Presentation Questions
The nurse evaluates his teaching as effective when a client with stage I laryngeal cancer states: A. I'm glad this was diagnosed early, when it can be treated with radiation so I won't lose my voice. B. Thank goodness this type of cancer usually doesn't spread anywhere else. C. I'm glad I don't have to worry about treating this cancer now because it is so early. D. I hate to think about eventually losing the ability to speak, but I'd rather treat it aggressively than to lose my life to cancer.
A. I'm glad this was diagnosed early, when it can be treated with radiation so I won't lose my voice. With stage I laryngeal cancer, radiation can cure the cancer, and preserve the voice. This cancer does metastasize to other areas.
The client is 4 hours post-lobectomy for lung cancer. Which assessment data warrant immediate intervention by the nurse? A. Intake of 1500 mL IV and output of 1000 mL. B. 450 mL of bright red drainage in the chest tube. C. Complaining of pain at a 10 on a 1-10 scale. D. Absent lung sound on the side of surgery.
Answer B 450 mL bright red drainage in the chest tube implies post-surgical hemorrhage and should report to physician immediately.
A client is at risk for lung cancer asks about the reason for having a computed tomography (CT) scan as part of the initial exam. What is the nurse's best response? "A CT Scan is: A. Far superior to magnetic resonance imaging for evaluating lymph node metastasis." B. Noninvasive and readily available." C. Useful for distinguishing small differences in tissue density and detecting nodal involvement." D. Used to distinguish a malignant from non-malignant adenopathy."
C) Useful for distinguishing small differences in tissue density and detecting nodal involvement. CT scanning is the standard noninvasive method used in a workup for lung cancer because it can distinguish small differences in tissue density and can detect nodal involvement. CT is comparable to MRI in evaluating lymph node metastasis. CT is noninvasive and usually available, but these are not the main reasons for its use. CT can distinguish malignancy in some situations only.
The nurse is caring for a 78 year old male with lung cancer who is receiving chemotherapy. The client states he is not eating well but otherwise feel healthy. Which meal suggestion would be best for this client? A. Cereal with milk and strawberries B. Toast, gelatin dessert, and cookies C. Broiled chicken, green beans, and cottage cheese D. Steak and french fries
C. Broiled chicken, green beans, and cottage cheese Carbohydrates are the first substance used by the body for energy. Proteins are needed to maintain muscle mass, repair tissue, and maintain osmotic pressure in the vascular system. Fats, in a small amount are needed for energy production.
A client is admitted to the recovery room after cystoscopy with biopsy. Before the nurse can discharge the client, the nurse should be sure the client: A. Has a bowel movement B. Has received the first dose of pain medication C. Has voided D. Has no blood in their urine
C. Has voided The nurse should verify that the client has voided prior to discharge in order to evaluate bladder function. Bowel function is not expected to be affected with this procedure. There may not be a need for pain medication immediately following this procedure and before discharge, but the nurse should assess the client's pain status and inform the client about the use and side effects of the medication. It is normal for the client to have hematuria following this procedure.
The nurse should assess the client with bladder cancer for which of the following? A. Suprapubic pain B. Dysuria C. Painless hematuria D. Urine retention
C. Painless hematuria Painless hematuria is the most common clinical finding in bladder cancer. Other symptoms include urinary frequency, urgency and dysuria, but these are not as common. Suprapubic pain and urine retention do not occur in bladder cancer.
The school nurse is preparing to teach a health promotion class to high school seniors. Which information regarding self-care should be included when teaching? A. Wear sunscreen with a protection factor of 10 or less when in the sun B. Try to stay out of the sun between 0300 and 0500 daily C. Perform a thorough skin check monthly D. Remember caps and long sleeves do not help prevent skin cancer
C. Perform a thorough skin check monthly Early detection is key
Which of the following nursing interventions would be most helpful in making the respiratory effort of a client with metastatic lung cancer more efficient? A. Teaching the client diaphragmatic breathing techniques B. Administering cough suppressants as ordered C. Teaching and encouraging pursed-lip breathing D. Placing the client in low semi-fowlers position
C. Teaching and encouraging pursed-lip breathing For clients with obstructive versus restrictive disorders, extending exhalation through pursed-lip breathing will make the respiratory effort more efficient.
