211 Final- Oncology

While on spring break, a 22-year-old client was taken to the hospital for heat stroke and alcohol poisoning. The client is worried and states that a biopsy was taken and showed "some kind of benign condition." Which response by the nurse would be best? A. "I understand that you are worried. Benign conditions are noncancerous, but let's look at your chart to see your results." B. "You have every right to be upset; a benign condition means you may have cancerous cells. Let me call your health care provider to talk to you." C. "Are you sure a biopsy was done? Your admitting diagnosis would not prompt that kind of procedure." D. "Do not worry; if something was wrong, your primary health care provider would have told you and started treatment."

A. "I understand that you are worried. Benign conditions are noncancerous, but let's look at your chart to see your results."

The clinic nurse is caring for an adult oncology client who reports extreme fatigue and weakness after the first week of radiation therapy. Which response by the nurse would best reassure this client? A. "These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory studies and test results." B. "These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer." C. "Try not to be concerned about these symptoms. Every client feels this way after having radiation therapy." D. "Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying."

A. "These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory studies and test results."

An adult client with leukemia will soon begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy? A. Administer an antiemetic. B. Administer an antimetabolite. C. Administer a tumor antibiotic. D. Administer an anticoagulant.

A. Administer an antiemetic.

The nurse is caring for a client who is to begin receiving external radiation for a malignant tumor of the neck. While providing client education, what potential adverse effects should the nurse discuss with the client? A. Impaired nutritional status B. Cognitive changes C. Diarrhea D. Alopecia

A. Impaired nutritional status

A client with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this client's plan of care? A. Limit the time that visitors spend at the client's bedside. B. Teach the client to perform all aspects of basic care independently. C. Assign male nurses to the client's care whenever possible. D. Situate the client in a shared room with other clients receiving brachytherapy.

A. Limit the time that visitors spend at the client's bedside.

A nurse who works in an oncology clinic is assessing a client who has arrived for a 2-month follow-up appointment following chemotherapy. The nurse notes that the client's skin appears yellow. Which blood tests should be done to further explore this clinical sign? A. Liver function tests (LFTs) B. Complete blood count (CBC) C. Platelet count D. Blood urea nitrogen and creatinine

A. Liver function tests (LFTs)

The nurse is describing some of the major characteristics of cancer to a client who has recently received a diagnosis of malignant melanoma. When differentiating between benign and malignant cancer cells, the nurse should explain differences in which of the following aspects? (Select all that apply.) A. Rate of growth B. Ability to cause death C. Cell size D. Cell location E. Ability to spread

A. Rate of growth B. Ability to cause death E. Ability to spread

The home health nurse is performing a home visit for an oncology client discharged three days ago after completing chemotherapy treatment for non-Hodgkin lymphoma. The nurse's priority assessment should include examination for the signs and symptoms of which complication? A. Tumor lysis syndrome (TLS) B. Syndrome of inappropriate antidiuretic hormone (SIADH) C. Disseminated intravascular coagulation (DIC) D. Hypercalcemia

A. Tumor lysis syndrome (TLS)

When discussing with a client factors that distinguish malignant cells from benign cells of the same tissue type, which characteristic should the nurse mention? A. Slow rate of mitosis of cancer cells B. Different proteins in the cell membrane C. Differing size of the cells D. Different molecular structure in the cells

B. Different proteins in the cell membrane

A client's most recent diagnostic imaging has revealed that lung cancer has metastasized to the bones and liver. What is the most likely mechanism by which the client's cancer cells spread? A. Apoptosis B. Lymphatic circulation C. Invasion D. Angiogenesis

B. Lymphatic circulation

An oncology nurse educator is providing health education to a client who has been diagnosed with skin cancer. The client's wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite? A. Malignant cells possess greater mobility than normal body cells. B. Malignant cells contain proteins called tumor-associated antigens. C. Chromosomes contained in cancer cells are more durable and stable than those of normal cells. D. The nuclei of cancer cells are unusually large, but regularly shaped.

