ATI Med Surg Oncology Dynamic Quizzes

A client who has stage II breast cancer asks the nurse about sites of metastasis for this cancer. Which of the following responses should the nurse make?

"Breast cancer tends to metastasize to the bones." Common sites of breast cancer metastasis are the bones, lungs, brain, and liver. Incorrect Answers: A. ""It's too soon to worry about something that might not happen."" This response is nontherapeutic because it dismisses the client's concern by not answering her question and gives her false reassurance. B. Breast cancer does not usually metastasize to the stomach. Common sites of metastasis include the lungs, brain, and liver. C. ""Breast cancer tends to metastasize to the bones."" This response is nontherapeutic because it dismisses the client's concern by not answering her question and gives her false reassurance.

A nurse is reinforcing preoperative teaching with a client who has colorectal cancer and is scheduled to undergo placement of a colostomy with a perineal wound. Which of the following statements by the client indicates an understanding of the teaching?

"I can have only liquids for 2 days before the surgery." The client should consume a full or clear liquid diet for 24 to 48 hr before the surgery to decrease bulk. The client should consume a low-residue diet for several days prior to surgery to decrease peristalsis. Incorrect Answers: A. Following the placement of a colostomy with a perineal wound, rectal sensations such as pain and itching might occur even after healing of the client's surgical wound. B. The client should sit on foam pads or soft pillows and avoid the use of rubber donut devices because of the increased pressure on the incisional site. D. Following surgery, the client's colostomy should begin to function within 2 to 4 days.

A nurse is reinforcing teaching with a client who has cancer and is receiving external radiation therapy. Which of the following statements made by the client indicates an understanding of the teaching?

"I need to protect the area from sunlight." To prevent skin irritation and subsequent breakdown, the nurse should instruct the client to protect areas of skin from sunlight. Incorrect Answers: B. The nurse should instruct the client to avoid the application of skin lotion, as this might remove the radiation site markings. Additionally, the cream might irritate the skin or cause an allergic reaction. C. The nurse should instruct the client that massaging the area can create friction on the radiated skin, which might lead to skin breakdown. D. External radiation sites are marked to indicate the exact area to receive the radiation therapy. Washing off the markings is contraindicated.

A nurse is reinforcing teaching with a client who has cancer and is undergoing external radiation treatment. Which of the following statements by the client indicates an understanding of the teaching?

"I should use my hand instead of a washcloth to wash the areas being radiated." It is gentler to wash the areas being radiated with the hand instead of a washcloth. Incorrect Answers: A. No powders, lotions, ointments, or creams should be used on the areas being radiated unless prescribed by the provider. B. The areas being radiated should be dried by gently patting instead of rubbing. C. The client should not apply sunscreen to the areas being radiated. Instead, the client should protect these areas by wearing clothing, staying in the shade when in intense sun, or avoiding sun exposure.

A nurse is reinforcing teaching with a client who has stomatitis due to chemotherapy. Which of the following statements by the client indicates a need for FURTHER instructions?

"I will cleanse my mouth after meals with an alcohol-based mouthwash." The nurse should identify that this statement indicates a need for further reinforcement of teaching. This client who has stomatitis should avoid the use of alcohol-based mouthwash because it can irritate and burn the mucous membranes. Incorrect Answers: A. The nurse should instruct the client to use a soft toothbrush or foam swab to prevent causing additional trauma to or bleeding of oral tissues. C. The nurse should instruct the client to use a straw when drinking liquids to reduce the exposure of liquids to the oral mucosa, thereby decreasing irritation. D. The nurse should instruct the client to rinse the mouth often with a hydrogen peroxide, warm saline, or baking soda solution to promote comfort and healing.

A hospice nurse is reinforcing teaching about palliative care to the partner of a client who has end-stage liver cancer. Which of the following statements by the partner indicates an understanding of teaching?

"I will continue to talk to him, even when he's sleeping." Hearing is thought to be the last sense lost in the dying process; therefore, the partner should continue to communicate with the client. Incorrect Answers: A. Clients who are approaching death often refuse nourishment and should not be forced to eat or drink. B. Clients who are approaching death should be positioned with the head elevated or on a side. C. Clients should be covered with a non-electric blanket to keep the extremities warm.

A nurse is reinforcing discharge teaching with a client following open radical prostatectomy. The client is going home with an indwelling urinary catheter. Which of the following statements by the client indicates an understanding of the teaching?