The nurse is instructing a client about skin care while receiving radiation therapy to the chest. What should the nurse instruct the client to do? A. Apply lotion if the skin becomes dry B. Shave the chest to prevent contamination from chest hair C. Wash the area with tepid water and mild soap D. Keep the area covered with a non-adherent dressing between treatments
C. Wash the area with tepid water and mild soap Clients receiving radiation therapy experience dryness or redness in the area of the radiation. The nurse instructs the client to wash the area with soap and water and to keep it dry. The client does not apply lotion, shave or cover the area.
A client is receiving chemotherapy that has the potential to cause pulmonary toxicity. Which signs or symptoms indicate a toxic response to the chemotherapy? A. Decreased appetite B. Drowsiness C. Spasms of the diaphragm D. Cough and shortness of breath
D. Cough and Shortness of Breath Cough and SOB may indicate decreased pulmonary function secondary to drug toxicity. Decrease in appetite, difficulty thinking clearly and spasms of diaphragm may result from chemo, however, they are not indicative of pulmonary toxicity.
Which client is at greater risk for the development of skin cancer? A. The African American male who lives in the northeast B. The elderly Hispanic female who moves from Mexico as a child. C. The client who has a family history of basal cell carcinoma D. The client with fair completion who cannot get a tan
D. The client with fair complexion who cannot get a tan
After surgery for head and neck cancer, a client has a permanent tracheostomy. The nurse should teach the client and family about the importance of: A. Providing tracheostomy site care. B. Addressing the psychosocial issues related to tracheostomy. C. Observing for early signs and symptoms of skin breakdown around the tracheostomy site. D. Using humidifiers to prevent thick, tenacious secretions.
D. Using humidifiers to prevent thick, tenacious secretions. Providing adequate humidification for the client with a trach is essential. The client no longer has functions of the nose for warming , moistening, or filtering the air when breathing through the trach site. All other options are important however using humidifier to prevent thick, tenacious secretions is the most important for long term management and preventing pulmonary infection.
A nurse is conducting a cancer risk screening program. Which client is at greatest risk for skin cancer? A.) 45-year-old healthcare worker B.) 15-year-old high school student C.) a 30-year-old butcher D.) a 60-year-old mountain biker
D.) Basal cell carcinoma occurs most commonly in sun-exposed areas of the body. The incidence of skin cancer is highest in older people who live in the mountains or spend outdoor leisure time at higher altitudes.
The Nurse is educating a group of students on skin cancer prevention, which of the following statements by a student shows an understanding of learning? A. "So the most important thing I can do is avoid direct sunlight exposure?" B. "Scrubbing my skin well to slough off the dead cells after being in the sun will help reduce my risk of getting skin cancer." C. "I can use a tanning booth to help avoid the harsh rays that cause skin cancer." D. "Sunscreen only helps if it is SPF 100. Anything below that doesn't help."
A UV light from the sun is a direct correlation to sun damage and a risk for skin cancer
A client with bladder cancer has gross hematuria. The client's hemoglobin is 8.0 g/DL (80g/L), and the healthcare provider prescribes a unit of packed red blood cells. The client has an existing intravenous infusion of normal saline using a 19-gauge needle. To administer the packed red blood cells, the nurse should: A. Attach the packed cells to the existing 19-gauge IV of normal saline using the Y tubing B. Start an additional 22-gauge IV site because the packed blood cells must be given in a separate line C. Attach the packed blood cells to the existing 22-gauge IV of 5% dextrose using Y tubing D. Start an additional IV access device with with a 22-gauge intravenous cannulation device
A The packed red blood cells should be administered using a central catheter or 19-gauge needle. Y tubing and the normal saline solution are used to keep the vein open when the blood transfusion is complete. Blood is not compatible with dextrose because dextrose may cause blood coagulation. Blood products should be given with normal saline solution. A blood filter must be used for all blood products to filter out sediment from stored blood products. It is not necessary to add another IV access.
You are seeing a 16 year old patient in for her yearly check up. The patient states that her grandmother had recently been diagnosed with melanoma. The patient asks you what the different risk factors are that are associated with skin cancers: A. Family History B. Using daily moisturizers C. Using indoor tanning beds D. Having many moles E. Having black hair
A, C, D
When the nurse is counseling a 60-year-old African-American male client with all of these risk factors for lung cancer, teaching should focus most on which risk factor? A. Tobacco use B. Ethnicity C. Gender D. Increased age
A. Tobacco use Although all of these are risk factors for lung cancer, the client's tobacco use is the only factor that he can change. Ethnicity, gender, and increasing age are associated with lung cancer, but they are not modifiable risks.
