B. SCREENING AND EARLY DETECTION

27. Which of the following statements is accurate regarding prostate-specific antigen (PSA)?

1. PSA screening for prostate cancer is controversial.
2. All men with prostate cancer secrete PSA.
3. PSA is the primary screening method for prostate cancer.
4. A PSA greater than 2 ng/ml is the threshold for performing biopsies to diagnose prostate cancer.

28. The most widely used screening programs have been for the early detection of:

1. Breast and cervical cancer
2. Breast and colon cancer
3. Colon and cervical cancer
4. Breast and prostate cancer

29. Nurses must communicate to patients about the accuracy of screening tests. Which of the following attributes is correct?

1. The sensitivity of a screening test is its ability to detect those individuals without cancer.
2. The specificity of a screening test is its ability to identify those individuals without cancer.
3. A true-positive test is a normal test for cancer in an individual who does not have cancer.
4. A false-negative test is a normal test in an individual who does not have cancer.

30. Which of the following tests is recommended by the American Cancer Society to screen for polyps and colorectal cancer in asymptomatic individuals ages 50 and above?

1. Flexible sigmoidoscopy every 2 years
2. Digital rectal examination
3. Colonoscopy every 10 years
4. Double-contrast barium enema every 10 years

31. You are providing a community education program on cancer prevention when a participant asks what is cancer screening and is it important if you are healthy and have no problems. Your most appropriate response is:

1. Screening for genetic abnormalities that put individuals at high-risk for developing cancer is a form of cancer screening.
2. Cancer must be measurable and detectable to be detected on a screening examination.
3. Cancer screening is aimed at individuals with no symptoms with the goal of finding disease when it is more easily treated.
4. Screening tests seek to decrease both the morbidity and mortality associated with cancer.

32. The single most important factor in whether an individual has ever had a screening test is:

1. Recommendation by a nurse
2. Recommendation by a family member
3. Recommendation by a friend who has cancer
4. Recommendation by their insurance provider

33. Which of the following models has been developed for use in women with a risk for developing breast cancer?

1. Couch
2. Bethesda
3. Gail
4. Family History Assessment Tool

34. Which of the following statements is most accurate regarding the cancer screening process?

1. The first step in the cancer screening process is the risk assessment.
2. A review of past and present medical history
3. A risk factor does not mean that a person will develop cancer.
4. Provide a risk assessment tool for the patient.

35. Research has shown that providing patients with an individualized risk estimate, as opposed to providing general information about risk, significantly increased the probability that those individuals would participate in a screening program. It is best to explain to patients which of the following?

1. The predictive value of their chance for developing cancer
2. Their absolute and relative risk of developing cancer
3. A model that predicts their risk of developing cancer
4. Their genetic risk is what is most important.

36. A nurse asks you which risk model should be used to calculate a patient’s risk of having a cancer susceptibility mutation for colorectal cancer.

1. Gail
2. Tyrer-Cuzick
3. PREMM
4. Claus

37. Which of the following modalities is used to screen for lung cancer?

1. Chest x-ray
2. Low-dose computed tomography
3. Sputum cytology
4. Magnetic resonance imaging (MRI) of the chest

38. One of the early signs of ovarian cancer is:

1. Frequent urinary tract infections
2. Thin, bloody vaginal discharge
3. Heavy and painful menstruation
4. Bloating

39. Physical recognition of cutaneous melanoma (CM) by practitioners can be initiated by using the ABCDE rule. In this rule, C stands for:

1. Change in symmetry
2. Crusting or bleeding
3. Color irregularity
4. Cause

40. Which of the following statements about dysplastic nevi (DN) is correct?

1. DN occurs in approximately 40% of the general population.
2. DNs are easy to identify on physical examination.
3. The total number of DNs is an indicator of risk for developing malignant melanoma.
4. DNs develop in young adults and especially in those with sunburns as a child.

41. One way that basal cell carcinoma (BCC) is distinguished from squamous cell carcinoma (SCC) is by its:

1. Common occurrence on the head and hands
2. Lower incidence
3. Less well-demarcated margins
4. Slower growth rate

42. Which of the following is the most likely presenting symptom in a patient with Hodgkin lymphoma?

1. Edema in the upper part of the body
2. Enlarged cervical lymph nodes
3. A palpable mass in the axillary or inguinal lymph nodes
4. An upper respiratory infection

43. Ms. Allison notices a “funny discoloration” on her arm and comes in for an examination. She tells you that her brother died at age 38 from a common skin cancer. Based on this information, you should be suspicious for:

1. Squamous cell carcinoma (SCC)
2. Basal cell carcinoma (BCC)
3. Melanoma
4. Leukoplakia

44. Mr. Eliot, 64 and a smoker for 17 years, has an undifferentiated neoplasm arising in the proximal right bronchus. Which symptom most typically reflects this?

1. Barrel chest
2. Bulges on the thorax
3. Breathlessness
4. Superior vena cava obstruction

45. Mrs. Smith is pregnant and discovers a mass in the upper outer quadrant of her left breast. Following her physical exam, the physician is most likely to order which of the following tests?

1. Ultrasound
2. Fine-needle aspiration
3. Mammogram (diagnostic)
4. Positron emission tomography (PET) scan

46. Mrs. Blase presents with a continuous sore throat, and increased difficulty chewing and swallowing. These symptoms are possibly an indication of which type of cancer?

1. Cancer of the larynx
2. Esophageal cancer
3. Cancer of the oral cavity
4. Cancer of the salivary gland

47. The most common presenting symptom of testicular cancer is:

1. A small, hard mass in the testis
2. A dragging sensation
3. Swelling
4. Dull aching or pain in the scrotal area

48. Early detection of stomach cancer is difficult because:

1. Symptoms appear in advanced disease.
2. People tend to self-medicate themselves for gastrointestinal distress.
3. Risk factors for the disease have not yet been identified.
4. None of the diagnostic tests or procedures currently available accurately detect gastric cancer in its early stages.