Cellular Regulation

The nurse is teaching a group of parents whose children have sickle cell anemia. When a parent asks the cause of the symptoms, the nurse responds with which of the following? 1 "Sickled cells increase the blood flow through the body, which causes pain." 2 "The sickled cells mix with normal cells, which causes the immune system to be depressed." 3 "Sickled cells cause bone marrow depression." 4 "Sickled cells clump in the smaller blood vessels and obstruct blood flow."

4

Treatment

HOP hydrate Oxygen Pain (opiods, morphine, dilotid)- Watch RR, constipation, addiction cannot cure Medications- Hydrea Diagnostics- Radiolycyte High protein & high calorie diet, but Oz is priority

What should any older adult patient be evaluated for whose chief complaint is back pain and who has an elevated total protein level? A Anemia B Leukemia C Multiple myeloma D Non-Hodgkin lymphoma

C

Which of the following meals would be most appropriate for a patient whose only cancer treatment symptom that impacts intake is neutropenia? a. Baked macaroni and cheese with cooked green beans b. Cottage cheese and fresh fruit plate c. Soft cooked eggs with toast d. Caesar salad with Caesar salad dressing

A

Which of the following is a type of leukemia? 1 Acute myeloid 2 Chronic myeloid 3 Acute lymphocytic 4 Chronic lymphocytic 5 All of the above

5

Superior vena cava syndrome

A tumor compresses the superior vena cava, resulting in increased central venous pressure and venous collateral formation This causes edema above the level of the chest, including the face, neck, and periorbital region Edema produces a headache, SOB, or dizziness S/S progress slowly over many weeks and then improve due to the formation of venous collaterals or treatment

Skin Cancer

ABCDE Assymetry Border irregularity Color variegation Diameter- greater than 6 mm Evolves over a period of time

What aggravates a crisis

Activity and cold (vasoconstriction)

Tamoxifen (Nolvadex)

Antineoplastic, antiestrogen hormone Inhibits cell division by binding to cytoplasmic estrogen receptors, resembles normal cell complex but inhibits DNA synthesis and estrogen response of target tissue TAMI OX SUN Thrombocytopenia, luekpenia, visual accuity decrease Antacids prior to and assess CBC Mechanical birth control Increase fluids to 2-3 l per day, iron and vitamin supplements O- opthmalogist X out crushing, breaking, or chewing tablets Sunscreen Undesirable effects- DVT, PE, N/V Nutritious diet

Interventions for oxygenation

Assess first, raise the HOB, turn, cough, deep breath, incentive spirometer, bronchodialtors

7. Which statement indicates the client with HIV needs further instruction about healthy eating? a. "Eating fat increases my chances of getting fat around my middle, so I am trying to choose all nonfat or low-fat food." b. "Eating carbs makes insulin resistance worse, so I am eating a very-low- carbohydrate diet." c. "Protein is the most important nutrient, so I am eating extra red meat at every meal." d. "Monounsaturated fats in olive oil, canola oil, nuts, and avocado are healthiest. I am eating more of them and less of other types of fats."

B

Undesirable effects from anticancer drugs

BARFS Bone marrow suppression Alopecia Retching N/V Fear and anxiety Stomatitis

Cancer can be a difficult disease to treat because A cells no longer progress through the normal cell cycle. B cells can develop resistance to drug therapy. C cells remain dormant, emerging months to years later. D the exact cause of cancer is not known.

C

Antineoplastic Agents

CANCER Cbc, platelets, monitor Antimetics before drug Nephrotoxicity- undesirable effect Counseling regarding reproduction issues Encourage hand washing- avoid crowds Recommend a wig for alopecia

Sickle Cell

Cells look like sickles Obstruction of vessels by clumped sickel cells

Assessment/diagnosis of lung cancer

Chest X-ray, Catscan, bronchoscopy, biopsy, PET

Lymphedema

Chronic swelling of an extremity due to interrupted lymphatic circulation

The nurse knows her instructions on how to reduce the risk of foodborne illness have been understood when the client states a. "It is okay to thaw food at room temperature as long as I cook it immediately after it is defrosted." b. "Leftovers are not safe to eat." c. "Fruits and vegetables do not need to be washed if I peel them or eat them after they are cooked." d. "All meat, fish, and poultry should be cooked to the well-done stage."

