Cancer PrepU
A nurse is administering daunorubicin through a peripheral I.V. line when the client complains of burning at the insertion site. The nurse notes no blood return from the catheter and redness at the I.V. site. The client is most likely experiencing which complication? Erythema Flare Extravasation Thrombosis
Extravasation
A nurse has agreed to draft a medication teaching plan for a patient who is taking the hormonal agent, Aromasin, an aromatase inhibitor for postmenopausal women with breast cancer. The nurse knows that a major teaching point is to tell the patient to: Report the unusual sign of nausea. Be alarmed if she notices fluid retention. Increase her intake of calcium-rich foods. Report the unexpected sign of increased appetite and weight gain.
Increase her intake of calcium-rich foods.
When caring for an older client who is receiving external beam radiation, which is the key point for the nurse to incorporate into the plan of care? Time, distance, and shielding The use of disposable utensils and wash cloths Avoid showering or washing over skin markings. Inspect the skin frequently.
Inspect the skin frequently.
The nurse at the clinic explains to the patient that the surgeon will be removing a mole on the patient's back that has the potential to develop into cancer. The nurse informs the patient that this is what type of procedure? Diagnostic Palliative Prophylactic Reconstructive
Prophylactic
You are a clinic nurse. One of your clients has found she is at high risk for breast cancer. She asks you what can be done to reduce her risk. What is a means of reducing the risk for breast cancer?
Prophylactic surgery
When the client complains of increased fatigue following radiotherapy, the nurse knows this is most likely to be related to which factor? The cancer is spreading. The cancer cells are dying in large numbers. Fighting off infection is an exhausting venture. Radiation can result in myelosuppression.
Radiation can result in myelosuppression.
A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: TIS, N0, M0. What does this classification mean? No evidence of primary tumor, no abnormal regional lymph nodes, and no evidence of distant metastasis Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis Can't assess tumor or regional lymph nodes and no evidence of metastasis Carcinoma in situ, no demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis
Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis
The nurse assesses that extravasation of a chemotherapy agent has occurred. What should the initial action of the nurse be? Apply a warm compress to the area. Discontinue the infusion. Inject an antidote, if required. Place ice over the site of infiltration.
Discontinue the infusion
While doing a health history, a client tells the nurse that her mother, grandmother, and sister died of cancer. The client wants to know what she can do to keep from getting cancer. What would be the nurse's best response? "You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is." "If you eat right, exercise, and get enough rest, you can prevent breast cancer." "With your family history, there is nothing you can do to prevent getting cancer." "Cancer often skips a generation, so don't worry about it."
"You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is."
The oncology nurse is giving chemotherapy to a client in a short stay area. The client confides that they are very depressed. The nurse recognizes depression as which of the following? A psychiatric diagnosis everyone has at one time or another. A side effect of the neoplastic drugs. A normal reaction to the diagnosis of cancer. An aberrant psychologic reaction to the chemotherapy.
A normal reaction to the diagnosis of cancer.
A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells? Liver Colon Reproductive tract White blood cells (WBCs)
Liver
Which is a growth-based classification of tumors? Sarcoma Carcinoma Malignancy Leukemia
Malignancy
The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a bone marrow transplant? Monitor the client's toilet patterns. Monitor the client closely to prevent infection. Monitor the client's physical condition. Monitor the client's heart rate.
Monitor the client closely to prevent infection.
According to the tumor-node-metastasis (TNM) classification system, T0 means there is No evidence of primary tumor No regional lymph node metastasis No distant metastasis Distant metastasis
No evidence of primary tumor
Which type of surgery is used in an attempt to relieve complications of cancer? Palliative Prophylactic Reconstructive Salvage
Palliative
During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior? Promotion Initiation Prolongation Progression
Progression
A client with metastatic pancreatic cancer underwent surgery to remove a malignant tumor in the pancreas. Despite the tumor being removed, the physician informs the client that chemotherapy must be started. Why might the physician opt for chemotherapy? To prevent metastasis Angiogenesis Stomatitis Fatigue
To prevent metastasis
The root cause of cancer is damage to cellular deoxyribonucleic acid (DNA) which can be caused by many factors, or carcinogens. What factors can be carcinogenic? Select all that apply. dietary substances environmental factors viruses gender age
dietary substances environmental factors viruses
The clinic nurse is caring for a client who has just been diagnosed with a tumor. The client says to the nurse "The doctor says my tumor is benign. What does that mean?" What is the nurse's best response? "Benign tumors can spread from one place to another." "Benign tumors don't usually cause death." "Benign tumors invade surrounding tissue." "Benign tumors grow very rapidly."
"Benign tumors don't usually cause death."
