Lewis - Med Surg - Ch. 15: Cancer

You are a hospice nurse caring for a patient with cancer in her home. You have explained to the patient and the family that the patient is at risk for hypercalcemia. You have educated them on that signs and symptoms of hypercalcemia. What else would you teach this patient and family to do to reduce the risk of hypercalcemia? A. Stool softeners are contraindicated. B. Laxatives should be taken daily. C. Consume 2 to 4 L of fluid daily. D. Restrict calcium intake.

C. Consume 2 to 4 L of fluid daily.

The nurse is caring for a patient who smokes 2 packs/day. To reduce the patient's risk of lung cancer, which action by the nurse is best? A. Teach the patient about the seven warning signs of cancer. B. Plan to monitor the patient's carcinoembryonic antigen (CEA. level. C. Discuss the risks associated with cigarettes during every patient encounter. D. Teach the patient about the use of annual chest x-rays for lung cancer screening.

C. Discuss the risks associated with cigarettes during every patient encounter.

Your patient is receiving carmustine, a chemotherapy agent. A significant side effect of this medication is thrombocytopenia. Which symptom would the nurse assess for in patients at risk for thrombocytopenia? A. Interrupted sleep pattern B. Hot flashes C. Nose bleed D. Increased weight

C. Nose bleed

During a routine health examination, a 40-year-old patient tells the nurse about a family history of colon cancer. Which action should the nurse take next? A. Teach the patient about the need for a colonoscopy at age 50. B. Teach the patient how to do home testing for fecal occult blood. C. Obtain more information from the patient about the family history. D. Schedule a sigmoidoscopy to provide baseline data about the patient.

C. Obtain more information from the patient about the family history.

After change-of-shift report on the oncology unit, which patient should the nurse assess first? A. Patient who has a platelet count of 82,000/µL after chemotherapy B. Patient who has xerostomia after receiving head and neck radiation C. Patient who is neutropenic and has a temperature of 100.5° F (38.1° C) D. Patient who is worried about getting the prescribed long-acting opioid on time

C. Patient who is neutropenic and has a temperature of 100.5° F (38.1° C)

You are caring for a 39-year-old woman with a family history of breast cancer. She has requested a breast tumor marking test and the results are positive. The patient is requesting a bilateral mastectomy. What is this surgery an example of? A. Salvage surgery B. Palliative surgery C. Prophylactic surgery D. Reconstructive surgery

C. Prophylactic surgery

Your patient has just returned from the PACU after salvage surgery for renal carcinoma. What would you assess this patient for? A. Vasoconstriction B. Anorexia C. Wound dehiscence D. Metastasis to the brain

C. Wound dehiscence

Which delivery system would be used to deliver regional chemotherapy for metastasis from primary colorectal cancer? A. intrathecal B. intraarterial C. intravenous D. intraperitoneal

D. intraperitoneal

What factor differentiates a malignant tumor from a benign tumor? A. it causes death B. it grows at a faster rate C. it is often encapsulated D. it invades and metastasizes

D. it invades and metastasizes

What is the name of a tumor from the embryonal mesoderm tissue of origin located in the anatomic site of the meninges that has malignant behavior? A. meningitis B. meningioma C. meningocele D. meningeal sarcoma

D. meningeal sarcoma

PRIORITY DECISION: The patient with advanced cancer is having difficulty controlling her pain. She says she is afraid she will become addicted to the opioids. What is the first thing the nurse should do for this patient? A. administer a non steroidal anti-inflammatory drug B. assess the patient's vital signs and behavior to determine the medication to use C. have the patient keep a pain diary to better assess the patient's potential addiction D. obtain a detailed pain history including quality, location, intensity, duration, and type of pain

D. obtain a detailed pain history including quality, location, intensity, duration, and type of pain

You are caring for an oncology patient at risk for disseminated intravascular coagulation (DIC). What would be the appropriate care for this patient? (Mark all that apply.) A. Assist patient to turn, cough, and deep breathe B. Accurate I & O C. Prevent bleeding D. Assess hearing disturbances E. Maximize physical activity

A, B, C A. Assist patient to turn, cough, and deep breathe B. Accurate I & O C. Prevent bleeding

Which factors will assist a patient in coping positively with having cancer (select all that apply) A. feeling in control B. strong support system C. internalizing feelings D. possibility of a cure or control E. a young person will adapt more easily F. not having had to cope with previous stressful events

A, B, D A. feeling in control B. strong support system D. possibility of a cure or control

You are giving a report in your pathophysiology class. The subject of your report is cancer cells. In differentiating between benign and malignant cells, what characteristics would you cite? (Mark all that apply.) A. Rate of growth B. Ability to cause death C. Size of cells D. Cell contents E. Ability to spread

