Management of Patients with Oncology Disorder

After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? Encouraging rhythmic breathing exercises Administering metoclopramide and dexamethasone as ordered Withholding fluids for the first 4 to 6 hours after chemotherapy administration Serving small portions of bland food

Administering metoclopramide and dexamethasone as ordered

5-Fluorouracil (5FU) is classified as which type of antineoplastic agent? Alkylating Antimetabolite Nitrosoureas Mitotic spindle poisons

Antimetabolite

Which oncologic emergency involves the accumulation of fluid in the pericardial space? Tumor lysis syndrome Syndrome of inappropriate antidiuretic hormone release (SIADH) Cardiac tamponade Disseminated intravascular coagulation (DIC)

Cardiac tamponade

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. Most clients believe the discomfort is well worth the cure for cancer. Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects. Clinical trials are opening up new cancer treatments all the time.

Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.

A 28-year-old man was recently diagnosed with leukemia. He is admitted to the hospital for further analysis and chemotherapy initiation. He only complains of fatigue. Laboratory evaluation reveals pancytopenia, hyperkalemia (K 6.8), uric acid 13, hyperphosphatemia (12), and elevated lactate dehydrogenase (LDH). What is the most likely cause of his electrolyte abnormalities? Tumor lysis syndrome Acute renal failure Hypercalcemia None of these

Tumor lysis syndrome

What is the best way for the nurse to assess the nutritional status of a patient with cancer? Monitor daily caloric intake. Weigh the patient daily. Assess BUN and creatinine levels. Observe for proper wound healing.

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

The nurse is to administer a vesicant chemotherapeutic drug to a client who had a right mastectomy and inserts the intravenous line In the client's left hand In the client's right forearm With a soft, plastic catheter With a butterfly needle

With a soft, plastic catheter

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

acute leukopenia.

The nurse is completing an admission assessment for a client receiving interstitial implants for prostate cancer. The nurse documents this as external beam radiation therapy. brachytherapy. a contact mold. systemic radiation.

brachytherapy.

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 specific in the S phase cell-cycle specific in the P phase. cell-cycle nonspecific. cell-cycle specific in the M phase.

cell-cycle nonspecific.

Carcinogens are factors related to the formation of various malignancies. Which factor has the greatest impact on the development of all cancers? defective genes chemical agents environmental factors viruses

chemical agents

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: absorption through the goggles. inhalation of aerosols. absorption through the gloves. absorption through the gown.

inhalation of aerosols.

An 82-year-old woman with a history of breast cancer presents to the clinic with complaints of headaches for the past 2 weeks. She describes daily retro-orbital headaches that are worse in the morning. In addition, she notes severe nausea and vomiting. MRI of the brain reveals multiple metastatic lesions. Which of the following is the most appropriate initial management for this patient? Biopsy the lesions Surgical resection Dexamethasone Repeat MRI in 6 months

Dexamethasone

A serum sodium concentration lower than 115 mEq/L (115 mmol/L) is associated with anorexia. myalgia. weight gain. seizure.

seizure.

The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important? Prepare food separately from family members. Use disposable utensils for the next month. Shield your throat area when near others. Flush the toilet several times after every use.

Flush the toilet several times after every use.

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 clean my teeth gently several times per day." "I replace my toothbrush every month." "I lubricate my lips with petroleum jelly." "I use an alcohol-based mouthwash every morning."

I clean my teeth gently several times per day."

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. 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.

Identify own perception of cancer and set realistic goals.

Chemotherapeutic agents have which effect associated with the renal system? Hypercalcemia Hypophosphatemia Increased uric acid excretion Hypokalemia

Increased uric acid excretion

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.

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 toilet patterns. Monitor the client to prevent sepsis. Monitor the client's heart rate. Monitor the client's physical condition.

Monitor the client to prevent sepsis.

A nurse is receiving a client with a radioactive implant for the treatment of cervical cancer. What is the nurse's best action? Place a chair next to the bed to allow the spouse to sit. Place the client in a private room. Have visitors wear dosimeters for safety. Allow visitors to telephone only.

Place the client in a private room.