The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia? "The hair loss is usually temporary." "New hair growth will return without any change to color or texture." "Clients with alopecia will have delay in grey hair." "Wigs can be used after the chemotherapy is completed."
"The hair loss is usually temporary."
To combat the most common adverse effects of chemotherapy, a nurse should administer an: antiemetic. antimetabolite. antibiotic. anticoagulant.
Antiemetic
As a nurse who provides care for many patients with cancer, you are aware that cancer makes patients susceptible to many other health problems. Which of the following assessments addresses the leading cause of death among patients who have cancer? Assessing patients' lower legs for redness, swelling, or pain on dorsiflexion Arranging for serial electrocardiograms (ECGs) or cardiac telemetry whenever possible Monitoring white blood cell (WBC) counts and assessing patients' integumentary systems Auscultating patients' lungs thoroughly and monitoring oxygen saturation levels
Monitoring white blood cell (WBC) counts and assessing patients' integumentary systems
A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of Risk for impaired skin integrity. Which intervention should be part of this client's care plan? Avoiding using soap on the irradiated areas Applying talcum powder to the irradiated areas daily after bathing Wearing a lead apron during direct contact with the client Removing thoracic skin markings after each radiation treatment
Avoiding using soap on the irradiated areas
A 66-year-old man is receiving radiation therapy and chemotherapy for the treatment of small cell lung cancer. The nurse has assessed him many times since he was admitted to the hospital. This morning, he admits that his greatest challenge he is currently facing is his overwhelming fatigue. How should the nurse respond to this patient's statement? "Your fatigue is actually a sign that your body is redirecting its energies toward healing and away from more common functions like mobility." "I'm sure you'll agree that fatigue, even when it's severe, is much preferable to pain. It's fortunate that your pain is now well-controlled." "That must be incredibly difficult for you. How would you rate your fatigue if you had to give it a number from 1 to 10?" "That's entirely normal, given what your body is going through and how much treatment you're currently getting."
"That must be incredibly difficult for you. How would you rate your fatigue if you had to give it a number from 1 to 10?"
A patient with a diagnosis of renal cell carcinoma is being treated with chemotherapy. During a previous round of chemotherapy, the patient's tumor responded well to treatment but the chemotherapy caused intense nausea and vomiting. How should the patient's potential nausea and vomiting be addressed during this current round of treatment? Prioritize nonpharmacological treatments over medications. Administer antiemetics in anticipation of the patient's nausea. Provide the patient with antiemetics at his first complaint of nausea. Administer antiemetics if the patient vomits or believes he will soon vomit.
Administer antiemetics in anticipation of the patient's nausea.
After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? Serving small portions of bland food Encouraging rhythmic breathing exercises Administering metoclopramide and dexamethasone as ordered Withholding fluids for the first 4 to 6 hours after chemotherapy administration
Administering metoclopramide and dexamethasone as ordered
Which type of hematopoietic stem cell transplantation (HSCT) is characterized by cells from a donor other than the patient? Allogeneic Autologous Syngeneic Homogenic
Allogeneic
Which of the following is a term used to describe the process by which a new blood supply is formed? Angiogenesis Mitosis Apoptosis Carcinogenesis
Angiogenesis
Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client? Autologous Prophylactic Therapeutic Allogeneic
Autologous
Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client? Autologous Prophylactic Therapeutic Allogeneic
Autoloogus
The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise? Eat wholesome meals. Avoid spicy and fatty foods. Avoid intake of fluids. Eat warm or hot foods.
Avoid spicy and fatty foods.
Mrs. Unger is a 53-year-old woman who was diagnosed with breast cancer following a process that began with abnormal screen mammography results. Mrs. Unger, her oncologist, and surgeon have agreed on a mastectomy as treatment and have discussed the importance of rigorously assessing whether her cancer has metastasized. What action will best detect possible metastasis of Mrs. Unger's breast cancer? Serial bone marrow biopsies Biopsy of the axillary lymph nodes Careful grading of the tumor cells Gauging her response to radiation therapy
Biopsy of the axillary lymph nodes
You are an oncology nurse caring for a client who tells you that their tastes have changed. They go on to say that "meat tastes bad". What is a nursing intervention to increase protein intake for a client with taste changes? Stay away from protein beverages. Encourage maximum fluid intake. Encourage cheese and sandwiches. Suck on hard candy during treatment.
Encourage cheese and sandwiches.
What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen? Encourage fluid intake to dilute the urine. Take measures to acidify the urine and prevent uric acid crystallization. Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL. Limit fluids to 1,000 mL daily to prevent accumulation of the drug's end products after cell lysis.
Encourage fluid intake to dilute the urine.