A, B, E A. Rate of growth B. Ability to cause death E. Ability to spread

You are the nurse caring for an adult patient who has developed a mild oral yeast infection following chemotherapy. What should you encourage the patient to do? (Mark all that apply.) A. Use a lip lubricant B. Scrub the tongue with a firm-bristled toothbrush C. Use dental floss every 24 hours D. Rinse the mouth with normal saline E. Eat hot foods to aid in killing the yeast

A, C, D A. Use a lip lubricant C. Use dental floss every 24 hours D. Rinse the mouth with normal saline

Cancer cells go through stages of development. What accurately describes the stage of promotion (select all that apply)? A. obesity is an example of a promoting factor B. the stage is characterized by increased growth rate and metastasis C. withdrawal of promoting factors will reduce the risk of cancer developing D. tobacco smoke is a complete carcinogen that is capable of both initiation and promotion E. promotion is the stage of cancer development in which there is an irreversible alteration in the cell's DNA

A, C, D A. obesity is an example of a promoting factor C. withdrawal of promoting factors will reduce the risk of cancer developing D. tobacco smoke is a complete carcinogen that is capable of both initiation and promotion

The nurse at the clinic is interviewing a 64-year-old woman who is 5 feet, 3 inches tall and weighs 125 pounds (57 kg). The patient has not seen a health care provider for 20 years. She walks 5 miles most days and has a glass of wine 2 or 3 times a week. Which topics will the nurse plan to include in patient teaching about cancer screening and decreasing cancer risk (select all that apply)? A. Pap testing B. Tobacco use C. Sunscreen use D. Mammography E. Colorectal screening

A, C, D, E A. Pap testing C. Sunscreen use D. Mammography E. Colorectal screening

A patient develops neutropenia after receiving chemotherapy. Which information about ways to prevent infection will the nurse include in the teaching plan (select all that apply)? A. Cook food thoroughly before eating. B. Choose low fiber, low residue foods. C. Avoid public transportation such as buses. D. Use rectal suppositories if needed for constipation. E. Talk to the oncologist before having any dental work done.

A, C, E A. Cook food thoroughly before eating. C. Avoid public transportation such as buses. E. Talk to the oncologist before having any dental work done.

A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. The nurse teaches the patient about management of the skin reaction. Which statement, if made by the patient, indicates the teaching was effective? A. "I can buy some aloe vera gel to use on the area." B. "I will expose the treatment area to a sun lamp daily." C. "I can use ice packs to relieve itching in the treatment area." D. "I will scrub the area with warm water to remove the scales."

A. "I can buy some aloe vera gel to use on the area."

A patient who is diagnosed with cervical cancer that is classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is most appropriate? A. "The cancer involves only the cervix." B. "The cancer cells look almost like normal cells." C. "Further testing is needed to determine the spread of the cancer." D. "It is difficult to determine the original site of the cervical cancer."

A. "The cancer involves only the cervix."

The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient? A. "These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and X-ray studies." B. "These symptoms are part of your disease and can't be helped." C. "Don't be concerned about these symptoms. Everybody feels this way after having radiation therapy." D. "This is a good sign. It means that only the cancer cells are dying."

A. "These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and X-ray studies."

A widowed mother of four school-age children is hospitalized with metastatic ovarian cancer. The patient is crying and tells the nurse that she does not know what will happen to her children when she dies. Which response by the nurse is most appropriate? A. "Why don't we talk about the options you have for the care of your children?" B. "I'm sure you have friends that will take the children when you can't care for them." C. "For now you need to concentrate on getting well and not worrying about your children." D. "Many patients with cancer live for a long time, so there is still time to plan for your children."

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

Adverse effects to chemotherapy are dealt with by patients and their caregivers every day. What would the nurse do to combat the most common adverse effects of chemotherapy? A. Administer an antiemetic B. Administer an antimetabolite C. Administer a tumor antibiotic D. Administer an anticoagulant

A. Administer an antiemetic

What is the most important focus of hospice care? A. Focus of care is on the family as well as the patient. B. Focus of care is on the patient centrally and the family peripherally. C. Focus of care is solely on the patient. D. Focus of care emotionally is totally on the family.

A. Focus of care is on the family as well as the patient.

Interleukin-2 (IL-2) is used as adjuvant therapy for a patient with metastatic renal cell carcinoma. Which information should the nurse include when explaining the purpose of this therapy to the patient? A. IL-2 enhances the immunologic response to tumor cells. B. IL-2 stimulates malignant cells in the resting phase to enter mitosis. C. IL-2 prevents the bone marrow depression caused by chemotherapy. D. IL-2 protects normal cells from the harmful effects of chemotherapy.

