AH3 Pearson NCLEX questions- Cancer (Exam #1)

Which behavior by the client indicates effective teaching of​ self-care postexcision of a skin cancer​ lesion? (Select all that​ apply.) A. Client verbalizes understanding of how to prevent recurrence B. Family verbalizes understanding of prevention measures C. Client is listening attentively to your teaching D. Client states the importance of avoiding exposure to direct sunlight E. Client indicates he will not use tanning machines

​A. Client verbalizes understanding of how to prevent recurrence B. Family verbalizes understanding of prevention measures D. Client states the importance of avoiding exposure to direct sunlight E. Client indicates he will not use tanning machines Rationale: The client will verbalize awareness of measures to prevent skin cancer​ recurrence, including proper use of sunscreen and clothing and avoidance of artificial tanning machines. The client listening attentively is not a measurement of teaching effectiveness.

A client with metastatic breast cancer asks where the cancer has spread. Which site should the nurse include in the​ response? (Select all that​ apply.) A. Bone B. Liver C. Brain D. Lungs E. Kidney

A. Bone B. Liver C. Brain D. Lungs Rationale: Common sites for metastasis from breast cancer include the​ brain, liver,​ bone, and lungs. The kidney is not considered a common site for metastasis from breast cancer.

The nurse evaluates teaching provided to a group of community members on breast cancer awareness. Which statement indicates that teaching on risk factors has been​ effective? (Select all that​ apply.) A. "Not breastfeeding increases the risk of breast​ cancer." B. "Having children after age 30 increases the risk of breast​ cancer." C. "Having previous irradiation of the chest increases the risk of breast​ cancer." D. "Experiencing menopause after age 50 increases the risk of breast​ cancer." E. "Having a​ first- or​ second-degree relative with breast cancer increases the risk of breast​ cancer." F. "Having harmful mutations in BRCA1 or BRCA2 suppression increases the risk of breast​ cancer."

A. "Not breastfeeding increases the risk of breast​ cancer." B. "Having children after age 30 increases the risk of breast​ cancer." C. "Having previous irradiation of the chest increases the risk of breast​ cancer." F. "Having harmful mutations in BRCA1 or BRCA2 suppression increases the risk of breast​ cancer." ​ Rationale: Not​ breastfeeding, having children after age​ 30, previous irradiation of the​ chest, and presence of harmful mutations in BRCA1 or BRCA2 suppression all increase the risk for breast cancer. Experiencing menopause after age​ 55, not​ 50, increases risk. Having a​ first-degree relative, but not having a​ second-degree relative, with breast cancer increases risk.

A client who is scheduled to have surgery for lung cancer asks the nurse to explain the goal of the surgery. Which response by the nurse is most​ accurate? A. "The goal of surgery is to remove all involved tissue while preserving as much functional lung as​ possible." B. "The goal of surgery is always to cure lung​ cancer." C. "The goal of surgery is to prevent the lung cancer from​ spreading." D. "The goal of surgery is to return you to the state of health you were before the diagnosis of lung​ cancer."

A. "The goal of surgery is to remove all involved tissue while preserving as much functional lung as​ possible." Rationale: The goal of lung cancer surgery is always to remove involved tissue and preserve functional lung tissue. It is not always possible to cure lung​ cancer, to return clients to their previous state of​ health, or to prevent the cancer from spreading.

The nurse is caring for a client with breast cancer who is having chemotherapy treatments. The client tells the​ nurse, "I am always​ tired, cannot​ concentrate, and am so​ forgetful." Which statement made by the nurse in response to the client is​ true? (Select all that​ apply.) A. "This is also called​ chemo-brain." B. "This may occur with​ chemotherapy; however, it is​ rare." C. "You might want to make notes if needed as a memory​ aid." D. "This may last up to 2 years after completion of​ chemotherapy." E. "This is an abnormal side effect of chemotherapy and is very​ concerning."

A. "This is also called​ chemo-brain." C. "You might want to make notes if needed as a memory​ aid." D. "This may last up to 2 years after completion of​ chemotherapy." Rationale:​ The client is experiencing a normal side effect of​ chemotherapy, also called​ chemo-brain. The nurse should suggest that the client make notes or use other memory aids as needed. These side effects may last up to 2 years after completion of chemotherapy.

The nurse administering a tuberculin skin test to a client who is suspected of having lung cancer explains why this is ordered. Which explanation is the most​ appropriate? A. "This test will identify if tuberculosis is the cause of your​ symptoms." B. "This test will provide evidence of metastatic disease so that appropriate treatment can be​ determined." C. "This test will help identify the presence of any cancer​ cells." D. "This test will help diagnose lung​ cancer."

A. "This test will identify if tuberculosis is the cause of your​ symptoms." ​Rationale: Lung cancer and tuberculosis may produce the same symptoms. A tuberculin skin test can rule out tuberculosis as the cause of these symptoms. Blood work​ (CBC, liver function​ tests, and serum​ electrolytes) is performed to evaluate for evidence of metastasis. Lung cancer is usually first identified by chest​ x-ray. Cytologic examination of a sputum specimen looks for the presence of cancer cells.

Treatment options for a client diagnosed with acute myeloid leukemia​ (AML) is being discussed. The nurse informs the client that the most likely treatment will include complete and sustained replacement of their blood cell lines​ (WBCs, RBCs, and​ platelets) with cells derived from donor stem cells. Which treatment is the nurse referring​ to? A. Allogeneic stem cell transplant​ (SCT) B. Autologous bone marrow transplant​ (BMT) C. Radiation D. Allogeneic bone marrow transplant​ (BMT)

A. Allogenic Stem Cell Transplant (SCT) Rationale: Complete and sustained replacement of recipient blood cell lines with cells derived from donor stem cells is an allogeneic stem cell transplant.​ Radiation, autologous​ BMT, and allogeneic BMT do not completely replace blood cell lines.

The nurse is providing cancer education at a health fair for women. Which screening test information should the nurse​ include? A. Annual mammography beginning at the age of 40 B. Colonoscopy every 2 years beginning at the age of 50 C. Fecal occult blood testing yearly beginning at the age of 30 D. Pap test and HPV exam annually beginning at the age of 21

A. Annual mammography beginning at the age of 40 ​ Rationale: Women should have mammograms annually beginning at the age of 40 years old. The nurse would instruct that fecal occult blood testing is done annually beginning at the age of 50 years or colonoscopies every 10 years. Pap and HPV testing is done every 3 years in women ages 21dash​29, not annually.

Which should the nurse include in the nutritional assessment of a client receiving cancer​ treatment? (Select all that​ apply.) A. Any changes in weight B. Location and intensity of pain C. Pain or difficulty with defecation D. Presence of nausea and vomiting E. Total protein and serum albumin levels

A. Any changes in weight D. Presence of nausea and vomiting E. Total protein and serum albumin levels Rationale: A nutritional assessment would include looking at the​ client's overall weight for weight loss due to inadequate oral intake. The nurse should also determine if the client has experienced any nausea or vomiting. This could interfere with taking in food. Laboratory tests such as the total protein and albumin levels will indicate the presence of good or poor nutrition.

The nurse is caring for a client with a history of nonmelanoma skin cancer. Which question during the health history should the nurse​ ask? A. "Are you exposed to any hazardous chemicals at​ work?" B. "Are you able to look forward so that I can look at your​ neck?" C. "Can you remove your shirt so that I can view the skin on your upper​ body?" D. "Can I take a photograph of this lesion on your​ arm?"

A. Are you exposed to any hazardous chemicals at work ​ Rationale: During a health history for a client with a history of nonmalignant​ skin, the nurse should ask specific questions related to the​ client's risk and behavior. It is known that certain chemicals have long been associated with nonmelanoma skin cancer. Asking the client to remove clothing to observe the​ skin, to take a photograph of a​ lesion, and to look forward to observe the neck are all part of the physical assessment.

The community health nurse is teaching a group of community members on the risk factors for developing lung cancer. Which information is most important for the nurse​ include? A. Avoid asbestos exposure. B. Limit secondhand smoke exposure. C. Avoid alcohol consumption. D. Engage in physical activity.

A. Avoid asbestos exposure ​ Rationale: The nurse should include information about how exposure to asbestos increases the​ client's risk for lung cancer. The nurse needs to educate the client about​ avoiding, not​ limiting, secondhand smoke. Alcohol intake is not linked to lung cancer. Physical activity does not affect the risk for lung cancer.

Which information should the nurse include in the discharge teaching for a client diagnosed with actinic​ keratosis? Select all that apply. A. Avoid sun exposure. B. Use sunscreen with at least 15 SPF. C. Wear long sleeves if outdoors during peak sun hours. D. Seek medical attention for any shiny or scaly skin lesions. E. Avoid​ indomethacin, lithium, and​ beta-adrenergic blocking agents.

A. Avoid sun exposure. B. Use sunscreen with at least 15 SPF. C. Wear long sleeves if outdoors during peak sun hours. D. Seek medical attention for any shiny or scaly skin lesions. ​ Rationale: Actinic keratosis is directly related to chronic sun​ exposure, photo​ damage, and psoriasis. The UV radiation exposure induces cellular DNA mutation in the skin. The absence of further UV light exposure may result in resolution through repair mechanisms. Additional UV light exposure may induce further DNA​ mutations, resulting in squamous cell cancer. The client should be taught to wear long​ sleeves, long​ pants, and a​ wide-brimmed hat if outdoors during sunlight hours. Using sunscreen with an SPF of at least 15 reduces the rate of the disorder. Shiny or scaly skin lesions are a manifestation of squamous cell cancer lesions.​ Indomethacin, lithium, and​ beta-adrenergic blocking agents are medications that can precipitate exacerbations of psoriasis and should be avoided if the client has a history of psoriasis. These medications do not cause an exacerbation of actinic keratosis.

The nurse is teaching a client with chronic myeloid leukemia​ (CML) about ongoing needs. Which intervention would the nurse include when educating this​ client? (Select all that​ apply.) A. Avoid​ alcohol-based mouthwash. B. Complete oral hygiene frequently. C. Drink five to eight glasses of water a day. D. Refrain from eating overly spicy foods. E. Participate in strenuous exercise.

A. Avoid​ alcohol-based mouthwash. B. Complete oral hygiene frequently. C. Drink five to eight glasses of water a day. D. Refrain from eating overly spicy foods. ​ Rationale: The nurse would educate the client to complete oral hygiene frequently to prevent infections. The nurse would educate the client to drink five to eight glasses of water a day to prevent dehydration. The nurse would educate the client to refrain from using​ alcohol-based mouthwashes and eating overly spicy foods to prevent injury to the oral mucosa. The nurse would educate the client to avoid contact sports and strenuous exercise to prevent​ injury, not encourage participation in them.

The nurse is providing a class at the local community center for mothers of​ school-age children. Which​ evidence-based cancer screening guideline should the nurse include concerning breast cancer​ prevention? A. Begin annual mammograms at age 45. B. Complete monthly​ self-breast exams. C. Get a breast exam every 2 years by a healthcare provider. D. Obtain annual breast ultrasounds beginning at age 55.

A. Begin annual mammograms at age 45 ​ Rationale: Annual mammograms should be done beginning at age 45. There is no clear benefit indicated by physical breast exams by either clients or healthcare providers. The nurse would not necessarily include this in the guidelines. Breast ultrasounds are generally done as a​ follow-up for abnormalities detected by a​ mammogram; they are not routinely recommended.

A client is returning to the oncology clinic after a skin biopsy on an arm lesion revealed melanoma. Which additional diagnostic test should the nurse expect to be ordered to evaluate this client for​ metastasis? (Select all that​ apply.) A. Bone scan B. Chest​ x-ray C. Radiation therapy D. CT scan of the liver E. Liver function tests

A. Bone scan B. Chest x-ray D. CT Scan of the liver E. Liver function tests Rationale: The client with a positive biopsy for melanoma would need further diagnostic tests to rule out metastasis and to perform staging of the malignancy. These would include a CT of the brain and​ liver, liver function​ tests, an initial chest​ x-ray, and a bone scan. Radiation therapy would be used in the treatment of inoperable lesions because of the location or for a client who is a poor surgical​ risk; it is not used to evaluate for metastasis or lesion staging.

A client with cancer is complaining about rapid weight and muscle mass loss. The nurse explains that they are experiencing which characteristic feature of​ cancer? A. Cachexia B. Paraneoplastic syndrome C. Metastasis D. Tumor lysis syndrome

A. Cachexia ​ Rationale: Cachexia is the wasting syndrome that includes malnutrition and unexplained loss of weight and muscle mass. Metastasis refers to the spreading of malignant neoplasms to other areas of the body. Paraneoplastic syndrome is a rare disorder triggered by an altered immune system response to the neoplasm. In tumor lysis​ syndrome, cellular lysis leads to the release of intracellular contents into the circulation causing​ hyperkalemia, hyperuricemia, and hyperphosphatemia.