The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action? Extravasation Stomatitis Nausea and vomiting Bone pain
Extravasation
What foods should the nurse suggest that the patient consume less of in order to reduce nitrate intake because of the possibility of carcinogenic action? Eggs and milk Fish and poultry Ham and bacon Green, leafy vegetables
Ham and bacon
You are an oncology nurse who has reconstituted a patient's scheduled chemotherapeutic drug. What action should you perform prior to administering this drug?
Have a colleague confirm the chemotherapy dose
A decrease in circulating white blood cells (WBCs) is referred to as Granulocytopenia Thrombocytopenia Leukopenia Neutropenia
Leukopenia
The nurse provides care on an oncology unit, where many patients undergo surgery during cancer treatment and face a particularly high risk of deep vein thrombosis (DVT) because of an increase in circulating procoagulants. The nurse should prioritize which type of assessments? Active and passive range of motion Petechiae and hematomas on the lower extremities Nausea that fails to respond to antiemetics Limb symmetry and calf pain
Limb symmetry and calf pain
The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant? Monitor the client's toilet patterns. Monitor the client closely to prevent infection. Monitor the client's physical condition. Monitor the client's heart rate.
Monitor the client closely to prevent infection.
A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication? Urine output of 400 ml in 8 hours Serum potassium level of 2.6 mEq/L Blood pressure of 120/64 to 130/72 mm Hg Sodium level of 142 mEq/L
Serum potassium level of 2.6 mEq/L
A nurse is caring for a client receiving chemotherapy. Which assessment finding places the client at the greatest risk for an infection? White blood cell (WBC) count of 9,000 cells/mm3 Stage 3 pressure ulcer on the left heel Temperature of 98.3° F (36.8° C) Ate 75% of all meals during the day
Stage 3 pressure ulcer on the left heel
A nurse is administering a chemotherapeutic medication to a client, who reports generalized itching and then chest tightness and shortness of breath. The nurse immediately Stops the chemotherapeutic infusion Administers diphenhydramine Gives prednisolone IV Places the client on oxygen by nasal cannula
Stops the chemotherapeutic infusion
A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention? The I.V. site is red and swollen. The client states he is nauseous. The laboratory reports a white blood cell (WBC) count of 1,000/mm3. The client begins to shiver.
The I.V. site is red and swollen.
The nursing instructor is discussing the difference between normal cells and cancer cells with the pre-nursing class in pathophysiology. What would the instructor cite as a characteristic of a cancer cell?
The cell membrane of malignant cells contains proteins called tumor-specific antigens.
A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem? The patient requests that her family bring her makeup and wig. The patient begins to discuss the future with her family. The patient reports less disruption from pain and discomfort. The patient cries openly when discussing her disease.
The patient requests that her family bring her makeup and wig
A 36-year-old man is receiving three different chemotherapeutic agents for Hodgkin's disease. The nurse explains to the client that the three drugs are given over an extended period because: The three drugs can be given at lower doses. The second and third drugs increase the effectiveness of the first drug. The first two drugs are toxic to cancer cells, and the third drug promotes cell growth. The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.
The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.
The physician is attending to a 72-year-old client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation? To remove the tumor from the brain To prevent the formation of new cancer cells To analyze the lymph nodes involved To destroy marginal tissues
To prevent the formation of new cancer cells
The nurse evaluates teaching as effective when a female client states that she will Use sunscreen when outdoors. Decrease tobacco smoking from one pack/day to half a pack/day. Exercise 30 minutes 3 times each week. Obtain a cancer history from her parents.
Use sunscreen when outdoors
The nurse is teaching a client newly diagnosed with cancer about chemotherapy. The nurse tells the client he'll receive an antitumor antibiotic. The nurse knows that this type of medications is: cell-cycle nonspecific. cell-cycle specific in the S phase. cell-cycle specific in the M phase. cell-cycle specific in the P phase.
cell-cycle nonspecific
A nurse is preforming a home visit for a client who received chemotherapy within the past 24 hours. The nurse observes a small child playing in the bathroom, where the toilet lid has been left up. Based on these observations, the nurse modifies the client's teaching plan to include: expected chemotherapy-related adverse effects. chemotherapy exposure and risk factors. signs and symptoms of infection. reinforcement of the client's medication regimen.
chemotherapy exposure and risk factors.
A client without symptoms or complaints receives a diagnosis of prostate cancer after a routine physical. What factors contributed to this diagnosis? Select all that apply. client history risk factors tumor markers environmental factors
client history risk factors tumor markers
Which statement by a client undergoing external radiation therapy indicates the need for further teaching? "I'll wash my skin with mild soap and water only." "I'll not use my heating pad during my treatment." "I'll wear protective clothing when outside." "I'm worried I'll expose my family members to radiation."
"I'll wash my skin with mild soap and water only."
