Cancer/End of Life Review

filgrastim

stimulates neutrophil production

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? Administer antiemetics in anticipation of the patient's nausea. Administer antiemetics if the patient vomits or believes he will soon vomit. Provide the patient with antiemetics at his first complaint of nausea. Prioritize nonpharmacological treatments over medications.

Administer antiemetics in anticipation of the patient's nausea.

A serum sodium concentration lower than 115 mEq/L (115 mmol/L) is associated with myalgia. anorexia. seizure. weight gain.

seizure.

The client has finished the first round of chemotherapy. Which statement made by the client indicates a need for further teaching by the nurse? "I will use birth control measures until after all treatment is completed." "Hair loss may not occur until after the second round of therapy." "I can continue taking my vitamins and herbs because they make me feel better." "I will eat clear liquids for the next 24 hours."

"I can continue taking my vitamins and herbs because they make me feel better."

The nurse is caring for a client is scheduled for chemotherapy followed by autologous stem cell transplant. Which of the following statements by the client indicates a need for further teaching? "I will receive chemotherapy until most of the cancer is gone, and then I will get my own stem cells back." "The doctor will remove cells from my bone marrow before beginning chemotherapy." "I will need to be in protective isolation for up to 3 months after treatment." "I hope they find a bone marrow donor who matches."

"I hope they find a bone marrow donor who matches."

After a bone marrow transplant (BMT), the client should be monitored for at least 60 days 30 days 100 days 14 days

100 days

A nurse is teaching a client with bone marrow suppression about the time frame when bone suppression will be noticeable after administration of floxuridine. What is the time frame the nurse should include with client teaching? 2 to 4 days 21 to 28 days 24 hours 7 to 14 days

7 to 14 days

glucagon

A protein hormone secreted by pancreatic endocrine cells that raises blood glucose levels; an antagonistic hormone to insulin.

The client is scheduled for a breast lump excision and sentinel node biopsy. What should the nurse know in planning care for the client with a negative biopsy report? The entire breast and all regional lymph nodes will be excised. A lump excision is not necessary. A wide excision of lump will be performed. The lump and all axillary lymph nodes will be excised.

A wide excision of lump will be performed.

Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode should the nurse anticipate? Repeat biopsy is needed before treatment begins. Adjuvant therapy is likely. No further treatment is indicated. Palliative care is likely.

Adjuvant therapy is likely.

allopurinol

Antigout

5-Fluorouracil (5FU) is classified as which type of antineoplastic agent? Nitrosoureas Alkylating Mitotic spindle poisons Antimetabolite

Antimetabolite

Which of the following advice does the nurse offer clients who are undergoing unsealed radiation therapy to reduce exposure? Avoid kissing and sexual contact. Avoid drinking plenty of fluids. Avoid applying skin moisturizers. Avoid eating for 3 hours after therapy.

Avoid kissing and sexual contact.

A client has been receiving chemotherapy. Upon assessing the client during morning rounds, the nurse notes the client is now bleeding from intravenous and venipuncture sites. Stool is positive for occult blood. The client is requesting to sit in a chair for a meal. The nurse implements the following interventions: (Select all that apply.) Monitor vital signs once a shift. Check intake and output records. Assist the client to a chair. Assess level of consciousness. Apply pressure to the bleeding sites.

Check intake and output records. Assess level of consciousness. Apply pressure to the bleeding sites.

A client has just received stem cell transplantation as treatment for leukemia. What are the post procedural nursing interventions for clients receiving any form of stem cell transplantation? Closely monitor the client for at least 3 months. Closely monitor the client for at least 5 months. Closely monitor the client for at least 3 days. Closely monitor the client for at least 4 weeks.

Closely monitor the client for at least 3 months.

The drug interleukin-2 is an example of which type of biologic response modifier? Retinoids Monoclonal antibodies Antimetabolites Cytokine

Cytokine

A patient with uterine cancer is being treated with internal radiation therapy. What would the nurse's priority responsibility be for this patient? Wear a lead apron when providing direct patient care. Maintain as much distance as possible from the patient while in the room. Alert family members that they should restrict their visiting to 5 minutes at any one time. Explain to the patient that she will continue to emit radiation while the implant is in place.

Explain to the patient that she will continue to emit radiation while the implant is in place.

The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important? Flush the toilet twice after every use. Prepare food separately from family members. Shield your throat area when near others. Use disposable utensils for the next month.

Flush the toilet twice after every use.

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? Inspect the skin frequently. The use of disposable utensils and wash cloths Avoid showering or washing over skin markings. Time, distance, and shielding

Inspect the skin frequently.

A patient is taking vincristine, a plant alkaloid for the treatment of cancer. What system should the nurse be sure to assess for symptoms of toxicity? Gastrointestinal system Pulmonary system Urinary system Nervous system

Nervous system

A nurse assesses an oncology client with stomatitis during a chemotherapy session. Which nursing intervention would most likely decrease the pain associated with stomatitis? Recommend that the client discontinue chemotherapy. Check regularly for signs and symptoms of stomatitis. Monitor the client's platelet and leukocyte counts. Provide a solution of viscous lidocaine for use as a mouth rinse.

Provide a solution of viscous lidocaine for use as a mouth rinse.

A patient is admitted for an excisional biopsy of a breast lesion. What intervention should the nurse provide for the care of this patient? Provide time for the patient to discuss her concerns. Counsel the patient about the possibility of losing her breast. Provide aseptic care to the incision postoperatively. Clarify information provided by the physician.

