cellular aberrations 3

Halstead surgery

12. The removal of entire breast, pectoralis major and minor muscles and neck lymph nodes which is followed by skin grafting is a procedure called:

A. Bone marrow depression B. Recent surgery C. Pregnancy D. All of the above

13. Chemotherapy is one of the therapeutic modalities for cancer. This treatment is contraindicated to which of the following conditions?

Strawberry yogurt

13. The nurse teaches a patient with cancer of the liver about high-protein, high-calorie diet choices. Which snack choice by the patient indicates that the teaching has been effective?

The client's pain rating

1. The home health care nurse is caring for a male client with cancer and the client is complaining of acute pain. The appropriate nursing assessment of the client's pain would include which of the following

Administer the chemotherapy through a small-bore catheter

1. When the nurse is administering a vesicant chemotherapeutic agent intravenously, an important consideration is to

"I rarely have the energy to get out of bed."

10. The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient may indicate a need for a change in treatment?

Hyperuricemia

10.The client with leukemia is receiving Myleran (busulfan) and Zyloprim (allopurinol). The nurse tells the client that the purpose if the allopurinol is to prevent:

Annual Pap smear for sexually active women only

11. A 25-year-old patient is inquiring about the methods or ways to detect cancer earlier. The nurse least likely identifies this method by stating:

WBC count of 1700/µl

11. Which information noted by the nurse reviewing the laboratory results of a patient who is receiving chemotherapy is most important to report to the health care provider?

Hospitalization will be required for several weeks after the hematopoietic stem cell transplant (HSCT)

12. A bone marrow transplant is being considered for treatment of a patient with acute leukemia that has not responded to chemotherapy. In discussing the treatment with the patient, the nurse explains that

Avoid presenting foods for which the patient has a strong dislike

14. The nurse has identified the nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste sensation in a patient with lung cancer who has had a 10% loss in weight. An appropriate nursing intervention that addresses the etiology of this problem is to

The nurse should wear a mask and gloves

14. The nurse is preparing Cytoxan (cyclophosphamide). Safe handling of the drug should be implemented to protect the nurse from injury. Which of the following actions by the nurse should be corrected?

Risk for ineffective adherence to treatment related to denial of need for chemotherapy

15. After the nurse has explained the purpose of and schedule for chemotherapy to a 23-year-old patient who recently received a diagnosis of acute leukemia, the patient asks the nurse to repeat the information. Based on this assessment, which nursing diagnosis is most likely for the patient?

Encapsulated

15. Neoplasm can be classified as either benign or malignant. The following are characteristics of malignant tumor apart from:

The patient's visitors bring in some fresh peaches from home

16. A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the RN caring for the patient indicates that the nurse should take action?

"Sudden weight loss of unexplained etiology can be a warning sign of cancer."

16. On a clinic visit a client who has a relative with cancer, is asking about the warning signs that may relate to cancer. The nurse correctly identifies the warning signs of cancer by responding:

Tumor, node, metastasis

17. In staging and grading neoplasm TNM systems is used. TNM stands for:

The NA assists the patient to use dental floss after eating

17. Which action by a nursing assistant (NA) when caring for a patient who has pancytopenia indicates a need for the nurse to intervene?

Uric acid level

18. A with tumor lysis syndrome (TLS) is taking Zyloprim (allopurinol). Which laboratory value should the nurse monitor to determine the effectiveness of the medication?

"BSE palpation is done by starting at the center going to the periphery in a circular motion."

18. Breast self examination (BSE) is one of the ways to detect breast cancer earlier. The nurse is conducting health teaching to female clients in a clinic. During evaluation the clients are asked to state what they learned. Which of the following statements made by a client needs further teaching about BSE?

C. Constipation

19. A client had undergone radiation therapy (external). The expected side effects include the following apart from:

"Can you tell me what has been helpful to you in the past when coping with stressful events?"

19. When assessing a patient's needs for psychologic support after the patient has been diagnosed with stage I cancer of the colon, which question by the nurse will provide the most information?

Encourage the patient to purchase a wig or hat and wear it once hair loss begins

2. A chemotherapeutic agent known to cause alopecia is prescribed for a patient. To maintain the patient's self-esteem, the nurse plans to

Bowel sounds

2. Nurse Melinda is caring for a client who is postoperative following a pelvic exenteration and the physician changes the client's diet from NPO status to clear liquids. The nurse makes which priority assessment before administering the diet?