"I will take acetaminophen if I have any pain." The nurse should teach the client to avoid aspirin and NSAIDs for at least 2 weeks following surgery to prevent the risk of bleeding. Incorrect Answers: A. The nurse should instruct the client to shower rather than take a bath for 2 to 3 weeks following an open radical prostatectomy. C. The nurse should instruct the client to use stool softeners rather than suppositories to control constipation. D. The client's bladder control might not return immediately, but practicing Kegel exercises can help with incontinence. Urinary incontinence can last for 1 to 2 years following surgery.

A nurse is reinforcing teaching with a client who has leukemia and has developed thrombocytopenia. Which of the following instructions should the nurse include in the teaching?

"Use an electric razor when shaving." The nurse should instruct the client to use an electric razor to prevent nicks and cuts caused by conventional razors that can increase the risk of bleeding. Incorrect Answers: A. The nurse should instruct the client not to floss because of the increased risk of bleeding of the gums. B. The nurse should instruct the client not to blow or put anything up the nose because of the risk for causing a nosebleed. D. The nurse should instruct the client to wear shoes that have a firm sole to avoid an accidental puncture of the sole that could prompt bleeding from a cut to the foot.

A nurse is reinforcing postoperative discharge teaching with a client following a panhysterectomy for uterine cancer. Which of the following pieces of information should the nurse provide?

"You might experience manifestations of menopause." A panhysterectomy includes the removal of the uterus and the ovaries, which might cause manifestations of menopause (e.g. hot flashes, night sweats, and vaginal dryness). Incorrect Answers: A. The nurse should inform the client that following a panhysterectomy, pregnancy is not possible, and birth control is no longer required. C. The nurse should inform the client to not lift anything heavier than 2.3 to 4.5 kg (5 to 10 lb). D. Pain or burning on urination is not an expected outcome of a panhysterectomy, and the client should report these findings to the provider. Such manifestations can indicate a urinary tract infection.

A nurse is reinforcing teaching with a client about how to perform a breast self-examination (BSE). The nurse should identify which of the following findings as an indication of breast cancer?

A nontender, hard lump that is palpated in a breast Cancerous tumors are typically hard, fixed, irregular in shape, and nontender to palpation. The nurse should instruct the client to notify the provider promptly if she palpates a hard, nontender lump. Incorrect Answers: A. Moveable lumps that increase in tenderness during the menstrual period are an indication of fibrocystic breast tissue. B. Multiple masses of regular shape in both breasts are characteristic of fibrocystic breast disease. C. Bilaterally darkened areolas are an expected finding in dark-skinned women and an expected change during pregnancy in light-skinned women.

A nurse on an oncology unit is reinforcing discharge teaching with an adolescent client who received a bone marrow transplant for leukemia. Which of the following pieces of information should the nurse include? (Select all that apply.)

A. "You should take your temperature at least once a day." C. "Examine your feet every day." Clients who are postoperative following bone marrow transplants are immunosuppressed and should continually monitor for manifestations of infection. A temperature that is greater than 38°C (100°F) should be reported immediately to the provider. Also, the client should examine the feet daily to identify injuries that might increase the risk of infection. Incorrect Answers: B. Clients who have had a bone marrow transplant are immunosuppressed. They should avoid crowds such as those encountered at school, a mall, or a movie theater. They will also require time at home to recover and should limit their visitors to individuals who are healthy. D. Alcohol can cause trauma and irritation to the gums and tissues. Rinsing the toothbrush in a weak bleach solution or placing it in the dishwasher weekly are safer alternatives. E. Raw foods can carry bacteria that may lead to an increased risk of infection.

A nurse is caring for a postmenopausal client who is concerned that she might have a higher-than-average risk of breast cancer. After collecting data from the client, the nurse should identify which of the following factors as increasing her breast-cancer risk? (Select all that apply.)

A. Increased breast density B. BMI 32 D. Hormonal replacement therapy for 10 years Women who have dense breast tissue are at an increased risk of developing breast cancer because they have more connective and glandular breast tissue. Postmenopausal obesity increases the risk of developing breast cancer. Hormone-related risks for developing breast cancer include the long-term use of oral contraceptives or hormone replacement therapy, early menarche, late menopause, and first pregnancy after 30 years of age. Incorrect Answers: C. Women who are nulliparous have a higher risk of developing breast cancer. E. Consuming 3 to 14 alcoholic beverages per week increases the risk of developing breast cancer.

A nurse is caring for a client who recently had chemotherapy and now has myelosuppression. Which of the following interventions should the nurse initiate? (Select all that apply.)

