Complex GI Navigator Quiz

What is your full name?
Please type your manager's name.
What is the most common site of colorectal metastasis?
Brain
Adrenal glands
Liver
Bone
What is the most common type of esophageal cancer?
Lymphoma
Adenocarcinoma
Pancreatic cancer
Esophageal cancer
Colorectal cancer is the most common cancer of the gastrointestinal tract. What is the second most common malignancy?
Liver cancer
Gastric cancer
Pancreatic cancer
Esophageal cancer
What is the most common pathology of malignant gastric tumors?
Lymphoma
Carcinoid tumors
Adenocarcinoma
Squamous cell carcinoma
A patient has been told by the healthcare provider that the cells in a bowel tumor are poorly differentiated. The patient asks the nurse what is meant by "poorly differentiated". Which of the following is the BEST response?
The cells in your tumor do not look very different from normal bowel cells
The tumor cells have DNA that is different from your normal bowel cells
The cells in your tumor have mutated from the normal bowel cells
The cells in your tumor look very different from normal bowel cells
Neoplasm can be classified as either benign or malignant. The following are characteristics of a malignant tumor EXCEPT:
Potential for metastasis
Ability to infiltrate surrounding tissue
Always encapsulated
Poorly differentiated cells
A patient asks, "What are tumor-suppressor genes?" As part of your answer, you explain that tumor-suppressor genes code for proteins that ___________ growth-promoting factors.
Enhance
Inactivate
Fuel
Duplicate
Which of the following best describes tumor angiogenesis?
A process whereby tumor cells are able to divide despite low hemoglobin
A response to tumor hypoxia
A process whereby tumors create their own vascular network
A process whereby tumors are deprived of a vascular network
Which of the following is NOT a normal function of the esophagus? 
Conducts food and fluids from the pharynx to the stomach
Facilitates airflow to the lungs
Facilitates swallowing through primary and secondary peristalsis
Prevent reflux of stomach contents by contraction of the lower esophageal sphinctor
Which of the following is NOT one of the three major parts of the stomach?
Fundus
Body
Duodenum
Antrum
Which of the following is NOT one of the three main parts of the pancreas?
Splenic flexure
Tail
Head
Body
Which of the following GI cancer type has the lowest 5-year survival rate?
Colon
Pancreatic
Rectal
Gastric
Which tumor marker is commonly used as an indicator of tumor burden and for monitoring recurrence of colorectal cancer?
CA 19-9
CA 27-29
Carcinoembryonic antigen (CEA)
Alpha-fetoprotein (AFP)
A 70 year-old man with a 40 pack-year history of smoking presents with dysphagia. His barium swallow is suspicious for esophageal cancer. The nurse should educate him about which test to confirm the diagnosis?
Magnetic resonance imaging (MRI)
Computed tomography (CT) scan
Positron emission tomography (PET) scan
Endoscopy
What is the tumor marker used to screen individuals at high risk for primary liver cancer?
Carcinoembryonic antigen (CEA)
CA 19-9
AFP (Alpha-fetoprotein)
Human Chorionic Gonadtropic Beta subunit (BHCG)
The TNM system is utilized for staging and grading neoplasms. TNM stands for:
Time, Neoplasm, Mode of growth
Tumor, Node, Metastasis
Tumor, Neoplasm, Mode of growth
Time, Node, Metastasis
Mr. Thompson would like you to explain the relationship among tumor size, node involvement, and prognosis. Which of the following statements is MOST accurate?
Smaller tumors with positive node involvement have the best prognosis
Larger tumors with negative node involvement have the best prognosis
Smaller tumors with negative node involvement have the worst prognosis
Larger tumors with positive node involvement have the worst prognosis
The MOST important objective of solid tumor staging is:
To provide information regarding risk factors
To identify individuals at high risk for disease recurrence
To determine performance status and eligibility for research protocols
To provide the necessary information for individual treatment planning
Which of the following diagnostic procedures would you expect to be ordered to assist in detection of distant metastasis in a patient with esophageal cancer?
Endoscopy
Chest x-ray
PET scan
Barium swallow
The regional lymph nodes on a gastric cancer patient cannot be assessed. Utilizing the TNM system, what would be the correct staging for N (node)?
N1
N2
NX
Leave it blank
A stage IV pancreatic tumor is designated by which grouping of primary tumor (T), lymph node status (N), and metastasis (M)?
T4, N3, M0
T4, N2, M0
Any T, N3, M0
Any T, any N, M1
Neoadjuvant treatment is defined as:
Treatment that occurs after surgery
Another name for immunotherapy
Treatment given as a first step to shrink a tumor before the main treatment, which is usually surgery, is given
A specialized type of radiation therapy
Which of the following radiation side effects would be most common in clients receiving radiation therapy for rectal cancer?
Intestinal obstruction
Diarrhea
Nausea
Bone marrow suppression
Which type of colorectal surgery is associated with a higher incidence of quality of life issues after surgery?
Abdominoperineal resection
Right hemicolectomy
Subtotal colectomy
Low anterior resection
Which is the initial best choice of treatment for pancreatic cancer?
Surgery
Chemotherapy
Radiation therapy
Radio frequency ablation
Because clients are at risk for “dumping syndrome” after gastric resection, nursing education for the client should include which of the following?