The nurse is updating the care plan for a client recovering from a mastectomy. Which should the nurse include to prevent​ infection? (Select all that​ apply.) A. Change dressings and IV tubing using aseptic technique. B. Encourage​ range-of-motion exercises in the affected arm each shift. C. Observe incision and IV sites for​ pain, redness,​ swelling, and drainage. D. Assess surgical dressings for​ bleeding, drainage,​ color, and odor every 4 hours for 24 hours. E. Tell the client to avoid deodorant and talcum powder on the affected side until the incision is completely healed.

A. Change dressings and IV tubing using aseptic technique. C. Observe incision and IV sites for​ pain, redness,​ swelling, and drainage. D. Assess surgical dressings for​ bleeding, drainage,​ color, and odor every 4 hours for 24 hours. E. Tell the client to avoid deodorant and talcum powder on the affected side until the incision is completely healed. ​Rationale: The care plan would include changing dressings and IV tubing using aseptic​ technique; observing incision and IV sites for​ pain, redness,​ swelling, and​ drainage; and assessing surgical dressings for​ bleeding, drainage,​ color, and odor every 4 hours for 24 hours. Telling the client to avoid deodorant and talcum powder on the affected side until the incision is completely healed will also help to prevent infection. Encouraging​ range-of-motion exercises in the affected arm will help to promote optimal circulation.

The nurse is conducting a community program and will discuss the symptoms of lung cancer. Which symptoms should the nurse include in the​ teaching? (Select all that​ apply.) A. Chronic cough B. Hemoptysis C. Small amounts of yellow or green sputum D. Wheezing E. Sharp, stabbing chest pain

A. Chronic cough B. Hemoptysis D. Wheezing Rationale: Symptoms of lung cancer include chronic cough and hemoptysis. Wheezing is present as a result of airway obstruction. Yellow or green sputum is usually the result of a pulmonary​ infection, not lung cancer. The pain associated with lung cancer is dull and aching.

The nurse is evaluating the laboratory results of a​ client's elevated​ prostate-specific antigen​ (PSA) test. Which statement regarding the PSA test should the nurse​ consider? (Select all that​ apply.) A. Clients with a normal PSA may have prostate cancer. B. An elevated PSA may indicate prostatitis. C. Fluctuating PSA test results strongly indicate prostate cancer. D. A urinary tract infection may elevate a​ client's PSA. E. PSA levels should be interpreted in conjunction with a​ client's health history.

A. Clients with a normal PSA may have prostate cancer. B. An elevated PSA may indicate prostatitis. D. A urinary tract infection may elevate a​ client's PSA. E. PSA levels should be interpreted in conjunction with a​ client's health history. ​ Rationale: Until​ recently, the National Cancer Institute guidelines included considering a PSA level of 4.0​ ng/mL or lower to be normal.​ However, current research suggests that men with normal PSA levels may nevertheless have prostate cancer.​ Likewise, an elevated or fluctuating PSA​ level, which previously was considered to be a relative indication for prostate​ biopsy, has been known to occur also in conditions such as prostatitis and urinary tract infection.​ Therefore, PSA levels are now interpreted in conjunction with the​ client's health history.

The nurse is caring for a client with lung cancer who asks what symptoms would indicate that the cancer has metastasized. Which symptom should the nurse include in the​ response? (Select all that​ apply.) A. Confusion and impaired gait B. Bone pain C. Pathologic fractures D. Jaundice E. Nausea and vomiting

A. Confusion and impaired gait B. Bone pain C. Pathologic fractures D. Jaundice Rationale: Confusion and impaired gait indicate possible metastasis to the brain. Bone pain and pathologic fractures indicate metastasis to the bone. Jaundice indicates metastasis to the liver. Nausea and vomiting are generic​ symptoms, not necessarily associated with metastasis.

A client diagnosed with actinic keratosis has been sent for a specialty​ follow-up. Which treatment should the nurse expect the client to​ undergo? (Select all that​ apply.) A. Curettage B. Cryotherapy C. Phototherapy D. Topical creams E. Chemical peeling

A. Curettage B. Cryotherapy D. Topical Creams E. Chemical peeling Rationale: Cryotherapy is the most common treatment for actinic keratosis. Curettage is also used to scrape off damaged​ cells; it may be followed by​ electrosurgery, in which a​ pencil-shaped instrument is used to cut and destroy the affected tissue with an electric current. Topical medications used to treat actinic keratosis include creams that destroy cells by blocking essential cellular functions. Chemical peeling involves applying a chemical solution that causes the skin to blister and​ peel, allowing new skin to form. Phototherapy treatment is used for the treatment of​ psoriasis, not for the treatment of actinic keratosis.

The nurse is interviewing a client admitted with a diagnosis of prostate cancer and questions the client regarding his symptoms. Which​ symptom, if experienced by the​ client, supports the​ diagnosis? (Select all that​ apply.) A. Dysuria B. Polyuria C. Nocturia D. Frequent urination E. Reduction in urinary stream

A. Dysuria C. Nocturia D. Frequent urination E. Reduction in urinary stream Rationale: Dysuria is painful or difficult urination that occurs because of prostatic cancer. As the tumor​ grows, it can compress the​ urethra, leading to urinary obstruction. The tumor may metastasize directly into the seminal vesicles or bladder or may spread via the lymphatic and venous systems. Other manifestations of prostate cancer include​ hematuria, nocturia, increased urinary​ frequency, reduction in urinary​ stream, and abnormal prostate on digital rectal exam. Polyuria is not a symptom of prostate cancer.

When assessing a client with​ cancer, which immune system manifestation would be a​ concern? A. Evidence of infection B. Cyanosis C. Absent bowel signs D. Behavioral changes

A. Evidence of infection ​ Rationale: Evidence of infection is an immune system manifestation that would be a concern for the client with cancer. It is important for a client with cancer to maintain a healthy immune system as it plays a role in destroying the cancer. When the immune system discovers a​ neoplasm, it tries to destroy it using the resources of the body. The body mounts an​ all-out assault on the foreign​ invader, calling on many​ resources, including chemical​ mediators, hormones and​ enzymes, blood​ cells, antibodies,​ proteins, and inflammatory and immune responses. Absent bowel​ signs, behavioral​ changes, and cyanosis are concerning​ manifestations, but they are not related to the immune system.

The nurse is performing a physical assessment of a client suspected of cancer. Which component of the​ client's health history is most important for the nurse to consider while assessing the client for​ cyanosis? A. Exposure to secondhand smoke B. Sun exposure C. Complaints of abdominal pain D. Complaints of constant migraines

A. Exposure to secondhand smoke Rationale: Exposure to secondhand smoke is most relevant to the respiratory assessment that the nurse is performing. Sun exposure is more relevant to an integumentary assessment. Complaints of constant migraines would be more relevant to a neurological assessment. Complaints of abdominal pain are more relevant to a gastrointestinal assessment.

When assessing a client diagnosed with​ melanoma, which assessment should the nurse include in the​ client's health​ history? A. Family history of skin cancer B. Measurement of skin lesions C. Inspection of skin color D. Palpation of skin texture

A. Family history of skin cancer ​ Rationale: During the health history portion of the nursing​ assessment, the nurse would assess for a family history of skin cancer. Inspection of skin​ color, palpation of the​ texture, and measurement of lesions would be completed during the physical examination of the nursing assessment.

The nurse examining a client notices a skin lesion exhibiting the characteristics of early stage malignant melanoma. Which feature would the nurse have​ observed? (Select all that​ apply.) A. Flat B. Raised C. Asymmetric D. More than 3 mm in diameter E. More than 6 mm in diameter

A. Flat C. Asymmetric E. More than 6 mm in diameter Rationale: Almost all malignant melanomas are more than 6 mm in​ diameter, are​ asymmetric, and initially develop within the epidermis over a long period. While confined to the​ epidermis, the lesions are flat and relatively benign.

A​ 52-year-old client is admitted to the hospital​ and, after careful​ evaluation, is diagnosed with malignant melanoma. Which factor would determine the prognosis of this​ case? (Select all that​ apply.) A. Gender B. Metastasis C. Allergy status D. Family history E. Past medical history

A. Gender B. Metastasis ​ Rationale: The prognosis for survival among people diagnosed with malignant melanoma is determined by several​ variables, including tumor​ thickness, ulceration,​ metastasis, site, and the​ client's age and gender. Younger clients and women have a somewhat better chance of survival.

The parents of a child with cancer tell the nurse that the​ child's brother is acting out since the diagnosis and the parents are looking for advice. Which instruction would be most appropriate for the nurse to give to the​ parents? A. Give the child attention. B. Praise the child. C. Punish the child. D. Buy toys for the child.

A. Give the child attention ​ Rationale: The sibling of a child with cancer may be afraid of getting sick as well. The sibling may also be resentful of the ill child receiving all the attention.​ Therefore, the nurse should instruct the parents to give the sibling more attention. The nurse should not instruct the parents to punish or praise the child. Buying toys for the child is not​ appropriate, as the child only wants and needs attention.

The family of a client with cancer has contacted the nurse indicating that the client has been experiencing severe nausea with intermittent vomiting. Which intervention should the nurse encourage the family to do to address this​ issue? (Select all that​ apply.) A. Have the client avoid liquids with meals. B. Have the client sit upright for an hour after meals. C. Administer​ around-the-clock antiemetic drugs. D. Allow the client to eat whatever is appealing. E. Encourage the client to eat​ small, frequent​ low-fat meals with dry foods. F. Temporarily hold all foods and fluids from the client until the vomiting completely subsides.

A. Have the client avoid liquids with meals. B. Have the client sit upright for an hour after meals. C. Administer​ around-the-clock antiemetic drugs. E. Encourage the client to eat​ small, frequent​ low-fat meals with dry foods. ​ Rationale: Clients with cancer may frequently experience nausea and vomiting. To combat​ this, clients should be encouraged to avoid liquids with​ meals, sit upright for an hour after​ meals, and to eat​ small, frequent​ low-fat meals with dry foods such as toast or crackers. In​ general, if nausea and vomiting is not​ occurring, the client should be allowed to eat whatever is appealing. Holding all foods and fluids is not currently indicated unless the identified measures do not​ work, at which point the healthcare provider may consider other measures to address the nausea and vomiting.

The nurse is teaching a client with​ chemotherapy-induced stomatitis ways to improve oral intake. Which statement made by the client indicates a need for further​ instruction? A. "I should eat spicy foods to promote taste bud​ stimulation." B. "I should include Chlorhexidine mouthwash to prevent gum​ trauma." C. "I should use a soft toothbrush in order to remove the​ plaque." D. "I should use lubricating lip moisturizers to protect my​ lips."

A. I should eat spicy foods to promote taste bud stimulation Rationale: The client would need to consume a bland diet and avoid spicy foods. This statement indicates the client needs further education. The nurse would instruct the client to use lubricating lip moisturizers to protect the lips and a soft toothbrush and Chlorhexidine mouthwash to prevent trauma to the gums and oral cavity.

The client has indicated that he will be treated with a biologic for his leukemia. The nurse should expect that a drug from which group could be​ ordered? (Select all that​ apply.) A. Interferon B. Interleukin C. Imatinib mesylate D. Cyclophosphamide E. Colony-stimulating factor

A. Interferon B. Interleukin E. Colony-stimulating factor ​ Rationale: Interferons,​ interleukins, and​ colony-stimulating factors are all biological therapies that are used in the treatment of leukemia. Cyclophosphamide​ (Cytoxan) and imatinib mesylate​ (Gleevec) are both chemotherapy​ medications, not biological​ therapies, that are used to treat leukemia.

The nurse is discussing benign versus malignant neoplasms with a client who is being evaluated for possible malignancy. Which characteristic of a malignant neoplasm would the nurse include in the​ discussion? (Select all that​ apply.) A. Invasive B. Cohesive C. Rapid growth D. Encapsulated E. Not always easy to remove

A. Invasive C. Rapid growth E. Not always easy to remove Rationale: As compared with benign​ neoplasms, malignant neoplasms are​ invasive, grow​ rapidly, and are not always easy to remove. Benign​ neoplasms, not malignant​ neoplasms, are generally cohesive and encapsulated.

The nurse assigns a client with lung cancer the nursing diagnosis of Activity Intolerance​ (NANDA-I ©2014). Which intervention should the nurse include in the care​ plan? A. Keep​ frequently-used objects within the​ client's easy reach. B. Discourage the​ client's family from providing assistance to the client. C. Plan care to cluster activities. D. Encourage the client to remain in bed as much as possible.