D

Within what time frame is collateral circulation usually developed in a woman after a mastectomy? A 1 week B 2 weeks C 3 weeks D 4 weeks

D

Risk Factors

Enviromental Smoking Secondhand smoking Carcinogens

Mammogram

Every year starting at 40 years old Ultrasound if something is found Biopsy (invasive, confirms cancer)

Syndromes

Help the diagnosis of NSCLC in a pt without a history of cancer, or it may be evidence of recurrence. usually treating the underlying disease relieves the s/s of the syndromes

Paraneoplastic syndromes

Hormone like substances produced by the tumor enter the bloodstream and affect tissues or organs even though the cancer hasn't metastasized. Clinical manifestations include hypercalcemia, which can lead to n/v, confusion or lethargy, or hyper coagulability that causes thrombus formation, either in superficial or deep veins, as well as other signs such as gynecomastia

Neupogen

Increases new white blood cells used with Leukemia

Lung Cancer

Leading cancer killer among men/women in the US 70% of lung cancer spreads Caused by smoking Most common- NSCLC- 85-90% of cancers

Preventing skin cancer

Minimize sun exposure: • To the extent possible, avoid sun between the hours of 10 am and 4 pm. • Wear protective clothing (e.g., long-sleeved clothing, broadbrimmed hats). • Seek shady areas when outdoors. • Use caution around snow and water because of reflective sun rays. Use sunscreen: • Use a sunscreen with a sun protection factor (SPF) of 15 or higher that protects against both ultraviolet-A (UVA) and ultraviolet-B (UVB) rays. • Apply generously 20 minutes prior to sun exposure (e.g., going outdoors). • Reapply every 2 hours, or immediately after swimming. • Use lip balm with SPF of 15 or higher. Do not use artificial ultraviolet sources (e.g., tanning beds and booths). Check your skin regularly: • Perform self-examination monthly. • Schedule an examination by primary provider yearly, if over the age of 50 years.

Breast self exam

Monthly 1 week after menses

Hypercalcemia

Muscle weakness, constipation, anorexia, n/v, polyuria and polydipsia, dehydration, hypoactive deep tendon reflex, lethargy, bone pain

Hypocalcemia

Numbness, tingling, positive trousseau sign, hyperactive reflex, seizures

Interventions

Procrit, blood transfusion, prevent infection, limit visitors

Leukemia

RBC, WBC old RBC- spleen Blood cells originate in bone marrow uncontrolled proliferation

Pneumenectomy

Removal of entire lung Lobectomy- 1 lobe Bilobectomy- 2 lobes

Hypoxia S/S

Restlessnesss, tachycardia, tachypnea, dypsnea, increased agitation, diaphoresis, retractions, altered LOC Late signs- increased restlessness, somnolence, stupor, dyspnea, decreased respirations, bradycardia, cyanosis

S/S of breast cancer

Retraction (dimpling, creasing, changes in contour) Increased venous prominence (Unilateral) Peau d' Orange (edema) orange peel apparence Nipple inversion Pagets disease

Hydroxyurea (Hydrea)

Sickle cell anemia supplemental agent and antineoplastic agent Increases production of fetal hemoglobin in sickle cell disease. Interferes in DNA synthesis SCARED Sickle cell anemia supplemental agent Cancer treatment, antineoplastic agent Advise to use contraceptive, high risk of birth defects Renal and liver function must be monitored Educate client on handeling capsules, use gloves and hand washing before and after taking Decreased WBC and platelets, danger of infection bleeding, and bruising

Radiation

Skin care, chemo-hair loss, N/V

The nurse is planning future care with a middle-aged woman who has undergone surgical resection for lung cancer. Which plan will best promote adaptation and rehabilitation? a) planning a progressive activity regimen b) arranging a visit from a client who has recovered from a similar surgery c) teaching about dressing care d) questing house cleaning services for 3 months

a

A client at risk for lung cancer asks about the reason for having a computed tomography (CT) scan as part of the initial exam. What is the nurse's best response? "A CT scan is: a) useful for distinguishing small differences in tissue density and detecting nodal involvement." b) used to distinguish a malignant from a nonmalignant adenopathy." c) far superior to magnetic resonance imaging for evaluating lymph node metastasis." d) noninvasive and readily available."

