PrepU: Hinkle Ch 15 Oncolog

A nurse is caring for a client who is receiving chemotherapy and has a platelet count of 30,000/mm3. Which statement by the client indicates a need for additional teaching? "I removed all the throw rugs from the house." "I use an electric razor to shave." "I floss my teeth every morning." "I take a stool softener every morning."

"I floss my teeth every morning."

A client calls the oncology office nurse and reports nausea and vomiting one week after receiving chemotherapy. What action should the nurse recommend? Obtaining acupressure treatments Practicing relaxation techniques Using imagery techniques Taking prescribed ondansetron

Taking prescribed ondansetron

An oncology clinic nurse is reinforcing prevention measures for oropharyngeal infections to a client receiving chemotherapy. Which statement by the client indicates that teaching was successful? "I use an alcohol-based mouthwash every morning." "I lubricate my lips with petroleum jelly." "I replace my toothbrush every month." "I clean my teeth gently several times per day."

"I clean my teeth gently several times per day."

A nurse is teaching a client who is receiving radiation treatment for left lower lobe lung cancer. Which client statement indicates a need for further teaching? "I'll use hats to protect my head from the sun when my hair falls out." "I'll allow myself plenty of time to rest between activities." "Most of the adverse effects should go away shortly after my last radiation treatment." "If I get nauseous, I'll try to eat several small, bland meals each day."

"I'll use hats to protect my head from the sun when my hair falls out." The client requires additional teaching if he mentions that he will lose the hair on his head as a result of radiation therapy. Alopecia is an acute, localized adverse effect of radiation.

A bowel resection is scheduled for a client with the diagnosis of colon cancer with metastasis to the liver and bone. Which statement by the nurse best explains the purpose of the surgery? "This surgery will prevent further tumor growth." "Tumor removal will promote comfort." "Once the tumor is removed, cell pathology can be determined." "Removing the tumor is a primary treatment for colon cancer."

"Tumor removal will promote comfort."

While doing a health history, a client tells the nurse that their mother, grandmother, and sister died of cancer. The client wants to know what to do to keep from getting cancer. What would be the nurse's best response? "If you eat right, exercise, and get enough rest, you can prevent breast cancer." "With your family history, there is nothing you can do to prevent getting cancer." "Cancer often skips a generation, so don't worry about it." "You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is."

"You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is."

The client is scheduled for a breast lump excision and sentinel node biopsy. What should the nurse know in planning care for the client with a positive biopsy? The lump and all axillary lymph nodes will be excised. A lump excision is not necessary. The entire breast and all regional lymph nodes will be excised. A wide excision of lump will be performed.

A wide excision of lump will be performed.

A 67-year-old client is admitted for diagnostic studies to rule out cancer. The patient is white, married, has been employed as a landscaper for 40 years, and has a 36-year history of smoking a pack of cigarettes daily. What significant risk factors does the nurse recognize this patient has? Select all that apply. Marital status Cigarette smoking Age Occupation Race

Age Cigarette smoking Occupation

A client has been receiving chemotherapy. Upon assessing the client during morning rounds, the nurse notes the client is now bleeding from intravenous and venipuncture sites. Stool is positive for occult blood. The client is requesting to sit in a chair for a meal. The nurse implements the following interventions: (Select all that apply.) Monitor vital signs once a shift. Assess level of consciousness. Assist the client to a chair. Apply pressure to the bleeding sites. Check intake and output records.

Assess level of consciousness. Apply pressure to the bleeding sites.

The patient diagnosed with thrombocytopenia is at risk for which of the following adverse effects: Headache Diminished reflexes Bleeding Stomatitis

Bleeding

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 External Teletherapy

Brachytherapy

The nurse should teach the patient who is being radiated about protecting his skin and oral mucosa. An important teaching point would be to tell the patient to: Apply a small ice compress to the treated area afterward to decrease localized redness, post-radiation. Use an approved emollient 2 hours before the radiation to give the skin time to absorb the medication and provide a shield for damage. Cleanse the skin with a mild soap, using his fingertips, not a rough wash cloth. Use an ointment, after treatment, to decrease the feeling of burning, which may last for several hours.

Cleanse the skin with a mild soap, using his fingertips, not a rough wash cloth.

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 hair dryer to quickly dry the hair. Avoid hair dyes or permanent wave solutions. Use shampoo and conditioner every day. Cut long hair before treatment begins. Use a wide-tooth comb to style the hair.