A. Keep frequently used objects within the client's easy reach ​Rationale: Keeping frequently used objects within easy reach allows the client to conserve energy. Family assistance should be encouraged. The maintenance of physical activity to the level of tolerance should be encouraged. Nursing activities should be alternated with frequent rest periods.

The nurse is completing an assessment on a client diagnosed with acute myeloid leukemia​ (AML). Assessment data include an altered level of​ consciousness, client complaints of​ headache, and nausea and vomiting. The nurse anticipates this may be due to which pathophysiological​ change? A. Leukemic cell infiltration B. Inadequate production of RBCs C. Immature WBCs D. Reduced coagulation factors

A. Leukemic cell infiltration Rationale: Leukemic cell infiltration can result in multisystem effects. Meningeal infiltration is characterized by manifestations of increased pressure including​ headache, altered level of​ consciousness, cranial nerve​ impairment, and nausea and vomiting. Immature WBCs can lead to increased infection risk. Reduced coagulation factors can lead to bleeding. Inadequate production of RBCs can lead to anemia.

The nurse is providing teaching to a client receiving brachytherapy. Which point would the nurse​ prioritize? (Select all that​ apply.) A. Limit close contact with others. B. Wear condoms during intercourse. C. Assess skin for irritation. D. Report urinary frequency. E. Only wear cotton underwear.

A. Limit close contact with others B. Wear condoms during intercourse D. Report urinary frequency ​ Rationale: Limiting close contact and wearing condoms will decrease exposure to others. Brachytherapy can cause urinary frequency. Skin irritation is not common with brachytherapy. The client can wear underwear that is​ comfortable; it does not have to be cotton only.

When assessing an adult survivor of childhood​ cancer, which factor should the nurse identify as increasing the risk for​ long-term emotional and psychologic​ distress? (Select all that​ apply.) A. Low income B. Unemployment C. Low education D. Non-intact family E. Poor health status F. Diagnosis before age 5

A. Low income B. Unemployment C. Low education E. Poor health status Rationale: Low​ income, unemployment, low​ education, and poor health status are correlated with the highest risk of​ long-term emotional and psychologic distress in adult survivors of childhood cancer.​ Non-intact family and diagnosis before age 5 are not correlated with the highest risk.

The nurse is teaching the parents of a child with acute lymphocyte leukemia​ (ALL) about the​ long-term effects of treatment for this disease. Which potential chronic health challenge should the nurse discuss regarding what the child might face as an​ adult? (Select all that​ apply.) A. Obesity B. Infertility C. Pancreatitis D. Growth retardation E. Growth hormone deficiency

A. Obesity B. Infertility E. Growth hormone deficiency ​ Rationale: Adult survivors of ALL often face chronic health challenges due to the medications and therapies used to treat​ ALL, including growth hormone​ deficiency, infertility, and obesity. They may also suffer from​ hypertension, chronic​ fatigue, osteoporosis, and development of secondary cancers. Pancreatitis and growth retardation are not indicated as chronic adult health challenges secondary to treatment for ALL.

The nurse prepares to visit the home of a client recovering from a mastectomy for breast cancer. Which should be included in the ongoing care of this​ client? (Select all that​ apply.) A. Postmastectomy exercises B. Signs and symptoms of infection C. Importance of adequate rest periods D. Possible participation in a support group E. Keeping the affected limb immobile as much as possible

A. Postmastectomy exercises B. Signs and symptoms of infection C. Importance of adequate rest periods D. Possible participation in a support group ​ Rationale: The ongoing care of the client who has undergone surgical interventions for breast cancer include telling about the importance of adequate​ rest, talking about signs and symptoms of​ infection, teaching postmastectomy​ exercises, and possibly participating in a support group. The client should be encouraged to use the affected limb for daily needs to maintain function and​ strength; the client should not keep it immobile.

Which nursing intervention would help to directly address the anemia that occurs with​ leukemia? (Select all that​ apply.) A. Promote rest. B. Perform blood transfusions. C. Monitor coagulation studies. D. Administer epoetin as prescribed. E. Administer preventive antimicrobials as prescribed.

A. Promote rest. B. Perform blood transfusions. D. Administer epoetin as prescribed. ​ Rationale: Clinical therapies to address the anemia secondary to leukemia include promoting​ rest, administering medications such as epoetin to stimulate RBC​ production, and performing blood transfusions. Other therapies to address anemia include improving nutritional status and monitoring vital signs and CBCs. Monitoring coagulation studies would address​ bleeding, while administering antimicrobials would address the risk for infection.

The nurse is preparing a poster on prostate cancer for display at a health fair. Which information should the nurse include on the​ poster? (Select all that​ apply.) A. Prostate cancer occurs more often in African American men than in Caucasian American men. B. Prostate cancer is the most common type of cancer among men. C. Prostate cancer is the second leading cause of death in North America. D. Prostate cancer confined to the prostate has a​ 100% survival rate at 5 years. E. Prostate cancer incidence is reduced in men who take large amounts of vitamin A.

A. Prostate cancer occurs more often in African American men than in Caucasian American men. B. Prostate cancer is the most common type of cancer among men. C. Prostate cancer is the second leading cause of death in North America. D. Prostate cancer confined to the prostate has a​ 100% survival rate at 5 years. Rationale: Prostate cancer is the most common type of cancer among men and is the second leading cause of death in North America. When confined to the​ prostate, the​ 5-year survival rate is​ 100%. If the cancer spreads​ regionally, the survival rate is​ 95% after 5 years. This disease occurs in African American men at a rate of more than​ 60% higher than seen in Caucasian American men. Asian Americans and Native Americans have the lowest incidence of prostate cancer. Taking large amounts of vitamin A does not reduce the incidence of prostate cancer.

When planning care for a client with acute lymphocytic leukemia​ (ALL), the nurse addresses the problem of insufficient calorie intake. Which nursing intervention will assist in addressing this​ problem? A. Provide mouth care before meals. B. Medicate for pain 90 minutes before meals. C. Provide​ high-fat meals throughout the day. D. Weigh the client weekly.

A. Provide mouth care before meals Rationale: Providing mouth care before meals will assist in addressing the problem of insufficient calorie intake when caring for a client with ALL. Weighing the client​ daily, not​ weekly, will assist in addressing the problem of insufficient calorie intake when caring for a client with ALL. Medicating for pain 30​ minutes, not 90​ minutes, before meals will assist in addressing the problem of insufficient calorie intake when caring for a client with ALL. Providing​ low-fat meals, not​ high-fat meals, will assist in addressing the problem of insufficient calorie intake when caring for a client with ALL.

The nurse is caring for a client receiving chemotherapy and radiation. Which intervention should the nurse include to protect the client from​ infection? (Select all that​ apply.) A. Provide skin care. B. Administer antiemetics. C. Instruct the client to avoid crowds. D. Perform good handwashing. E. Include strict aseptic technique.

A. Provide skin care. C. Instruct the client to avoid crowds. D. Perform good handwashing. E. Include strict aseptic technique. Rationale: As the skin is a​ person's first line of​ defense, maintaining intact skin integrity is imperative. The nurse should instruct the client to avoid crowds to prevent infection. The nurse should implement good handwashing and maintain strict aseptic technique to protect the client.

A​ 29-year-old client received a diagnosis of pancreatic cancer 2 weeks ago. He complains of having severe nausea and vomiting. He has not been able to progress to a full diet. Which is an example of a collaborative intervention that might decrease the​ client's symptoms? A. Providing antiemetic drugs before meals B. Adding flavorful spices to season the food C. Performing regular assessments frequently D. Talking about macronutrients and micronutrients

A. Providing antiemetic drugs before meals Rationale: Providing antiemetic drugs before meals is a collaborative effort with the prescribing healthcare provider. No prescription or collaboration is needed for performing regular assessments​ frequently, or for talking about macronutrients and micronutrients. Adding more spices might increase nausea and vomiting due to heightened GI sensitivity.

The community health nurse conducting a teaching session on lung cancer explains that smoking is the leading risk factor for lung cancer. Which additional risk factor should the nurse include in the​ teaching? (Select all that​ apply.) A. Radon exposure B. Ionizing radiation C. Asbestos D. Exposure to the sun E. Lack of physical activity

A. Radon exposure B. Ionizing radiation C. Asbestos Rationale: Radon​ (a radioactive gas present in​ closed-in spaces in the​ environment), ionizing​ radiation, and asbestos are all risk factors for lung cancer. Exposure to the sun is a risk factor for skin cancer. Lack of physical activity is not a risk factor for lung cancer.

The nurse prepares a teaching poster for placement in a​ women's health clinic. Which activity should the nurse identify to help prevent breast​ cancer? (Select all that​ apply.) A. Refraining from smoking B. Engaging in physical activity C. Completing monthly​ self-breast exams D. Limiting hormone therapy in duration and dose E. Avoiding exposure to environmental pollution and radiation

A. Refraining from smoking B. Engaging in physical activity D. Limiting hormone therapy in duration and dose E. Avoiding exposure to environmental pollution and radiation Rationale: Refraining from​ smoking, engaging in physical​ activity, limiting hormone therapy in duration and​ dose, and avoiding exposure to environmental pollution and radiation can all help prevent the development of breast cancer. Completing monthly​ self-breast exams can help detect breast cancer early but does not prevent breast cancer.

The nurse is providing teaching to a client who will begin radiation therapy for prostate cancer. Which information should the nurse include regarding sexual​ function? A. Sexual function may be impaired. B. It is not necessary to use condoms during intercourse. C. Sexual function will not be impaired. D. Testosterone will be given to assist sexual function.

A. Sexual function may be impaired ​ Rationale: Sexual function may be impaired. Testosterone would not be​ used, as tumors could be androgen dependent. Condoms would be recommended during intercourse to protect the​ client's partner from radiation.

The nurse is reviewing care instructions for a client who had a radical mastectomy of the right breast. Which instruction is appropriate for the nurse to include in the teaching​ session? (Select all that​ apply.) A. ​"Sleep with the right arm elevated on a​ pillow." B. "You will be able to resume playing golf with your​ friends." C. "You should apply hot compresses to the right arm if it is​ aching." D. "Do not allow anyone to take your blood pressure in the right​ arm." E. "It is okay to carry your purse on your right arm as long as it is not​ heavy."

A. Sleep with the right arm elevated on a pillow D. Do no allow anyone to take your blood pressure in the right arm ​Rationale: Elevation of the affected extremity after lymph node removal will allow drainage of​ fluid, prevent​ swelling, and promote circulation. Compression of the arm on the surgical side may increase the risk of developing lymphedema. The client should avoid carrying a purse or a briefcase on the affected arm. The client should avoid hot water contact on the affected extremity. Heat promotes vasodilation and fluid accumulation. Sports such as golf should be avoided in a client with a radical mastectomy.

A client with breast cancer receives diagnostic testing and scan results that indicate a tumor that is 4.2 cm in size with evidence of metastasis to movable ipsilateral axillary nodes only. According to the TNM staging​ system, how should this​ client's breast cancer be​ staged? A. T2 N1 M0 B. T1 N0 MO C. Tis N1 M0 D. T3 N2 M1

A. T2 N1 M0 Rationale: This​ client's breast cancer would be staged as T2 N1 M0. T2 indicates a tumor no larger than 5​ cm, N1 indicates metastasis to movable ipsilateral axillary​ nodes, and M0 indicates no distant metastasis. T1 indicates a tumor no larger than 2 cm. This indicates a tumor in situ. T3 indicates a tumor larger than 5 cm. N0 indicates no regional lymph node metastasis. N2 indicates metastasis to ipsilateral fixed axillary nodes. M1 indicates distant metastasis.

A client with breast cancer asks which medication will most likely be used for chemotherapy before having surgery. Which medication should the nurse explain as the most common hormone therapy used to treat breast​ cancer? A. Tamoxifen B. Anastrozole C. Letrozole D. Trastuzumab

A. Tamoxifen Rationale: Tamoxifen is the most common hormone therapy drug used to treat breast cancer. It works by preventing estrogen from attaching to estrogen receptors on the cancer​ cells, which inhibits tumor growth and ultimately kills tumor cells. Letrozole​ (an aromatase​ inhibitor) has Trastuzumab​ (Herceptin) is used to stop the growth of breast tumors that express the​ HER2/neu receptor. Anastrozole​ (Arimidex) is the aromatase inhibitor used as first line treatment in postmenopausal women.