The nurse is caring for a client with the diagnosis of colon cancer with metastasis to the liver. Which statement made by the client indicates an understanding of the diagnosis? "Once the colon tumor is removed, I will be fine." "I will be happy once all the cancer is cut out." "How could I be so unlucky to get cancer twice?" "My cancer has now spread to my liver."
"My cancer has now spread to my liver."
Which occurs when fluid accumulates in the pericardial space and compresses the heart? Cardiac tamponade Superior vena cava syndrome (SVCS) SIADH DIC
Cardiac tamponade
A cancer client makes the following statement to the nurse: "I guess I will tell my doctor to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die." Which of the following facts supports the use of chemotherapy for this client? Nausea and vomiting are only a factor for the first 24 hours after treatment. Most clients believe the discomfort is well worth the cure for cancer. Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects. Clinical trials are opening up new cancer treatments all the time.
Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.
The nurse should teach the patient who is being radiated about protecting his skin and oral mucosa. An important teaching point would be to tell the patient to: Cleanse the skin with a mild soap, using his fingertips, not a rough wash cloth. Use an ointment, after treatment, to decrease the feeling of burning, which may last for several hours. Apply a small ice compress to the treated area afterward to decrease localized redness, post-radiation. Use an approved emollient 2 hours before the radiation to give the skin time to absorb the medication and provide a shield for damage.
Cleanse the skin with a mild soap, using his fingertips, not a rough wash cloth.
Which oncologic emergency involves the failure in the negative feedback mechanism that normally regulates the release of antidiuretic hormone (ADH)? Syndrome of inappropriate antidiuretic hormone release (SIADH) Cardiac tamponade Disseminated intravascular coagulation (DIC) Tumor lysis syndrome
Syndrome of inappropriate antidiuretic hormone release (SIADH)
What should the nurse tell a client who is about to begin chemotherapy and is anxious about hair loss? The client should consider getting a wig or cap prior to beginning treatment. Alopecia related to chemotherapy is relatively uncommon. The hair will grow back within 2 months post therapy. The hair will grow back the same as it was before treatment.
The client should consider getting a wig or cap prior to beginning treatment.
A client is undergoing chemotherapy treatment for prostate cancer and has lost considerable weight due to nausea and vomiting. Which nursing intervention is appropriate for the client?
Adjusting the client's meal plan before and after chemotherapy
Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode will the nurse anticipate? No further treatment is indicated. Adjuvant therapy is likely. Palliative care is likely. Repeat biopsy is needed before treatment begins.
Adjuvant therapy is likely.
Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth? Control Cure Palliation Prevention
Control
For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan? Administering aspirin if the temperature exceeds 102° F (38.8° C) Inspecting the skin for petechiae once every shift Providing for frequent rest periods Placing the client in strict isolation
Inspecting the skin for petechiae once every shift
The nurse is evaluating the client's risk for cancer and recommends changes when the client states she uses the treadmill for 30 minutes on 5 days each week eats red meat such as steaks or hamburgers every day works as a secretary at a medical radiation treatment center drinks 1 glass of wine at dinner each night
eats red meat such as steaks or hamburgers every day
A young female client has received chemotherapeutic medications and asks about any effects the treatments will have related to her sexual health. The most appropriate statement by the nurse is "You will need to practice birth control measures." "You will continue having your menses every month." "You will experience menopause now." "You will be unable to have children."
"You will need to practice birth control measures."
A male client has been unable to return to work for 10 days following chemotherapy as the result of ongoing fatigue and inability to perform usual activities. Laboratory test results are WBCs 2000/mm³, RBCs 3.2 x 10¹²/L, and platelets 85,000/mm³. The nurse notes that the client is anxious. Which of the following is the priority nursing diagnosis? Risk for infection related to inadequate defenses Fatigue related to deficient blood cells Activity intolerance related to side effects of chemotherapy Anxiety related to change in role function
Risk for infection related to inadequate defenses
Which of the following would be consistent with a benign neoplasm? Usually progressive and slow Grows by invasion Gains access to the blood and lymph channels to metastasize Cells are undifferentiated
Usually progressive and slow
Which of the following would be inconsistent as a common side effect of chemotherapy? Weight gain Alopecia Myelosuppression Fatigue
Weight Gain
Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure? Family history Drug history Blood studies Allergy history
Blood Studies
A nurse is developing a care plan for bone marrow suppression, the major dose-limiting adverse reaction to floxuridine (FUDR). How long after drug administration does bone marrow suppression become noticeable? 24 hours 2 to 4 days 7 to 14 days 21 to 28 days
7 to 14 days
What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen? It attacks cancer cells during their vulnerable phase. It functions against disseminated disease. It causes a systemic reaction. It targets normal body cells as well as cancer cells.
It targets normal body cells as well as cancer cells