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

Progression

A nurse is caring for a client receiving chemotherapy. Which assessment finding places the client at the greatest risk for infection? Ate 75% of all meals during the day White blood cell (WBC) count of 9,000 cells/mm3 Temperature of 98.3° F (36.8° C) Stage 3 pressure ulcer on the left heel

Stage 3 pressure ulcer on the left heel

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 the same as it was before treatment. The hair will grow back within 2 months post therapy.

The client should consider getting a wig or cap prior to beginning treatment.

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? Loss is inevitable so client is making final plans. Anger directed toward nursing staff is not unusual in dealing with cancer clients. The client is just trying to protect self from potential loss. The cancer is viewed as a punishment from past actions.

The cancer is viewed as a punishment from past actions.

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. viruses age gender dietary substances environmental factors

viruses dietary substances environmental factors

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 hypertension symptoms of gout symptoms of constipation symptoms of anemia

symptoms of gout

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? Check the client's history for a congenital link to thrombocytopenia. Monitor daily platelet counts. Closely observe the client's skin for petechiae and bruising. Perform a cardiovascular assessment every 4 hours.

Closely observe the client's skin for petechiae and bruising.

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 meat such as steaks or hamburgers every day

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? cryoablation prophylactic palliative local excision

prophylactic

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

radiation therapy surgery chemotherapy hyperthermia

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 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."

"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 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."

"I will brush my teeth after every meal."

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 Proton therapy Teletherapy External

Brachytherapy

A patient with uterine cancer is being treated with internal radiation therapy. What would the nurse's priority responsibility be for this patient? 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. Explain to the patient that she will continue to emit radiation while the implant is in place. 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 client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action? Bone pain Extravasation Nausea and vomiting Stomatitis

Extravasation

A patient with uterine cancer is being treated with intracavitary radiation. The patient will emit radiation while the implant is in place. The nurse is aware of the precautions necessary for the provider of care and visitors. Which of the following are appropriate guidelines to follow? Select all that apply. Family members should stand about 6 feet from the patient. Visitors may stay for 30 minutes or less. The nurse can provide direct care for up to 60 minutes per 8-hour shift. Plastic aprons should be worn to buffer the exposure.

Family members should stand about 6 feet from the patient. Visitors may stay for 30 minutes or less.

A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis? Red, open sores on the oral mucosa Yellow tooth discoloration White, cottage cheese-like patches on the tongue Rust-colored sputum

Red, open sores on the oral mucosa

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? Activity intolerance related to side effects of chemotherapy Anxiety related to change in role function Fatigue related to deficient blood cells Risk for infection related to inadequate defenses

Risk for infection related to inadequate defenses

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 Emission of abnormal proteins Random, rapid growth of the tumor Cells colonizing to distant body parts

Tumor pressure against normal tissues

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 side effect of the neoplastic drugs. A psychiatric diagnosis everyone has at one time or another. An aberrant psychologic reaction to the chemotherapy. A normal reaction to the diagnosis of cancer.

A normal reaction to the diagnosis of 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 experience menopause now." "You will continue having your menses every month." "You will be unable to have children." "You will need to practice birth control measures."

"You will need to practice birth control measures."

A 42-year-old man with a medical history significant for lung cancer is brought to an emergency room for altered mental status. His family reports he altered his mental status for 3 days. He has been lethargic and difficult to arouse. On examination, he has orthostatic blood pressure and dry mucous membranes. Laboratory evaluation reveals Ca 14.5 mg/dl and Cr 2.0 mg/dl. Which of the following is the most appropriate initial management for this patient? 0.9% saline bolus Furosemide Pamidronate 0.45% saline bolus

0.9% saline bolus

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? 7 to 14 days 21 to 28 days 24 hours 2 to 4 days

7 to 14 days

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? Applying talcum powder to the irradiated areas daily after bathing Removing thoracic skin markings after each radiation treatment Avoiding using soap on the irradiated areas Wearing a lead apron during direct contact with the client

Avoiding using soap on the irradiated areas

You are the nurse caring for a client with cancer. The client complains of 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? High cholesterol levels Fatigue Infection Ulceration

Fatigue

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

Increase her intake of calcium-rich foods.