The nurse is teaching the family of a​ soon-to-be discharged client with cancer about when to call 911 versus when to call the healthcare provider. Which signs and​ symptoms, if​ noted, would necessitate calling​ 911? (Select all that​ apply.) A. The client has become unconscious. B. The client is complaining of a severe headache. C. The client is physically abusive and hurting themself. D. The client has developed new bleeding from the rectum. E. The client has difficulty breathing accompanied by a bluish tinge of the lips and face

A. The client has become unconscious C. The client is physically abusive and hurting themself E. The client has difficulty breathing accompanied by a bluish tinge of the lips and face Rationale: If the client becomes​ unconscious, is physically abusive and hurting​ themself, or has difficulty breathing accompanied by a bluish tinge of the lips and​ face, the client or family should call 911. If a severe headache or bleeding from a new site should​ occur, the client or family should first contact the healthcare provider.

A​ 33-year-old woman has just given birth to identical twin girls. Both newborns had Apgar scores of 8. Twin A weighed 8 lbs 3​ oz, and twin B weighted 7 lbs 8 oz. During postdelivery​ assessment, the client asks the nurse about a term she heard on​ TV, "the human​ genome." What can the nurse tell her about her​ newborns' genomes? A. The newborns have identical genomes. B. A high Apgar score means high genome scores. C. Testing is needed to assess their genomes. D. The larger newborn has a larger genome.

A. The newborns have identical genomes Rationale: The newborns have identical genomes due to having the same exact DNA. This fact is not altered by​ weight, testing, or an Apgar score.

A client with breast cancer is scheduled for radiation prior to surgery. Which situation supports the use of radiation prior to​ surgery? A. The tumor is unusually large. B. The tumor is expressing the​ HER2/neu receptor. C. Pain from the tumor is severe. D. The cancer has already metastasized.

A. The tumor is unusually large Rationale: Radiation may be done to shrink an unusually large tumor prior to surgery. Palliative radiation may be used to treat chest wall recurrences and some bone metastases to help control pain and prevent fractures. Radiation is not necessarily indicated if the tumor has already metastasized.​ Herceptin, not​ radiation, may be used to stop the growth of tumors that express the​ HER2/neu receptor.

A client with lung cancer who is to begin a regimen of radiation therapy asks the nurse the purpose of radiation therapy. Which should the nurse include in the response to the​ client? (Select all that​ apply.) A. To debulk tumors B. To relieve​ cough, bone​ pain, and dyspnea C. To attack tumor cells at different parts of the cell cycle D. To treat vena cava syndrome E. To treat cancer that has spread by direct extension to other thoracic structures

A. To debulk tumors B. To relieve​ cough, bone​ pain, and dyspnea D. To treat vena cava syndrome E. To treat cancer that has spread by direct extension to other thoracic structures ​ Rationale: Radiation therapy is used to debulk​ tumors, to treat symptoms and complications of lung​ cancer, and to treat cancer that has spread by direct extension. Chemotherapy is used to attack tumor cells at different parts of the cell cycle.

Which statement by the nurse shows a need for further education about the essentials of​ genetics? A. "Two copies of a Y chromosome result in a​ female." B. "People have 46​ chromosomes." C. "DNA molecules are made up of long​ sequences." D. "Identical twins have the same​ DNA."

A. Two copies of a Y chromosome result in a female Rationale: Two copies of an X​ chromosome, not a Y​ chromosome, result in a female child. Identical twins have the same DNA. People have 46 chromosomes. DNA molecules are made up of long sequences.

The nurse caring for a client with acute lymphoblastic leukemia​ (ALL) would assess for which sign and​ symptom? (Select all that​ apply.) A. Weakness B. Bleeding C. Splenomegaly D. Decreased energy E. Recurrent infections

A. Weakness B. Bleeding D. Decreased energy E. Recurrent infections Rationale: Weakness,​ bleeding, decreased​ energy, and recurrent infections are all clinical manifestations of ALL. Splenomegaly is a clinical manifestation of chronic lymphocytic leukemia​ (CLL), acute myeloid leukemia​ (AML), and chronic myeloid leukemia​ (CML). Other manifestations of ALL include​ pallor, bone​ pain, weight​ loss, sore​ throat, and night sweats.

A client with acute lymphocytic leukemia presents to the hospital for his first dose of​ high-dose induction chemotherapy. What precaution should the nurse take during​ administration? A. Wear personal protective equipment. B. Place client in a negative pressure room. C. Premedicate client for allergic reaction. D. Have client wear a mask during treatment.

A. Wear personal protective equipment Rationale: Individuals who handle chemotherapeutic drugs are at constant risk of exposure because of the toxicity of antineoplastic medications. This risk of exposure can be minimized through the use of personal protective equipment​ (PPE) (i.e.,​ gowns, gloves, eye and face​ shields, and respirator​ protection) and a​ needle-less system. Clients who receive chemotherapy should wear a mask if they have a low WBC and at risk for exposure to infection. Clients who exhibit a reaction to the chemotherapy should be premedicated prior to their next administration. Negative pressure rooms are used for clients with a​ disease, such as​ tuberculosis, that is transmitted through the air by droplet​ nuclei, not for clients receiving chemotherapy.

The nurse is caring for a client newly admitted with suspected leukemia. The nurse anticipates which test will be ordered to confirm the​ diagnosis? (Select all that​ apply.) A. Platelet count B. Sedimentation rate C. Red blood cell count D. White blood cell count E. Bone marrow aspiration

A. platelet count C. RBC Count D. WBC count E. Bone marrow aspiration ​ Rationale: A complete blood count and​ differential, which include red and white blood cell​ counts, are helpful in diagnosing leukemia because they provide information on the​ size, number, and morphology of blood cells. Platelet counts are also helpful in finding thrombocytopenia secondary to leukemia. Bone marrow aspiration provides information about bone marrow cells and any abnormal blood cell formation. Sedimentation rate is not useful in diagnosing leukemia.

The nurse is discussing risks of external beam radiation for prostate cancer. The nurse would include which risk in this​ teaching? (Select all that​ apply.) A. Increased testosterone B. Erectile dysfunction C. Improved libido D. Urinary incontinence E. Rectal damage

B. ED D. Urinary incontinence E. Rectal damage Rationale: Erectile​ dysfunction, urinary​ incontinence, and rectal damage can occur as a result of external beam radiation. Radiation would not increase testosterone levels or improve libido.

The nurse assesses a client with dimpling of the skin in the left upper outer quadrant of the right breast and nipple discharge. Which question should the nurse ask to learn if the client is experiencing other clinical manifestations of breast​ cancer? A. "Have you noticed any itching around the nipple or in the area affected by​ dimpling?" B. "Have you noticed a rash or skin irritation around the nipple​ area?" C. "Have you been experiencing any night sweats or​ low-grade fevers?" D. "Does the skin in the left upper outer quadrant of the right breast feel warm to​ touch?"

B. "Have you noticed a rash or skin irritation around the nipple​ area?" Rationale: A persistent rash near the nipple area and skin irritation can both be clinical manifestations of breast cancer. Night​ sweats, low-grade​ fevers, itching of the breast and warmth in the affected area are not common manifestations of breast cancer.

A client diagnosed with lung cancer​ states, "I'm confused. My doctor said I have adenocarcinoma of the​ lungs, yet my wife believes she was told that I have​ non-small-cell carcinoma. Can you help me understand the​ difference?" Which response by the nurse is​ accurate? A. "It is best if you​ don't focus on what the cancer is called as they all present in a similar​ way." B. "It can be​ confusing, but adenocarcinoma is actually one type of​ non-small-cell carcinoma." C. "There are many different terms for the same cancer depending on who you are talking​ to." D. "I think your wife is probably referring to​ small-cell carcinoma, which is another name for​ adenocarcinoma."

B. "It can be​ confusing, but adenocarcinoma is actually one type of​ non-small-cell carcinoma." Rationale: The vast majority of primary lung lesions are bronchogenic carcinomas that are tumors of the airway epithelium. These tumors are further differentiated as​ small-cell carcinomas or​ non-small-cell carcinomas, and include​ adenocarcinomas, squamous cell​ carcinomas, and​ large-cell carcinomas. It is best to answer the​ client's question and provide accurate information.

The nurse is providing a seminar to men regarding screening for prostate cancer. Which percentage should the nurse present as the​ 5-year survival rate for prostate cancer confined to the​ prostate? A. 95% B. 100% C. 85% D. 80%

B. 100% Rationale: The​ 5-year survival rate for prostate cancer confined to the prostate is​ 100%. It is a commonly occurring cancer. If the cancer​ spreads, the survival rate is​ 95% after 5 years.

The nurse recognizes the importance of promoting effective cardiorespiratory function for a client with lung cancer. Which intervention should the nurse include in the plan of​ care? (Select all that​ apply.) A. Elevate the head of the bed to 30 degrees. B. Administer supplemental oxygen as ordered. C. Provide chest physiotherapy with percussion and postural drainage. D. Suction the airway every 15 minutes. E. Assist the client to​ turn, cough, and deep breathe.

B. Administer supplemental oxygen as ordered. C. Provide chest physiotherapy with percussion and postural drainage. E. Assist the client to​ turn, cough, and deep breathe. ​ Rationale: Administering supplemental oxygen improves oxygenation status. Chest physiotherapy with percussion and postural​ drainage, and​ turning, coughing, and deep breathing help maintain airway patency. Suctioning the airway should only be done as needed. Elevate the head of the bed to at least 60 degrees to permit optimal lung expansion.

The nurse is educating a client newly diagnosed with prostate cancer regarding the purpose of androgen deprivation therapy. Which teaching would the nurse include in this​ education? A. Androgen deprivation therapy is preferred over chemotherapy. B. Androgen deprivation therapy decreases cancer cell growth. C. Androgen deprivation therapy improves erectile dysfunction. D. Androgen deprivation therapy increases tumor suppressor cells.

B. Androgen deprivation therapy decreases cancer cell growth ​ Rationale: Most cancer cells are androgen dependent and depriving the cells of androgen hormones can cause the cells to either die or cease growing. Androgen deprivation therapy is used in conjunction with radiation and chemotherapy. Androgen deprivation will not improve erectile dysfunction.

Other than​ cancer, which disease is caused by problems in cellular​ regulation? (Select all that​ apply.) A. Polio B. Anemia C. Pneumonia D. Polycythemia E. Sickle cell disease

B. Anemia D. Polycythemia E. Sickle cell disease ​ Rationale: Anemia, sickle cell​ disease, and polycythemia are caused by problems in cellular regulation. Polio is caused by a virus. Pneumonia can be caused by a virus or by bacteria.

The nurse is completing the care plan for a client admitted for treatment of injury. Which intervention should the nurse include in the plan to decrease risk for injury related to​ bleeding? (Select all that​ apply.) A. Monitor renal function. B. Avoid invasive procedures. C. Assess vital signs every four hours. D. Carefully monitor intake and output. E. Assess body systems for bleeding every shift. F. Instruct the client to avoid forceful coughing or sneezing.

B. Avoid invasive procedures. C. Assess vital signs every four hours. E. Assess body systems for bleeding every shift. F. Instruct the client to avoid forceful coughing or sneezing. ​Rationale: To protect the client from injury related to​ bleeding, the nurse should avoid invasive​ procedures, assess vital signs every four​ hours, assess body systems for bleeding every​ shift, and instruct the client to avoid forceful coughing or sneezing. Monitoring renal function and intake and output help to prevent and manage adverse medication effects.

A client with lung cancer has a respiratory rate of 28 breaths per minute and a heart rate of 90 bpm at rest. The client complains of being short of breath when walking from bed to the bathroom and asks for the head of the bed to be elevated because it makes it easier to breathe. Which nursing diagnosis should the nurse​ address? A. Gas​ Exchange, Impaired B. Breathing​ Pattern, Ineffective C. Pain, Acute D. Grieving

B. Breathing patter, Ineffective ​ Rationale: Tachypnea, shortness of breath with​ exertion, and needing the head of the bed to be elevated all indicate that the client is exhibiting an ineffective breathing pattern. To assign a diagnosis of Gas​ Exchange, Impaired the nurse needs to assess the arterial blood gasses or pulse oximetry or note cyanosis. The client in this scenario does not complain of pain. These symptoms do not fit the diagnosis of grieving. ​(NANDA-I ©2014)

A female client has a​ grapefruit-sized tumor in her abdomen. Her healthcare provider believes the tumor is life threatening. Which diagnostic test is appropriate to determine the extent of the​ tumor? A. Cytological examination of aspirated tumor cells B. Computerized tomography​ (CT) scan C. Cytological examination of exfoliated cells from the epithelial surface of the tumor D. Tumor markers

B. CT Scan Rationale: Diagnostic imaging tests are used to determine the extent of a tumor when it has reached a​ life-threatening size. Cytological examination of tumor cells identifies the​ classification, grading, and staging of the cancer. Tumor markers are proteins detected in body fluids that indicate a tumor may exist in the body.

