Cellular Regulation

Melanoma

most common occurrence of this carcinoma is place where moles are evident. These pigmented cancers may arise in melanin-producing epidermal cells.

A nurse is obtaining a health history from the parents of a toddler who has recently been diagnosed with acute lymphocytic leukemia. Which early physiologic changes does the nurse expect the parents to report?

Pale skin, Eating less food, Purplish spots on the skin

The nurse is teaching a client self-management of skin cancer. Which statement made by the client indicates the need for further learning?

"I should limit sun exposure to between 7am and 12pm."

A 4-year-old child is found to have acute lymphoblastic leukemia. One of the parents tells the nurse, "We just had a discussion with our pediatrician about starting chemotherapy, consolidation therapy, and radiation therapy. We're so confused, and we don't know what to do. We want to do what is best for our child, but we don't want any unnecessary suffering." What is the best response by the nurse?

"Maybe you could talk with your healthcare provider about getting a second opinion from a specialist in leukemia."

A nurse is performing an assessment on a client with probable acute lymphocytic leukemia (ALL). Which clinical manifestation will the nurse expect to be present?

Ecchymosis

A nurse plans to take the temperature of a 4-year-old child with a diagnosis of leukemia who has a fever. Which thermometers with the most accurate results can the nurse use safely for this child?

Infrared, tympanic, chemical dot, axilla

While completing an assessment, the nurse finds that a client has decreased thickness and excessive dryness of the epidermis. Which clinical finding is associated with this skin assessment?

Skin fragility

A client is diagnosed with Hodgkin disease. Which lymph nodes does the nurse expect to be affected first?

Cervical

A farmer seeks medical care for a large crusty patch of skin on the cheek. The client states that even after using different remedies, it still bleeds easily and has not gotten better. From the client's history, the nurse suspects skin cancer. Which factor in the client's history helped the nurse form this conclusion?

Exposure to radiation

A nurse is performing an assessment on a fifth-grader who has been admitted to the pediatric unit with the diagnosis of acute lymphocytic leukemia (ALL). What early clinical findings does the nurse expect to identify?

Fatigue and ecchymotic areas

A young adult male client is undergoing tests to confirm the diagnosis of Hodgkin lymphoma. The wife states, "Don't you think it is unlikely for someone like my husband to have cancer?" The nurse's response is based on what information about Hodgkin lymphoma?

Diagnosed during adolescence and young adulthood

A client has colorectal cancer and is receiving cetuximab. Which process does cetuximab inhibit?

Epidermal growth factor receptors (EGFRs)

A nurse is assessing a child with leukemia who is undergoing chemotherapy. Which side effect does the nurse anticipate?

Epistaxis - nosebleeds are expected in a child with leukemia who is undergoing chemotherapy because the bone marrow is depressed and the number of platelets decreases substantially.

A 75-year-old male with a history of cancer of the prostate is admitted for a prostatectomy. The clients prostate specific antigen (PSA) levels have been increasing. This finding should prompt the nurse to include what in the client's plan of care?

Handle the client gently when turning - increasingly elevated PSA levels may indicate a worsening of the client's condition with possible metastasis to the bone, increasing the risk of pathologic fractures.Which group of clients should the nurse anticipate to have the highest incidence of non-Hodgkin lymphomas? Older adults - the incidence increases with age; the disease is more common in men and older adults.

For which clinical manifestation should the nurse assess a client with melanoma?

Irregularly shaped, pigmented papule

A client reports a facial lesion that has recently grown and is changing in appearance. The client is on oral methoxsalen. Which condition would the nurse expect?

Melanoma

A nurse is assessing a 55-year-old client who is experiencing postmenopausal bleeding. The tentative diagnosis is endometrial cancer. Which findings in the clients history are risk factors associated with endometrial cancer?

Obesity, Cigarette smoking, Family history of endometrial cancer, Previous hormone replacement therapy

A client with a history of chronic myelogenous leukemia and splenomegaly is admitted to the hospital. What should the nurse expect to identify when completing the admission assessment?

Tender mass in the left upper abdomen - Splenomegaly usually accompanies chronic myelogenous leukemia; the spleen usually is gross, palpable and tender and necessitates removal. The spleen is located high in the abdomen on the left side and usually is not palpable unless it is enlarged.

A client who works in the leather industry complains of a bloody discharge and persistent pain after the treatment of sinusitis. The client has a history of smoking. The nurse suggests the client consult a primary healthcare provider immediately. Which risk does the nurse suspect in the client?

Tumor of the nasal cavity

Dysplactic Nevus

clinically manifested by an irregular border, possibly notched, variegated color of tan, brown, black, red or pink within a single mole. At least one flat portion is present, often at the edge of the mole.

When providing care to a 6-year-old child with leukemia, a nurse notes blood on the pillowcase and several bloody tissues. What blood component value on the child's laboratory results should the nurse verify?

Platelets

A nurse is caring for a client with a diagnosis of cancer of the prostate. The nurse should teach the client that which serum level will be monitored throughout the course of the disease?

Prostate-specific antigen (PSA)

A nurse is caring for a child with newly diagnosed acute lymphoblastic leukemia. What clinical findings does the nurse anticipate with assessing the child?

Pallor, Fatigue, Multiple bruises

A client is admitted with a suspected malignant melanoma on the arm. When performing the physical assessment, what would the nurse expect to find?

Brown or black mole with red, white or blue areas

The nurse is performing a skin assessment of a client. Which findings in the client may indicate a risk of skin cancer?

Lesion, Lumps, Rashes

The nurse reviews the medical records of four male clients. Which client will the nurse assess most closely for developing prostate cancer?

Black 55-year-old

The nurse is caring for a client in the postanesthesia care unit. The client had a suprapubic prostatectomy for cancer of the prostate and has a continuous bladder irrigation (CBI) in place. Which primary goal is the nurse trying to achieve with the CBI?

Prevent the development of clots in the bladder

The nurse finds that a client has dysuria, hesitancy, urinary urgency and leaking. The laboratory reports of the client reveal serum PSA levels of 5ng/mL and elevated prostatic acid phosphate (PAP) levels. Which disease condition does the nurse suspect?

Prostate Cancer

An 11-year-old client is admitted with enlarged supraclavicular lymph nodes, fatigue, and low-grade fever. She also has a persistent nonproductive cough. In light of these findings, the nurse knows to gear education toward preparation for which therapies?

Computed tomography (CT) and lymph node biopsy