Chapter 12
Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode should the nurse anticipate? · Palliative care is likely. · No further treatment is indicated. · Adjuvant therapy is likely. · Repeat biopsy is needed before treatment begins.
Adjuvant therapy is likely.
A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication? · Serum potassium level of 2.6 mEq/L · Urine output of 400 ml in 8 hours · Blood pressure of 120/64 to 130/72 mm Hg · Sodium level of 142 mEq/L
Serum potassium level of 2.6 mEq/L
The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important? · Shield your throat area when near others. · Flush the toilet several times after every use. · Prepare food separately from family members. · Use disposable utensils for the next month.
Flush the toilet several times after every use.
An oncologist advises a client with an extensive family history of breast cancer to consider a mastectomy. What type of surgery would the nurse include in teaching? · prophylactic · palliative · cryosurgery · local excision
prophylactic
Which class of antineoplastic agents is cell cycle-specific? · Antimetabolites (5-FU) · Nitrosoureas (carmustine) · Alkylating agents (cisplatin) · Antitumor antibiotics (bleomycin)
Antimetabolites (5-FU)
The drug interleukin-2 is an example of which type of biologic response modifier? · Antimetabolites · Retinoids · Cytokine · Monoclonal antibodies
Cytokine
A patient will be having an endoscopic procedure with a diagnostic biopsy. What type of biopsy does the nurse explain will remove an entire piece of suspicious tissue? · Punch biopsy · Incisional biopsy · Excisional biopsy · Needle biopsy
Excisional biopsy
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? · Thrombosis · Extravasation · Flare · Erythema
Extravasation
You are the nurse caring for a client with cancer. The client reports pain and nausea. When assessed, you note that the client appears fearful. What other factor must you consider when a client with cancer indicates signs of pain, nausea, and fear? · Infection · High cholesterol levels · Ulceration · Fatigue
Fatigue
A patient is to receive Bacille Calmette-Guerin (BCG), a nonspecific biologic response modifier. Why would the patient receive this form of treatment? · For cancer of the lungs · For cancer of the bladder · For skin cancer · For cancer of the breast
For cancer of the bladder
A client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer? · Rash · Persistent nausea · Chronic ache or pain · Indigestion
Indigestion
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 · Inspect the skin frequently. · Avoid showering or washing over skin markings.
Inspect the skin frequently.
An oncology client will begin a course of chemotherapy and radiation therapy for the treatment of bone metastases. What is one means by which malignant disease processes transfer cells from one place to another?
Invading healthy host tissues
A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the best teaching by the nurse? · It treats drug-related anemia. · It stimulates the immune system against the tumor cells. · It prevents alopecia. · It lowers serum and uric acid levels.
It lowers serum and uric acid levels.
The nurse is caring for a client undergoing an incisional biopsy. Which statement does the nurse understand to be true about an incisional biopsy? · It removes an entire lesion and the surrounding tissue. · It removes a wedge of tissue for diagnosis. · It treats cancer with lymph node involvement. · It is used to remove cancerous cells using a needle.
It removes a wedge of tissue for diagnosis.
The nurse is assessing the diet of a female client. To decrease the risk of cancer in general, the nurse instructs the client to · Ingest two to three servings of fruits and vegetables each day. · Include at least 6 ounces of meat in meals every day. · Limit alcohol ingestion to one drink per day. · Decrease cigarette smoking from one pack/day to 1/2 pack/day.
Limit alcohol ingestion to one drink per day.
The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest? · Malignant tumor with metastasis to surrounding tissue · Benign fibrocystic disease · Normal finding · Malignant tumor
Malignant tumor
A nurse is teaching a community class about how to decrease the risk of cancer. Which food should the nurse recommend? · Oranges · Low-fat hot dogs · Medium-rare steak · Smoked ham
Oranges
A nurse is caring for a client receiving chemotherapy. Which assessment finding places the client at the greatest risk for an infection? · Temperature of 98.3° F (36.8° C) · White blood cell (WBC) count of 9,000 cells/mm3 · Stage 3 pressure ulcer on the left heel · Ate 75% of all meals during the day
Stage 3 pressure ulcer on the left heel
A client with a brain tumor is undergoing radiation and chemotherapy for treatment of cancer. The client has recently reported swelling in the gums, tongue, and lips. Which is the most likely cause of these symptoms? · Stomatitis · Neutropenia · Extravasation · Nadir
Stomatitis
A nurse is caring for a client receiving chemotherapy. Which nursing action is most appropriate for handling chemotherapeutic agents? · Break needles after the infusion is discontinued. · Throw I.V. tubing in the trash after the infusion is stopped. · Disconnect I.V. tubing with gloved hands. · Wear disposable gloves and protective clothing.
Wear disposable gloves and protective clothing.
What is the best way for the nurse to assess the nutritional status of a patient with cancer? · Monitor daily caloric intake. · Assess BUN and creatinine levels. · Observe for proper wound healing. · Weigh the patient daily.
Weigh the patient daily.
Which of the following would be inconsistent as a common side effect of chemotherapy? · Fatigue · Myelosuppression · Weight gain · Alopecia
Weight gain
Which type of surgery is used in an attempt to relieve complications of cancer? · Salvage · Reconstructive · Palliative · Prophylactic
Palliative
Carcinogens are factors related to the formation of various malignancies. Which factor has the greatest impact on the development of all cancers? · chemical agents · environmental factors · defective genes · viruses
chemical agents
The nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice? · eats red meat such as steaks or hamburgers every day · drinks one glass of wine at dinner each night · works as a secretary at a medical radiation treatment center · uses the treadmill for 30 minutes on 5 days each week
eats red meat such as steaks or hamburgers every day
A nurse is performing 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.
After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? · Administering metoclopramide and dexamethasone as ordered · Encouraging rhythmic breathing exercises · Withholding fluids for the first 4 to 6 hours after chemotherapy administration · Serving small portions of bland food
Administering metoclopramide and dexamethasone as ordered
The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise? · Eat warm or hot foods. · Avoid spicy and fatty foods. · Avoid intake of fluids. · Eat wholesome meals.
Avoid spicy and fatty foods.
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) · 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 · cell division or mitosis during the M phase of the cell cycle
normal cellular processes during the S phase of the cell cycle
The nurse is completing an admission assessment for a client receiving interstitial implants for prostate cancer. The nurse documents this as · brachytherapy. · external beam radiation therapy. · a contact mold. · systemic radiation.
brachytherapy.
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: · Use an ointment, after treatment, to decrease the feeling of burning, which may last for several hours. · 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. · Apply a small ice compress to the treated area afterward to decrease localized redness, post-radiation.
Cleanse the skin with a mild soap, using his fingertips, not a rough wash cloth.
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? · Monitor daily platelet counts. · Check the client's history for a congenital link to thrombocytopenia. · Perform a cardiovascular assessment every 4 hours. · Closely observe the client's skin for petechiae and bruising.
Closely observe the client's skin for petechiae and bruising.
What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen? · 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. · Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL. · Take measures to acidify the urine and prevent uric acid crystallization.
Encourage fluid intake to dilute the urine.
An oncology client will begin a course of chemotherapy and radiation therapy for the treatment of bone metastases. What is one means by which malignant disease processes transfer cells from one place to another? · Phagocytizing healthy cells · Invading healthy host tissues · Adhering to primary tumor cells · Inducing mutation of cells of another organ
Invading healthy host tissues
What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen? · It causes a systemic reaction. · It attacks cancer cells during their vulnerable phase. · It targets normal body cells as well as cancer cells. · It functions against disseminated disease.
It targets normal body cells as well as cancer cells.
A client has received several treatments of bleomycin. It is now important for the nurse to assess Skin integrity Hand grasp Urine output Lung sounds
Lung sounds
A client with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location rules out the use of enteral feeding. What intervention will best meet this client's nutritional needs? · Administration of parenteral feeds via a peripheral IV · Parenteral nutrition given via a peripherally inserted central catheter · Maintaining NPO status and IV hydration until treatment completion · Insertion of an NG tube for administration of feeds
Parenteral nutrition given via a peripherally inserted central catheter
What should the nurse tell a client who is about to begin chemotherapy and is anxious about hair loss? · The hair will grow back within 2 months post therapy. · 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 the same as it was before treatment.
The client should consider getting a wig or cap prior to beginning treatment.
Which statement is true about malignant tumors? · They usually grow slowly. · They demonstrate cells that are well differentiated. · They gain access to the blood and lymphatic channels. · They grow by expansion.
They gain access to the blood and lymphatic channels
The client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse? · Tumor pressure against normal tissues · Cells colonizing to distant body parts · Emission of abnormal proteins · Random, rapid growth of the tumor
Tumor pressure against normal tissues
A client with advanced cancer makes the following comment to the nurse: "Why are you bathing me? I am going to die no matter what." What is the most appropriate response of the nurse? · "A bath will make you feel better." · "Do you want to skip the bath today?" · "Would you like to talk about what you are feeling?" · "I can give you some medicine to make you feel better."
"Would you like to talk about what you are feeling?"
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: · Use an approved emollient 2 hours before the radiation to give the skin time to absorb the medication and provide a shield for damage. · Apply a small ice compress to the treated area afterward to decrease localized redness, post-radiation. · Use an ointment, after treatment, to decrease the feeling of burning, which may last for several hours. · Cleanse the skin with a mild soap, using his fingertips, not a rough wash cloth.
Cleanse the skin with a mild soap, using his fingertips, not a rough wash cloth.
A nurse is teaching a client who is receiving radiation treatment for left lower lobe lung cancer. Which client statement indicates a need for further teaching? · "I'll use hats to protect my head from the sun when my hair falls out." · "I'll allow myself plenty of time to rest between activities." · "If I get nauseous, I'll try to eat several small, bland meals each day." · "Most of the adverse effects should go away shortly after my last radiation treatment."
"I'll use hats to protect my head from the sun when my hair falls out."
A patient with uterine cancer is being treated with internal radiation therapy. What would the nurse's priority responsibility be for this patient? · Explain to the patient that she will continue to emit radiation while the implant is in place. · Alert family members that they should restrict their visiting to 5 minutes at any one time. · Wear a lead apron when providing direct patient care. · Maintain as much distance as possible from the patient while in the room.
Explain to the patient that she will continue to emit radiation while the implant is in place
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's heart rate. · Monitor the client's physical condition. · Monitor the client closely to prevent infection.
· Monitor the client closely to prevent infection.
A nurse assesses an oncology client with stomatitis during a chemotherapy session. Which nursing intervention would most likely decrease the pain associated with stomatitis? · Monitor the client's platelet and leukocyte counts. · Provide a solution of viscous lidocaine for use as a mouth rinse. · Recommend that the client discontinue chemotherapy. · Check regularly for signs and symptoms of stomatitis.
Provide a solution of viscous lidocaine for use as a mouth rinse.
The physician is attending to a client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation? · To prevent the formation of new cancer cells · To analyze the lymph nodes involved · To destroy marginal tissues · To remove the tumor from the brain
To prevent the formation of new cancer cells
A client receiving chemotherapy has a nursing diagnosis of Deficient diversional activity related to decreased energy. Which client statement indicates an accurate understanding of appropriate ways to deal with this deficit? · "I'll bowl with my team after discharge." · "I'll play card games with my friends." · "I'll eat lunch in a restaurant every day." · "I'll take a long trip to visit my aunt."
"I'll play card games with my friends."
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.
Which is a sign or symptom of septic shock? Altered mental status Warm, moist skin Hypertension Increased urine output
Altered mental status
A decrease in circulating white blood cells (WBCs) is referred to as · Granulocytopenia · Thrombocytopenia · Neutropenia · Leukopenia
Leukopenia
During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior?
Progression
An oncology nurse is caring for a client who is taking antineoplastic agents. What symptoms would the nurse consider with tumor lysis syndrome when monitoring this client? · symptoms of constipation · symptoms of gout · symptoms of hypertension · symptoms of anemia
symptoms of gout
The nurse is caring for a client with cancer. The client asks the nurse why colony-stimulating factors are being administered in addition to chemotherapy. Which response by the nurse is appropriate? · to enhance the action of the chemotherapy · suppression of the bone marrow · to shorten the period of neutropenia · to decrease the need for additional adjuvant therapies
to shorten the period of neutropenia
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 invade surrounding tissue." · "Benign tumors don't usually cause death." · "Benign tumors grow very rapidly."
"Benign tumors don't usually cause death."
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 invade surrounding tissue." · "Benign tumors don't usually cause death." · "Benign tumors grow very rapidly." · "Benign tumors can spread from one place to another."
"Benign tumors don't usually cause death."
While doing a health history, a client tells the nurse that her mother, her grandmother, and her sister died of breast cancer. The client asks what she can do to keep from getting cancer. What is the best response by the nurse? · "If you eat right, exercise, and get enough rest, you can always prevent breast cancer." · "Cancer prevention and detection can be done with blood analysis for tumor markers to measure your risk level." · "Cancer often skips a generation, so don't worry about it." "With your family history, there is nothing you can do to prevent getting cancer, so be mindful of your family risk factors
"Cancer prevention and detection can be done with blood analysis for tumor markers to measure your risk level."
A nurse is caring for a client who is receiving chemotherapy and has a platelet count of 30,000/mm3. Which statement by the client indicates a need for additional teaching? · "I removed all the throw rugs from the house." · "I take a stool softener every morning." · "I use an electric razor to shave." · "I floss my teeth every morning."
"I floss my teeth every morning."
The nurse instructs a client receiving chemotherapy on actions to prevent the development of stomatitis. Which client statement indicates to the nurse that teaching has been effective? · "I will brush my teeth after every meal." · "I will reduce smoking to after meals only." · "I will limit alcoholic beverages to one a day." · "I will eat spicy foods with a cool beverage."
"I will brush my teeth after every meal."
The nurse is evaluating if a client with Hodgkin disease understands the monitoring that needs to be done at home between radiation treatments. Which statement would indicate that the client knows how to detect a major complication? "I will monitor the loss of body hair every week." "I will measure my neck circumference every day." "I will take my temperature every day." "I will check the circulation in my arms every day."
"I will take my temperature every day."
The nurse is instructing a client on how to care for skin that has become dry after radiation therapy. Which statement by the client indicates that they understand the teaching? "I should take antihistamines to decrease the itching I'm experiencing." "I can apply an over-the-counter medicated ointment to relieve the dryness." "It's safe to apply a nonperfumed lotion to my skin." "A heating pad, set on the lowest setting, will help decrease my discomfort."
"It's safe to apply a nonperfumed lotion to my skin."
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? · "I will be happy once all the cancer is cut out." · "Once the colon tumor is removed, I will be fine." · "My cancer has now spread to my liver." · "How could I be so unlucky to get cancer twice?"
"My cancer has now spread to my liver."
A 70-year-old client asks the nurse if they need to have a mammogram. Which is the nurse's best response? "The incidence of breast cancer increases with age." "Having a mammogram when you are older is less painful." "It will be sufficient if you perform breast examinations monthly." "We need to consider your family history of breast cancer first."
"The incidence of breast cancer increases with age."
The clinic nurse is caring for a 42-year-old client who reports extreme fatigue and weakness after the first week of radiation therapy. Which response by the nurse would best reassure this client? · "Try not to be concerned about these symptoms. Every client feels this way after having radiation therapy." · "These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer." · "These symptoms are commonly associated with radiation therapy. We'll discuss some strategies to minimize and cope with fatigue." · "Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying."
"These symptoms are commonly associated with radiation therapy. We'll discuss some strategies to minimize and cope with fatigue."
When reporting to the outpatient cancer center for their first chemotherapy treatment, a client appears anxious and apprehensive. Which statement by the nurse may help allay the client's anxiety? · "We wear gowns and gloves to administer chemotherapy drugs because they're very dangerous." · "As a precaution, we wear gowns, goggles, and gloves to administer the medication." · "You may have a seat right over here." · "You look anxious, don't worry you will get used to this place."
"We wear gowns and gloves to administer chemotherapy drugs because they're very dangerous."
While doing a health history, a client tells the nurse that their mother, grandmother, and sister died of cancer. The client wants to know what to do to keep from getting cancer. What would be the nurse's best response? · "If you eat right, exercise, and get enough rest, you can prevent breast cancer." · "Cancer often skips a generation, so don't worry about it." · "With your family history, there is nothing you can do to prevent getting cancer." · "You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is."
"You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is."
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? · 21 to 28 days · 7 to 14 days · 2 to 4 days · 24 hours
7 to 14 days
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 normal reaction to the diagnosis of cancer. · A psychiatric diagnosis everyone has at one time or another. · An aberrant psychologic reaction to the chemotherapy. · A side effect of the neoplastic drugs.
A normal reaction to the diagnosis of cancer.
The nurse is planning care for a client scheduled for treatment with cytotoxic medications. What is important for the nurse to include in the plan of care to combat the most common side effects of cytotoxic medications? Offer an appetite suppressant. Teach the client about adverse effects of chemotherapy. Implement contact precautions. Administer an antiemetic.
Administer an antiemetic.
Which type of hematopoietic stem cell transplantation (HSCT) is characterized by cells from a donor other than the patient? · Allogeneic · Autologous · Homogenic · Syngeneic
Allogeneic
An oncology nurse is contributing to the care of a client who has failed to respond appreciably to conventional cancer treatments. As a result, the care team is considering the possible use of biologic response modifiers (BRMs). The nurse should know that these achieve a therapeutic effect by what means? · Focusing the client's immune system exclusively on the tumor · Potentiating the effects of chemotherapeutic agents and radiation therapy · Promoting the synthesis and release of leukocytes · Altering the immunologic relationship between the tumor and the client
Altering the immunologic relationship between the tumor and the client
5-Fluorouracil (5FU) is classified as which type of antineoplastic agent? · Alkylating · Antimetabolite · Nitrosoureas · Mitotic spindle poisons
Antimetabolite
Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client? · Autologous · Prophylactic · Allogeneic · Therapeutic
Autologous
The nurse is evaluating bloodwork results of a client with cancer who is receiving chemotherapy. The client's platelet count is 60,000/mm3. Which is an appropriate nursing action? · Avoiding the use of products containing aspirin · Providing a razor so the client can shave · Providing commercial mouthwash to the client · Taking the client's temperature rectally
Avoiding the use of products containing aspirin
The patient diagnosed with thrombocytopenia is at risk for which of the following adverse effects: · Diminished reflexes · Bleeding · Headache · Stomatitis
Bleeding
A client diagnosed with leukemia is now experiencing neutropenia. Which assessment related to neutropenia is a priority for the nurse? Heart sounds Blood pressure Bowel sounds Breath sounds
Breath sounds
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 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 · Can't assess tumor or regional lymph nodes and no evidence of metastasis
Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis
A nurse is planning caring for a client who has developed erythema following radiation therapy for a lesion on the left lower leg. Which intervention would the nurse include in the client's plan of care to best support skin recovery at the affected site? Select all that apply. · Keep the area cleanly shaven · Wear clothing that fits snugly · Apply an emollient immediately before treatment · Cleanse with lukewarm water and pat dry · Periodically apply ice
Cleanse with lukewarm water and pat dry
Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth? · Palliation · Control · Cure · Prevention
Control
Which procedure uses liquid nitrogen to freeze tissue, thereby destroying cells?
Cryoablation
Which of the following is a type of procedure that uses liquid nitrogen to freeze tissue and cause cell destruction? · Laser surgery · Chemosurgery · Cryosurgery · Electrosurgery
Cryosurgery
While administering an intravenous chemotherapeutic medication to a client, the nurse assesses swelling at the insertion site. What is the nurse's first action? Aspirate as much of the fluid as possible. Administer a neutralizing solution. Apply a warm compress. Discontinue the intravenous medication.
Discontinue the intravenous medication.
A client being treated for breast cancer reports pain as being 7 on a scale from 0 to 10. Which type of pain indicates to the nurse that the client is experiencing lymph obstruction from the disease? · Dull, aching, tightness · Burning, sharp, tingling · Distention, crampy · Sharp, throbbing
Dull, aching, tightness
Which grade of tumor is also known as a well-differentiated tumor? · Grade IV · Grade II · Grade III · Grade I
Grade I
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? · Ham and bacon · Green, leafy vegetables · Eggs and milk · Fish and poultry
Ham and bacon
The health care provider recommends that parents have their daughter vaccinated with HPV vaccine. What is this vaccine for? · Help prevent breast cancer · Help prevent leukemia · Help prevent cervical cancer · Help prevent lung cancer
Help prevent cervical cancer
A client with leukemia received induction chemotherapy 2 days ago and is now reporting severe diarrhea, decreased urination, cardiac dysrhythmias, and paresthesia with tetany. Laboratory reports reveal hyperkalemia, hyperuricemia, and hypocalcemia. Which action would the nurse anticipate? tetanus immunization and neurovascular checks every two hours I.V. fluids to increase urine output and allopurinol to inhibit uric acid limit fluids and monitor output to assess for kidney failure I.V. fluids and loop diuretic to prevent fluid overload and restore acidity
I.V. fluids to increase urine output and allopurinol to inhibit uric acid
What can the nurse do to meet the challenges in caring for a patient with cancer? · Set the same goals for all patients with cancer. · Identify own perception of cancer and set realistic goals. · Ensure that the patient has the financial means to afford their care. · Tell the patient about the things the patient has done to cause cancer.
Identify own perception of cancer and set realistic goals.
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. · Report the unexpected sign of increased appetite and weight gain. · Be alarmed if she notices fluid retention. · Increase her intake of calcium-rich foods.
Increase her intake of calcium-rich foods.
While completing an admission assessment, the client reports a family history of breast cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology? · Exposure to chemicals and spermicides · Smoking and tobacco use · Increased tumor suppressor genes · Inherited gene mutation
Inherited gene mutation
Which is a growth-based classification of tumors? · Leukemia · Sarcoma · Malignancy · Carcinoma
Malignancy
Which of the following is a characteristic of a malignant tumor? · It gains access to the blood and lymphatic channels. · It is usually slow growing. · It demonstrates cells that are well differentiated. · It grows by expansion.
It gains access to the blood and lymphatic channels.
A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician orders mitomycin and other chemotherapeutic agents for palliative treatment. How does mitomycin exert its cytotoxic effects? It inhibits ribonucleic acid (RNA) synthesis. It's cell cycle-phase specific. It inhibits protein synthesis. It inhibits deoxyribonucleic acid (DNA) synthesis.
It inhibits deoxyribonucleic acid (DNA) synthesis.
A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician orders mitomycin and other chemotherapeutic agents for palliative treatment. How does mitomycin exert its cytotoxic effects? · It's cell cycle-phase specific. · It inhibits protein synthesis. · It inhibits ribonucleic acid (RNA) synthesis. · It inhibits deoxyribonucleic acid (DNA) synthesis.
It inhibits deoxyribonucleic acid (DNA) synthesis.
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 destroys the cell membrane, causing lysis. · It interferes with deoxyribonucleic acid (DNA) replication only. · It interferes with ribonucleic acid (RNA) transcription only. · It interferes with DNA replication and RNA transcription.
It interferes with DNA replication and RNA transcription.
During a routine checkup, a nurse assesses a client with acquired immunodeficiency syndrome (AIDS) for signs and symptoms of cancer. What is the most common AIDS-related cancer? · squamous cell carcinoma · Kaposi's sarcoma · multiple myeloma
Kaposi's sarcoma
Cancer has many characteristics. What is one of the most discouraging characteristics of cancer? · Metastasis · Carcinogenesis · Large size tumors · Slow growth
Metastasis
In which phase of the cell cycle does cell division occur? · G2 phase · G1 phase · Mitosis · S phase
Mitosis
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 closely to prevent infection.
A nurse is caring for a client after a bone marrow transplant. What is the nurse's priority in caring for the client? · Monitor the client's heart rate. · Monitor the client to prevent sepsis. · Monitor the client's physical condition. · Monitor the client's toilet patterns.
Monitor the client to prevent sepsis.
According to the tumor-node-metastasis (TNM) classification system, T0 means there is · No distant metastasis · No evidence of primary tumor · Distant metastasis · No regional lymph node metastasis
No evidence of primary tumor
A nurse is receiving a client with a radioactive implant for the treatment of cervical cancer. What is the nurse's best action? · Place the client in a private room. · Have visitors wear dosimeters for safety. · Allow visitors to telephone only. · Place a chair next to the bed to allow the spouse to sit.
Place the client in a private room.
The client with acute lymphocytic leukemia (ALL) is at risk for infection. What action should the nurse take? · Have staff wear gowns and gloves. · Have the client wear a mask. · Restrict visitors. · Place the client in a private room.
Place the client in a private room.
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? · Curative surgery · Prophylactic surgery · Reduction surgery · Palliative surgery
Prophylactic surgery
Which of the following does a nurse have to assess during the bone marrow transplant (BMT) procedure? · Blood pressure status · Electrolyte levels · Urine gravity status · Psychological status
Psychological status
The nurse is reviewing the lab report for a client in hospice care with breast cancer and brain metastasis. According to the information in the chart, what should the nurse do next? Refrain from reporting the results because the client is in hospice care. Report the elevated potassium level immediately. Document these results on the medical record. Report the elevated calcium level immediately.
Report the elevated calcium level immediately.
After being seen in the oncology clinic, a client with severe bone marrow suppression is admitted to the hospital. The client's cancer therapy consisted of radiation and chemotherapy. When developing the care plan for this client, which nursing diagnosis takes priority? · Anxiety · Risk for injury · Risk for infection · Imbalanced nutrition: Less than body requirements
Risk for infection
A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication?
Serum potassium level of 2.6 mEq/L
The nurse is caring for a client with a benign breast tumor. The tumor may have which characteristic? · Ability to invade other tissues · Undifferentiated cells · Slow rate of growth · Causes generalized symptoms
Slow rate of growth
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 · Gives prednisolone IV · Administers diphenhydramine · Places the client on oxygen by nasal cannula · Stops the chemotherapeutic infusion
Stops the chemotherapeutic infusion
The nurse is invited to present a teaching program to parents of school-age children. Which topic would be of greatest value for decreasing cancer risks? · Breast and testicular self-exams · Pool and water safety · Sun safety and use of sunscreen · Hand washing and infection prevention
Sun safety and use of sunscreen
A client calls the oncology office nurse and reports nausea and vomiting one week after receiving chemotherapy. What action should the nurse recommend? · Obtaining acupressure treatments · Using imagery techniques · Taking prescribed ondansetron · Practicing relaxation techniques
Taking prescribed ondansetron
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 first two drugs are toxic to cancer cells, and the third drug promotes cell growth. · The second and third drugs increase the effectiveness of the first drug. · The three drugs have a synergistic effect and act on the cancer cells with different mechanisms. · The three drugs can be given at lower doses.
The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.
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 · Fatigue · Angiogenesis · Stomatitis
To prevent metastasis
A client is receiving radiation therapy and asks the nurse about oral hygiene. What teaching specific to the client's situation should the nurse include? · Treat cavities immediately. · Use a soft toothbrush and allow it to air dry before storing. · Gargle after each meal. · Floss before going to bed.
Use a soft toothbrush and allow it to air dry before storing.
A client who is receiving chemotherapy develops stomatitis. What should the nurse instruct the client to do? Avoid using dental floss until the stomatitis is resolved. Use a soft-bristled toothbrush after each meal. Rinse the mouth with full-strength hydrogen peroxide every 4 hours. Drink hot tea with honey to soothe the painful oral mucosa.
Use a soft-bristled toothbrush after each meal.
A client has a saline-only peripherally inserted central catheter (PICC). What should the nurse do to maintain the catheter? Avoid flushing any ports unless they appear blocked. Flush the port using 3 mL of saline after each use. Add 10 units of heparin to each saline flush to prevent clotting. Utilize a 10-mL saline flush to maintain line patency.
Utilize a 10-mL saline flush to maintain line patency.
The nurse is instructing a client about skin care while receiving radiation therapy to the chest. What should the nurse instruct the client to do? Keep the area covered with a nonadherent dressing between treatments. Apply lotion if the skin becomes dry. Wash the area with tepid water and mild soap. Shave the chest to prevent contamination from chest hair.
Wash the area with tepid water and mild soap.
A client received chemotherapy 24 hours ago. Which precautions are necessary when caring for the client? · Wear sterile gloves. · Wear personal protective equipment when handling blood, body fluids, and feces. · Place incontinence pads in the regular trash container. · Provide a urinal or bedpan to decrease the likelihood of soiling linens.
Wear personal protective equipment when handling blood, body fluids, and feces.
A nurse is caring for a client receiving chemotherapy. Which nursing action is most appropriate for handling chemotherapeutic agents? Dispose of intravenous (IV) tubing in the trash container closest to the client. Wear a pair of sterile gloves when disconnecting intravenous (IV) tubing. Reconstitute oral forms at the medication station. Wear protective clothing.
Wear protective clothing.
A client diagnosed with cancer is receiving chemotherapy. The nurses should assess which diagnostic value while the client is receiving chemotherapy? pancreatic enzymes bone marrow cells liver tissues heart tissues
bone marrow cells
A home care nurse assesses for disease complications in a client with bone cancer. Which laboratory value may indicate the presence of a disease complication? calcium level of 11.6 mg/dl (2.9 mmol/L) potassium level of 6.3 mEq/L sodium level of 110 mEq/L magnesium level of 0.9 mg/dl
calcium level of 11.6 mg/dl (2.9 mmol/L)
The nurse understands that the client should be given human papillomavirus (HPV) vaccine per the health care provider's orders. What does this vaccine help prevent? · leukemia · lung cancer · cervical cancer · breast cancer
cervical cancer
The nurse is caring for a client who is receiving external beam radiation therapy for the treatment of lung cancer. What should the nurse assess the client for while they are receiving radiation therapy? dysphagia normal white blood cell count improved energy level diarrhea
dysphagia
A toddler receiving chemotherapy after surgery for a Wilms tumor has developed neutropenia. The parent is trying to encourage the child to eat by bringing extra foods to the room. Which food would the nurse discourage for this child? · fresh strawberries · a milkshake · fudge · French fries
fresh strawberries
After a gastric cancer resection for a malignant tumor, a client is scheduled to undergo radiation therapy. What is the most important information the nurse should include in the discharge teaching plan? · how to exercise to attain activity goals · what do for alopecia · how to maintain adequate nutrition · where to access community resources
how to maintain adequate nutrition
A nurse caring for a client who has just received chemotherapy infusion is wearing a disposable gown, gloves, and goggles for protection. The nurse knows that accidental exposure to chemotherapy agents can occur through: · inhalation of aerosols. · absorption through the goggles. · absorption through the gloves. · absorption through the gown.
inhalation of aerosols.
A 65-year-old client has been told by the health care provider that their prostate cancer was graded at stage IIB. The client inquires if this means they are going to die soon. What is the best response by the nurse? "Prostate cancer at this stage: · is difficult to predict." · is very fast growing." · has spread to the bone." · is very slow growing."
is very slow growing."
A client asks the nurse what PSA is. The nurse should reply that it stands for prostate-specific antigen, which is used to screen for prostate cancer. pneumococcal strep antigen, which is a bacteria that causes pneumonia. Papanicolaou-specific antigen, which is used to screen for cervical cancer. protein serum antigen, which is used to determine protein levels.
prostate-specific antigen, which is used to screen for prostate cancer.
Palliation refers to · hair loss related to the treatment of cancer. · relief of symptoms associated with disease and promotion of comfort and quality of life. · the spread of cancer cells from the primary tumor to distant sites. · the lowest point of white blood cell depression after therapy that has toxic effects on bone marrow.
relief of symptoms associated with disease and promotion of comfort and quality of life.
A client with a recent history of GI disturbance has been scheduled for a barium study. The physician ordered this particular test for this client because it will:
show movement of the GI tract.
The lethal tumor dose is defined as the dose that will eradicate what percentage of the tumor yet preserve normal tissue? · 75% · 85% · 65% · 95%
95%
An oncology clinic nurse is reinforcing prevention measures for oropharyngeal infections to a client receiving chemotherapy. Which statement by the client indicates that teaching was successful? · "I use an alcohol-based mouthwash every morning." · "I clean my teeth gently several times per day." · "I lubricate my lips with petroleum jelly." · "I replace my toothbrush every month."
"I clean my teeth gently several times per day."
A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed? · "I will be glad to finally be done with treatments for this thing." · "Thank goodness the tumor is contained and curable." · "I guess the doctor could not remove the entire tumor." · "I am so glad the doctor was able to remove the entire tumor."
"I guess the doctor could not remove the entire tumor."
A nurse is caring for a 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? · "I'll only need chemotherapy treatment before receiving my bone marrow transplant." · "I always had a good appetite. Even with chemo I shouldn't have to make any changes to my diet." · "I should be able to finally start a family after I'm finished with the chemo." · "I'll have to remain in the hospital for about 3 months after my transplant."
"I'll only need chemotherapy treatment before receiving my bone marrow transplant."
Which statement by a client undergoing external radiation therapy indicates the need for further teaching? · "I'll wear protective clothing when outside." · "I'm worried I'll expose my family members to radiation." · "I'll not use my heating pad during my treatment." · "I'll wash my skin with mild soap and water only."
"I'm worried I'll expose my family members to radiation."
A patient will be receiving radiation for 6 weeks for the treatment of breast cancer and asks the nurse why it takes so long. What is the best response by the nurse? · "It allows time for you to cope with the treatment." · "It is not really understood why you have to go for 6 weeks of treatment." · "It will allow time for the repair of healthy tissue." · "It will decrease the incidence of leukopenia and thrombocytopenia."
"It will allow time for the repair of healthy tissue."
A bowel resection is scheduled for a client with the diagnosis of colon cancer with metastasis to the liver and bone. Which statement by the nurse best explains the purpose of the surgery? · "Once the tumor is removed, cell pathology can be determined." · "This surgery will prevent further tumor growth." · "Removing the tumor is a primary treatment for colon cancer." · "Tumor removal will promote comfort."
"Tumor removal will promote comfort."
A nurse is assessing a 75-year-old woman who had a total hysterectomy when she was 30 years old and normal Pap test results for the past 10 years. The client asks about continuing the Pap test. What is the best response by the nurse? · "You may choose to discontinue this test." · You need to continue obtaining a Pap test for only the next 5 years." · "You will need to continue for the rest of your life." · "You could have stopped immediately after your hysterectomy."
"You may choose to discontinue this test."
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 positive biopsy? · A lump excision is not necessary. · The lump and all axillary lymph nodes will be excised. · The entire breast and all regional lymph nodes will be excised. · A wide excision of lump will be performed
A wide excision of lump will be performed
A client diagnosed with cancer has the tumor staged and graded based on what factors? · How they differentiate the cell type · How they tend to grow and the cell type · How they spread and differentiate · How they spread and tend to grow
How they tend to grow and the cell type
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. · Increase her intake of calcium-rich foods. · Report the unexpected sign of increased appetite and weight gain. · Be alarmed if she notices fluid retention.
Increase her intake of calcium-rich foods.
Chemotherapeutic agents have which effect associated with the renal system? · Hypokalemia · Increased uric acid excretion · Hypercalcemia · Hypophosphatemia
Increased uric acid excretion
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? · Urinary system · Pulmonary system · Gastrointestinal system · Nervous system
Nervous system
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? · Reconstructive · Palliative · Prophylactic · Diagnostic
Prophylactic
A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis? · Rust-colored sputum · Yellow tooth discoloration · Red, open sores on the oral mucosa · White, cottage cheese-like patches on the tongue
Red, open sores on the oral mucosa
A client asks the nurse what is causing the fatigue following radiotherapy. What is the nurse's best response? · The cancer cells are dying in large numbers. · Fighting off infection is an exhausting venture. · The cancer is spreading to other parts of the body. · Substances are released when tumor cells are destroyed.
Substances are released when tumor cells are destroyed.
A client returns to the surgeon's office for a report on a diagnostic procedure to determine the cell composition of the client's abdominal neoplasm. Which term is significant to indicate the likelihood of the tumor spreading? · benign · primary site · neoplasm · lesion
benign
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.
A client with a recent history of GI disturbance has been scheduled for a barium study. The physician ordered this particular test for this client because it will: · provide a three-dimensional cross-sectional view. · show movement of the GI tract. · remove a tissue sample from the GI tract. · show tumor "hot spots" in the GI tract.
show movement of the GI tract.
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." · "I hope they find a bone marrow donor who matches." · "I will need to attend follow-up visits for up to 3 months after treatment." · "The doctor will remove cells from my bone marrow before beginning chemotherapy."
"I hope they find a bone marrow donor who matches."
Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure? · Blood studies · Family history · Allergy history · Drug history
Blood studies
Which of the following would be consistent with a benign neoplasm? · Usually progressive and slow · Cells are undifferentiated · Gains access to the blood and lymph channels to metastasize · Grows by invasion
Usually progressive and slow
A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells? · Colon · Reproductive tract · Liver · White blood cells (WBCs)
Liver
A patient is scheduled for cryoablation for cervical cancer and tells the nurse, "I am not exactly sure what the surgeon is going to do." What is the best response by the nurse? · "The surgeon is going to use medication to inject the area." · "The surgeon is going to use a laser to remove the area." · "The surgeon is going to use liquid nitrogen to freeze the area." · "The surgeon is going to use radiofrequency to ablate the area."
· "The surgeon is going to use liquid nitrogen to freeze the area."
The nurse is providing education to a client with cancer radiation treatment options. The nurse determines that the client understands the teaching when the client states that which type of radiation aims to protect healthy tissue during the treatment? · Brachytherapy · Teletherapy · External · Proton therapy
Brachytherapy
Which oncologic emergency involves the accumulation of fluid in the pericardial space? · Syndrome of inappropriate antidiuretic hormone release (SIADH) · Cardiac tamponade · Tumor lysis syndrome · Disseminated intravascular coagulation (DIC)
Cardiac tamponade
A client is receiving external radiation to the left thorax to treat lung cancer. Which intervention should be part of this client's care plan? · Wearing a lead apron during direct contact with the client · Avoiding using soap on the irradiated areas · Removing thoracic skin markings after each radiation treatment · Applying talcum powder to the irradiated areas daily after bathing
Avoiding using soap on the irradiated areas
A patient is admitted for an excisional biopsy of a breast lesion. What intervention should the nurse provide for the care of this patient? · Counsel the patient about the possibility of losing her breast. · Provide time for the patient to discuss her concerns. · Clarify information provided by the physician. · Provide aseptic care to the incision postoperatively.
Provide time for the patient to discuss her concerns.
A client reports a new onset of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. The health care provider orders a diagnostic workup, which reveals end-stage gallbladder cancer. What nursing intervention should be used to facilitate adaptive coping? · Encourage ventilation of negative feelings. · Assist with self-care activities of daily living. · Refer client for professional counseling. · Provide written education for prescribed treatments.
Refer client for professional counseling.
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 4 weeks. · Closely monitor the client for at least 3 days. · Closely monitor the client for at least 5 months.
Closely monitor the client for at least 3 months.
The nurse is working with a client who has had an allo-hematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of metastasis. nadir. acute leukopenia. graft-versus-host disease.
graft-versus-host disease.
Which of the following is generally NOT considered to be a carcinogen?
Parasites
After a bone marrow transplant (BMT), the client should be monitored for at least · 100 days · 60 days · 14 days · 30 days
100 days
A nurse is caring for a client with prostate cancer and assesses bleeding gums and hematuria. What serum indicator should the nurse relate the bleeding? · neutrophil count of 40% · lymphocyte count of 30% · platelet count of 60,000/mm3 · reticulocyte count of 1%
platelet count of 60,000/mm3
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 · Anxiety related to change in role function · Activity intolerance related to side effects of chemotherapy
Risk for infection related to inadequate defenses
The nurse is conducting a screening for familial predisposition to cancer. Which element should the nurse note as a possible indication of hereditary cancer syndrome? · A first cousin diagnosed with cancer · Onset of cancer after age 50 in family member · A second cousin diagnosed with cancer · An aunt and uncle diagnosed with cancer
An aunt and uncle diagnosed with cancer
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 be unable to have children." · "You will continue having your menses every month." · "You will experience menopause now."
"You will need to practice birth control measures."
A client diagnosed with cancer makes the following statement to the nurse: "I guess I will tell my health care provider 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. · Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects. · Clinical trials are opening up new cancer treatments all the time. · Most clients believe the discomfort is well worth the cure for cancer.
Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.
An oncology nurse is caring for a client who relates that certain tastes have changed. The client states that "meat tastes bad." What nursing intervention can be used to increase protein intake for a client with taste changes? · Suck on hard candy during treatment. · Stay away from protein beverages. · Encourage eating cheese, eggs, and legumes · Encourage maximum fluid intake.
Encourage eating cheese, eggs, and legumes
The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action?
Extravasation
For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan? · Providing for frequent rest periods · Placing the client in strict isolation · Inspecting the skin for petechiae once every shift · Administering aspirin if the temperature exceeds 102° F (38.8° C)
Inspecting the skin for petechiae once every shift
The nurse on the oncology unit is caring for a client with a total white blood cell (WBC) count equal to 2000/µL (2.0 ×109/L). Which intervention is most important to include in the plan of care? · Monitor temperature every 4 hours · avoid rectal thermometers and suppositories · restrict visitors and provide a private room · perform proper hand hygiene
perform proper hand hygiene
A nurse is caring for a client who is undergoing chemotherapy. Current laboratory values are noted on the medical record. Which action would be most appropriate for the nurse to implement? wearing a protective gown and particulate respiratory mask when completing treatments contacting the health care provider (HCP) for a prescription for hematopoietic factors such as erythropoietin washing hands before and after entering the room restricting visitors
washing hands before and after entering the room
An oncology client has just returned from the postanesthesia care unit after an open hemicolectomy. This client's plan of nursing care should prioritize which of the following? · Assess the client hourly for signs of compartment syndrome. · Assess the client's fine motor skills once per shift. · Assess the client's wound for dehiscence every 4 hours. · Maintain the client's head of bed at 45 degrees or more at all times.
· Assess the client's wound for dehiscence every 4 hours.
The nurse is caring for a client who will be undergoing a mastectomy. What would the nurse include in preoperative teaching? Explain there will be minimal effects from anesthesia because the surgery is done so quickly. Teach about the Jackson-Pratt drain, pressure dressing, and deep-breathing exercises. Inform the client that food or fluids will not be allowed for the first 2 days postoperatively. Explain that a small dressing will be placed on the chest and removed 12 hours postoperatively.
Teach about the Jackson-Pratt drain, pressure dressing, and deep-breathing exercises.
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 can continue taking my vitamins and herbs because they make me feel better." · "I will eat clear liquids for the next 24 hours." · "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."
A client is scheduled to undergo weekly intravesical chemotherapy for bladder cancer for 8 weeks. Which statement indicates that the client understands how to manage the urine as a biohazard? · "I should use a separate bathroom from the rest of the family for the next 8 weeks." · "I'll void into a bedpan and then empty the urine into the toilet." · "It's important to clean the bathroom daily with disinfectant wipes." · "I can disinfect the urine and toilet with bleach for 6 hours following a treatment."
"I can disinfect the urine and toilet with bleach for 6 hours following a treatment."
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.
A newly diagnosed cancer client is crying and states the following to the nurse: "I promised God that I will be a better person if I can just get better." What is the appropriate assessment of this comment by the nurse? · Anger directed toward nursing staff is not unusual in dealing with cancer clients. · Loss is inevitable so client is making final plans. · The cancer is viewed as a punishment from past actions. · The client is just trying to protect self from potential loss.
The cancer is viewed as a punishment from past actions
The nurse is to administer a vesicant chemotherapeutic drug to a client who had a right mastectomy and inserts the intravenous line · With a soft, plastic catheter · In the client's left hand · With a butterfly needle · In the client's right forearm
With a soft, plastic catheter
The nurse is conducting a health history for a client at risk for cancer. Which lifestyle factor is considered a risk for colorectal cancer? a diet low in vitamin C multiple sex partners a high dietary intake of artificial sweeteners a high-fat, low-fiber diet
a high-fat, low-fiber diet
A client has an abnormal result on a Papanicolaou test. The client asks the nurse what dysplasia means. Which definition should the nurse provide? replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin alteration in the size, shape, and organization of differentiated cells increase in the number of normal cells in a normal arrangement in a tissue or an organ
alteration in the size, shape, and organization of differentiated cells
A client with metastatic ovarian cancer is ordered cisplatin. Before administering the first dose, the nurse reviews the client's medication history for drugs that may interact with cisplatin. Which drug may cause significant interactions when given concomitantly with cisplatin? a tetracycline a cephalosporin erythromycin an aminoglycoside
an aminoglycoside
The nurse is speaking to a group of women about early detection of breast cancer. Which screening does the nurse recommend to women age 50 and older? annual self breast examination annual mammogram biennial clinical breast examination by a healthcare provider annual test for hormonal receptor assay
annual mammogram
To combat the most common adverse effects of chemotherapy, a nurse should administer an: · anticoagulant. · antiemetic. · antimetabolite. · antibiotic.
antiemetic.
The family of an older adult with terminal cancer asks about having hospice services. What should the nurse tell the family? Hospice care: · can only be provided in the inpatient setting. · is staffed exclusively by professional health care workers. · focuses only on the needs of the client. · focuses on supportive care for the client and family.
focuses on supportive care for the client and family.
A nurse is assessing a client with lymphoma who reports distress 9 days after chemotherapy. Because of the risk for septic shock, the nurse should assess the client for which cluster of symptoms? flushing, decreased oxygen saturation, and mild hypotension high-grade fever, normal blood pressure, and increased respirations low-grade fever, chills, and tachycardia elevated temperature, oliguria, and hypotension
low-grade fever, chills, and tachycardia
Cancer is the second leading cause of death in the United States, second only to heart disease. Half of all men and one third of all women will develop cancer during their lifetimes. Which types of cancer have the highest prevalence among both men and women? · lung and colon · skin and brain · lung and skin · colon and skin
lung and colon
A medication nurse is preparing to administer 0900 medications to a client with liver cancer. Which consideration is the nurse's highest priority? · frequency of the medication · metabolism of the medication · purpose of the medication · necessity of the medication
metabolism of the medication
A client tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client's lump is cancerous? nonpalpable right axillary lymph nodes mobile mass that is soft and easily delineated eversion of the right nipple and mobile mass nonmobile mass with irregular edges
nonmobile mass with irregular edges