A client who is 30 weeks pregnant has been diagnosed with breast cancer. The client tells the nurse that the oncologist has recommended​ chemotherapy, but she fears for the safety of the fetus. Which response by the nurse is the most appropriate to address the​ client's concerns? A. "I understand that it is a difficult choice for​ you, but the cancer must be​ treated, and chemotherapy is really the only viable option for the cancer you​ have." B. "Certain types of chemotherapy can be administered in the second and third trimester.​ Let's talk about the safety of these​ options." C. "Surgery is really the only safe​ option; you should talk to the oncologist about surgical treatment​ only." D. "Radiation therapy can be narrowly focused so that no harm will come to the fetus. Would you prefer to try that​ instead?"

B. Certain types of chemotherapy can be administered in the second and third trimester. Let's talk about the safety of these options ​ Rationale: Informing the client that certain types of chemotherapy can be administered in the second and third trimester and offering to discuss the safety of these options would best respond to the​ client's concerns. While surgery is the safest​ option, indicating to the client that it is the only safe option does not best respond to the​ client's concerns. Radiation therapy is generally avoided due to potential harm to the fetus. Telling the client that it is the only viable option is not necessarily a valid statement nor does it acknowledge the concerns the client is expressing.

Which activity should the nurse teach a client who has been diagnosed with melanoma skin cancer in the past to​ follow? A. Staying inside during the summer B. Checking skin routinely for any large moles C. Reporting to the office every 6 months D. Washing the skin with a special solution

B. Checking skin routinely for any large moles ​ Rationale: One of the risk factors for melanoma skin cancer is a high number of moles or large moles.​ Therefore, routine skin assessment would be important. The client would be advised to call the health care provider if any changes in lesions or new lesions appear. Staying indoors is not practical.​ Instead, clients should be advised to wear sunscreen with a skin protection factor​ (SPF) of at least 15 and to cover vulnerable sites. The client would be advised to call the healthcare provider. The client does not need to wash with a special solution.

The nurse preceptor discusses with a new graduate the external agents known to cause cancer. Which external agent should the preceptor include in the​ discussion? A. Inherited traits B. Chemicals C. Immune conditions D. Hormones

B. Chemicals ​ Rationale: Chemicals and radiation are considered external factors that are known to cause cancer.​ Hormones, immune​ conditions, and inherited mutations are internal factors that are known to cause cancer.

A​ 62-year-old woman has been diagnosed with a pigmented basal cell carcinoma following a skin biopsy. The client has already had an excision of the lesion. Which additional therapy should the nurse expect may be​ recommended? (Select all that​ apply.) A. Laser surgery B. Chemotherapy C. Immunotherapy D. Radiation therapy E. Topical creams or gels

B. Chemotherapy C. Immunotherapy D. Radiation therapy ​ Rationale: Immunotherapy, radiation​ therapy, and chemotherapy are additional therapies that may be recommended by the healthcare provider for a nonmelanoma type of skin cancer. Laser surgery and topical creams would be appropriate for actinic keratosis.

Which factor increases the risk of developing​ leukemia? (Select all that​ apply.) A. Obesity B. Cigarette smoking C. Previous cancer treatment D. Excessive caffeine ingestion E. Diagnosis of Down syndrome

B. Cigarette smoking C. Previous cancer treatment E. Diagnosis of Down syndrome​ Rationale: Cigarette​ smoking, chromosomal alterations from Down​ syndrome, and​ long-term changes in cellular production from previous cancer treatments are factors that increase the risk for developing leukemia. Caffeine intake and obesity do not increase the risk for developing leukemia.

The nurse is caring for a client with severe anemia. Which clinical manifestation of anemia would indicate the client has cardiovascular​ compromise? (Select all that​ apply.) A. Urticaria B. Cyanosis C. Chest pain D. Tachycardia E. Nausea and vomiting

B. Cyanosis C. Chest pain D. Tachycardia Rationale: Cardiovascular signs of anemia occur due to lack of oxygenation. This includes​ cyanosis, chest​ pain, and tachycardia.​ Urticaria, nausea, and vomiting are clinical manifestations of anaphylaxis.

The nurse is providing education regarding dietary risk for prostate cancer. Which food would the nurse prioritize as carrying the highest​ risk? A. Fruits B. Dairy C. Fish D. Vegetables

B. Dairy Rationale: Diets high in animal​ fat, such as dairy​ products, increase the risk for prostate cancer.​ Vegetables, fruits, and fish would be acceptable dietary choices.

Which modifiable risk factor should the nurse assess to determine the risk of cancer development in a​ client? (Select all that​ apply.) A. Age B. Diet C. Tobacco use D. Sun exposure E. Family history

B. Diet C. Tobacco use D. Sun exposure​ Rationale: Modifiable risk factors are those that can be changed by the client. These include​ diet, tobacco​ use, and sun exposure. Nonmodifiable risk​ factors, such as age and family​ history, cannot be changed.

The nurse is providing discharge teaching to the parent of a​ 12-year-old child with leukemia. Which recommendation by the nurse is most​ appropriate? A. Allow the child to refrain from schoolwork during periods of hospitalization. B. Encourage the child to return to school as soon as possible. C. Keep consistent meal and bedtime regimes. D. Explore how to teach the child at home until full recovery.

B. Encourage the child to return to school as soon as possible ​ Rationale: School-age children may show anger and sadness over the losses they are experiencing and look for more emotional and social support from their friends and family.​ Therefore, they should return to school as soon as possible after diagnosis and teachers should be made aware of their situation. Arrangements should be made for tutors to assist the child with schoolwork during hospitalization and home care if needed.​ Infants, toddlers, and young children should be assisted to maintain feeding and bedtime routines as much as​ possible, whereas a​ 12-year-old child is able to handle more independence and control.

Which intervention promotes optimal circulation after a surgical intervention for breast​ cancer? A. Observing the surgical site for redness and swelling B. Encouraging​ range-of-motion exercises in the affected arm C. Monitoring surgical drains for amount and color of drainage D. Assessing for manifestations of lymphedema

B. Encouraging range of motion exercises in the affected arm Rationale: Encouraging​ range-of-motion exercises in the affected arm will help promote optimal circulation. Assessing for manifestations of​ lymphedema, observing the surgical site for redness and​ swelling, and monitoring surgical drains for amount and color of drainage do not help promote optimal circulation.

The nurse is caring for a client who has presented with a new lesion on the right foot. Which question should the nurse ask during the client​ interview? (Select all that​ apply.) A. "Do you wear socks to​ bed?" B. "Have you ever been badly​ sunburned?" C. "How many hours a day are you on your​ feet?" D. "Have you noticed any changes in the​ lesion?" E. "Have you been exposed to any chemicals in your​ job?"

B. Have you ever been badly sunburned? D. Have you noticed any changes in the lesion E. Have you been exposed to any chemicals in your job? Rationale: Clients with skin cancer should undergo a skin assessment. Specific health history questions include the​ following: bullet Have any members of your family ever been treated for skin​ cancer? bullet Have you had a skin cancer removed from any part of your​ body? bullet Have you noticed any change in the​ size, shape, or color of a​ mole, wart,​ birthmark, or​ scar? bullet Do you have any​ moles, warts,​ birthmarks, or scars that​ itch, are​ painful, have​ crusting, or​ bleed? bullet In what parts of the country or world have you​ lived? bullet Have you ever been badly​ sunburned? bullet Do you visit tanning​ salons? bullet Are you exposed to any hazardous chemicals in your​ job?

A client was diagnosed with malignant melanoma following careful evaluation of a skin lesion. The nurse explains to the client that the level of invasion of the tumor and its maximum thickness will be measured. The nurse is referring to which​ assessment? A. Palpation B. Microstaging C. Biopsy D. Excision

B. Microstaging ​ Rationale: Microstaging describes the assessment of the level of invasion of a malignant melanoma and the maximum tumor thickness. In the Clark system of​ microstaging, the vertical growth of the lesion is measured from the epidermis to the subcutaneous tissue to determine the level of invasion. Biopsy is examination of tissue removed from the body to discover the​ presence, cause, or extent of disease. Palpation is using the hands to examine the body. Excision is the surgical removal of tissue.

Which information should a nurse provide to new mothers about the care of their baby when they go​ home? A. It is important not to keep the newborn in sunlight for more than 15 minutes. B. Newborns should not be exposed to direct sunlight. C. Sunscreen may be harmful to a​ newborn's skin. D. Sunscreen should be applied every 2 hours if outdoors.

B. Newborns should not be exposed to direct sunlight ​ Rationale: Newborns should not be exposed to direct sunlight. For infants 6 months or​ older, sunscreen should be applied.

Which screening test is used to detect prostate​ cancer? A. Sigmoidoscopy B. PSA C. CA 125 D. Mammography

B. PSA ​ Rationale: PSA is the screening test for prostate cancer. CA 125 is a tumor marker for ovarian cancer. Sigmoidoscopy is a screening test for colon cancer. Mammography is a screening test for ovarian cancer.

Which laboratory test is performed to screen for prostate​ cancer? A. CMP B. PSA C. BNP D. CBC

B. PSA ​ Rationale: PSA is the screening test for prostate cancer. CBC and CMP may be performed to provide a baseline prior to​ treatment; however, they are not diagnostic for prostate cancer. BNP is a test to assess clients with heart failure.

The nurse is discussing the most common symptom associated with diagnosis of advanced prostate cancer. Which symptom would the nurse​ include? A. Nausea B. Pain C. Edema D. Diarrhea

B. Pain ​Rationale: Pain is the most common symptom associated with prostate cancer due to bone metastasis. Prostate cancer in the early stages is often asymptomatic.​ Nausea, diarrhea, and edema are not generally associated with prostate cancer symptoms.

The nurse is providing education regarding screening for prostate cancer. Which age should the nurse instruct the men with low risk factors to initiate prostate cancer​ screening? A. 40 B. 65 C. 50 D. 35

C. 50 ​Rationale: For men at average risk of prostate cancer and whose life expectancy is at least 10​ years, this discussion and informed decision should be initiated at 50 years of age.

The nurse is providing teaching to a client to promote urinary elimination following a transurethral resection of the prostate. Which instruction should the nurse​ include? A. Void at intervals of 4-6 hours. B. Perform pelvic floor exercises. C. Increase fluid intake. D. Take testosterone as prescribed.

B. Perform pelvic floor exercises ​ Rationale: Pelvic floor exercises will strengthen the pelvic floor and decrease stress incontinence. Increasing fluid intake can contribute to incontinence. Voiding should be every 2-4 hours. Testosterone would not be prescribed for urinary incontinence.

The community nurse is conducting a class on smoking cessation. The nurse discusses the danger of secondhand smoke. Which information is incorrect regarding secondhand​ smoke? A. Secondhand smoke increases the risk of developing bladder cancer. B. Secondhand smoke is more detrimental to adults than to children. C. Secondhand smoke increases the risk of developing brain tumors. D. Secondhand smoke is a cause of cancer.

B. Secondhand smoke is more detrimental to adults than to children Rationale: Secondhand smoke is more detrimental to children than adults because​ children's cells are more rapidly growing and dividing. Secondhand smoke increases the risk of developing many types of​ cancer, including brain tumors in children and bladder cancer in adults.

Which of the following is a way that the nurse can help a client with breast cancer who is experiencing anticipatory grieving before her double​ mastectomy? (Select all that​ apply.) A. Denial B. Silence C. Venting D. Active listening E. Nonverbal support gestures

B. Silence D. Active listening E. Nonverbal support gestures​ Rationale: The nurse can use active​ listening, silence, and nonverbal support gestures to help the client. Neither denial nor venting is helpful.

Which type of lung cancer should the nurse describe as being able to synthesize bioactive products and hormones such as adrenocorticotropic or antidiuretic​ hormones? A. Large-cell carcinomas B. Small-cell carcinomas C. Adenocarcinomas D. Squamous cell carcinomas

B. Small-cell carcinomas ​Rationale: Small-cell carcinomas can synthesize bioactive products and​ hormones, such as adrenocorticotropic​ hormones; antidiuretic​ hormone, a​ parathormone-like hormone; and​ gastrin-releasing peptide.​ Adenocarcinomas, squamous cell​ carcinomas, and​ large-cell carcinomas are classified as​ non-small-cell carcinomas. They do not possess this ability.

A client is diagnosed with adenocarcinoma of the breast. Based upon this​ diagnosis, where should the nurse expect the source of the cancer to​ be? A. Nipple epithelium B. Terminal section of the breast ductal tissue C. Mammary layer fatty tissue D. Subcutaneous fat

B. Terminal section of the breast ductal tissue ​ Rationale: Most breast cancers are adenocarcinomas and arise out of the terminal section of the breast ductal tissue.