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? The use of disposable utensils and washcloths Inspect the skin frequently Avoid showering or washing over skin markings. Time, distance, and shielding

Inspect the skin frequently

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 DNA replication and RNA transcription. It interferes with ribonucleic acid (RNA) transcription only. It interferes with deoxyribonucleic acid (DNA) replication only.

It interferes with DNA replication and RNA transcription.

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 is used to remove cancerous cells using a needle. 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 removes a wedge of tissue for diagnosis.

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. Check regularly for signs and symptoms of stomatitis. Recommend that the client discontinue chemotherapy.

Provide a solution of viscous lidocaine for use as a mouth rinse.

The nurse is caring for a client with a benign breast tumor. The tumor may have which characteristic? Causes generalized symptoms Ability to invade other tissues Slow rate of growth Undifferentiated cells

Slow rate of growth

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. Substances are released when tumor cells are destroyed. The cancer is spreading to other parts of the body. Fighting off infection is an exhausting venture.

Substances are released when tumor cells are destroyed.

A 71-year-old man who has lung cancer was admitted to the hospital with worsening dyspnea. He complains of progressive dyspnea for a few months. What is the most likely diagnosis? Pericardial tamponade Congestive heart failure Superior vena cava (SVC) syndrome None of these

Superior vena cava (SVC) syndrome

A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention? The I.V. site is red and swollen. The client begins to shiver. The laboratory reports a white blood cell (WBC) count of 1,000/mm3. The client states he is nauseous.

The I.V. site is red and swollen.

For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan? Inspecting the skin for petechiae once every shift Placing the client in strict isolation Administering aspirin if the temperature exceeds 102° F (38.8° C) Providing for frequent rest periods

Inspecting the skin for petechiae once every shift

A client has cancer of the neck and is receiving external beam radiation therapy to the site. The client is experiencing trauma to the irradiated skin. The nurse does all of the following. (Select all that apply.) applies an over-the-counter ointment to the skin uses cool water to wash the neck area inspects for skin damage of the chest area assesses the client for any sun exposure avoids shaving the irradiated skin

avoids shaving the irradiated skin assesses the client for any sun exposure

Which statement by a client undergoing external radiation therapy indicates the need for further teaching? "I'll not use my heating pad during my treatment." "I'm worried I'll expose my family members to radiation." "I'll wear protective clothing when outside." "I'll wash my skin with mild soap and water only."

"I'm worried I'll expose my family members to radiation."

The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia? "New hair growth will return without any change to color or texture." "The hair loss is usually temporary." "Wigs can be used after the chemotherapy is completed." "Clients with alopecia will have delay in grey hair."

"The hair loss is usually temporary."

The lethal tumor dose is defined as the dose that will eradicate what percentage of the tumor yet preserve normal tissue? 65% 85% 95% 75%

95%

The nurse is preparing a teaching tool about alopecia caused by cancer treatment. Which information will the nurse emphasize in this tool? Select all that apply. Use a wide-tooth comb to style the hair. Avoid hair dyes or permanent wave solutions. Use a hair dryer to quickly dry the hair. Cut long hair before treatment begins. Use shampoo and conditioner every day.

Use a wide-tooth comb to style the hair. Avoid hair dyes or permanent wave solutions. Cut long hair before treatment begins.

A nurse is administering a peripheral chemotherapeutic agent. What nursing actions are used for extravasation of a chemotherapeutic agent? Select all that apply. Administer an antidote, if indicated Aspirate any residual drug from the IV line Apply warm compresses to the irritated site to encourage healing Stop the medication infusion at the first sign of extravasation Schedule the client for implanted device

Administer an antidote, if indicated Aspirate any residual drug from the IV line Stop the medication infusion at the first sign of extravasation

A 75-year-old man with lung cancer was admitted to the hospital with worsening dyspnea. He has complained of progressive dyspnea for 2 months. On physical examination, he has distended jugular veins, a plethoric face, venous collaterals on his chest wall, and distant heart sounds. What is the most likely diagnosis? Pericardial tamponade Constrictive pericarditis Congestive heart failure Superior vena cava (SVC) syndrome

Superior vena cava (SVC) syndrome