B. Malignant cells contain proteins called tumor-associated antigens.

A client newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe? A. Pruritis (itching) B. Nausea and vomiting C. Altered glucose metabolism D. Confusion

B. Nausea and vomiting

The nurse is caring for a client with an advanced stage of breast cancer and the client has recently learned that the cancer has metastasized. The nurse enters the room and finds the client struggling to breathe, and the nurse's rapid assessment reveals that the client's jugular veins are distended. The nurse should suspect the development of what oncologic emergency? A. Increased intracranial pressure B. Superior vena cava syndrome (SVCS) C. Spinal cord compression D. Metastatic tumor of the neck

B. Superior vena cava syndrome (SVCS)

A patient's tumor is stage T2, NO, MO. This staging indicates which of the following about the patient's status? A. There is an advanced tumor with indication of metastasis but no indication of lymph node involvement B. The patient has a measurable tumor with no metastasis or involvement of nodes. C. There is an advanced tumor with metastasis D. There is an advanced tumor with indication of involvement of lymph nodes but no indication of metastasis

B. The patient has a measurable tumor with no metastasis or involvement of nodes.

A client on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in clients at risk for thrombocytopenia? A. Interrupted sleep pattern B. Hot flashes C. Epistaxis D. Increased weight

C. Epistaxis

The nurse reviews the laboratory results of a patient scheduled to receive cancer chemotherapy and finds that the white blood cell count is 400/mm3. What is the priority action of the nurse? A. Administer the chemotherapy as ordered with a normal saline piggyback B. Examine the patient's diet for foods that will boost immunity C. Initiate reverse isolation precautions D. Administer the patient's erythropoietin injection now

C. Initiate reverse isolation precautions

The nurse manager is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, which action should the nurse manager emphasize? A. Adjust the dose to the client's present symptoms. B. Wash hands with an alcohol-based cleanser following administration. C. Use gloves and a lab coat when preparing the medication. D. Dispose of the antineoplastic wastes in the hazardous waste receptacle.

D. Dispose of the antineoplastic wastes in the hazardous waste receptacle.

A client receiving chemotherapy has a white blood cell count of 1000/mm3. What actions by the nurse are most appropriate? (Select all that apply.) a. Assess all mucous membranes every 4 to 8 hours. b. Do not allow the client to eat meat or poultry. c. Listen to lung sounds and monitor for cough. d. Monitor the venous access device appearance with vital signs. e. Take and record vital signs every 4 to 8 hours.

a. Assess all mucous membranes every 4 to 8 hours c. Listen to lung sounds and monitor for cough. d. Monitor the venous access device appearance with vital signs. e. Take and record vital signs every 4 to 8 hours.

The nurse caring for oncology clients knows that which form of metastasis is the most common? a. Bloodborne b. Direct invasion c. Lymphatic spread d. Via bone marrow

a. Bloodborne

A patient who is diagnosed with cervical cancer that is classified as TisN0M0 asks the nurse what the letters and numbers mean. Which response by the nurse is most appropriate? a. The cancer involves only the cervix b. The cancer cells look almost like normal cells c. Further testing is needed to determine the spread of the cancer d. It is difficult to determine the original site of the cervical cancer

a. The cancer involves only the cervix

Your patient will be receiving external beam radiation on an outpatient basis. In teaching your patient about what to expect from the therapy, you should be sure to include the following. (Select all that apply) a. They need to keep away from other people for 48 hours because they are radioactive so they must drive straight home b. A marker will be placed on the skin where the radiation should hit c. An expected complication is urinary retention d. Treatment can be divided over' a period of 4-6 weeks, e. The maximum effect of radiation will occur at the skin's surface

a. They need to keep away from other people for 48 hours because they are radioactive so they must drive straight home d. Treatment can be divided over' a period of 4-6 weeks,

A client tells the oncology nurse about an upcoming vacation to the beach to celebrate completing radiation treatments for cancer. What response by the nurse is most appropriate? a. Avoid getting salt water on the radiation site. b. Do not expose the radiation area to direct sunlight. c. Have a wonderful time and enjoy your vacation! d. Remember you should not drink alcohol for a year.

b. Do not expose the radiation area to direct sunlight.