The nurse preceptor is reviewing the physical appearance of actinic keratosis with a graduate nurse. Which statement by the graduate nurse is accurate​? A. "The appearance is a tumor that ulcerates and​ bleeds." B. "The appearance is shiny and may be​ scaly." C. "The appearance is the same as basal cell​ carcinoma." D. "The appearance is a​ small, firm red​ nodule."

B. The appearance is shiny and may be scaly ​ Rationale: Actinic keratosis can be described as​ follows: erythematous, rough macules a few millimeters in​ diameter; often shiny but may be​ scaly; if scales are​ removed, underlying skin​ bleeds; occurs in multiple​ patches, primarily on the​ face, dorsa of the​ hands, the​ forearms, and​ sometimes, on the upper​ trunk; and, enlargement or ulceration of the lesions suggests transformation to malignancy. The other answers do not describe actinic keratosis.

The nurse is presenting to a group of young adults at a local gym on the topic of skin cancer. Which information should the nurse​ include? A. The importance of showering well after perspiring B. The dangers of UV rays to the skin from a tanning bed C. The dangers of stretching the skin when using weights D. The importance of having a skin injury checked immediately

B. The dangers of UV rays to the skin from a tanning bed ​Rationale: Primary prevention includes avoiding prolonged sun exposure and refraining from the use of artificial tanning machines. In​ fact, a study has concluded that with just one indoor tanning​ session, an​ individual's risk for developing melanoma increases by​ 20%. Perspiration, stretching the skin during​ exercise, and having a skin injury do not increase the risk of skin cancer.

How is surgery used to stage​ cancer? A. To relieve secondary effects of the cancer B. To discover how much cancer exists and if it has spread C. As prophylaxis to remove tissue that can potentially become cancerous D. To remove the cancerous lesion along with removal of normal surrounding tissue

B. To discover how much cancer exists and if it has spread ​ Rationale: Surgery is used to stage cancer by discovering how much cancer exists and if it has spread. Surgery may be used as prophylaxis to relieve​ cancer's secondary effects and to remove a cancerous​ lesion, but these procedures are not related to staging.

The nurse is discussing health promotion interventions with the parents of a child born with Down syndrome. Which intervention would be most appropriate for the nurse to include in the education related to the increased risk for acute lymphocytic​ leukemia? A. "Your child should have regular medical checkups and testing as recommended by the healthcare​ provider." B. "You need to be aware of the increased​ risk, but​ unfortunately, there really are no interventions we can recommend to help reduce this​ risk." C. "You should make sure to complete screening tests for acute lymphocytic leukemia​ annually." D. "You should be aware of the symptoms of acute lymphocytic​ leukemia, as they are very distinctive and can help diagnose it​ early."

B. You need to be aware of the increased risk, but unfortunately, there really are no interventions we can recommend to help reduce this risk ​ Rationale: Children with chromosomal abnormalities such as Down syndrome have an increased risk for ALL.​ Unfortunately, there are no screening procedures or blood tests that can identify ALL before symptoms​ occur, thus the best intervention is for parents to ensure the child has regular medical checkups and any recommended testing. Since there are no screening tests for​ ALL, encouraging the parents to do this would not be an appropriate intervention. The symptoms of ALL are similar to symptoms for many health disorders. While awareness of them is​ important, they are not distinctive and will not necessarily help the parents know that ALL is occurring. Regular medical checkups are useful in helping to reduce risk by allowing early detection.

A client with chronic myeloid leukemia​ (CML) is admitted to a clinic. The nurse understands the client is least likely to be part of which demographic​ group? A. Older than 65 years B. Younger than 20 years C. Female D. Male

B. Younger than 20 years old ​ Rationale: CML makes up about​ 15% of all adult​ leukemias, with the average age of diagnosis at 65 years. Though CML affects women more than​ men, it is least likely to affect children.

The nurse reviews a list of clients scheduled for​ women's health visits. For which age range should the nurse emphasize the importance of early detection and treatment of breast​ cancer? A. 50-54 B. 60-64 C. 75-79 D. 45-49

C. 75-79 ​ Rationale: The incidence of breast cancer is highest in women between the ages of 75 and 79 years in the United States. Even​ so, all women should be counselled on actions for prevention and early detection of breast cancer.

A client with breast cancer asks how a modified radical mastectomy differs from a radical mastectomy. What should the nurse respond to this​ client? A." A modified radical mastectomy includes removal of the breast followed by immediate breast reconstruction​ surgery." B. "A modified radical mastectomy removes just the tumor and the surrounding​ margins." C. "A modified radical mastectomy removes the breast tissue and lymph nodes but leaves the chest wall​ intact." D. "A modified radical mastectomy removes the complete breast​ only."

C. "A modified radical mastectomy removes the breast tissue and lymph nodes but leaves the chest wall​ intact." ​ Rationale: A modified radical mastectomy removes the breast tissue and lymph nodes but leaves the chest wall​ intact, whereas a radical mastectomy also removes the chest wall muscles. Removal of only the complete breast is a simple mastectomy. Removal of the tumor and surrounding margins only is a segmental mastectomy. A modified radical mastectomy does not include breast reconstruction.

A client with lung cancer asks why he is scheduled for chemotherapy prior to surgery for a wedge resection. Which response by the nurse is most​ accurate? A. "Chemotherapy is another way to remove cancer​ cells." B. "Chemotherapy is used to treat vena cava​ syndrome." C. "Chemotherapy is used to shrink the tumor so that it can be removed more​ easily." D. "Chemotherapy is used to relieve​ cough, bone​ pain, or​ dyspnea."

C. "Chemotherapy is used to shrink the tumor so that it can be removed more​ easily." Rationale: Chemotherapy is used to shrink tumors so they can more easily be removed in surgery. It is not used to remove cancer cells. Radiation therapy is used to treat vena cava syndrome and relieve​ cough, bone​ pain, or dyspnea.

The family members of a client being treated for leukemia ask the nurse if it is OK to give the client a botanical​ medicine, which they have heard can be helpful for leukemia clients. Which response by the nurse accurately answers this​ question? A. "Botanical therapies are natural and should be fine to give to the​ client, as long as you only give small​ amounts." B. "Botanicals interfere with the effectiveness of the chemotherapy drug and should not be given​ concurrently; you can use it once the chemotherapy is​ done." C. "Please speak with your healthcare provider about what specifically you would like to​ use, so they can make sure it will not interact with the chemotherapy the client is​ receiving." D. "Complementary therapies such as botanicals do not have the value they claim and should be​ avoided."

C. "Please speak with your healthcare provider about what specifically you would like to​ use, so they can make sure it will not interact with the chemotherapy the client is​ receiving." Rationale: Complementary health approaches such as nutritional​ support, imagery, and relaxation can be helpful.​ However, they should initially be discussed with the healthcare provider to avoid possible interactions. Stating that complementary therapies do not have the value they claim may be inaccurate and does not provide an adequate answer to the​ family's question. The​ client's family should not be told it is acceptable to administer them in small doses before checking with the healthcare provider. The statement that they interfere with the chemotherapy may not be​ valid, since the nurse has not checked for potential interactions.

The nurse is caring for a woman in the third trimester of pregnancy who has been diagnosed with acute leukemia. The client is very frightened and concerned about the safety of the fetus. Which response by the nurse would be most appropriate in this​ situation? A. "I am really sorry that this has happened to​ you; there are very few options available in this​ situation, almost all with bad outcomes for the​ fetus." B. "Fortunately, this has occurred later in your​ pregnancy, and there are many options available to safely treat you and maintain the​ pregnancy." C. "The provider will discuss the risks and benefits with​ you, so you can make an informed decision about​ treatment." D. "If you want to treat the​ leukemia, the pregnancy must be​ terminated."

C. "The provider will discuss the risks and benefits with​ you, so you can make an informed decision about​ treatment." ​ Rationale: A diagnosis of acute leukemia during pregnancy is complicated due to the potential impact of chemotherapy​ and/or targeted therapies on the fetus. Delaying treatment can be​ risky; pregnancy termination may be the only option to save the​ mother's life.​ Thus, the healthcare provider must discuss all risks and benefits with the client to allow an informed decision. Telling the client the pregnancy must be terminated is not necessarily valid or therapeutic.​ Furthermore, indicating there are many safe options for treatment or that all options available have bad outcomes are not necessarily​ evidence-based statements.

The nurse is caring for a client with a diagnosis of cancer. The nurse explains a test that is ordered to determine the blood supply to the tumor. To which test is the nurse​ referring? A. Computed tomography​ (CT) scan B. Magnetic resonance imaging​ (MRI) C. Angiography D. X-ray

C. Angiography ​ Rationale: Angiography is used to determine the blood supply to the tumor. A CT​ scan, MRI, and​ x-ray better show solid masses.

During an initial examination of a​ client, the nurse finds a​ suspicious-looking skin​ lesion, possibly indicating malignancy. Which type of skin lesion should the nurse​ consider? (Select all that​ apply.) A. Psoriasis B. Actinic keratosis C. Basal cell carcinoma D. Malignant melanoma E. Squamous cell carcinoma

C. Basal cell carcinoma D. malignant melanoma E. Squamous cell carcinoma ​ Rationale: Basal cell carcinoma is an epithelial cancerous tumor originating from the basal layer of the epidermis or from cells in the surrounding dermal structures. Squamous cell carcinoma is a malignant tumor of the squamous epithelium of the skin or mucous membranes. Malignant melanoma is a cancerous skin lesion that arises from the​ melanocytes, or the cells located at or near the basal layer of the skin. Actinic keratosis is an epidermal noncancerous skin lesion directly related to chronic sun exposure and photo damage. Psoriasis is a chronic immune noncancerous skin disorder.

A client has a mass that has been identified by a mammogram. Which test may be ordered to further differentiate the mammogram​ results? A. HER2/neu testing B. Chest​ x-ray C. Breast biopsy D. PET scan

C. Breast biopsy Rationale: A breast biopsy may be used to further assess the tumor identified in the mammogram. A PET scan would not be used to further confirm the diagnosis of breast cancer.​ Rather, this test is used to assess for metastasis. A chest​ x-ray will not further differentiate mammogram results.​ HER2/neu testing is used to guide prognosis and treatment.

The nurse is assessing a client with stage I prostate cancer. Which description is consistent with this​ stage? A. Extension into the seminal vesicle B. Poorly differentiated C. Confined to the prostate D. Lymph node involvement

C. Confined to the prostate Rationale: Stage I prostate cancer is confined to the prostate and is well differentiated. Stage II is poorly differentiated. Extension into the seminal vesicle occurs in stage III and lymph node involvement is in stage IV.

A client presents to the clinic and learns that testing has revealed a precursor skin lesion that has been present since birth. The nurse should suspect that the client has which​ lesion? A. Dysplastic nevus B. Lentigo maligna C. Congenital nevus D. Nodular melanoma

C. Congenital Nevus ​ Rationale: Congenital nevi are present at birth. Some lesions are​ small; others are large enough to cover an entire body area. Their color can range from brown to black. They are often slightly​ raised, with an irregular surface and a fairly regular border. Dyplastic nevi have irregular pigmentation with mixtures of​ tan, brown,​ black, red, and pink. Lentigo maligna lesions are a tan or black patch on the skin that looks like a freckle. These lesions grow​ slowly, becoming​ mottled, dark,​ thick, and nodular. They are usually seen on one side of the face in an older adult who has had a large amount of sun exposure. Nodular melanoma presents as a papule that looks like a smooth pimple that grows at a steady rate. This lesion also has skin over the tumor that is shiny and may be pearly​ white, pink, or flesh colored.

A​ client's biopsy revealed dysplasia of cells. The client asks the​ nurse, "What does this​ mean?" Which response by the nurse is​ correct? A. "Dysplasia refers to cells that have irreversible damage and will become​ cancerous." B. "Dysplasia consists of abnormal cells for which the damage is​ irreversible." C. "Dysplasia refers to abnormal variations in cell​ size, shape,​ appearance, and arrangement that are often caused by​ irritation." D. "Dysplasia means that the number of cells has increased and they have become​ denser."

C. Dysplasia refers to abnormal variations in cell size, shape, appearance, and arrangement that are often caused by irritation ​ Rationale: Dysplastic cells show abnormal variations in​ size, shape, and appearance and a disturbance in their usual arrangement. Although under certain circumstances they can become​ malignant, the dysplasia is usually reversed once the source of irritation is eliminated. Hyperplasia is an increase in the number or density of normal cells. Anaplasia is the regression of a cell to an immature or undifferentiated cell type and is often associated with malignancies. It is one of the criteria used to grade the aggressiveness of cancer cells.