A. IL-2 enhances the immunologic response to tumor cells.

You are caring for a patient who is to begin receiving external radiation for a malignant tumor of the head and neck. While doing patient education, what side effects should the nurse discuss with the patient that should be assessed because of the radiation treatment? A. Impaired nutritional status B. Pink oral mucosa C. Diarrhea D. Alopecia

A. Impaired nutritional status

You are the clinic nurse in an oncology clinic. Your patient arrives for a 2-month follow-up appointment following chemotherapy. You note that the patient's skin appears yellow. Which blood tests should be done to further explore this clinical sign? A. Liver function test B. CBC C. Platelet count D. Electrolytes

A. Liver function test

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

A. Palliative

The nurse assesses a patient with non-Hodgkin's lymphoma who is receiving an infusion of rituximab (Rituxan). Which assessment finding would require the most rapid action by the nurse? A. Shortness of breath B. Temperature 100.2° F (37.9° C) C. Shivering and complaint of chills D. Generalized muscle aches and pains

A. Shortness of breath

The nurse is presenting a community education program related to cancer prevention. Based on current cancer death rates, the nurse emphasizes what as the most important preventative action for both men and women? A. Smoking cessation B. routine colonoscopies C. protection from ultraviolet light D. regular examination of reproductive organs

A. Smoking cessation

When caring for a patient who is pancytopenic, which action by unlicensed assistive personnel (UAP) indicates a need for the nurse to intervene? A. The UAP assists the patient to use dental floss after eating. B. The UAP adds baking soda to the patient's saline oral rinses. C. The UAP puts fluoride toothpaste on the patient's toothbrush. D. The UAP has the patient rinse after meals with a saline solution.

A. The UAP assists the patient to use dental floss after eating.

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 the patient is meeting the goal of improved body image and self-esteem? A. The patient requests that her family bring her makeup and wig. B. The patient begins to discuss the future with her family. C. The patient reports less disruption from pain and discomfort. D. The patient cries openly when discussing her disease.

A. The patient requests that her family bring her makeup and wig.

The nurse is caring for a patient with colon cancer who is scheduled for external radiation therapy to the abdomen. Which information obtained by the nurse would indicate a need for patient teaching? A. The patient swims a mile 3 days a week. B. The patient snacks frequently during the day. C. The patient showers everyday with a mild soap. D. The patient has a history of dental caries with amalgam fillings.

A. The patient swims a mile 3 days a week.

You are a home health nurse caring for an oncology patient discharged home 3 days ago after completing therapy. What would you assess the patient for? A. Tumor lysis syndrome B. Syndrome of inappropriate antiduretic hormone C. Disseminated intravascular coagulation D. Hypercalcemia

A. Tumor lysis syndrome

For which type of malignancy should the nurse expect the use for intravesicular route of regional chemotherapy delivery? A. bladder B. leukemia C. osteogenic sarcoma D. metastasis to the brain

A. bladder

To prevent the debilitating cycle of fatigue-depression-fatigue in patients receiving radiation therapy, what should the nurse encourage the patient to do? A. implement walking program B. ignore the fatigue as much as possible C. do the most stressful activities when the fatigue is tolerable D. schedule rest periods throughout the day whether fatigue is present or not

A. implement walking program

During initial chemotherapy a patient with leukemia develops hyperkalemia and hyperuricemia. The nurse recognizes these symptoms as an oncologic emergency and anticipates that the priority treatment will be to, A. increase urine output with hydration therapy B. establish electrocardiogram monitoring (ECG) C. administer a bisphosphonate such as pamidronate (Aredia) D. restrict fluids and administer hypertonic sodium chloride solution

A. increase urine output with hydration therapy

Which classification of chemotherapy drugs is cell-cycle non-specific, breaks the DNA helix which interferes with DNA replication, and cross the blood-brain barrier? A. nitrosoureas B. antimetabolic C. mitotic inhibitors D. antitumor antibiotics

A. nitrosoureas

Which word identifies a mutation of protooncogenes? A. oncogenes B. retrogenes C. oncofetal antigens D. tumor angiogenesis factor

A. oncogenes

Which mutated tumor suppressor gene is most likely to contribute to many types of cancer, including breast, bladder, colorectal, and lung? A. p53 B. APC C. BRCA1 D. BRCA2

A. p53

A patient with a genetic mutation of BRCA1 and a family history of breast cancer is admitted to the surgical unit where she is scheduled that day for a bilateral simple mastectomy. What is the reason for this procedure? A. prevent breast cancer B. diagnose breast cancer C. cure or control breast cancer D. provide palliative care for untreated breast cancer

A. prevent breast cancer

While a patient is receiving intravenous doxorubicin hydrochloride, the nurse observes that there is swelling and pain at the IV site. The nurse should A. stop the administration of the drug immediately. B. notify the patient's physician. C. continue to administer but decrease the rate of infusion. D. apply a warm compress to the site.

A. stop the administration of the drug immediately.

What does the presence of carcinoembryonic antigen (CEAs) and alpha-fetoprotein (AFP) on cell membranes indicate has happened to the cells? A. they have shifted to more immature metabolic pathways and functions B. they have spread from areas of original development to different body tissues C. they have produces abnormal toxins or chemicals that indicate abnormal cellular function D. they have become more differentiated as a result of repression of embryonic functions

A. they have shifted to more immature metabolic pathways and functions

The home health nurse cares for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient indicates a need for further assessment? A. "I have frequent muscle aches and pains." B. "I rarely have the energy to get out of bed." C. "I experience chills after I inject the interferon." D. "I take acetaminophen (Tylenol) every 4 hours."