Mammography, Colorectal screening, Pap testing, Sunscreen use

20. A 61-year-old woman who is 5 feet, 3 inches tall and weighs 125 pounds (57 kg) tells the nurse that she has a glass of wine two or three times a week. The patient works for the post office and has a 5-mile mail-delivery route. This is her first contact with the health care system in 20 years. Which of these topics will the nurse plan to include in patient teaching about cancer? Select all that apply

Aspirin every 4 hours

20. Nurse Janet is assigned in the oncology section of the hospital. Which of the following orders should the nurse question if a client is on radiation therapy?

Washing the area with a bar of scented soap and water and patting it dry not rubbing it

21. Skin reactions are common in radiation therapy. Nursing responsibilities on promoting skin integrity should be promoted apart from:

Metozol (metoclopramide)

22. Nausea and vomiting is an expected side effect of chemotherapeutic drug use. Which of the following drugs should be administered to a client on chemotherapy to prevent nausea and vomiting?

3 feet

23. Radiation protection is very important to implement when performing nursing procedures. When the nurse is not performing any nursing procedures what distance should be maintained from the client?

To promote safety, the client is assisted by therapy personnel while the machine is in operation=

24. The following are teaching guidelines regarding radiation therapy except:

5 minutes

25. Contact of client on radiation therapy should be limited only to how many minutes to promote safety of the therapy personnel?

Hemorrhagic cystitis

26. A client is taking Cyclophosphamide (Cytoxan) for the treatment of lymphoma. The nurse is very cautious in administering the medication because this drug poses the fatal side effect of:

Red-orange urine

27. Cytarabine (Ara-C) is an antimetabolite that can cause a common cytarabine syndrome which includes the following, except:

Dexamethasone

28. To provide relief from the cytarabine syndrome, which drug is given?

Adrucil (fluorouracil)

29. Chemotherapeutic agents have different specific classifications. The following medications are antineoplastic antibiotics except:

Enhance the patient's immunologic response to tumor cells

9. Interleukin-2 (IL-2) is used as adjuvant therapy for a patient with metastatic renal cell carcinoma. The nurse teaches the patient that the purpose of therapy with this agent is to

Enlarged lymph nodes

3. A male client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment findings would the nurse expect to note specifically in the client?

Interrupted family processes related to the effect of illness on family members

3. A patient with ovarian cancer tells the nurse, "I don't think my husband cares about me anymore. He rarely visits me." On one occasion when the husband was present, he told the nurse he just could not stand to see his wife so ill and never knew what to say to her. An appropriate nursing diagnosis in this situation is

Mitotic inhibitor

30. Specific classification of the chemotherapeutic agent, Vincristine (Oncovin) is:

Emcyt (estramustine)

31. A client is diagnosed with progressive prostate cancer. The nurse expects which drug is given?

"I will avoid eating hot and spicy foods."

32. A client taking a chemotherapeutic agent understands the effects of therapy by stating:

Stage II

33. A client is diagnosed with breast cancer. The tumor size is up to 5 cm with axillary and neck lymph node involvement. The client is in what stage of breast cancer?

"Pink peel" skin

34. The classic symptoms that define breast cancer includes the following except:

Modified radical mastectomy

35. Surgical procedure to treat breast cancer involves the removal of the entire breast, pectoralis major muscle and the axillary lymph nodes is:

Do not spread to other tissues and organs

36. While being prepared for a biopsy of a lump in the right breast, the patient asks the nurse what the difference is between a benign tumor and a malignant tumor. The nurse explains that a benign tumor differs from a malignant tumor in that benign tumors

"Your tumor cells look more like immature fetal cells than normal bowel cells."

37. A patient who has been told by the health care provider that the cells in a bowel tumor are poorly differentiated asks the nurse what is meant by "poorly differentiated." Which response should the nurse make?

"Annual x-rays will increase your risk for cancer because of exposure to radiation."

38. A patient who smokes tells the nurse, "I want to have a yearly chest x-ray so that if I get cancer, it will be detected early." Which response by the nurse is most appropriate?