a

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? a) 7 to 14 days b) 2 to 4 days c) 24 hours d) 21 to 28 days

a

At what age is an individual most at risk for acquiring acute lymphocytic leukemia (ALL)? a) 4 to 12 years b) 40 to 50 years c) 60 to 70 years d) 20 to 30 years

a

After lobectomy for lung cancer, a client receives a chest tube connected to a disposable chest drainage system. The nurse observes that the drainage system is functioning correctly when she notes tidal movements or fluctuations in which compartment of the system as the client breathes? a) Air-leak chamber b) Water-seal chamber c) Suction control chamber d) Collection chamber

b

During a breast examination, which finding most strongly suggests that a client has breast cancer? a) Multiple firm, round, freely movable masses that change with the menstrual cycle b) A fixed nodular mass with dimpling of the overlying skin c) Slight asymmetry of the breasts d) Bloody discharge from the nipple

b

The client with acute leukemia and the health care team establish mutual client outcomes of improved tidal volume and activity tolerance. Which measure would be least likely to promote these outcomes? a) using a stationary bicycle in the room b) lying in bed and taking deep breaths c) ambulating in the hallway d) sitting up in a chair

b

A 62-year-old female is taking long-acting morphine 120 mg every 12 hours for pain from metastatic breast cancer. She can have 20 mg of immediate-release morphine every 3 to 4 hours as needed for breakthrough pain. The health care provider (HCP) should be notified if the client uses more than how many breakthrough doses of morphine in 24 hours? a) one b) two c) seven d) four

c

A client has just begun treatment with busulfan, 4 mg by mouth daily, for chronic myelogenous leukemia. The client receives busulfan until his white blood cell (WBC) count falls to between 10,000/mm3 and 25,000/mm3. Then the drug is stopped. When should treatment resume? a) When lost hair begins to grow back b) When the WBC falls to 5,000/mm3 c) When the WBC count rises to 50,000/mm3 d) When the client displays anemia

c

A nurse is assessing a client with multiple myeloma. The nurse should keep in mind that clients with multiple myeloma are at risk for: a) acute heart failure. b) hypoxemia. c) pathologic bone fractures. d) chronic liver failure.

c

Doxorubicin is prescribed for a female client with breast cancer. The client is distressed about hair loss. What should the nurse do? a) Recommend that the client limit social contacts until hair regrows. b) Explain that hair loss is temporary and will quickly grow back to its original appearance. c) Provide resources for a wig selection before hair loss begins. d) Have the client wash and massage the scalp daily to stimulate hair growth.

c

A client recently diagnosed with lung cancer tells the nurse that she has been having difficulty sleeping and is often preoccupied with thoughts about how her life has changed. She says, "I wish my life could just go on the way it was." Which issue should the nurse discuss with the client first? a) managing insomnia b) preparing a will c) relieving anxiety d) understanding grief

d

A client with a suspected diagnosis of lung cancer has a bronchoscopy with biopsy. Following the procedure the nurse should: a) advise the client not to talk until the gag reflex returns. b) encourage the client to gargle with oral lidocaine to decrease throat irritation. c) administer pain medication as needed to relieve mediastinal discomfort. d) monitor the client for signs of pneumothorax.

d

On the third postoperative day after a radical mastectomy, the drainage tube is removed, and the dressings are changed. The client appears shocked when she sees the operative area and exclaims, "I look horrible! Will it ever look better?" Which response by the nurse would be most appropriate? a) "Do not worry. You know the tumor is gone, and the area will heal very soon." b) "After it heals and you are dressed, you will not even know you had surgery." c) "Would you like to meet Ms. Paul? She looks just great and she had a mastectomy, too." d) "You are shocked by the sudden change in your appearance as a result of this surgery, are you not?"

d

The nurse is teaching the family of a client diagnosed with leukemia about ways to prevent infection. Which instruction has the most impact? a) Bathing the client daily b) Ingesting a plant-based diet c) Covering the client's mouth when coughing d) Maintaining an intact skin integrity

d

Risk for sickle crisis

dehyration (tenting, dry mucous membranes

Treatment

depends on cell type, stage, and physiologic status radiation, chemo, surgery, resection

Skin cancer risk factors

fair skinned, fair hair, blue eyes, celtic origin People who sunburn and do not tan chronic sun exposure Exposure to chemical pollutants (industrial workers in arsenic, nitrates, coal, tar and pitch, oils and paraffins) • Adults >50 years of age • Male gender (twice the rate of basal cell carcinoma as seen in women) • History of x-ray therapy for acne or benign lesions • Scars from severe burns • Chronic skin irritations • Immunosuppression • Genetic factors

Anemia

may need blood transfusion

The 45 year old female client with a family history of breast cancer asks the nurse, "Is there anything I can do to improve my chances of not getting breast cancer like my sister and mother? What is the best response 1 There are medications and lifestyle risks to reduce the risk 2 No. Clients that have a strong family history just have to hope they don't get it 3 You sound worried. Would you like to talk about how you feel 4 Do any other relatives have breast or other female cancers?

