test 5 chpt. 6 cancer care med surge

stage 4 colon cancer recurred and metastasized- what type of surgery?

palliative

39- woman-family history of breast cancer- positive breast tumor marking test- pt. requests bilateral mastectomy- example of what type of oncology surgery?

prophylactic surgery

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?

Closely observe the client's skin for petechiae and bruising

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 brush my teeth after every meal

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."

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 removes a wedge of tissue for diagnosis.

what characteristics of a cancer cell should educator cite?

Malignant cells contain proteins called tumor specific antigens

The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant?

Monitor pt. closely to prevent infection

As a nurse who provides care for many patients with cancer, you are aware that cancer makes patients susceptible to many other health problems. Which of the following assessments addresses the leading cause of death among patients who have cancer?

Monitoring white blood cell (WBC) counts and assessing patients' integumentary systems

newly diagnosed with cancer- starting chemo- nurse providing anticipatory guidance about potential adverse effects- nurse describes?

Nausea and vomiting

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 need to use birth control

What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen?

It targets normal body cells as well as cancer cells.

advanced breast cancer- metastasized- nurse finds patient struggling to breathe- JVD-development of what oncologic emergency?

Superior Vena Cava Syndrome (SVCS)

When discussing follow-up appointments with a client, the client asks the nurse, "The health care provider said that I have an abdominal neoplasm. What does that mean?" Which statement(s) accurately answers the client's question? Select all that apply.

"You have a new growth of abnormal tissue in your abdomen." "You have an abdominal tumor."

Which occurs when fluid accumulates in the pericardial space and compresses the heart?

Cardiac tamponade

Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth?

Control

During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior?

Progression

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?

Prophylactic

After being seen in the oncology clinic, a client with severe bone marrow suppression is admitted to the hospital. The client's cancer therapy consisted of radiation and chemotherapy. When developing the care plan for this client, which nursing diagnosis takes priority?

Risk for infection

screening for relevant cancers?

secondary prevention

example of primary prevention?

teaching patients to wear sunscreen

preparing female patient for hematopoietic stem cell transplant (HSCT) Nurse emphasizes to family and friends?

Do not visit if you've had a recent infection

prostate cancer scheduled for interstitial implant for high dose radiation- what safety measures?

limit the time visitors spend at the pts. bedside

diagnostic imaging revealed lung cancer metastasized to bone and liver- most likely mechanism by which the cancer cells spread?

lymphatic circulation

Public health nurse- intervention most directly addresses the leading cause of cancer deaths in North America?

smoking cessation

A nurse is administering a chemotherapeutic medication to a client, who reports generalized itching and then chest tightness and shortness of breath. The nurse immediately

stop the chemotherapeutic infusion

pt. receiving Iv doxorubicin hydrochloride- for cancer treatment- nurse observes swelling and pain at IV site- prioritize what action?

stopping the administration of the drug immediately

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?

the hair loss is usually temporary

The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action?

extravasation

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:

The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.

A nurse is caring for a client receiving chemotherapy. Which nursing action is most appropriate for handling chemotherapeutic agents?

Wear disposable gloves and protective clothing

You are a nurse who works in a public health setting. As such, you participate in many health promotion activities that are ultimately aimed at reducing the high incidence and prevalence of cancer in American society. Which of the following activities is an example of secondary prevention?

Teaching older adults why and how to perform fecal occult blood tests

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?

Inspect the skin frequently

According to the TNM classification system, T0 means there is

No evidence of primary tumor

oncology pt. experiencing skin reactions to radiation therapy, diagnosed- impaired skin integrity- (erythema) what intervention?

avoid rubbing or scratching affected area

erythema from radiation therapy- what should nurse instruct to do?

avoid using soap on the treatment area

school nurse teaching nutritional class- what menu choice would be best for potentially reducing risk of cancer?

baked apricot chicken, steamed broccoli

Which does a nurse thoroughly evaluate before a hematopoietic stem cell transplant (HSCT) procedure?

blood studies

hospice care- new admit- what principles guide hospice care?

care addresses needs of pt. as well as needs of family

Carcinogens are factors related to the formation of various malignancies. Which factor has the greatest impact on the development of all cancers?

chemical agents

The nurse is conducting a community education program using the American Cancer Society's colorectal screening and prevention guidelines. The nurse determines that the participants understand the teaching when they identify that people over the age of 50 should have which screening test every 10 years?

colonoscopy

A nurse is teaching a community class about how to decrease the risk of cancer. Which food should the nurse recommend?

Oranges

Which type of surgery is used in an attempt to relieve complications of cancer?

Palliative

A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication?

Serum potassium level of 2.6 mEq/L

A client with a brain tumor is undergoing radiation and chemotherapy for treatment of cancer. The client has recently reported swelling in the gums, tongue, and lips. Which is the most likely cause of these symptoms?

Stomatitis

When addressing a community group, the nurse identifies consumption of which substance(s) as a risk factor for the development of cancer? Select all that apply.

Tobacco Processed meats Alcohol

While doing a health history, a client tells the nurse that her mother, her grandmother, and her sister died of breast cancer. The client asks what she can do to keep from getting cancer. What is the best response by the nurse?

"Cancer prevention and detection can be done with blood analysis for tumor markers to measure your risk level.

Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode should the nurse anticipate?

Adjuvant therapy is likely.

After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention?

Administering metoclopramide and dexamethasone as ordered

Carmustine- chemo agent-significant side effect is thrombocytopenia-symptom of thrombocytopenia?

Epistaxis (nose bleed)

You are an oncology nurse who has reconstituted a patient's scheduled chemotherapeutic drug. What action should you perform prior to administering this drug?

Have a colleague confirm the chemotherapy dose.

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 floss my teeth every morning

pt. to begin external radiation for malignant tumor on neck- pt. education- what adverse effects should nurse discuss?

Impaired nutritional status

6-month prognosis following diagnosis of extensive stage small-cell lung cancer- Pt. wants to die at home- team believes care needs are unable to be met- alternative?

discuss a referral to hospice care

safe administration of antineoplastic agents- what action should nurse emphasize?

dispose of the antineoplastic waste in the hazardous waste receptacle

50 year man leukemia- starting chemo- what will nurse do to combat most common adverse affects of chemo?

administer an antiemetic

The nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice?

eats red meat such as steaks or hamburgers every day

just finished radiation therapy- what health problem?

impaired wound healing

Which is a growth-based classification of tumors?

malignancy

16 year girl- alopecia from chemo-what action would best indicate she is meeting goal of improved body image and self esteem?

patient requests her family bring her makeup and a wig

42 year male- complains of extreme fatigue and weakness after first week of radiation- which response by nurse would best reassure?

these symptoms usually result from radiation therapy, however we will continue to monitor your lab and x-ray studies