Provide time for the patient to discuss her concerns.

The nurse knows that interferon agents are used in association with chemotherapy to produce which effects in the client? Suppression of the bone marrow Shorten the period of neutropenia Enhance action of the chemotherapy Decrease the need for additional adjuvant therapies

Shorten the period of neutropenia

Carcinogens are factors related to the formation of various malignancies. Which factor has the greatest impact on the development of all cancers? defective genes viruses chemical agents environmental factors

chemical agents

A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention? 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 client states he is nauseous.

The I.V. site is red and swollen.

Use of chemicals or chemotherapy applied directly to tissue to cause destruction

chemosurgery

The nurse is teaching a client about cancer prevention. The nurse evaluates teaching as most 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. Obtain a cancer history from her parents. Exercise 30 minutes 3 times each week.

Use sunscreen when outdoors.

A client, 66 years old, has just been diagnosed with multiple myeloma (a cancer of the plasma) and will be initiating chemotherapy. The nurse, in an outpatient clinic, reviews the medications the client has been taking at home. The medications include pantoprazole for gastroesophageal reflux disease (GERD) and an over-the-counter calcium supplement to prevent osteoporosis. What interventions should the nurse take? Select all that apply. asks about nausea and vomiting instructs the client to discontinue calcium teaches the client to report abdominal or bone pain restricts fluids to 1500 mL per day provides information about antidiarrheal medication

asks about nausea and vomiting instructs the client to discontinue calcium teaches the client to report abdominal or bone pain

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 gender age viruses environmental factors

dietary substances viruses environmental factors

removal of the whole tumor for biopsy

excisional biopsy

Well-differentiated tumors

grade I

Poorly differentiated tumors

grade VI

a wedge of tissue is removed and biopsied

inscisional biopsy

dose that will eradicate 95% of the tumor yet preserve normal tissue.

lethal tumor dose

lowest point of blood cell depression after therapy that has toxic effects on the bone marrow

nadir

____________ (prior to local definitive treatment) radiation therapy, with or without chemotherapy, is used to reduce tumor size in order to facilitate surgical resection.

neoadjuvant

A client with ovarian cancer is ordered hydroxyurea, an antimetabolite drug. Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. What mechanism of action do antimetabolites interferes with? the chemical structure of deoxyribonucleic acid (DNA) and chemical binding between DNA molecules (cell cycle-nonspecific) normal cellular processes during the S phase of the cell cycle cell division or mitosis during the M phase of the cell cycle one or more stages of ribonucleic acid (RNA) synthesis, DNA synthesis, or both (cell cycle-nonspecific)

normal cellular processes during the S phase of the cell cycle

After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? Serving small portions of bland food Administering metoclopramide and dexamethasone as ordered Encouraging rhythmic breathing exercises Withholding fluids for the first 4 to 6 hours after chemotherapy administration

Administering metoclopramide and dexamethasone as ordered

identification of the type of tissue from which the tumor originated & the degree to which the cells resemble the original tissue

tumor grading

The assessment of the extent of tumor growth, invasion, and metastasis.

tumor staging

A client diagnosed with acute myelocytic leukemia has been receiving chemotherapy. During the last 2 cycles of chemotherapy, the client developed severe thrombocytopenia requiring multiple platelet transfusions. The client is now scheduled to receive a third cycle. How can the nurse best detect early signs and symptoms of thrombocytopenia? Check the client's history for a congenital link to thrombocytopenia. Perform a cardiovascular assessment every 4 hours. Monitor daily platelet counts. Closely observe the client's skin for petechiae and bruising.

Closely observe the client's skin for petechiae and bruising.

A client is receiving the cell cycle-nonspecific alkylating agent thiotepa (Thioplex), 60 mg weekly for 4 weeks by bladder instillation as part of chemotherapy regimen to treat bladder cancer. The client asks the nurse how the drug works. How does thiotepa exert its therapeutic effects? It interferes with ribonucleic acid (RNA) transcription only. It interferes with DNA replication and RNA transcription. It destroys the cell membrane, causing lysis. It interferes with deoxyribonucleic acid (DNA) replication only.

It interferes with DNA replication and RNA transcription.

A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells? White blood cells (WBCs) Colon Liver Reproductive tract

Liver

A client has received several treatments of bleomycin. It is now important for the nurse to assess Lung sounds Skin integrity Urine output Hand grasp

Lung sounds

The nursing instructor is discussing the diagnosis of cancer with their nursing class. The instructor tells her students that scientists have predicted that gene therapy will one day play a large role in the prediction, diagnosis, and treatment of cancer. What cancer is gene therapy currently being investigated in the treatment of? Melanoma Osteosarcomas Leukemia Pancreatic

Melanoma

TNM

tumor-node-metastasis

50% glucose with insulin

tx for hyperkalemia

______________ excisions (en bloc dissections) include removal of the primary tumor, lymph nodes, adjacent involved structures, and surrounding tissues that may be at high risk for tumor spread.

wide or radical

A patient is to receive Bacille Calmette-Guerin (BCG), a nonspecific biologic response modifier. Why would the patient receive this form of treatment?

bladder cancer

tumor lysis syndrome

can develop from chemotherapy for cancers with rapid cell turnover. It is characterized by hyperphosphatemia, hyocalcemia, hyperkalemia (EKG changes), and hyperuricemia. Prevention of tumor lysisi syndrome invovles hydration and the use of hypouricemic agents such as allopurinol or rasburicase

Antitumor antibiotics are cell cycle ____________.

nonspecific