The nurse admits a client from the postanesthesia care unit post wedge resection for a lung tumor. Which action should the nurse take first​? A. Provide reassurance and emotional support. B. Document the​ pulse, respiratory​ rate, and blood pressure. C. Elevate the head of the bed to 60 degrees. D. Check the dressing for drainage.

C. Elevate the head of the bed to 60 degrees Rationale: Elevating the head of the bed to 60 degrees reduces pressure on the diaphragm and allows for lung​ expansion, making it easier for the client to breathe. Airway and breathing needs always take priority. Documentation is always the last​ step, after all client needs are met. Emotional needs should be met after all physical needs are met.

The nurse is discussing early detection of breast cancer with a group of teenage women. Which information should the nurse include to decrease the risk for mortality and promote positive client​ outcomes? A. Encourage annual mammograms beginning at age 30. B. Encourage genetic testing for BRCA 1 and 2. C. Encourage monthly​ self-breast exams. D. Encourage annual laboratory tests including red blood​ cell, white blood​ cell, and platelets.

C. Encourage monthly self-breast exams Rationale: Early detection does not prevent breast cancer but it can reduce risk for mortality and promote better outcomes. Because of​ this, clients should be encouraged to do monthly breast​ self-examinations. Genetic​ testing, annual mammograms beginning at age​ 30, and annual laboratory tests would not be recommended to detect early breast cancer.

A​ 22-year-old female contacts the nurse at the local community clinic about the need for a Pap test. The individual informs the nurse that she had a Pap test 1​ ½ years ago. Which response by the nurse provides accurate information about the frequency of Pap test screenings according to current screening​ guidelines? A. "It is required every 5​ years." B. "It is required every 2​ years." C. "It is required every 3​ years." D. "It is required​ annually."

C. It is required every 3 years ​ Rationale: For women ages 21-29, a Pap test and HPV test should be done every 3 years. For women ages 30-65, a Pap test and HPV test should be done every 3-5 years.

The nurse is teaching a client about the estrogen compound​ (diethylstilbestrol) that has been prescribed for prostate cancer. Which statement indicates that the teaching has been​ successful? A. "This drug does not put me at risk for any cardiovascular​ problems." B. "The effects of the drug are​ irreversible." C. "It may cause my breasts to​ enlarge." D. "It is a very expensive drug and may require insurance​ approval."

C. It may cause my breasts to enlarge Rationale: Estrogen compounds are more likely than other hormone therapy for prostate cancer to cause gynecomastia​ (hypertrophy of breast​ tissue). Estrogen compounds can cause an increased risk of cardiovascular problems. The effects of the drug are reversible and it is not​ expensive, so there should be no insurance issue.

Which statement by the nurse demonstrates understanding of older adult clients with​ cancer? A."Older adult clients have a greater tolerance for cancer​ treatement." B. "Older adult clients have better outcomes for cancer​ treatement." C. "Older adult clients usually have a comorbid​ condition." D. "There is no correlation between the functional ability of an older adult and predisposition to poorer​ outcomes."

C. Older adult clients usually have a comorbid condition Rationale: Older adults experiencing cellular regulation disorders are more likely to have comorbidities such as​ lung, kidney, or heart​ disease, which can increase their risk of treatment complications. These individuals are also less likely to tolerate the necessary treatment or its adverse reactions. Older adults with cellular regulation disorders who have a lower functional status are generally predisposed to poorer outcomes.

The healthcare provider has informed the nurse that they have scheduled a biopsy for the client with leukemia. The nurse reviews the client​ information, which​ includes: WBCs 57 x 103​/µL; HCT​ 21%; platelets 29 x 103​/µL; RBCs 2.41 x 103​/mm3​; BP​ 106/46; HR​ 96; RR 24. Which information would prompt the nurse to contact the healthcare provider concerning this​ procedure? A. WBCs 57 x 103​/µL B. BP​ 106/46 mmHg C. Platelets 29 x 103​/µL D. RBCs 2.41 x 103​/mm3

C. Platelets 29x103/µL Rationale: A platelet count of less than​ 50,000 would contraindicate invasive procedures such as biopsies or lumbar​ punctures; thus, the nurse should contact the healthcare provider about this result. An elevated WBC​ count, decreased​ HCT, or decreased RBC count would not necessarily contraindicate this procedure

The nurse understands that​ external-beam radiation used for treatment for cancer uses which​ high-energy source? A. Gamma rays B. Neutrons C. Protons D. Ultraviolet rays

C. Protons Rationale: External-beam radiation uses​ x-rays and may include​ high-energy protons to kill cancer cells.​ Neutrons, gamma​ rays, and ultraviolet rays are not used in​ external-beam radiation.

The nurse is caring for a client who is scheduled for a biopsy of a suspicious mass in the breast. The client is crying and is tachycardic and tachypneic. Based on this assessment​ data, which problem is a​ priority? A. Body image disturbance B. Impairment of gas exchange C. Risk for infection D. Anxiety

D. Anxiety ​ Rationale: The client is exhibiting signs and symptoms of​ anxiety, which is a common nursing problem in clients with a breast disorder. The data provided do not support the nursing problems of risk for​ infection, body image​ disturbance, or impaired gas exchange.

The nurse is interviewing a client admitted with lung cancer. Which symptom reported by the client would be consistent with this​ diagnosis? A. Respiratory rate of 20 breaths per minute B. Nausea and vomiting C. Recent weight loss of 10 pounds over 3 weeks D. Cough of​ 1-week duration productive of yellow mucus

C. Recent weight loss of 10 pounds over 3 weeks ​ Rationale: Sudden,​ rapid, unexplained weight loss is one systemic symptom of lung cancer. Other systemic and paraneoplastic manifestations include​ anorexia, fatigue, and​ weakness; bone​ pain, tenderness, and​ swelling; clubbing of the fingers and​ toes; and various​ endocrine, neuromuscular,​ cardiovascular, and hematologic symptoms. Nausea and vomiting are generic symptoms not specific to lung cancer. A productive cough of short duration is more likely to be a symptom of a respiratory​ infection, cold, or flu. A respiratory rate of 20 breaths per minute is within the normal range.

The nurse caring for a client with neutropenia would assess for which​ disorder? (Select all that​ apply.) A. Petechiae B. Hematuria C. Septicemia D. Pneumonia E. Mucous membrane ulceration

C. Septicemia D. Pneumonia E. Mucous membrane ulceration Rationale: Manifestations due to neutropenia include recurrent severe infections such as​ septicemia, pneumonia, and abscesses. It leads to mucous membrane ulceration as well. The manifestations of thrombocytopenia include​ petechiae, purpura,​ ecchymoses, epistaxis,​ hematomas, hematuria, and gastrointestinal bleeding.

The nurse is performing an initial assessment of a lesion on the​ client's right thigh. Which action is important to assess lesions that may be in the​ dermis? A. Pinch the skin between your fingers. B. Rub forcefully on the specific area. C. Stretch the​ client's skin tightly. D. Knead the area with a closed fist.

C. Stretch the client's skin tightly ​ Rationale: Inspect and palpate the skin. Stretching the skin tightly during assessment facilitates assessment of nodular and scaly lesions and lesions in the dermis.

A client complains that a mole on his forearm is painful. Which manifestation should lead the nurse to suspect malignant​ melanoma? A. The mole looks like a freckle. B. The mole ranges in color from brown to black. C. The mole appears to be bigger than a pencil eraser. D. The mole has irregular borders.

C. The mole appears to be bigger than a pencil eraser Rationale: Malignant melanoma includes moles with a diameter greater than 6 mm​ (the size of a pencil​ eraser). Dysplastic​ nevi, a precursor to​ melanoma, have irregular borders. Congenital​ nevi, a precursor to​ melanoma, have moles that range in color from brown to black. Lentigo​ maligna, a precursor to​ melanoma, has the appearance of a freckle.

For which purpose would a client with lung cancer receive laser bronchoscopy​ treatment? A. To reconstruct the cancerous portion of the main bronchus B. To remove a small section of peripheral lung tumors C. To resect tumors located in the main bronchus D. To resect a portion of the main bronchus

C. To resect tumors located in the main bronchus ​ Rationale: Laser bronchoscopy is used to resect tumors located in the main bronchus. Reconstruction is not part of treatment. Peripheral lung tumors are not located in the main bronchus. Resection of portions of the main bronchus is not done.

Which intervention would the nurse expect the healthcare provider to prescribe to most effectively treat a client with severe anemia related to acute blood​ loss? A. Ferrous sulfate orally three times a day B. B12 injection subcutaneously C. Transfuse packed red blood cells D. Erythropoietin injections up to three times a week

C. Transfuse packed red blood cells​ Rationale: A client with severe anemia related to acute blood loss needs fast replacement.​ Therefore, the nurse would administer a transfusion of packed red blood cells. B12 is used to treat pernicious​ anemia, not blood loss anemia. Ferrous sulfate and erythropoietin injections will not work fast to bring the​ client's blood counts to an acceptable range.

The nurse understands that which surgery involves removal of parts of the prostate gland through the penis and​ urethra? A. Radical prostatectomy B. Retropubic prostatectomy C. Transurethral prostatectomy D. Perineal prostatectomy

C. Transurethral Prostatectomy ​ Rationale: Transurethral resection of the prostate​ (TURP) involves removal of parts of the prostate gland by a surgical instrument that is inserted into the end of the penis and through the urethra. Radical prostatectomy involves removal of the​ prostate, prostate​ capsule, seminal​ vesicles, and a portion of the bladder neck. A fairly new treatment is laparoscopic radical​ prostatectomy, in which small incisions are made in the abdomen and a laparoscope is inserted and used to remove the prostate. Retropubic prostatectomy may be performed because it allows adequate control of​ bleeding, visualization of the prostate bed and bladder​ neck, and access to pelvic lymph nodes. Perineal prostatectomy is often preferred for older men or those who are poor surgical risks.

While conducting a preventive health seminar on lung​ cancer, a member of the audience​ asks, "I've been smoking for 40 years. Why stop​ now?" Which response by the nurse most accurately addresses the participants risk for lung​ cancer? A. "While it may not lower your​ risk, you will probably find that you will feel better and have less​ illness." B. "I understand what you are​ saying, but your​ second-hand smoke can affect those around​ you." C. "Given your long history of smoking it probably​ won't have any effect. But for anyone under age​ 40, you can lower your risk by​ 90%" D. "It is never too late to stop. The sooner you stop the greater the chance for lowering your risk for lung cancer.

D. "It is never too late to stop. The sooner you stop the greater the chance for lowering your risk for lung cancer. Rationale: There is a dose-response relationship between smoking and lung​ cancer: The more the individual smokes and the longer the individual​ smokes, the greater the risk.​ Therefore, quitting at any time may help lower the risk. Among smokers who quit before 40 years of​ age, the risk of death due to conditions associated with continued smoking decreases by approximately​ 90%. While​ second-hand smoke can increase the risk of others and with stopping smoking the individual most likely will feel better and have fewer​ illnesses, it is not the primary reason an individual should stop smoking to decrease risk of cancer.

An​ 84-year-old client has been diagnosed with early stage chronic lymphocytic leukemia​ (CLL). The client is not currently symptomatic. The​ client's daughter asks the nurse why the client is not being referred for chemotherapy or radiation. Which response by the nurse provides the most accurate​ response? A. "Whether or not to treat is based on​ age; your mother is past the age where treatment would be​ considered." B. "There is no effective treatment for CLL in older​ adults; they will usually die from other causes before the CLL causes​ death." C. "Your mother has too many comorbid​ conditions, thus treatment would not be​ effective." D. "Treatment will begin if your mother starts to exhibit​ symptoms; earlier treatment has not been shown to improve​ outcomes."

D. "Treatment will begin if your mother starts to exhibit​ symptoms; earlier treatment has not been shown to improve​ outcomes." Rationale: The accurate response would be to inform the​ client's daughter that evidence has not supported improved outcomes through the use of chemotherapy prior to symptoms being noted. Responses that indicate treatment decisions are based on​ comorbidities, age, or that treatment is not effective are not valid.

Which type of skin lesion should the nurse suspect for a client who is scheduled for​ cryosurgery? A. Nodular basal cell carcinoma B. Malignant melanoma C. Superficial basal cell carcinoma D. Actinic keratosis

D. Actinic Keratosis ​ Rationale: Cryosurgery is a recommended procedure for a client diagnosed with actinic keratosis. Surgical​ excision, chemotherapy,​ and/or radiation are used for malignant melanoma. Nodular basal cell carcinoma can be treated with surgical​ excision, cryotherapy, and radiotherapy. Superficial basal cell carcinoma can be treated with radiation​ therapy, biological​ therapy, and vaccines.