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

You are the clinic nurse caring for a patient whose grandmother, mother, and sister all had breast cancer. She has requested a screening test to determine her risk of developing breast cancer, and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response? A. "Research has shown that eating a healthy diet can reduce your chance of breast cancer." B. "Research has shown that taking tamoxifen can reduce your chance of breast cancer." C. "Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer." D. "Research has shown that reducing your intake of red meat can reduce your chance of breast cancer."

B. "Research has shown that taking tamoxifen can reduce your chance of breast cancer."

A patient who is being treated for stage IV lung cancer tells the nurse about new-onset back pain. Which action should the nurse take first? A. Give the patient the prescribed PRN opioid. B. Assess for sensation and strength in the legs. C. Notify the health care provider about the symptoms. D. Teach the patient how to use relaxation to reduce pain.

B. Assess for sensation and strength in the legs.

The nurse teaches a patient with cancer of the liver about high-protein, high-calorie diet choices. Which snack choice by the patient indicates that the teaching has been effective? A. Lime sherbet B. Blueberry yogurt C. Cream cheese bagel D. Fresh strawberries and bananas

B. Blueberry yogurt

A chemotherapy drug that causes alopecia is prescribed for a patient. Which action should the nurse take to maintain the patient's self-esteem? A. Tell the patient to limit social contacts until regrowth of the hair occurs. B. Encourage the patient to purchase a wig or hat and wear it once hair loss begins. C. Teach the patient to gently wash hair with a mild shampoo to minimize hair loss. D. Inform the patient that hair usually grows back once the chemotherapy is complete.

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

A patient with Hodgkin's lymphoma who is undergoing external radiation therapy tells the nurse, "I am so tired I can hardly get out of bed in the morning." Which intervention should the nurse add to the plan of care? A. Minimize activity until the treatment is completed. B. Establish time to take a short walk almost every day. C. Consult with a psychiatrist for treatment of depression. D. Arrange for delivery of a hospital bed to the patient's home.

B. Establish time to take a short walk almost every day.

The nursing instructor is teaching a class in oncology nursing to her junior nursing students. The instructor is aware that infection is a significant consideration when providing care to an oncology patient. The leading cause of death in an oncology patient is infection caused by what? A. Malnutrition B. Impaired skin integrity C. Poor hygiene D. Broken oral mucosa

B. Impaired skin integrity

You are admitting an oncology patient to your unit prior to surgery. The patient has just finished radiation therapy. What does this put your patient at increased risk for? A. Nutritional deficit B. Impaired wound healing C. Cardiac tamponade D. Tumor lysis syndrome

B. Impaired wound healing

You are caring for a 14-year-old female patient with leukemia. She has developed alopecia due to treatment for the leukemia. What would be an expected outcome found on her plan of care? A. Maintains adequate hydration B. Interacts and socializes with others C. Verbalizes positive self-awareness D. Maintains academic standing in school

B. Interacts and socializes with others

The staff educator is giving a class on oncology nursing for a group of nurses new to the unit. What is the most common mechanism of metastasis of cancer cells? A. Hematologic spread B. Lymphatic circulation C. Invasion D. Angiogenisis

B. Lymphatic circulation

A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment. The patient asks the nurse what the most common side effect of chemotherapy is. What would be the best answer the nurse could give? A. Alopecia B. Nausea and vomiting C. Altered glucose metabolism D. Increased appetite

B. Nausea and vomiting

The nursing instructor is discussing benign versus malignant cells in the pathophysiology class. What distinguishes malignant cells from benign cells of the same tissue type? A. Slow rate of mitosis of cancer cells B. Proteins in the cell membrane C. Size of cells D. Stability of cells

B. Proteins in the cell membrane

The nurse should include which food choice when providing dietary teaching for a patient scheduled to receive external beam radiation for abdominal cancer? A. Fresh fruit salad B. Roasted chicken C. Whole wheat toast D. Cream of potato soup

B. Roasted chicken

The school health nurse is presenting a health-promotion class to a group of middle-school students. Which is the best intervention to address health-promotion strategies related to the leading cause of cancer deaths in North America? A. Monthly self-breast exams B. Smoking cessation C. Annual colonoscopies D. Monthly testicular exams

B. Smoking cessation

The nurse administers an IV vesicant chemotherapeutic agent to a patient. Which action is most important for the nurse to take? A. Infuse the medication over a short period of time. B. Stop the infusion if swelling is observed at the site. C. Administer the chemotherapy through a small-bore catheter. D. Hold the medication unless a central venous line is available.

