PU CH12 ONCOLOGIC MANAGEMENT PART I

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

A

A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: Tis, N0, M0. What does this classification mean? A. No evidence of primary tumor, no abnormal regional lymph nodes, and no evidence of distant metastasis B. Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis C. Can't assess tumor or regional lymph nodes and no evidence of metastasis D. Carcinoma in situ, no demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis

B

The nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice? A. uses the treadmill for 30 minutes on 5 days each week B. eats red meat such as steaks or hamburgers every day C. works as a secretary at a medical radiation treatment center D. drinks one glass of wine at dinner each night

B

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.) A. Monitor vital signs once a shift. B. Assess level of consciousness. C. Assist the client to a chair. D. Apply pressure to the bleeding sites. E. Check intake and output records.

B D E

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

A

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? A. "The hair loss is usually temporary." B. "New hair growth will return without any change to color or texture." C. "Clients with alopecia will have delay in grey hair." D. "Wigs can be used after the chemotherapy is completed."

A

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

C

Palliation refers to A. the spread of cancer cells from the primary tumor to distant sites. B. hair loss related to the treatment of cancer. C. relief of symptoms associated with disease and promotion of comfort and quality of life. D. the lowest point of white blood cell depression after therapy that has toxic effects on bone marrow.

C

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

D

A nurse is assessing a 75-year-old woman who had a total hysterectomy when she was 30 years old and normal Pap test results for the past 10 years. The client asks about continuing the Pap test. What is the best response by the nurse? A. "You will need to continue for the rest of your life." B. You need to continue obtaining a Pap test for only the next 5 years." C. "You could have stopped immediately after your hysterectomy." D. "You may choose to discontinue this test."

D

A decrease in circulating white blood cells (WBCs) is referred to as A. Granulocytopenia B. Thrombocytopenia C. Leukopenia D. Neutropenia

C

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

B

A patient will be receiving radiation for 6 weeks for the treatment of breast cancer and asks the nurse why it takes so long. What is the best response by the nurse? A. "It allows time for you to cope with the treatment." B. "It will allow time for the repair of healthy tissue." C. "It will decrease the incidence of leukopenia and thrombocytopenia." D. "It is not really understood why you have to go for 6 weeks of treatment."

B

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? A. cryosurgery B. prophylactic C. local excision D. palliative

B

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? A. Nausea and vomiting are only a factor for the first 24 hours after treatment. B. Most clients believe the discomfort is well worth the cure for cancer. C. Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects. D. Clinical trials are opening up new cancer treatments all the time.

C

A nurse is administering daunorubicin through a peripheral I.V. line when the client complains of burning at the insertion site. The nurse notes no blood return from the catheter and redness at the I.V. site. The client is most likely experiencing which complication? A. Erythema B. Flare C. Extravasation D. Thrombosis

C

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

D

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

D

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? A. "Removing the tumor is a primary treatment for colon cancer." B. "This surgery will prevent further tumor growth." C. "Once the tumor is removed, cell pathology can be determined." D. "Tumor removal will promote comfort."

D

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: A. Cleanse the skin with a mild soap, using his fingertips, not a rough wash cloth. B. Use an ointment, after treatment, to decrease the feeling of burning, which may last for several hours. C. Apply a small ice compress to the treated area afterward to decrease localized redness, post-radiation. D. Use an approved emollient 2 hours before the radiation to give the skin time to absorb the medication and provide a shield for damage.

A

A 36-year-old man is receiving three different chemotherapeutic agents for Hodgkin's disease. The nurse explains to the client that the three drugs are given over an extended period because: A. The three drugs can be given at lower doses. B. The second and third drugs increase the effectiveness of the first drug. C. The first two drugs are toxic to cancer cells, and the third drug promotes cell growth. D. The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.

A

A patient is scheduled for cryoablation for cervical cancer and tells the nurse, "I am not exactly sure what the surgeon is going to do." What is the best response by the nurse? A. "The surgeon is going to use medication to inject the area." B. "The surgeon is going to use liquid nitrogen to freeze the area." C. "The surgeon is going to use a laser to remove the area." D. "The surgeon is going to use radiofrequency to ablate the area."

B

A patient is admitted for an excisional biopsy of a breast lesion. What intervention should the nurse provide for the care of this patient? A. Clarify information provided by the physician. B. Provide aseptic care to the incision postoperatively. C. Provide time for the patient to discuss her concerns. D. Counsel the patient about the possibility of losing her breast.

C

Which type of hematopoietic stem cell transplantation (HSCT) is characterized by cells from a donor other than the patient? A. Allogeneic B. Autologous C. Syngeneic D. Homogenic

A

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

A

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? A "I floss my teeth every morning." B. "I use an electric razor to shave." C. "I take a stool softener every morning." D. "I removed all the throw rugs from the house."

A

The physician is attending to a client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation? A. To remove the tumor from the brain B. To prevent the formation of new cancer cells C. To analyze the lymph nodes involved D. To destroy marginal tissues

B

A client with a recent history of GI disturbance has been scheduled for a barium study. The physician ordered this particular test for this client because it will: A. show movement of the GI tract. B. remove a tissue sample from the GI tract. C. show tumor "hot spots" in the GI tract. D. provide a three-dimensional cross-sectional view.

A