A client has a platelet count of 9800/mm3. What action by the nurse is most appropriate? a. Assess the client for calf pain, warmth, and redness. b. Instruct the client to call for help to get out of bed. c. Obtain cultures as per the facilitys standing policy. d. Place the client on protective isolation precautions.

b. Instruct the client to call for help to get out of bed.

A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months after radiation therapy for breast cancer. What response by the nurse is most appropriate? a. Are you getting adequate rest and sleep each day? b. It is normal to be fatigued even for years afterward. c. This is not normal and I'll let the provider know. d. Try adding more vitamins B and C to your diet.

b. It is normal to be fatigued even for years afterward.

Our client receiving radiation therapy reports severe itching and irritation. What actions does the nurse delegate to assistive personnel (AP) ? (Select all that apply) a. Teach the client to avoid sunlight b. Make sure no clothing is rubbing the site c. Apply steroid creams to the skin d. Help the client pat skin dry after bath e. Inquire about psychosocial effects of the areas of skin irritation

b. Make sure no clothing is rubbing the site d. Help the client pat skin dry after bath

After receiving the hand-off report, which client should the oncology nurse see first? a. Client who is afebrile with a heart rate of 108 beats/min b. Older client on chemotherapy with mental status changes c. Client who is neutropenic and in protective isolation d. Client scheduled for radiation therapy today

b. Older client on chemotherapy with mental status changes

When reviewing the chart for a patient with cervical cancer, the nurse notes that the cancer is staged as T2 N2, M2. The nurse will teach the patient which of the following? a. The tumor has spread. b. The cancer is localized to the cervix and surrounding tissue. c. Palliative care is not appropriate. d. There are nodules present in two places.

b. The cancer is localized to the cervix and surrounding tissue.

The nursing instructor explains the difference between normal cells and benign tumor cells. What information does the instructor provide about these cells? a. Benign tumors grow through invasion of other tissue. b. Benign tumors have lost their cellular regulation from contact inhibition. c. Growing in the wrong place or time is typical of benign tumors. d. The loss of characteristics of the parent cells is called anaplasia

c. Growing in the wrong place or time is typical of benign tumors.

What statement indicates that the client understands teaching about neutropenia and bone marrow suppression? a. I will wait until after my chemotherapy session this week to attend the State Fair. b. I know that a slight fever may be normal for me with this condition. c. It will be better for me to do my holiday shopping online this year. d. I will incorporate several servings of fresh fruits and vegetables daily

c. It will be better for me to do my holiday shopping online this year.

The oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do? a. Periodically apply ice to the area b. Keep the area clean shaven c. Apply petroleum jelly to the affected area d. Avoid using soap on the treatment area

d. Avoid using soap on the treatment area

The nurse has taught a client with cancer ways to prevent infection. What statement by the client indicates that more teaching is needed? a. I should take my temperature daily and when I don't feel well. b. I will wash my toothbrush in the dishwasher once a week. c. I won't let anyone share any of my personal items or dishes. d. It's alright for me to keep my pets and change the litter box.

d. It's alright for me to keep my pets and change the litter box.

A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient? a. Remove food debris from the teeth and oral mucosa with a stiff toothbrush b. Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth c. Gargle and rinse the mouth several times a day with an antiseptic mouthwash d. Rinse the mouth before and after each meal and at bedtime with a saline solution

d. Rinse the mouth before and after each meal and at bedtime with a saline solution

A client is in the oncology clinic for a first visit since being diagnosed with cancer. The nurse reads in the clients chart that the cancer classification is TISN0M0. What does the nurse conclude about this clients cancer? a. The primary site of the cancer cannot be determined. b. Regional lymph nodes could not be assessed. c. There are multiple lymph nodes involved already. d. There are no distant metastases noted in the report

d. There are no distant metastases noted in the report

A client with cancer is admitted to a short-term rehabilitation facility. The nurse prepares to administer the clients oral chemotherapy medications. What action by the nurse is most appropriate? a. Crush the medications if the client cannot swallow them. b. Give one medication at a time with a full glass of water. c. No special precautions are needed for these medications. d. Wear personal protective equipment when handling the medications.

d. Wear personal protective equipment when handling the medications.