A. Prohibit bringing fresh flowers and plants into the client's room C. Ensure thorough cleaning of the client's room and bathroom daily E. Use dedicated equipment items such as stethoscopes Myelosuppression is bone-marrow depression, which puts the client at a high risk of infection after chemotherapy. Fresh flowers and potted plants can introduce microorganisms into the client's immediate environment. Due to the client's high risk of infection, the nurse should make sure the housekeeping staff clean and sanitize the client's environment daily. Additionally, the nurse should utilize single-use equipment as much as possible and keep reusable equipment like stethoscopes and blood pressure cuffs in the client's room for dedicated use with this client only. Incorrect Answers: B. Due to the client's high risk of infection, the nurse should limit visitors to healthy adults who practice good hand hygiene techniques before entering the client's room. It is not usually apparent when someone is carrying an airborne virus that has not yet caused clinical manifestations. This can put an immunocompromised client at risk of infection; therefore, the nurse should limit the client's contact with other staff and visitors. D. Due to the client's high risk of infection, the nurse should replace any wound dressings daily to allow inspection and cleaning of the wound as necessary to prevent infection.

A nurse is collecting data from a client who has colorectal cancer. Which of the following manifestations should the nurse expect to find?

Abdominal cramps Clients who have colorectal cancer are likely to have changes in bowel habits, occult blood in the stool, weight loss, fatigue, and "gas pains" or abdominal cramping. Incorrect Answers: A. Clients who have colorectal cancer are more likely to have blood in their stool than in their urine. C. Clients who have colorectal cancer are more likely to have weight loss than weight gain. D. Clients who have colorectal cancer are more likely to have anemia than polycythemia.

A nurse is contributing to the plan of care for a client who has thrombocytopenia due to chemotherapy. Which of the following interventions should the nurse include?

Avoid IM injections A client who has thrombocytopenia is at risk for bleeding; therefore, the nurse should avoid invasive procedures such as an IM injection. Incorrect Answers: B. The nurse should avoid any procedures, such as obtaining a rectal temperature, that can cause trauma to the rectum and increase the client's risk of rectal bleeding. C. The nurse should limit visitors for a client who has neutropenia. D. The nurse should promote safe oral hygiene but should instruct the client to avoid flossing due to the risk of bleeding.

A nurse is reinforcing discharge teaching with a client who is postoperative following a right mastectomy for breast cancer. The client will be going home with 2 Jackson-Pratt drains. Which of the following pieces of information should the nurse include in the teaching?

Avoid wearing deodorant until the drains are removed and the incision heals. The nurse should instruct the client to avoid applying deodorants and talcum powder to the affected underarm until the drainage tubes are removed and the incision is healed. Incorrect Answers: A. The nurse should instruct the client that cloudy, malodorous drainage might indicate infection and should be reported to the provider. B. The nurse should instruct the client to take baths until the provider removes the drainage tubes and stitches. D. The nurse should instruct the client that normal use and nonstrenuous exercise is appropriate before the provider removes the drainage tubes. More strenuous exercise can begin following the removal of the drains.

A nurse is caring for a client who has breast cancer and is receiving a combination of chemotherapy medications. The client expresses confusion about the therapy. Which of the following explanations should the nurse provide?

B. "The chemotherapy medications act at different stages of cell division so more tumor cells are destroyed." Different chemotherapeutic agents act at various stages of cellular mitosis (division). By combining agents, medication therapy is more effective in stopping or slowing the growth of cancerous cells by interfering with their ability to multiply. Incorrect Answers: A. A combination of chemotherapeutic agents does not lessen the incidence of renal toxicity. C. A combination of chemotherapeutic agents does not ensure a shorter duration of treatment. D. It is not entirely possible to eliminate the suppression of bone marrow caused by chemotherapeutic medications. The extent of bone marrow suppression is dependent on the specific medications being administered.

A nurse is talking with a group of women at a community center about the current recommendations for early detection of breast cancer. The nurse should recommend which of the following strategies?

Begin annual mammograms at age 40 Women should begin performing monthly breast self-examination at 20 years of age. From 20 to 39 years of age, women should have a breast examination by a health care provider every 3 years. Women older than 40 years of age should have annual breast examinations by a health care provider and an annual mammogram. Incorrect Answers: A. Ideally, women should begin breast self-examination in their early 20s. Some providers no longer recommend this practice, but women should be aware of the option starting in their early 20s. B. From age 20 to 39 years, women should have a breast examination by a health care provider every 3 years. D. "Have breast magnetic resonance imaging every 5 years after age 50" Women with moderate and high risk factors for breast cancer might benefit from having breast magnetic resonance imaging screening, but it is not a recommendation for all women.

