oncologic disorders

How can breast cancer prevention programs best serve women who are at risk and come from lower socioeconomic backgrounds?

Develop screening and educational programs.

A client undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should include which instruction?

"Keep the stoma moist."

Which nursing intervention is most appropriate for a client with multiple myeloma?

preventing bone injury

The nurse is preparing a client for magnetic resonance imaging (MRI) to confirm or rule out a spinal cord lesion. Which question would the nurse ask the client to assess for the greatest risk in the MRI scan room?

"Are you wearing a wedding band?"

The nurse reinforces instructions for a client diagnosed with acute lymphocytic leukemia (ALL) who is preparing for allogeneic bone marrow transplant. Which statement made by the client indicates to the nurse that the client understands the instructions?

"Before undergoing the bone marrow transplant, I will receive chemotherapy."

For a client with newly diagnosed cancer, the nurse assists in formulating a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client?

"Client verbalizes feelings of anxiety."

A client seeks care for hoarseness that has lasted for 1 month. To elicit the most appropriate information about this problem, the nurse should ask which question?

"Do you smoke cigarettes, cigars, or a pipe?"

A young adult client received her first chemotherapy treatment for breast cancer. Which statement by the client requires further exploration by the nurse?

"I don't care about the adverse effects of the drugs."

A client with cancer tells the nurse, "I found out about this new herbal treatment for breast cancer that I would really like to try." Which nursing response is appropriate?

"We should share this information with your health care provider."

The nurse is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society guidelines, what information would be the most important for the nurse to give the women?

"Women older than age 40 should have a mammogram and clinical examination every year"

A client in the final stages of terminal cancer tells the nurse, "I wish I could just be allowed to die. I'm tired of fighting this illness. I have lived a good life. I continue my chemotherapy and radiation treatments only because my family wants me to." How should the nurse respond?

"Would you like to meet with your family and health care provider about this matter?"

A nurse is working with a client who is afraid of dying after a biopsy result came back positive for cancer. What is the best reflective response by the nurse to enhance client communication?

"You are afraid to die."

A client with a history of colon cancer has a permanent colostomy. The nurse must irrigate the colostomy to prepare the client for diagnostic testing. When irrigating, how far into the stoma should the nurse insert the lubricated catheter?

2" to 4"

The nurse is caring for a client undergoing radiation therapy who is noted to have several ulcers of the mucous membranes. Which action will the nurse take as the priority?

Assess for dysphagia.

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 plan of care?

Avoiding using soap on the irradiated areas

A 45-year-old client receiving radiation therapy for thyroid cancer reports mouth and throat pain. While inspecting the mouth and throat, the nurse notices white patches and ulcerations in the oral mucosa. What do these findings suggest?

Candidiasis

A client diagnosed with acute myelocytic leukemia (AML) has been receiving chemotherapy. During the last two 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?

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

The nurse is caring for a client who was admitted with rectal bleeding. The client is at high risk for having colorectal cancer. The nurse anticipates the physician will order which diagnostic test to confirm this suspicion?

Colonoscopy

A client has been receiving chemotherapy for cancer treatment. The client is competent and has been actively involved in decisions regarding care; however, the client has now decided to refuse treatment. What should the nurse do when the client refuses the next dose of chemotherapy?

Document the client's choice and offer to discuss feelings about the chemotherapy.

A client is receiving chemotherapy to treat breast cancer. Which data collection finding indicates a fluid and electrolyte imbalance induced by chemotherapy?

Dry oral mucous membranes and cracked lips

A client with a diagnosis of ovarian cancer is receiving chemotherapy with cisplatin and reports nausea and loss of appetite resulting in decreased food intake. What should the nurse recommend to improve nutrition?

Eat small meals high in protein and calories throughout the day.

The nurse is caring for a client recently diagnosed with gastric cancer. Which bacteria does the nurse anticipate may be present?

Helicobacter pylori

A home care nurse assesses for disease complications in a client with bone cancer. The nurse knows that bone cancer may cause which electrolyte disturbance?

Hypercalcemia

A client with metastatic brain cancer is admitted to the oncology floor. According to the Patient Self-Determination Act of 1991 (PSDA), what is the hospital required to do concerning the execution of advance directives?

Inform the client or legal guardian of his right to execute an advance directive.

A client is undergoing a left modified radical mastectomy for breast cancer. Postoperatively, blood pressure should be obtained from the client's right arm, and the left arm and hand should be elevated as much as possible to prevent which condition?