B. Stop the infusion if swelling is observed at the site.

You are caring for a patient with an advanced stage of breast cancer. The cancer has metastasized. You enter the room and find the patient struggling to breath. You note that this patient's jugular veins are distended. What would you suspect is happening with this patient? A. Increased intracranial pressure B. Superior vena cava syndrome (SVCS) C. Spinal cord compression D. Metastatic tumor of the neck

B. Superior vena cava syndrome (SVCS)

The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention? A. The UAP flushes the toilet once after emptying the patient's bedpan. B. The UAP stands by the patient's bed for 30 minutes talking with the patient. C. The UAP places the patient's bedding in the laundry container in the hallway. D. The UAP gives the patient an alcohol-containing mouthwash to use for oral care.

B. The UAP stands by the patient's bed for 30 minutes talking with the patient.

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

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

A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse would indicate a need for further teaching? A. The patient ambulates several times a day in the room. B. The patient's visitors bring in some fresh peaches from home. C. The patient cleans with a warm washcloth after having a stool. D. The patient uses soap and shampoo to shower every other day.

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

The nurse in counseling a group of individuals over the age of 50 with average risk for cancer about screening tests for cancer. Which screening recommendation should be preformed to screen for colorectal cancer? A. barium enema every year B. colonoscopy every 10 years C. fecal occult blood every 5 years D. annual prostate-specific antigen (PSA. and digital rectal exam

B. colonoscopy every 10 years

When teaching a patient with cancer about chemotherapy, which approach should the nurse take? A. avoid telling the patient about possible side effects of the drugs to prevent anticipatory anxiety B. explain that antiemetics, antidiarrheals, and analgesics will be provided as needed to control side effects C. assure the patient that the side effects from chemotherapy are uncomfortable but never life threatening D. inform the patient that chemotherapy-related alopecia is permanent but can be managed with lifelong use of wigs

B. explain that antiemetics, antidiarrheal, and analgesics will be provided as needed to control side effects

The nurse uses many precautions during IV administration of vesicant chemotherapeutic agents, primarily to prevent, A. septicemia B. extravasation C. catheter occlusion D. anaphylactic shock

B. extravasation

The patient was told she has carcinoma in situ, and the student nurse wonders what that is. How should the nurse explain this to the student nurse? A. evasion of the immune system by cancer cells B. lesion with histologic features of cancer except invasion C. capable of causing cellular alterations associated with cancer D. tumor cell surface antigens that stimulate immune response

B. lesion with histologic features of cancer except invasion

Which patient would be most likely to be cured with chemotherapy as a treatment measure? A. small cell lung cancer B. new neuroblastoma C. small tumor in the bone D. large hepatocellular carcinoma

B. new neuroblastoma

When the patient asks about the late effects of chemotherapy and high-dose radiation, what areas of teaching should the nurse plan to include when describing these effects? A. third space syndrome B. secondary malignancies C. chronic nausea and vomiting D. persistant myelosuppression

B. secondary malignancies

When a patient is undergoing brachytherapy, what is it important for the nurse to be aware of when caring for this patient? A. the patient will undergo simulation to identify and mark the field of treatment B. the patient is a source of radiation and personnel must wear film badges during care C. the goal of this treatment is only palliative and the patient should be aware of the expected outcomes D. computerized dosimetry is used to determine the maximum dose of radiation to the timor within an acceptable dose to normal tissue

B. the patient is a source of radiation and personnel must wear film badges during care

A small lesion is discovered in a patient's lung when an x-ray is performed for cervical spine pain. What is the definitive method of determining if the lesion is malignant? A. lung scan B. tissue biopsy C. oncofetal antigens in the blood D. CT or position emisson tomography (PET) scan

B. tissue biopsy

You are doing an initial assessment of a patient newly diagnosed with cancer. The patient tells you that he drinks about a quart of scotch every evening. What types of cancer does this put him at risk for? (Mark all that apply.) A. Pancreatic cancer B. Brain cancer C. Breast cancer D. Esophageal cancer E. Liver cancer

C, D, E C. Breast cancer D. Esophageal cancer E. Liver cancer

The nurse is caring for a patient who has been diagnosed with stage I cancer of the colon. When assessing the need for psychologic support, which question by the nurse will provide the most information? A. "How long ago were you diagnosed with this cancer?" B. "Do you have any concerns about body image changes?" C. "Can you tell me what has been helpful to you in the past when coping with stressful events?" D. "Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?"

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

A patient who is scheduled for a right breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is correct? A. "Benign tumors do not cause damage to other tissues." B. "Benign tumors are likely to recur in the same location." C. "Malignant tumors may spread to other tissues or organs." D. "Malignant cells reproduce more rapidly than normal cells."

C. "Malignant tumors may spread to other tissues or organs."

The nurse teaches a patient who is scheduled for a prostate needle biopsy about the procedure. Which statement, if made by the patient, indicates that teaching was effective? A. "The biopsy will remove the cancer in my prostate gland." B. "The biopsy will determine how much longer I have to live." C. "The biopsy will help decide the treatment for my enlarged prostate." D. "The biopsy will indicate whether the cancer has spread to other organs."