An 85 year old male client diagnosed with colon cancer asks the nurse, "why did I get colon cancer?" Which is the best response about colon cancer? A) Lack of fiber in the diet B) Greatest incidence among those younger than 50 C) Has no known risk factors D) Rare among male clients
Answer: A Rationale: Prolonged transit time due to low fiber diet allows for carcinogens to build up in the lumen of the colon.
A nurse is caring for a client 24 hours after an abdominal-perineal resection for a bowel tumor. The client's wife asks if she can bring him some of his favorite home-cooked Italian minestrone soup. What should the nurse do first? A) Auscultate for bowel sounds. B) Ask the client if he feels hunger or gas pains. C) Consult the dietician. D) Encourage the wife to bring the soup.
Answer: A Rationale: The nurse should perform a thorough assessment of the abdomen and auscultate for bowel sounds in all four quadrants. Clients who have gastrointestinal surgery may have decreased peristalsis for several days after surgery. The nurse should check the abdomen for distention and check with the client and the medical record regarding the passage of flatus or stool. Consulting with a dietician would be in appropriate because the client must be kept on nothing-by-mouth statun until bowel sounds are present. The nurse should explain to the wife that it is too soon after surgery for her husband to eat.
The occupational health nurse is preparing a presentation to a group of factory workers about preventing colon cancer. Which information should be included? A. Wear a high filtration mask around chemicals B. Eat several servings of cruciferous vegetables daily C. Take a multivitamin daily D. Do not engage in high-risk sexual behavior
Answer: B Rationale: Eating cruciferous vegetables protect cells from DNA damage, inactivate carcinogens, have antiviral, antibacterial effects, and anti-inflammatory effects, induce cell death (apoptosis), inhibit tumor blood vessel formation (angiogenesis)and tumor cell migration (needed for metastasis)
A patient with a new colostomy is being discharged. Which statement indicates a need for further teaching? A. If I notice any skin breakdown I will call the HCP B. I should drink only liquids until the colostomy starts to work C. I should not take a tub bath until the HCP says it's okay D. I should not drive or lift more than 5 pounds
Answer: B The patient should be on a regular diet with a working colostomy before discharge
A nurse is providing teaching about colon cancer to a group of women 45 to 65 years of age. Which of the following statements should the nurse include in the teaching? A. Colonoscopies for individuals with no family history should begin at age 40 B. A sigmoidoscopy is recommended every 5 years beginning at age 60 C. Fecal occult blood tests should be done annually beginning at age 50 D. An endoscopy provides a definitive diagnosis of colon cancer
Answer: C Fecal occult blood tests should be done annually by clients ages 50 to 75
The nurse is assessing a client with lung cancer. Which symptom does the nurse anticipate finding? A. Easy bruising B. Dyspnea C. Night sweats D. Chest wound
B. Dyspnea Dyspnea is a sign of lung cancer, as are cough, hoarseness, shortness of breath, bloody sputum, arm or chest pain, and dysphagia. Easy bruising is a nonspecific finding. Night sweats is a symptom of the lymphomas. A chest wound is not specific to lung cancer.
Which modifiable risk factor should the nurse identify for the development of cancer of the bladder in a client? A. Previous exposure to chemicals B. Pelvic radiation therapy C. Cigarette smoking D. Parasitic infections of the bladder
C Cigarette smoke contains more than 400 chemicals, 17 of which are known to cause cancer. The risk is directly proportional to the amount of smoking.
A client receiving radiation to the head and neck is experiencing stomatitis. The nurse should recommend: A. Evaluation by a dentist B. Alcohol-based mouth wash rinses. C. Artificial saliva D. Vigorous brushing of teeth after each meal
C. Artificial saliva Head and neck radiation can cause the complication of stomatitis and decreased salivary flow. A saliva substitute will assist with dryness, moistening food, and swallowing.
A client is receiving a radiation implant for the treatment of bladder cancer. Which of the following interventions is appropriate? A. Flush all urine down the toilet B. Restrict the client's fluid intake C. Place the client in a semi-private room D. Monitor the client for signs and symptoms of cystitis
D Cystitis is the most common adverse reaction of clients undergoing radiation therapy; symptoms include dysuria, frequency, urgency, and nocturia. Clients with radiation implants require a private room. Urine of clients with radiation implants for bladder cancer should be sent to the radioisotopes lab for monitoring. It is recommended that fluid intake be increased.