Lymphedema

A client with advanced cancer of the mouth has a swollen, necrotic, and weeping tongue. Which nursing intervention should be a priority in planning care?

Maintain a patent airway.

An oncology nurse educator is speaking to a women's group about breast cancer. Questions and comments from the audience reveal a misunderstanding of some aspects of the disease. Various members of the audience have made all of the following statements. Which statement is accurate?

Men can develop breast cancer.

Which intervention is appropriate for the nurse caring for a client in severe pain receiving a continuous I.V. infusion of morphine?

Obtaining baseline vital signs before administering the first dose

Which finding is an early indicator of bladder cancer?

Painless, intermittent hematuria

After a transsphenoidal adenohypophysectomy, a client is likely to undergo hormone replacement therapy. A transsphenoidal adenohypophysectomy is performed to treat which type of cancer?

Pituitary carcinoma

A client has been receiving chemotherapy to treat cancer. Which data collection finding suggests that the client has developed stomatitis (inflammation of the mouth)?

Red, open sores on the oral mucosa

A client is receiving chemotherapy and radiation for stage III breast cancer and has an ANC (absolute neutrophil count) of 800/mm3 (0.8 × 109/L) a hemoglobin of 10g/dL (100 g/L), and a platelet count of 108,000/mm3 (108 × 109/L) Based on these results, the nurse should be most concerned with which finding?

Temperature of 100.8 °F (38.2 °C), fatigue, and shortness of breath

A nurse is caring for a 25-year-old client with end-stage testicular cancer who has been referred to hospice care. Which of the following criteria excludes the client from hospice care?

The client entered a clinical trial through the National Cancer Institute.

A client with metastatic cancer is experiencing neuropathic pain. Which alternative therapy is most beneficial in treating this type of pain?

Transcutaneous electrical nerve stimulation (TENS)

A 55-year-old male client wishes to be proactive about health issues. To help ensure early identification of prostate cancer, the client should:

have a yearly digital rectal exam and prostate-specific antigen (PSA) test.

A nurse caring for a client who has just received chemotherapy infusion is wearing a disposable gown, gloves, and goggles for protection. The nurse knows that accidental exposure to chemotherapy agents can occur through

inhalation of aerosols.

A nurse is reinforcing education with the parent of an ill child about childhood immunizations. The nurse should tell the parent that only inactivated virus vaccines should be administered to children with which disorder?

leukemia

The nurse is assessing a client with multiple myeloma. The nurse should keep in mind that clients with multiple myeloma are at risk for:

pathologic bone fractures.

After being in remission from Hodgkin's disease for 18 months, a client develops a fever of unknown origin. The physician orders a blind liver biopsy to rule out advancing Hodgkin's disease and infection. Twenty-four hours after the biopsy, the client has a fever, reports severe abdominal pain and rigidity, and seems increasingly confused. The nurse suspects that these findings result from:

perforation of the colon caused by the liver biopsy.

The nurse on the oncology unit is caring for a client with a total white blood cell (WBC) count equal to 2000/µL (2.0 ×109/L). Which intervention is most important to include in the plan of care?

perform proper hand hygiene

A client has just been diagnosed with terminal cancer and is being transferred to home hospice care. The client's child tells the nurse, "I don't know what to say to my mother if she asks me about dying." Which responses by the nurse would be appropriate? Select all that apply.

-"Let's talk about your mother's illness and how it will progress." -"You sound like you have some questions about your mother dying. Let's talk about that." -"Tell me how you're feeling about your mother dying."

A client is admitted to the hospital with severe bone marrow depression related to chemotherapy. What does the nurse include when assisting with the development of the plan of care to decrease the risk of infection in this client? Select all that apply.

-Ensure the use of protective isolation protocol. -Wash hands before administering care. -Request that family members not bring flowers to the client's room.

After having a lobectomy for lung cancer, a client receives a chest tube connected to a three-chamber chest drainage system. Which observation would allow the nurse to determine that the drainage system is functioning correctly? Select all that apply.

-Fluctuations in the water-seal chamber occur when the client breathes. -Intermittent bubbling occurs in the suction control chamber. -Gentle bubbling occurs in the suction control chamber. -Drainage is collecting in the drainage chamber.

The nurse is caring for a client with bronchogenic carcinoma. Which nursing interventions are essential in the care of the client receiving a chemotherapeutic regimen? Select all that apply.

-Maintain a patent airway. -Alleviate anxiety by explaining procedures and care delivery. -Instruct the client on signs and symptoms of infection.

A multidisciplinary oncology team notes that a client who has been undergoing chemotherapy is now experiencing pancytopenia. When reviewing the laboratory data, which values support this diagnosis? Select all that apply.