C. "The biopsy will help decide the treatment for my enlarged prostate."

A 58-year-old male patient has been hospitalized for a wedge resection of the left lower lung lobe after a routine chest x-ray shows carcinoma. The patient is anxious and asks if he can smoke. Which statement by the nurse would be most therapeutic? A. "Smoking is the reason you're here." B. "The doctor left orders for you not to smoke." C. "You're anxious about the surgery. Do you see smoking as helping?" D. "Smoking is OK right now, but after your surgery it's contraindicated."

C. "You're anxious about the surgery. Do you see smoking as helping?"

The nurse receives change-of-shift report on the oncology unit. Which patient should the nurse assess first? A. 35-year-old patient who has wet desquamation associated with abdominal radiation B. 42-year-old patient who is sobbing after receiving a new diagnosis of ovarian cancer C. 24-year-old patient who received neck radiation and has blood oozing from the neck D. 56-year-old patient who developed a new pericardial friction rub after chest radiation

C. 24-year-old patient who received neck radiation and has blood oozing from the neck

You are the clinic nurse caring for a patient who was just told he was cancer free at 5 years after diagnosis. The patient has been told he is a cancer survivor. What is cancer survivorship? A. The period just after being pronounced cancer-free 5 years after being diagnosed B. The time during which the patient lives with an active diagnosis of cancer C. A phase of cancer care that comes after primary treatment and lasts until cancer recurrence or the end of life D. The end of cancer care

C. A phase of cancer care that comes after primary treatment and lasts until cancer recurrence or the end of life

A patient with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. Which action, if taken by the nurse, is most appropriate? A. Have the patient eat large meals when nausea is not present. B. Offer dry crackers and carbonated fluids during chemotherapy. C. Administer prescribed antiemetics 1 hour before the treatments. D. Give the patient two ounces of a citrus fruit beverage during treatments.

C. Administer prescribed antiemetics 1 hour before the treatments.

A patient with cancer has a nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste sensation. Which nursing action is most appropriate? A. Add strained baby meats to foods such as casseroles. B. Teach the patient about foods that are high in nutrition. C. Avoid giving the patient foods that are strongly disliked. D. Add extra spice to enhance the flavor of foods that are served.

C. Avoid giving the patient foods that are strongly disliked.

You are teaching a nutrition class in the local high school. One student tells you that he has heard that certain foods can increase the incidence of cancer. You respond, "Research has shown that certain foods appear to increase the risk of cancer." Which of the following menu selections would be the best choice for reducing the risks of cancer? A. Smoked salmon and green beans B. Pork chops and fried green tomatoes C. Baked apricot chicken and steamed broccoli D. Liver, onions, and steamed peas

C. Baked apricot chicken and steamed broccoli

External-beam radiation is planned for a patient with cervical cancer. What instructions should the nurse give to the patient to prevent complications from the effects of the radiation? A. Test all stools for the presence of blood. B. Maintain a high-residue, high-fiber diet. C. Clean the perianal area carefully after every bowel movement. D. Inspect the mouth and throat daily for the appearance of thrush.

C. Clean the perianal area carefully after every bowel movement.

During the teaching session for a patient who has a new diagnosis of acute leukemia the patient is restless and is looking away, never making eye contact. After teaching about the complications associated with chemotherapy, the patient asks the nurse to repeat all of the information. Based on this assessment, which nursing diagnosis is most appropriate for the patient? A. Risk for ineffective adherence to treatment related to denial of need for chemotherapy B. Acute confusion related to infiltration of leukemia cells into the central nervous system C. Risk for ineffective health maintenance related to anxiety about new leukemia diagnosis D. Deficient knowledge: chemotherapy related to a lack of interest in learning about treatment

C. Risk for ineffective health maintenance related to anxiety about new leukemia diagnosis

The nurse on a bone marrow transplant unit is caring for a patient with cancer who is preparing for engraphment for a bone marrow transplant. What is a priority nursing diagnosis for this patient? A. Fatigue and activity intolerance B. Altered nutrition: less than body requirements due to anorexia C. Risk for infection related to altered immunologic response D. Body image disturbance related to weight loss and anorexia

C. Risk for infection related to altered immunologic response

You are a part of a team of nurses that is developing an educational program entitled Cancer: Its Risks and What You Can Do About It. This program is an example of what? A. Primary prevention B. Risk reduction C. Secondary prevention D. Tertiary prevention

C. Secondary prevention

The nurse is caring for a patient with left-sided lung cancer. Which finding would be most important for the nurse to report to the health care provider? A. Hematocrit 32% B. Pain with deep inspiration C. Serum sodium 126 mEq/L D. Decreased breath sounds on left side

C. Serum sodium 126 mEq/L

Traditionally, nurses have been involved with tertiary prevention with their cancer patients. However, emphasis is also placed on both primary and secondary prevention. What would be an example of primary prevention? A. Yearly Papanicolaou tests B. Testicular self-examination C. Teaching patients to wear sunscreen D. Screening mammogram

C. Teaching patients to wear sunscreen

A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective? A. The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale). B. The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness. C. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs. D. The patient states that nonopioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief.

C. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.

Which normal tissue manifest early, acute response to radiation therapy? A. spleen and liver B. kidney and nervous tissue C. bone marrow and gastrointestinal mucosa D. hollow organs such as the stomach and bladder

C. bone marrow and gastrointestinal mucosa

What describes a primary use of therapy in cancer treatment? A. protect normal, rapaidly producing cells of the gastrointestinal system from damage during chemotherapy B. prevent the fatigue associated with chemotherapy and high-dose radiation as seen with bone marrow suppression C. enhance or supplement the effects of the host's immune response to tumor cells that produce flu-like symptoms D. depress the immune system and circulating lymphocytes as well as increase a sense of well-being by replacing central nervous system deficits

C. enhance or supplement the effects of the host's immune response to tumor cells that produce flu-like symptoms

An allogenic hematopoetic stem cell transplant is considered as treatment for a patient with acute myelogenous leukemia. What information should the nurse include when teaching the patient about this procedure? A. there is no risk for graft-versus-host disease because the donated marrow is treated to remove cancer cells B. the patient's bone marrow will be removed, treated, stored, and then reinfused after intensive chemotherapy C. peripheral stem cells are obtained from a donor who has a human leukocyte antigen (HLA. match with the patient D. there is no need for posttransplant protective isolation because the stem cells are infused directly into the blood.

C. peripheral stem cells are obtained from a donor who has a human leukocyte antigen (HLA. match with the patient

PRIORITY DECISION: While caring for a patient who is at the nadir of chemotherapy, the nurse establishes the highest priority for nursing actions related to: A. diarrhea B. grieving C. risk for infection D. inadequate nutritional intake

C. risk for infection

The nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. Which patient statement indicates that the teaching has been effective? A. "After cancer has not recurred for 5 years, it is considered cured." B. "The cancer will be cured if the entire tumor is surgically removed." C. "Cancer is never considered cured, but the tumor can be controlled with surgery, chemotherapy, and radiation." D. "I will need to have follow-up examinations for many years after I have treatment before I can be considered cured."

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

A patient has been assigned the nursing diagnosis of imbalanced nutrition: less than body requirements related to painful oral ulcers. Which nursing action will be most effective in improving oral intake? A. Offer the patient frequent small snacks between meals. B. Assist the patient to choose favorite foods from the menu. C. Provide teaching about the importance of nutritional intake. D. Apply the ordered anesthetic gel to oral lesions before meals.

D. Apply the ordered anesthetic gel to oral lesions before meals.

The nursing instructor is discussing the care of oncology patients with her junior nursing students. The instructor presents this scenario: An oncology patient develops erythema following radiation therapy. What should the nurse instruct the patient to do? A. Apply ice to the area. B. Keep the area cleanly shaven. C. Apply petroleum ointment to the affected area. D. Avoid using soap on the area of treatment.

D. Avoid using soap on the area of treatment.

The nurse assesses a patient who is receiving interleukin-2. Which finding should the nurse report immediately to the health care provider? A. Generalized muscle aches B. Complaints of nausea and anorexia C. Oral temperature of 100.6° F (38.1° C) D. Crackles heard at the lower scapular border

D. Crackles heard at the lower scapular border

You are caring for a patient has just been given a 6-month prognosis. The patient states that he would like to die at home. The patient's care needs are unable to be met in a home environment. What might you suggest as an alternative? A. Discuss a referral for rehabilitation hospital B. Panel the patient for a personal care home C. Discuss a referral for acute care D. Discuss a referral for hospice care

D. Discuss a referral for hospice care

You are orienting a new nurse to the oncology unit where you work. As you prepare to administer an antineoplastic agent to a one of your patients, what should you teach the new nurse about antineoplastic agents? A. Administer only prepackaged agents from the manufacturer B. Wash hands and arms following administration C. Use gloves and a lab coat D. Dispose of the antineoplastic wastes in the hazardous waste receptacle

D. Dispose of the antineoplastic wastes in the hazardous waste receptacle

You are a nurse working on a bone marrow transplant unit. Your patient is scheduled to receive a bone marrow transplant. What information will you provide to the patient's visitors? A. Bring plants to improve air quality. B. Take the patient to the cafeteria for meals. C. Wear hospital scrubs when entering the patient's room. D. Do not visit if you've had a recent infection.