1

Diagnostics

CBC w/ diff new organ/transplant- stay on immunosuppressants for life- always at risk for infection Bone marrow biopsy- hip or sternum

Key Principles of cancer

Infection Bleeding Anemia

Polycythemia vera

Polycythemia vera is a condition that places the patient at risk for thrombus formation and bleeding caused by dysfunctional platelets.

After a lobectomy for lung cancer, the nurse instructs the client to perform deep-breathing exercises to: a) control the rate of air flow to the remaining lobe to decrease the risk of hyperinflation. b) elevate the diaphragm to enlarge the thorax so that the lung surface area available for gas exchange is increased. c) expand the alveoli and increase lung surface available for ventilation. d) decrease blood flow to the lungs for rest and increased surface alveoli ventilation.

c

Symptoms of leukemia

ANTS Anemia, decreased hemoglobin Neutropenia- risk of infection Thrombocytopenia- bleeding Numerous immature WBC like ants in an ant colony Fatigue, bruising, petechaie, pain, frequent infections, swollen lymph, dyspnea, gum issues, pallor

The nurse is caring for a child who is in the hospital experiencing sickle cell crisis. The parents are asking the nurse which treatment will help cure the child. The nurse responds with which of the following? 1 Treatment is aimed at pain control, oxygen therapy, and hydration, but does not provide a cure. 2 Treatment with morphine will cure sickle cell disease. 3 Treatment with an exchange transfusion of blood will cure the child. 4There is no treatment for sickle cell crisis.

1

HIV Research of the Nutrition Infection Unit at Tufts University School of Medicine are as follows

37 to 45 cal/kg if the client's weight is stable and there are no secondary infections 45 cal/kg if the client has an opportunistic infection 55 cal/kg if the client is losing weight

A child with suspected sickle cell disease (SCD) is in the clinic for laboratory studies. The parents ask the nurse what results will tell the physician that their child has SCD. The nurse responds that which of the following is increased in this disease? A Hematocrit B Hemoglobin C Platelet count D Reticulocyte count

4

The 39 year old diagnosed with breast cancer is prescribed tamoxifen (Nolvadex). Which information is most important for the nurse to teach the client? 1. The medication will cause menopause symptoms 2. Nolvadex may cause vaginal discharge and nausea 3. Tamoxifen will slow the growth of estrogen-posotve tumors 4. It is important to see the gynecologist regularly

4 All important information to teach, but 4 is the most important

A client asks if it is okay to drink nutrition formulas in place of eating solid food because it seems to be the only thing she tolerates. Which of the following is the nurse's best response? a. "Nutrition formulas are okay to use as a supplement in your diet, but they do not provide enough nutrition to use them in place of a meal." b. "Nutrition formulas are rich in nutrients and can be used in place of meals if they are what you are able to tolerate best." c. "It is fine to rely on nutritional supplements but vary the brand to ensure you are getting adequate nutrition." d. "Nutrition formulas generally are too high in calories and protein to use in place of meals

A

Patient education after lymph node dissection

Avoid BP, injections, and blood draws in affected arm Use sunscreen, higher than 15 spf Apply insect repellent to avoid bites Wear gloves while gardening Use cooking mitt Use electric razor Avoid cutting cuticles Avoid lifting more than 5-10 lbs If trauma or break occur, wash with warm soap and water, apply OTC ointment (Neosporin, Bacitracin) observe for 24 hrs, if redness, swelling, or fever occurs, call surgeon or nurse

Antineoplastic drugs destroy human cells. They are most likely to cause cell death among healthy cells that A have poor cell membranes. B are rapidly turning over. C are in dormant tissues. D are across the blood-brain barrier.

