoma, and a patient receiving doxorubicin and cyclophosphamide every three weeks for breast cancer. The most common side effect likely to be experienced by all three patients is:
A patient receiving chemotherapy states, “The doctor says that if things do not improve after this round, he may change the chemotherapy. These treatments are getting rougher, and I don't know if I can continue. I have been reading about the macrobiotic diet. What do you think about it?” The APN's best response is:
- “There is no evidence that this diet is of any benefit in cancer treatment."
- “The diet may add to the effectiveness of the chemotherapy. “
- “Let's schedule a follow-up appointment to review the diet and implications for your treatment.”
- “Tell me what you know about the diet and why you think it might be helpful. “
Rationale: In general, African Americans have a decreased likelihood of surviving five years after diagnosis than whites for all cancer sites, and at all stages of diagnosis. Much or all of these differences are believed to be due to poverty, disparities in treatment, reduced access to medical care, or diagnoses at a later stage, when the disease has spread to regional or distant tissues.
Reference:American Cancer Society. (2014). Cancer facts and figures for African Americans 2013-2014. Atlanta, GA: Author, p. 9.
Rationale: Digital imaging to diagnose renal cell cancer includes abdominal computer tomography. Clinical symptoms of renal cell cancer include hematuria and flank pain.
Reference: Camp-Sorrell, D., & Hawkins, R.A. (Eds.). (2014). Clinical manual for the oncology advanced practice nurse (3rd ed.). Pittsburgh, PA: Oncology Nursing Society, pp. 710-712.
Rationale: To reduce treatment-related hematologic and gastrointestinal toxicities, the patient should be prescribed folic acid prior to initiating therapy, and continuing for three weeks after the last cycle.
Reference: Polovich, M., Olsen, M.. & LeFebvre, K.B. (Eds.). (2014). Chemotherapy and biotherapy guidelines and recommendations for practice (4th ed.). Pittsburgh, PA: Oncology Nursing Society, p. 36(t).
Rationale: Fatigue is one of the most common and distressful symptoms associated with the diagnosis and treatment of cancer.
Reference: Yarbro, C.H., Gobel, B.H., & Wujcik, D. (Eds.). (2010). Cancer nursing: Principles and practice (7th ed.). Sudbury, MA: Jones and Bartlett Learning, p. 773.
Rationale: It is important for health care professionals to discuss the alternative and complementary methods of cancer management. Open communication with patients and families allows the nurse to identify any unmet patient needs, assess understanding, and identify the motivation for the use of other therapies.
Reference: Yarbro, C.H., Gobel, B.H., & Wujcik, D. (Eds.). (2010). Cancer nursing: Principles and practice (7th ed.). Sudbury, MA: Jones and Bartlett Learning, p. 630.