D. Do not visit if you've had a recent infection.

A patient who has ovarian cancer is crying and tells the nurse, "My husband rarely visits. He just doesn't care." The husband indicates to the nurse that he never knows what to say to help his wife. Which nursing diagnosis is most appropriate for the nurse to add to the plan of care? A. Compromised family coping related to disruption in lifestyle B. Impaired home maintenance related to perceived role changes C. Risk for caregiver role strain related to burdens of caregiving responsibilities D. Dysfunctional family processes related to effect of illness on family members

D. Dysfunctional family processes related to effect of illness on family members

The nurse is caring for a patient receiving intravesical bladder chemotherapy. The nurse should monitor for which adverse effect? A. Nausea B. Alopecia C. Mucositis D. Hematuria

D. Hematuria

A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). The nurse will include which information in the patient's teaching plan? A. Transplant of the donated cells is painful because of the nerves in the tissue lining the bone. B. Donor bone marrow cells are transplanted through an incision into the sternum or hip bone. C. The transplant procedure takes place in a sterile operating room to minimize the risk for infection. D. Hospitalization will be required for several weeks after the stem cell transplant procedure is performed.

D. Hospitalization will be required for several weeks after the stem cell transplant procedure is performed.

The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer. Which information about the patient alerts the nurse to discuss a possible change in therapy with the health care provider? A. Poor oral intake B. Frequent loose stools C. Complaints of nausea and vomiting D. Increase in carcinoembryonic antigen (CEA)

D. Increase in carcinoembryonic antigen (CEA)

What defect in cellular proliferation is in involved in the development of cancer? A. a rate of cell proliferation that is more rapid than that of normal body cells B. shortened phases of cell life cycles with occasional skipping of GI or S phases C. Rearrangement of stem cell RNA that causes abdominal cellular protein synthesis D. Indiscriminate and continuous proliferation of cells with loss of contact inhibition

D. Indiscriminate and continuous proliferation of cells with loss of contact inhibition

Malignant disease processes have the ability to spread from one organ to another throughout the body. What is one means malignant disease processes transfer cells from one place to another? A. Adhering to primary tumor cells B. Causing mutation of cells of another organ C. Phagocytizing healthy cells D. Invading host tissues

D. Invading host tissues

An older adult patient who has colorectal cancer is receiving IV fluids at 175 mL/hour in conjunction with the prescribed chemotherapy. Which finding by the nurse is most important to report to the health care provider? A. Patient complains of severe fatigue. B. Patient needs to void every hour during the day. C. Patient takes only 50% of meals and refuses snacks. D. Patient has audible crackles to the midline posterior chest.

D. Patient has audible crackles to the midline posterior chest.

A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient? A. Remove food debris from the teeth and oral mucosa with a stiff toothbrush. B. Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth. C. Gargle and rinse the mouth several times a day with an antiseptic mouthwash. D. Rinse the mouth before and after each meal and at bedtime with a saline solution.

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

What is a minimally invasive surgical approach that is diagnostic for cancer and has, in some instances, replaced lymph node dissections? A. Lymphadenectomy B. Needle biopsy C. Open biopsy D. Sentinel lymph node biopsy

D. Sentinel lymph node biopsy

You have just admitted a new patient to the hospice program you work for. While you are doing the initial assessment, a family member states, "my sister just won't talk to any of us about what is happening to her." What should you do? A. Strive to facilitate communication between the family and health care providers. B. Strive to facilitate communication between the patient and health care providers. C. Strive to facilitate communication between family members and yourself. D. Strive to facilitate communication among family members.

D. Strive to facilitate communication among family members.

Which action should the nurse take when caring for a patient who is receiving chemotherapy and complains of problems with concentration? A. Teach the patient to rest the brain by avoiding new activities. B. Teach that "chemo-brain" is a short-term effect of chemotherapy. C. Report patient symptoms immediately to the health care provider. D. Suggest use of a daily planner and encourage adequate rest and sleep.

D. Suggest use of a daily planner and encourage adequate rest and sleep.

A patient with a large stomach tumor that is attached to the liver is scheduled to have a debulking procedure. Which information should the nurse teach the patient about the outcome of this procedure? A. Pain will be relieved by cutting sensory nerves in the stomach. B. Relief of pressure in the stomach will promote better nutrition. C. Tumor growth will be controlled by the removal of malignant tissue. D. Tumor size will decrease and this will improve the effects of other therapy.

D. Tumor size will decrease and this will improve the effects of other therapy.

The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which laboratory result is most important to report to the health care provider? A. Hematocrit of 30% B. Platelets of 95,000/µL C. Hemoglobin of 10 g/L D. White blood cell (WBC. count of 2700/µL

D. White blood cell (WBC. count of 2700/µL

A patient is admitted with acute myelogenous leukemia and a history of Hodgkin's lymphoma. What is the nurse likely to find in the patient's history? A. work as a radiation chemist B. Esptein-Barr virus diagnosed in vitro C. intense tanning throughout lifetime D. alkylating agents for treating the Hodgkin's lymphoma

D. alkylating agents for treating the Hodgkin's lymphoma

The patient is learning about skin care related to the external radiation that he is receiving. Which instruction should the nurse include in this teaching? A. moisturize skin with lotion B. keep the area covered if it is sore C. dry the skin thoroughly after cleaning it D. avoid extreme temperatures to the area

D. avoid extreme temperatures to the area