Increasing fluid intake with meals
Ingesting small, frequent meals
Recommending a high-carbohydrate, low-protein diet
Suggesting a high-fiber diet
What is the most definitive treatment option for primary liver cancer?
Surgery
Radiation therapy
Percutaneous ethanol injection
Systemic chemotherapy
The preferred initial therapy for anal cancer is which of the following?
Surgery
Radiation
Chemotherapy
Chemoradiation
Which information obtained by the nurse about a patient with colon cancer who is scheduled for external radiation therapy to the abdomen indicates a need for patient teaching?
The patient swims a mile 5 days a week
The patient eats frequently during the day
The patient showers with Dove soap daily
The patient has a history of dental caries
Which of the following statements is correct about the rate of cell growth in relation to chemotherapy?
Faster growing cells are less susceptible to chemotherapy
Non-dividing cells are more susceptible to chemotherapy
Faster growing cells are more susceptible to chemotherapy
Slower growing cells are more susceptible to chemotherapy
A 58 year-old man is going to have chemotherapy for pancreatic cancer. He asks how the chemotherapeutic drugs will work. The most accurate explanation is which of the following?
Chemotherapy affects all rapidly dividing cells
The molecular structure of DNA is altered
Cancer cells are susceptible to drug toxins
Chemotherapy encourages cancer cells to divide
The following are teaching guidelines regarding radiation therapy EXCEPT:
The therapy is painless
To promote safety, the client is assisted in the therapy room by therapy personnel while the machine is in operation
The client may communicate all concerns/needs while the machine is operating
Safety precautions are necessary only during the time of actual irradiation
Which is NOT a common side effect of opioids?
Sedation
Constipation
Increased motility
Respiratory depression
Neoadjuvant radiation therapy is used for colorectal cancer patients to do each of the following EXCEPT
Eliminate need for surgery
Decrease tumor size and render the tumor resectable
Eradicate microscopic disease
Decrease the incidence of local recurrence
Pancreaticoduodenectomy is also known as:
Endoscopy
Whipple procedure
Total colostomy
Abdominal ultrasound
Which of the following is NOT associated with increased risk of colorectal cancer?
Family history
Advanced age
Adenomatous polyps
Irritable bowel syndrome
The only risk factor that is definitively linked with the development of pancreatic cancer is which of the following?
Coronary artery disease
Cigarette smoking
Ingestion of smoked meats
Hyperbilirubinemia in infants
Which of the following is considered to be a risk factor for gastric cancer?
History of H. Pylori infection
High carbohydrate diet
Low-fiber diet
Gastroesophageal reflux disease (GERD)
The family member of a client diagnosed with gastric cancer asks the nurse what nutritional factors are important in the prevention of gastric cancer. Which of the following is NOT included in the education?
Avoidance of spicy foods
Avoidance of highly salted food
Limiting the intake of smoked foods
Increasing fruits and vegetables in the diet
Which of the following risk factors is NOT associated with the development of primary liver cancer?
Hepatitis B virus
Aflatoxin B exposure
Cirrhosis
Age
Which of the following is a genetic disorder characterized by hyperkeratosis of the palms and soles, oral leukoplakia, and is the only genetic syndrome known to increase risk of squamous cell carcinoma of the esophagus?
Achalasia
Tylosis
Dysentery
Marfan Syndrome
Which of the following is NOT a dietary or lifestyle risk factor associated with esophageal cancer?
Smoking
Obesity
Alcohol abuse
Ingestion of spicy foods
Which of the following is NOT a genetic factor in GI cancer development?
Gardner’s Syndrome
Turcot’s Syndrome
Peutz-Jeghers Syndrome
Progeria
The client may report symptoms of tenesmus and bright red blood in the stool if the tumor is located in which region of the colon?
Transverse
Rectum
Sigmoid
Ascending
Which of the following is considered a late symptom of colorectal cancer?
Flatulence
Diarrhea
Blood in the stool
Weight loss
A client with esophageal cancer who is experiencing dysphagia is trying to maintain caloric intake. The nurse should provide education on which of the following?
Instructions to maintain a clear liquid diet
Instructions to lie flat for 30 minutes after each meal
Instructions to eat small, frequent meals throughout the day
Instructions to limit meals to twice a day with high-calorie foods
The most common presenting complaint of esophageal cancer is which of the following?
Pain
Dysphagia
Hoarseness
Cough when swallowing
What is the MOST common presenting symptom of pancreatic cancer?
Pain
Ascites
Fatigue
Nausea and vomiting
What is the MOST common presenting symptom of gastric cancer?
Hematemesis
Weight loss
GERD
Lower extremity edema
Which is the MOST common presenting symptom of primary liver cancer?
Anorexia
Ascites
Right upper quadrant pain
Anemia
What is the symptom that is difficult to manage in clients with advanced primary liver cancer?
Infection
Bleeding
Pain
Bone metastasis
What is the most common presenting sign of anal cancer?
Bleeding
Pruritus
Lymphadenopathy
Diarrhea
Which of the following is NOT a common change in function for patients with colorectal cancer?
Increase or decrease in consistency of stool
Increased GERD
Inability to move stool through bowel or pencil-shaped stool
Changes in color of stool
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