Dietary fat and obesity promote growth of many types of cancer

39. In teaching about cancer prevention to a community group, the nurse stresses the promotion of exercise, normal body weight, and a low-fat diet because

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

4. A patient receiving head and neck radiation and systemic chemotherapy has ulcerations over the oral mucosa and tongue and thick, ropey saliva. An appropriate intervention for the nurse to teach the patient is to

. Abdominal distention

4. During the admission assessment of a 35 year old client with advanced ovarian cancer, the nurse recognizes which symptom as typical of the disease?

Have the patient ask the doctor about specific tests for colon cancer

40. During a routine health examination, a 30-year-old patient tells the nurse about a family history of colon cancer. The nurse will plan to

the cancer is localized to the cervix

41. When reviewing the chart for a patient with cervical cancer, the nurse notes that the cancer is staged as Tis, N0, M0. The nurse will teach the patient that

"The biopsy will help the doctor decide what treatment to use for my enlarged prostate."

42. Which statement by a patient who is scheduled for a needle biopsy of the prostate indicates that the patient understands the purpose of a biopsy?

"I will need to have follow-up examinations for many years after I have treatment before I can be considered cured."

43. The nurse is teaching a postmenopausal patient with breast cancer about the expected outcomes of her cancer treatment. The nurse evaluates that the teaching has been effective when the patient says

Reduction of the tumor burden to enhance adjuvant therapy

44. A patient with a large stomach tumor that is attached to the liver is scheduled to have a debulking procedure. The nurse explains that the expected outcome of this surgery is

Perform perianal care with sitz baths and meticulous cleaning

45. External-beam radiation is planned for a patient with endometrial cancer. The nurse teaches the patient that an important measure to prevent complications from the effects of the radiation is to

The NA stands by the patient's bed for an hour talking with the patient

46. Which action by a nursing assistant (NA) caring for a patient with a temporary radioactive cervical implant indicates that the RN should intervene?

Establish a time to take a short walk every day

47. A patient with Hodgkin's lymphoma is undergoing external radiation therapy on an outpatient basis. After 2 weeks of treatment, the patient tells the nurse, "I am so tired I can hardly get out of bed in the morning." An appropriate intervention for the nurse to plan with the patient is to

The patient swims a mile 5 days a week

48. Which information obtained by the nurse about a patient with colon cancer who is scheduled for external radiation therapy to the abdomen indicates a need for patient teaching?

"I can buy a steroid cream to use on the itching area."

49. A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. The nurse knows that teaching about management of the skin reaction has been effective when the patient says

Dyspnea

5. A patient who is receiving interleukin-2 (IL-2) therapy (Proleukin) complains to the nurse about all of these symptoms. Which one is most important to report to the health care provider?

Ruptured ovarian cyst

5. Nurse Kate is reviewing the complications of colonization with a client who has microinvasive cervical cancer. Which complication, if identified by the client, indicates a need for further teaching?

Administer prescribed antiemetics 1 hour before the treatments

50. A patient with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. An important nursing intervention for the patient is to

"It is possible you may have some changes in your sexual function, and you may want to consider pretreatment harvesting of sperm if you want children."

6. A 32-year-old male patient is to undergo radiation therapy to the pelvic area for Hodgkin's lymphoma. He expresses concern to the nurse about the effect of chemotherapy on his sexual function. The best response by the nurse to the patient's concerns is

Sarcoma

6. Mr. Miller has been diagnosed with bone cancer. You know this type of cancer is classified as:

"Why don't we talk about the options you have for the care of your children?"

7. A 40-year-old divorced mother of four school-age children is hospitalized with metastatic cancer of the ovary. The nurse finds the patient crying, and she tells the nurse that she does not know what will happen to her children when she dies. The most appropriate response by the nurse is

Bargaining

7. Sarah, a hospice nurse visits a client dying of ovarian cancer. During the visit, the client expresses that "If I can just live long enough to attend my daughter's graduation, I'll be ready to die." Which phrase of coping is this client experiencing?

Takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs

8. A patient who has terminal cancer of the liver and is cared for by family members at home tells the nurse, "I have intense pain most of the time now." The nurse recognizes that teaching regarding pain management has been effective when the patient

Cigarette smoking

8. The nurse is admitting a male client with laryngeal cancer to the nursing unit. The nurse assesses for which most common risk factor for this type of cancer?

The development of a vesicovaginal fistula

9. The female client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing: