Chapter 18: Cancer

During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior? Promotion Initiation Prolongation Progression

Progression

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? Diagnostic Palliative Prophylactic Reconstructive

Prophylactic

A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem? The patient requests that her family bring her makeup and wig. The patient begins to discuss the future with her family. The patient reports less disruption from pain and discomfort. The patient cries openly when discussing her disease.

The patient requests that her family bring her makeup and wig

A decrease in circulating white blood cells is granulocytopenia. thrombocytopenia. leukopenia. neutropenia.

leukopenia

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 nadir. graft-versus-host disease. metastasis. acute leukopenia.

graft-versus-host disease

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? Proton therapy Teletherapy Brachytherapy External

Brachytherapy

The nurse is conducting a health education about cancer prevention to a group of adults. What menu best demonstrates dietary choices for potentially reducing the risks of cancer? Smoked salmon and green beans Pork chops and fried green tomatoes Baked apricot chicken and steamed broccoli Liver, onions, and steamed peas

Baked apricot chicken and steamed broccoli

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

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? Excisional biopsy Incisional biopsy Needle biopsy Punch biopsy

Excisional biopsy

A client with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this client's plan of care? Limit the time that visitors spend at the client's bedside. Teach the client to perform all aspects of basic care independently. Assign male nurses to the client's care whenever possible. Situate the client in a shared room with other clients receiving brachytherapy.

Limit the time that visitors spend at the client's bedside

The nurse is caring for a client who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the client the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer? Palliative Reconstructive Salvage Prophylactic

Palliative

Which type of surgery is used in an attempt to relieve complications of cancer? Palliative Prophylactic Reconstructive Salvage

Palliative

The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the client is requesting a bilateral mastectomy. This surgery is an example of what type of oncologic surgery? Salvage surgery Palliative surgery Prophylactic surgery Reconstructive surgery

Prophylactic surgery

The nurse on a bone marrow transplant unit is caring for a client with cancer who has just begun hematopoietic stem cell transplantation (HSCT). What is the priority nursing diagnosis for this client? Fatigue related to altered metabolic processes Altered nutrition: less than body requirements related to anorexia Risk for infection related to altered immunologic response Body image disturbance related to weight loss and anorexia

Risk for infection related to altered immunologic response

A public health nurse has formed an interdisciplinary team that is developing an educational program entitled Cancer: The Risks and What You Can Do About Them. Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity? Disease prophylaxis Risk reduction Secondary prevention Tertiary prevention

Secondary prevention

A young client has been diagnosed with cancer that has metastasized to the lungs. During client education, the client's mother asks about tumor staging and its relation to her child's condition. What stage would the nurse expect this client's tumor to be assigned? Stage IV Stage III Stage I Stage 0

Stage IV

The nurse is caring for a client with an advanced stage of breast cancer and the client has recently learned that her cancer has metastasized. The nurse enters the room and finds the client struggling to breathe and the nurse's rapid assessment reveals that the client's jugular veins are distended. The nurse should suspect the development of what oncologic emergency? Increased intracranial pressure Superior vena cava syndrome (SVCS) Spinal cord compression Metastatic tumor of the neck

Superior vena cava syndrome (SVCS)

The nursing instructor is discussing the difference between normal cells and cancer cells with the pre-nursing class in pathophysiology. What would the instructor cite as a characteristic of a cancer cell? Malignant cells contain more fibronectin. The cell membrane of malignant cells contains proteins called tumor-specific antigens. Chromosomes are commonly found to be strong. Nuclei of cancer cells are large and regularly shaped.

The cell membrane of malignant cells contains proteins called tumor-specific antigens

What should the nurse tell a client who is about to begin chemotherapy and is anxious about hair loss? 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 within 2 months post therapy. 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 demonstrate cells that are well differentiated. They gain access to the blood and lymphatic channels. They usually grow slowly. They grow by expansion.

They gain access to the blood and lymphatic channels.

The physician is attending to a 72-year-old client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation? To remove the tumor from the brain To prevent the formation of new cancer cells To analyze the lymph nodes involved To destroy marginal tissues

To prevent the formation of new cancer cells

Which instructions are necessary for a client receiving systemic internal radiation therapy who is being discharged? Select all that apply. Wash hands carefully following toileting. Avoid all physical contact with family members. Use separate towels. Drink only clear fluids and water. Wash laundry separately.

Wash hands carefully following toileting. Use separate towels. Wash laundry separately.

The root cause of cancer is damage to cellular deoxyribonucleic acid (DNA) which can be caused by many factors, or carcinogens. What factors can be carcinogenic? Select all that apply. dietary substances environmental factors viruses gender age

dietary substances environmental factors viruses

The nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice? uses the treadmill for 30 minutes on 5 days each week eats red meat such as steaks or hamburgers every day works as a secretary at a medical radiation treatment center drinks one glass of wine at dinner each night

eats red meats such as steaks or hamburgers every day

According to the TNM classification system, T0 means there is no evidence of primary tumor. no regional lymph node metastasis. no distant metastasis. distant metastasis.

no evidence of primary tumor

A client has been diagnosed with a neoplasm and is seeking further information and possible treatment. The primary care physician described the neoplasm as "insidious." What does the word "insidious" mean? slow-growing life-threatening aggressive terminal

slow-growing

A nurse is caring for a client newly diagnosed with cancer. Which therapies are used to treat cancer? Select all that apply. surgery hyperthermia radiation therapy chemotherapy electroconvulsive therapy

surgery hyperthermia radiation therapy chemotherapy

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 floss my teeth every morning." "I use an electric razor to shave." "I take a stool softener every morning." "I removed all the throw rugs from the house."

"I floss my teeth every morning."

Following a bone marrow transplantation (BMT), the patient should be monitored for at least: 3 months 3 days 4 weeks 5 months

3 months

A client who is receiving chemotherapy for esophageal cancer complains of "feeling sick to my stomach all the time." What is the best suggestion the nurse can make to help alleviate this client's nausea? Eat low-fat foods. Consume warm or hot foods. Drink more soft drinks. Consume more salty foods.

Eat low-fat foods.

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 continue having your menses every month." "You will experience menopause now." "You will be unable to have children."

"You will need to practice birth control measures."

A computed tomography (CT) scan has detected a "spot" on a patient's liver, and a subsequent liver biopsy has revealed cancer and been submitted for staging and grading. The patient has asked you about the purpose of staging, stating that her oncologist's explanation left her somewhat confused. How could you best respond to this patient's question? "Staging allows the care team to determine how large and extensive your tumor is." "The purpose of staging is to determine the site where your cancer most likely originated." "Staging is the process that helps your care team determine your prognosis for recovery." "Staging is the process of classifying a tumor according to the type of tissue it's made of."

"Staging allows the care team to determine how large and extensive your tumor is."

A patient with a diagnosis of renal cell carcinoma is being treated with chemotherapy. During a previous round of chemotherapy, the patient's tumor responded well to treatment but the chemotherapy caused intense nausea and vomiting. How should the patient's potential nausea and vomiting be addressed during this current round of treatment? Prioritize nonpharmacological treatments over medications. Administer antiemetics in anticipation of the patient's nausea. Provide the patient with antiemetics at his first complaint of nausea. Administer antiemetics if the patient vomits or believes he will soon vomit.

Administer antiemtics in anticipation of the patient's nausea

A client is struggling emotionally with a recent diagnosis of lung cancer. Which nursing interventions would be most effective in helping the client deal with these emotions? Select all that apply. Assess the client's immediate support systems. Encourage the client to set goals for the future. Teach the client to use relaxation techniques. Encourage the client to make better choices.

Assess the client's immediate support systems. Encourage the client to set goals for the future. Teach the client to use relaxation techniques.

A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of Risk for impaired skin integrity. Which intervention should be part of this client's care plan? Avoiding using soap on the irradiated areas Applying talcum powder to the irradiated areas daily after bathing Wearing a lead apron during direct contact with the client Removing thoracic skin markings after each radiation treatment

Avoid using soap on the irradiated areas

An oncology nurse is caring for a client who has developed erythema following radiation therapy. What should the nurse instruct the client to do? Periodically apply ice to the area. Keep the area cleanly shaven. Apply petroleum jelly to the affected area. Avoid using soap on the treatment area.

Avoid using soap on the treatment area.

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 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 demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis

Carcinoma in situ, no demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis

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 neoplasm primary site lesion

benign

Your patient has recently completed her first round of chemotherapy in the treatment of lung cancer. When reviewing this morning's blood work, what findings would be suggestive of myelosuppression? Decreased sodium levels and decreased potassium levels Increased creatinine and blood urea nitrogen (BUN) Decreased platelets and red blood cells Increased white blood cells and c-reactive protein (CRP)

Decreased platelets and red blood cells

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? Erythema Flare Extravasation Thrombosis

Extravasation

The human body is an amazing mechanism with multiple compensatory mechanisms and built-in protection against invasion. One of these systems is the immune system which is a major factor in the prevention or development of cancer. Which of the following is a weapon in the immune system "arsenal"? Immune suppression Recognition of tumor-associated antigens Making antibodies that resist malignant cells Generating interferon in response to a viral invasion

Immune suppression

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. Be alarmed if she notices fluid retention. Increase her intake of calcium-rich foods. Report the unexpected sign of increased appetite and weight gain.

Increase her intake of calcium-rich foods.

What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen? It attacks cancer cells during their vulnerable phase. It functions against disseminated disease. It causes a systemic reaction. It targets normal body cells as well as cancer cells.

It targets normal body cells as well as cancer cells.

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 Insertion of an NG tube for administration of feeds Maintaining NPO status and IV hydration until treatment completion

Parenteral nutrition given via a peripherally inserted central catheter

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

Provide time for the patient to discuss her concerns.

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 three drugs can be given at lower doses. The second and third drugs increase the effectiveness of the first drug. The first two drugs are toxic to cancer cells, and the third drug promotes cell growth. The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.

The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.

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 will allow time for the repair of healthy tissue." "It will decrease the incidence of leukopenia and thrombocytopenia." "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."

The hospice nurse has just admitted a new client to the program. What principle guides hospice care? Care addresses the needs of the client as well as the needs of the family. Care is focused on the client centrally and the family peripherally. The focus of all aspects of care is solely on the client. The care team prioritizes the client's physical needs and the family is responsible for the client's emotional needs.

Care addressess the needs of the client as well as the needs of the family

The nurse is caring for a client who has just been given a 6-month prognosis following a diagnosis of extensive stage small-cell lung cancer. The client states that he would like to die at home, but the team believes that the client's care needs are unable to be met in a home environment. What might the nurse suggest as an alternative? Discuss a referral for rehabilitation hospital. Panel the client for a personal care home. Discuss a referral for acute care. Discuss a referral for hospice care.

Discuss a referral to hospice care.

The nurse manager is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, what action should the nurse manager emphasize? Adjust the dose to the client's present symptoms. Wash hands with an alcohol-based cleanser following administration. Use gloves and a lab coat when preparing the medication. Dispose of the antineoplastic wastes in the hazardous waste receptacle.

Dispose of the antineoplastic wastes in the hazardous waste receptacle.