-decreased white blood cells -decreased platelets -decreased red blood cells

A group of visitors arrives to visit a client in radiation precautions. Which visitor(s) should the nurse prohibit from entering the client's room? Select all that apply.

-pregnant adult -preschool-age child

The nurse is teaching a group of men about prostate health. Which of the following would be most important for the nurse to tell the men?

"You should discuss PSA testing with a health care provider to decide whether testing is the right choice for you."

A client who is receiving the first dose of chemotherapy expresses concern at the thought of losing their hair. What would be the most appropriate response by the nurse?

"Your hair loss will be temporary. Tell me about your concerns."

During a breast examination, which finding most strongly suggests that the client has breast cancer?

A fixed nodular mass with dimpling of the overlying skin

A client with stage II ovarian cancer undergoes a total abdominal hysterectomy and bilateral salpingo-oophorectomy with tumor resection, omentectomy, appendectomy, and lymphadenectomy. During the second postoperative day, which data collection finding would raise concern in the nurse?

Shallow breathing and increasing lethargy

A nurse receives a client assignment and is to care for a client who has terminal lung cancer. The nurse's father died two months ago from the same disease, and the nurse is having difficulty interacting with the client and family due to being overwhelmed with emotion. Which action should the nurse take?

Speak to the nurse in charge about the emotional reaction and explore options.

A client visits the gynecologist reporting pain during sexual intercourse. The physician orders include a Pap smear. The nurse is interviewing the client as part of her assessment. Which statement by the client would be most important for the nurse report to the physician?

"I had a human papillomavirus infection at age 32."

A nurse is providing nutritional teaching for a client with a family history of colon cancer. Which food choice by the client demonstrates an understanding of the correct diet to follow?

vegetarian chili

The nurse is providing breast cancer education at a community facility. The American Cancer Society (Canadian Cancer Society) recommends that women get mammograms:

yearly after age 40.

The nurse is caring for a client who just returned from the initial external beam radiation therapy (EBRT) session for lung cancer. Which statement by the client indicates the need for further clarification by the nurse regarding EBRT?

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

A client is scheduled for a surgical procedure for removal of a pancreatic tumor. The client states to the nurse, "I don't think I'll live through the surgery. I'm scared." What is the best response by the nurse?

"Let's talk about your concerns and fears."

A client recently diagnosed with metastatic liver cancer is admitted for hospice care. A person the nurse knows is a close friend of the client calls to ask about the client's condition. Which response by the nurse is most appropriate?

"Sharing the specifics of a client's condition is not allowed, but I'll make certain your friend knows you called."

The nurse is caring for a client who detected a lump in her right breast. The client asks the nurse " How do I find out if it's cancer?" Which statement by the nurse would be most appropriate?

"The physician will need to perform a fine needle aspiration and biopsy to confirm the diagnosis.

As part of a primary cancer prevention program, an oncology nurse speaks to the public at a health fair. When someone asks about laryngeal cancer, which statement by the nurse would be most helpful?

"To reduce the risk of developing laryngeal cancer you shouldn't smoke or drink alcohol."

A client in the final stages of terminal cancer tells the nurse, "I wish I could just be allowed to die. I'm tired of fighting this illness. I've lived a good life. I only continue my chemotherapy and radiation treatments because my family wants me to." What is the nurse's best response?

"Would you like to meet with your family and your health care provider about this matter?"

A client received chemotherapy 24 hours ago. Which intervention is the priority to include in the plan of care?

Wear personal protective equipment when handling blood, body fluids, or feces.

A nurse is participating in a cancer-screening program for colorectal cancer. Which client presents the fewest risk factors for colon cancer?

a 60-year-old client who follows a diet low in fat and high in fiber

A few minutes after beginning a blood transfusion, the nurse notes that the client has chills, dyspnea, and urticaria. The nurse reports this to the physician immediately because the client probably is experiencing:

a hemolytic allergic reaction caused by an antigen reaction.

The nurse is caring for a client who was admitted with rectal bleeding. The client is at high risk for having colorectal cancer. The nurse anticipates preparing the client for which diagnostic test to confirm this suspicion?

colonoscopy

The nurse is caring for a male client who reports difficulty urinating. Which laboratory test does the nurse anticipate may be administered?

prostate-specific antigen (PSA)

The nurse has instructed a group of adolescents about the importance of skin care and protection from the sun. Which type of cancer is the nurse hoping to prevent in this population?

squamous cell carcinoma