Upon helping assistive personnel with morning care of a client with​ cancer, the nurse notes that the​ client's gums are bleeding easily. Which intervention should the nurse include in the nursing care plan for future oral care of this​ client? A. Rinse the mouth twice daily with an​ alcohol-based mouthwash. B. Refer the client to a dental oncologist for assessment. C. Obtain a new toothbrush. D. Clean teeth with a soft cloth over the finger.

D. Clean teeth with a soft cloth over the finger ​ Rationale: Clients with cancer may experience impairment of the​ oral-pharyngeal-esophageal tissues. Oral care of the client should include measures to reduce trauma to the delicate tissues. If gums are friable and​ bleeding, cleaning should be done with a soft cloth over the finger or with toothpaste on a finger. A new toothbrush should be obtained​ monthly, but this does not address the current problem. When​ needed, the client should be seen by a dental​ oncologist, but that is not indicated at this time. Clients should use mouthwash several times a​ day, but they should be​ alcohol-free. In the case of bleeding​ gums, chlorhexidine mouthwash may be indicated.

The client care assistant tells the nurse that they think a client with cancer might have an infection. Which question asked by the nurse would help elicit information to most accurately identify early signs of infection in immunocompromised​ clients? A. "Has the drainage from their surgical wound​ increased? B. "Do they seem​ lethargic?" C. "Do they have a​ fever?" D. "Is their heart rate and respiratory rate​ increased?"

D. Is their heart rate and respiratory rate increased? Rationale: Early signs of infection in cancer clients include fever and increased respiration and pulse.​ However, in immunocompromised​ clients, fever may be absent. Lethargy and wound drainage can also be signs of infection but are not necessarily early signs of​ infection, nor the best to use to identify infection early.

The nurse is providing education to a client who has undergone a radical prostatectomy. Teaching on which topic is mostly likely to help decrease symptoms of urinary​ incontinence? A. Placement of a urostomy B. The use of a condom catheter C. Estrogen cream application D. Pelvic floor exercises

D. Pelvic floor exercises ​ Rationale: Urinary incontinence may occur due to prostate surgery for benign prostate​ hyperplasia, or prostate cancer. Pelvic floor muscle exercises such as Kegel exercises help to strengthen the pelvic muscles. Reductase inhibitors decrease the outlet resistance in overflow incontinence. Condom catheters would be used if the client was unable to control the flow of urine. Estrogen creams are used to treat females with urge incontinence. A urostomy is performed to bypass the urethra and cure bladder incontinence after trauma or surgery.

The nurse is aware that the client with leukemia is at risk for bleeding. Which diagnostic test should the nurse follow to manage​ risk? A. Bone marrow aspiration B. Red blood cell count C. White blood cell count D. Platelet count

D. Platelet count Rationale: The platelet count determines whether thrombocytopenia is present and if there is a risk of bleeding. Red and white blood cell counts are part of the complete blood count and​ differential, which evaluates the​ number, distribution, and morphology of blood cells. Bone marrow aspiration analyzes information about bone marrow cells.

Which assessment finding in a client receiving chemotherapy for cancer warrants immediate healthcare provider​ notification? A. Skin dryness B. Hair loss C. Weight gain of 2 pounds in 1 month D. Temperature of 101.6degreesF

D. Temperature of 101.6 degrees F ​ Rationale: Clients receiving chemotherapy for the treatment of cancer are at high risk for infection due to a suppressed immune system.​ Therefore, the nurse would notify the healthcare provider of a body temperature greater than 101.5degrees​F, because this signifies infection. Hair loss and skin dryness is normal and does not warrant immediate healthcare provider notification. A weight gain of 2 pounds in 1 month indicates true body weight and not fluid retention. This finding does not require the nurse to immediately notify the healthcare provider.

The nurse is developing a plan of care for the family of a​ preschool-aged child recently diagnosed with cancer. Which information concerning the​ child's possible reaction to the illness should the nurse discuss with the parents based on the​ child's developmental​ stage? A. The child will try to understand the illness and is reassured by interacting with other children their own age. B. The child will not understand the severity of the disease but will be impacted by pain and separation anxiety. C. The child can understand the diagnosis and benefit from opportunities to talk about the illness in their own words. D. The child is beginning to understand illness but may think they caused the illness and not understand why the parents cannot make the pain go away.

D. The child is beginning to understand illness but may think they caused the illness and not understand why the parents cannot make the pain go away ​Rationale: Preschoolers are beginning to understand illness but may think that they caused it and are confused about why the parent cannot make it go away. Infants and toddlers will not understand the severity of the disease but will be impacted by pain and separation anxiety.​ School-age children can understand the diagnosis and benefit from opportunities to discuss it. Adolescents find contact with others who have gone through the experience reassuring.

The nurse is caring for a client with transurethral resection of the prostate for prostate cancer. Which nursing diagnosis would the nurse​ prioritize? A. Sexual Dysfunction B. Urinary​ Elimination, Impaired C. Comfort, Impaired D. Urinary retention

D. Urinary retention ​ Rationale: Urinary retention is the priority for this client. Urinary incontinence and sexual dysfunction are important but are not priorities over retention of urine. Impaired comfort could be related to the retention of​ urine; however, it would be secondary to the retention of urine.​ (NANDA-I ©2014)

The results of a​ client's biopsy indicates neoplasm. The nurse understands that which characteristic indicates that the neoplasm is​ benign? A. Invades surrounding tissues B. Noncohesive C. Rapid growth D. Well-defined borders

D. Well-defined borders​ Rationale: A benign neoplasm has​ well-defined borders, slow​ growth, is​ cohesive, and pushes other tissues out of the way. A malignant neoplasm invades surrounding​ tissues, is​ noncohesive, does not stop at tissue​ borders, and grows rapidly.

Which assessment finding would the nurse expect to find in a client with a new diagnosis of pernicious​ anemia? (Select all that​ apply.) A. Pallor B. Weakness C. Constipation D. Sore, red tongue E. Spoon-shaped nails

​A. Pallor B. Weakness D. Sore, red tongue Rationale: Pernicious anemia is a vitamin B12 deficiency due to lack of intrinsic factor. This causes​ pallor, weakness, and a​ sore, red, beefy tongue. B12 deficiency causes​ diarrhea, not constipation.​ Spoon-shaped nails are a sign of​ iron-deficiency anemia.

A client asks the​ nurse, "Why is cigarette smoking the leading cause of lung​ cancer? What is so bad about​ cigarettes?" Which response by the nurse is​ accurate? A. "Cigarettes contain more than 700​ chemicals, 70 of which are known​ carcinogens." B. "Cigarette smoking introduces foreign substances in the​ body." C. "Cigarette smoking is​ addictive." D. "There are other more important causes of lung cancer than cigarette​ smoking."

​A. "Cigarettes contain more than 700​ chemicals, 70 of which are known​ carcinogens." Rationale: Cigarette smoke contains a large amount of​ chemicals, many of which are carcinogenic. Although it is addictive and a foreign substance to the​ body, this is not what makes it a risk factor for lung cancer. The American Cancer Society states that cigarette smoking is the leading cause of lung cancer.

The nurse is discussing chemotherapy with a client newly diagnosed with cancer. Which statement is accurate regarding​ chemotherapy? (Select all that​ apply.) A. "Some chemotherapy binds with​ DNA." B. "Iron supplements are part of​ chemotherapy." C. "Chemotherapy can have​ life-threatening side​ effects." D. "Chemotherapy involves the use of cytotoxic​ medications." E. "Pregnancy limits which kinds of chemotherapy can be​ used."

​A. "Some chemotherapy binds with​ DNA." C. "Chemotherapy can have​ life-threatening side​ effects." D. "Chemotherapy involves the use of cytotoxic​ medications." E. "Pregnancy limits which kinds of chemotherapy can be​ used." Rationale: Chemotherapy is the use of cytotoxic medications. Pregnancy limits using antimetabolites and hormones for chemotherapy. Chemotherapy can have​ life-threatening side effects. Iron supplements are part of treatment for​ anemia, not for cancer. Alkylating agents and antitumor antibiotics are chemotherapeutic agents that bind to DNA.

A client with sickle cell disease presents to the emergency department in sickle cell crisis. Which collaborative intervention would the nurse expect to​ perform? (Select all that​ apply.) A. Administer oxygen. B. Offer genetic counseling. C. Provide narcotic analgesics. D. Give supplemental folic acid. E. Infuse intravenous fluids.

​A. Administer oxygen C. Provide narcotic analgesics E. Infuse IV fluids Rationale: During a sickle cell​ crisis, the client is not receiving adequate oxygenation due to sickled cell production.​ Therefore, the nurse would administer oxygen. Inadequate oxygenation causes intense​ pain, so the nurse would give narcotic analgesics. It is also essential to infuse intravenous fluids to prevent sickled cells from clumping. The nurse would administer folic acid to a client with regular​ anemia, not sickle cell disease. Genetic counseling is​ important, but not during a sickle cell crisis.

During chemotherapy treatment for​ leukemia, when should the nurse monitor urine specific​ gravity? (Select all that​ apply.) A. Every eight hours B. If a change occurs in urine pH C. Before chemotherapy administration D. During chemotherapy administration E. When IV fluids are reduced to maintenance levels

​A. Every eight hours C. Before chemotherapy administration D. During chemotherapy administration E. When IV fluids are reduced to maintenance levels Rationale: Urine specific gravity should be obtained every eight​ hours, before and during chemotherapy​ administration, and when IV fluids are reduced to maintenance levels. It is not necessarily indicated if urine pH changes.

The nurse is teaching the client about the use of radiation for prostate cancer. Which fact would the nurse include in the​ teaching? (Select all that​ apply.) A. Precautions are necessary regarding pregnant women. B. It is unacceptable to share bathrooms with other members of the household. C. There is no restriction regarding close exposure with other members of the household. D. It is recommended that the client use condoms during intercourse. E. Sleep in a room alone for the first week to minimize prolonged exposure to others.

​A. Precautions are necessary regarding pregnant women. D. It is recommended that the client use condoms during intercourse. E. Sleep in a room alone for the first week to minimize prolonged exposure to others. Rationale: Precautions must be taken regarding the close contact with all persons in the​ household, especially children and pregnant women. Using a separate bathroom is not required. Condoms are needed to reduce radiation exposure during intercourse. It is also recommended that the client sleep alone for the first week to minimize exposure.

The nurse is providing health counseling to a​ 32-year-old woman whose mammogram indicates that she has dense breast tissue. Which information should the nurse provide to this client concerning this finding and breast​ health? A. The presence of dense breast tissue increases the risk of breast cancer before the age of 45. B. Dense breast tissue is very common at this age and does not affect breast health. C. Dense breast tissue is a protective effect for breast​ cancer, and rates of breast cancer in women with dense breast tissue are very low. D. Precancerous cells are found in dense breast​ tissue; thus, she should have further screening done for breast cancer.

​A. The presence of dense breast tissue increases the risk of breast cancer before the age of 45. Rationale: The presence of dense breast tissue increases the risk of breast cancer before the age of 45. The statement that dense breast tissue is not necessarily common at this age and increases the risk for breast cancer is not valid. Precancerous cells are not necessarily found in dense breast​ tissue, nor does dense breast tissue provide a protective effect against cancer.

Which category is included in the staging of lung cancer​ tumors? (Select all that​ apply.) A. Tumor size B. Tumor location C. Lymph node involvement D. Type of symptoms E. Presence of metastatic disease

​A. Tumor size B. Tumor location C. Lymph node involvement E. Presence of metastatic disease Rationale: The TNM system of staging tumors relies on tumor size and​ location, whether lymph nodes are​ involved, and presence or absence of distant metastasis. ​ "T" refers to the primary​ tumor, "N" refers to regional lymph​ node, and​ "M" refers to distant metastasis. Client symptoms are not used to classify tumors.

A​ college-age client asks the nurse about the relationship between breast cancer and alcohol use. Which response by the nurse provides the most accurate information for this​ client? A. "They have not established a firm link between alcohol use and breast cancer. Thus I would not be too​ concerned." B. "Evidence indicates that to decrease your risk for breast​ cancer, you should limit alcohol use to one drink per​ day." C. "If you are drinking hard​ liquor, you should limit it to one per​ day, but if you are drinking beer or​ wine, you can have more than one drink per​ day." D. "The amount of alcohol that increases risk varies from person to person due to differences in metabolism and alcohol​ tolerance."

​B. "Evidence indicates that to decrease your risk for breast​ cancer, you should limit alcohol use to one drink per​ day." Rationale: Alcohol is a known risk factor for breast cancer. Recommendations include limiting alcohol intake to a maximum of one drink per day. The other statements are not valid.