B

Cancer drugs are given in combination and over a period of time because it is difficult to affect A slowly growing cells. B cells in the dormant phase of the cell cycle. C cells that multiply rapidly and go through the cell cycle quickly. D cells that have moved from their normal site in the body

B

Cancer treatment usually occurs in several different treatment phases. In assessing the appropriateness of another round of chemotherapy for a particular patient, the nurse would evaluate which of the following as most important? A Hair loss B Bone marrow function C Anorexia D Heart rate

B

What makes a patient a candidate for parenteral nutrition support? a. Weight of less than 75% of ideal b. Chemoradiation to the head or neck c. Minimum improvement in nutritional parameters d. Deceased infection rate

B

Some properties of neoplastic cells are the same as the properties of normal cells, including aA naplasia. B metastasis. C mitosis. D autonomy.

C

What is one of the strongest links to cancer risk? a. Genetics b. Diet c. Body weight d. Occupation

C

Which term is used to describe the process that occurs when cells lose their cellular differentiation and organization? A. Autonomy B. Neoplasm C. Anaplasia D. Angiogenesis

C

The nurse knows her instructions about healthy eating to reduce the risk of cancer have been understood when the client states a. "If I follow those healthy eating guidelines, I will not get cancer." b. "To reduce the risk of cancer, I have to eat a vegetarian diet." c. "There is not enough known about diet and cancer to make informed choices about what to eat to reduce the risk of cancer." d. "A mostly plant-based diet may reduce the risk of cancer."

D

PROCRIT

Produces erythropoietin Red blood cells (Epogen, Procrit, Aranesp) O2 increases, decreases fatigue, weakness, SOB Chemotherapy, cancer Requires frequent HCTs for dosage adjustment IV or SQ injection only Three times weekly

An adult is dying from metastatic lung cancer, and all treatments have been discontinued. The client's breathing pattern is labored, with gurgling sounds. The client's spouse asks the nurse, "Can you do something to help with the breathing?" Which is the nurse's best response in this situation? a) Reposition the client, elevate the head of the bed, and provide a cool compress. b) Suction the client so that the client's spouse knows all interventions were performed. c) Direct the unlicensed assistive personnel (UAP) to assess the client's vital signs and provide oral care. d) Explain to the spouse that it is standard practice not to suction clients when treatments have been discontinued.

a

Several days before admission, a client reports finding a small lump in the left breast near the nipple. What should the nurse tell the client to do? a) Inform the physician immediately. b) Put a heating pad on the area to reduce inflammation. c) Squeeze the nipple to check for drainage. d) Check the area after the next menses.

a

The incidence and risk of cancer increase when smoking is combined with: a) asbestos exposure and alcohol consumption. b) alcohol consumption and human papillomavirus (HPV) infection. c) asbestos exposure and ultraviolet radiation exposure. d) ultraviolet radiation exposure and alcohol consumption.

a

A nurse is palpating the breast of a woman during an assessment. Which technique is performed correctly? A The nurse starts at the tail of Spence and moves in increasing smaller circles. B The nurse uses the palms of the hands to gently compress the breast tissue against the chest wall. C The nurse works in a counterclockwise direction and palpates from the periphery toward the areola. D The nurse starts at the inner edge of the breast and palpates up and down the breast.

A

The client asks what foods she can eat for protein because meat tastes "rotten" to her. Which of the following would be the nurse's best response? a. Cheese omelet, cold chicken sandwich, shrimp salad b. Vegetable soup, pulled-pork sandwich, meatloaf with gravy c. Spaghetti with meatballs, tacos, peanut butter and jelly sandwich d. Hot dogs, hamburgers, vegetable pizza

A

The goal of traditional antineoplastic drug therapy is to A reduce the size of abnormal cell mass for immune system destruction. B eradicate all of the abnormal cells that have developed. C destroy all cells of the originating type. D stimulate the immune system to destroy the neoplastic cells.

A

When should nutrition become part of the care plan for a client with HIV? a. Before the onset of symptoms b. When the client begins to lose weight c. After an acute episode of illness d. When weight loss is more than 5% of initial weight

A

Which of the following points would be most important for the nurse to stress when developing a patient teaching plan for a patient receiving antineoplastic therapy? A The importance of keeping the head covered at extremes of temperature. B The need to use barrier contraceptives because of the risk of serious fetal effects. C The importance of avoiding exposure to infection because the ability to heal or to fight infection is impaired. D The importance of avoiding food if nausea or vomiting is a problem. E The importance of avoiding digging in the dirt without protective coverings because of the many pathogens that live in the dirt that could cause infection. F The importance of taking periodic rest periods during the day because you will feel tired when your red blood cell count falls.

A, B, C, E, F

Hair loss, or alopecia, is an adverse effect of many antineoplastic agents. If a client is receiving a drug that usually causes alopecia, it is important that the nurse do which of the following? A Warn the patient that alopecia will occur. B Encourage the patient to arrange for an appropriate head covering at extremes of temperature. C Advise the patient to lie with the legs elevated and head low to promote circulation and prevent hair loss. D Encourage the patient to arrange for a wig or other head covering before the hair loss occurs. E Advise the patient that people will stare and can be rude when hair loss occurs. F Make arrangements for the patient to attend a support group before hair loss happens.

A, B, D

What should be included in the education plan for a patient after axillary lymph node dissection (ALND)? (Select all that apply.) A Avoid blood pressures, injections, and blood draws in affected extremity B Wear gloves for gardening C Maintain cuticles by cutting them D Use disposable razors for shaving armpits E Avoid lifting objects greater than 5 to 10 pounds

A, B, E Avoid blood pressures, injections, and blood draws in affected extremity Wear gloves for gardening Avoid lifting objects greater than 5 to 10 pounds Rationale: The patient should be instructed to avoid blood pressures, injections, and blood draws in the affected extremity; wear gloves for gardening; and avoid lifting objects greater than 5 to 10 pounds. They should also be instructed NOT to cut their cuticles but to have them pushed back during manicures and to use electric razors when shaving their armpits

It is important to explain to women that chemotherapeutic agents should not be used during pregnancy because A the tendency to cause nausea and vomiting will be increased. B of potential serious adverse effects on the rapidly multiplying cells of the fetus. C bone marrow toxicity could alter hormone levels. D patients may be weakened by the drug regimen.

B

You are caring for a patient with a Wilm's tumor who is receiving doxorubicin. What is an adverse effect of doxorubicin that you would teach the patient and their family about? A. Brown urine B. Red urine C. Orange urine D. Gold urine

B

Which of the following strategies would the nurse suggest to help the client increase the protein density of his diet? a. Top baked potatoes with sour cream. b. Mix cream cheese with butter and spread on hot bread. c. Substitute milk for water in recipes. d. Add whipped cream to coffee.

C

After inspecting the skin of a patient, the nurse documents the presence of a skin lesion as a palpable solid mass measured at 1 cm. What types of skin lesions might this describe? Select all that apply. A Macule B Patch C Plaque D Nodule E Bulla F Pustule

C,D

S/S of lung cancer

COUGH- early sign Coughing up blood (hemoptosis), chest pain, bone pain, F&E, SOB, dyspnea, frequent respiratory infections, recurring fever

Carcinomas are tumors that originate in A mesenchyme. B bone marrow. C striated muscle. D epithelial cells.

D

Metabolic alterations in the body can occur as effects of tumors. What can these metabolic alterations include? a. Decreased energy expenditure b. Increased muscle protein synthesis c. Decelerated fat breakdown d. Insulin resistance

D

A nurse is caring for a recently married, 29-year-old female client, who was diagnosed with acute lymphocytic leukemia. The client is preparing for an allogeneic bone marrow transplant. Which statement by the client demonstrates she understands the informed consent she gave about the diagnosis and treatment? a) "I always had a good appetite. Even with chemo I shouldn't have to make any changes to my diet." b) "I'll have to remain in the hospital for about 3 months after my transplant." c) "I'll only need chemotherapy treatment before receiving my bone marrow transplant." d) "I should be able to finally start a family after I'm finished with the chemo."

c

The nurse is assessing the breast of a female patient. Upon assessment, the nurse notices that the patient's skin of the breast thick and hard and that the skin pores are enlarged. The patient states that she thinks it looks like an "orange peel." How would the nurse document this assessment finding in her notes? A Cellulitis B Nipple inversion C Peau d'orange D Retraction of the skin

c Peau d'orange Rationale: Peau d'orange is associated with inflammatory breast cancer and is caused by interference with lymphatic drainage. The breast skin has an orange peel appearance in that the skin pores are enlarged and the skin is thick, hard, and immobile. These assessment findings are not indicative of cellulitis, nipple inversion, or skin retraction.

When reporting to the outpatient cancer center for his first chemotherapy treatment, a client appears anxious and apprehensive. Which statement by the nurse may help allay the client's anxiety? a) "You may have a seat right over here." b) "You look anxious, don't worry you will get used to this place." c) "We wear gowns and gloves to administer chemotherapy drugs because they're very dangerous." d) "As a precaution, we wear gowns, goggles, and gloves to administer the medication."

d