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

The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action? Nausea and vomiting Stomatitis Extravasation Bone pain

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

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 Ulceration Infection

Fatigue

A client diagnosed with cancer has the tumor staged and graded based on what?

How the tumor tends to grow and the cell type

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

Increased uric acid excretion

Which of the following is generally NOT considered to be a carcinogen? Dietary substances Defective genes Viruses Parasites

Parasites

The nurse at the clinic explains to the patient that the surgeon will be removing a mole on the patient's back that has the potential to develop into cancer. The nurse informs the patient that this is what type of procedure? Reconstructive Palliative Prophylactic Diagnostic

Prophylactic

A client reports a new onset of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. The health care provider orders a diagnostic workup, which reveals end-stage gallbladder cancer. What nursing intervention should be used to facilitate adaptive coping? Refer client for professional counseling. Provide written education for prescribed treatments. Assist with self-care activities of daily living. Encourage ventilation of negative feelings.

Refer client for professional counseling.

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

Risk for infection related to inadequate defenses

The nurse knows that interferon agents are used in association with chemotherapy to produce which effects in the client? Shorten the period of neutropenia Decrease the need for additional adjuvant therapies Suppression of the bone marrow Enhance action of the chemotherapy

Shorten the period of neutropenia Interferon agents are a type of biologic response modifiers (BRMs) used in conjunction with chemotherapy to reduce the risk of infection by shortening the period of neutropenia through bone marrow stimulation.

Which of the following are true statements about effective radiation therapy? Select all that apply. Cells are least vulnerable during DNA synthesis. Slower-growing tissues at rest (muscle) are more radioresistant. Tumors that are well oxygenated are more sensitive to radiation. Tumors that are small in size and dividing rapidly are more sensitive.

Slower-growing tissues at rest (muscle) are more radioresistant. Tumors that are well oxygenated are more sensitive to radiation. Tumors that are small in size and dividing rapidly are more sensitive.

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

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

Which of the following would be consistent with a benign neoplasm? Usually progressive and slow Gains access to the blood and lymph channels to metastasize Grows by invasion Cells are undifferentiated

Usually progressive and slow

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.) uses cool water to wash the neck area applies an over-the-counter ointment to the skin inspects for skin damage of the chest area avoids shaving the irradiated skin assesses the client for any sun exposure

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

The nurse is teaching a client about carcinogens. What carcinogens does the nurse include in the teaching? Select all that apply. dietary substances hormone replacement therapy environmental factors defective genes viruses chemical agents

dietary substances environmental factors viruses chemical agents defective genes hormone replacement therapy

Based on the understanding of the effects of chemotherapy, the nurse would anticipate which clinical finding in a client 2 weeks after therapy? constipation fever elevated white blood cells count change in hair color

fever

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

surgery hyperthermia radiation therapy chemotherapy

A client receiving treatment for a terminal illness develops cancer-related anorexia-cachexia syndrome (CACS). Which interventions will the nurse add to this client's plan of care? Select all that apply. Limit the intake of fluids during meals. Suggest foods that are high in calories and protein. Remove unpleasant sights and odors before meals. Remind the client to avoid alcoholic beverages at mealtimes. Encourage the client to eat three meals per day.

Limit the intake of fluids during meals. Remove unpleasant sights and odors before meals. Suggest foods that are high in calories and protein.

The nurse is caring for a client with a newly discovered tumor that may be benign or malignant. The client asks, "What makes a malignant tumor different from a benign one?" What should the nurse include in the response? Select all that apply. "The tumor grows slowly and may stop." "It does not spread to other areas of the body through blood and lymph channels." "The cells of the tumor bear little resemblance to the cells in the tissue where the tumor started." "The tumor may regress after its initial growth." "It grows by invasion and infiltrates the surrounding tissues."

The cells of the tumor bear little resemblance to the cells in the tissue where the tumor started." "It grows by invasion and infiltrates the surrounding tissues."

The client has finished the first round of chemotherapy. Which statement made by the client indicates a need for further teaching by the nurse? "Hair loss may not occur until after the second round of therapy." "I will eat clear liquids for the next 24 hours." "I can continue taking my vitamins and herbs because they make me feel better." "I will use birth control measures until after all treatment is completed.

"I can continue taking my vitamins and herbs because they make me feel better."

A client asks the nurse what is causing the fatigue following radiotherapy. What is the nurse's best response? Substances are released when tumor cells are destroyed. The cancer cells are dying in large numbers. 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.

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 With a butterfly needle In the client's right forearm With a soft, plastic catheter

With a soft, plastic catheter