A nurse is assisting with planning care for a client who is postoperative following a radical mastectomy. Which of the following interventions should the nurse include in the plan?

Begin exercises with the client 1 day after the procedure The nurse should plan to begin exercises that do not stress the incision on the first postoperative day to promote lymphatic return and mobility. Incorrect Answers: A. The nurse should plan to elevate the arm on the affected side when the client is in bed to promote the return of lymphatic fluid. B. The nurse should plan to instruct the client to avoid flexing her arm while ambulating to reduce the risk of contractures. D. The nurse should plan to ambulate the client on the first postoperative day to increase circulation, ventilation, and mobility.

A charge nurse is observing a newly licensed nurse provide care for a client. This client is receiving internal radiation therapy for the treatment of cervical cancer. Which of the following actions by the newly licensed nurse should prompt the charge nurse to intervene?

Borrowing a dosimeter film badge from another nurse before entering the client's room A nurse should never borrow a dosimeter film badge from another staff member. Nurses who are caring for the client should each have a personal badge. The badge must be worn any time the nurse is in the client's room to measure the radiation exposure that the nurse is receiving. Each film badge will indicate the nurse's cumulative radiation exposure. Incorrect Answers: A. The nurse should keep all dressings and linens in the client's room until after the radiation has been discontinued. B. The nurse should instruct visitors to limit their time with the client to 30 minutes per day and to stay 2 m (6 feet) away from the client. D. Equipment can be removed from the client's room at any time without special precautions. The equipment does not pose a hazard to other people because it is not emitting radiation. Items that should be given special consideration prior to removal are soiled dressings or linens.

A nurse is caring for a client who is receiving chemotherapy to treat cancer. Which of the following adverse effects should the nurse anticipate from the chemotherapy?

C. Pancytopenia Bone marrow suppression (a deficiency of WBCs, RBCs, and platelet counts) is an expected adverse effect of chemotherapy. Incorrect Answers: A. Gingival hyperplasia (overgrowth of gingival tissue in the mouth) is caused by poor oral hygiene, leading to bacterial plaque and tartar accumulation. It is not an adverse effect of chemotherapy. B. Hirsutism (excessive body or facial hair) is generally caused by Cushing syndrome, especially in women. The nurse should expect to see alopecia (hair loss) when the client receives chemotherapy. D. The client might have an inability or lack of desire to eat, causing weight loss due to the adverse effects of chemotherapy (e.g. a metallic taste in the mouth, nausea, and vomiting).

A nurse is planning care for a client who is postoperative following a urinary diversion to treat bladder cancer. Which of the following interventions should the nurse include in the plan of care?

Change the collection pouch in the early morning The nurse should plan to change the urinary collection pouch in the early morning when the client's urine output is reduced. Incorrect Answers: A. The nurse should empty the collection pouch when it is 1/3 to half full to keep the excess weight of the urine from causing the pouch to separate from the skin. B. The nurse should expect no delay in urinary output following surgery. The nurse should monitor the client's hourly urine output in the immediate postoperative period and then transition to monitoring every 4 to 8 hours. D. The nurse should not use hydrogen peroxide to cleanse the skin around the stoma and under the collection pouch. Instead, he nurse should use soap and water for cleansing to decrease the risk of irritating the area.

A nurse is contributing to the plan of care for a client who is receiving chemotherapy and has a protein deficiency. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

Correct Answers: A. Mix powdered skim milk into milk C. Add a slice of cheese to hot vegetables E. Mix yogurt into fresh fruit Dairy products are good sources of protein. Mixing powdered skim milk into milk, adding cheese to vegetables, and mixing yogurt into fresh fruit can provide the client with additional protein. Incorrect Answers: B. Clients who are immunocompromised should avoid foods that contain raw eggs because they are a potential source of infection. D. Adding honey to hot tea can increase the client's caloric intake, but it will not increase his protein intake. Honey is not a good source of protein.

A nurse in an oncology clinic is collecting data from a client who has early stage Hodgkin's lymphoma. Which of the following findings should the nurse expect?

Enlarged lymph nodes Hodgkin's lymphoma is a malignancy of lymphoid tissue found in the lymph nodes, spleen, liver, and bone marrow. The first manifestation of this cancer is often an enlarged painless lymph node, or nodes, which appear without a known cause. Other early manifestations include night sweats, unexplained weight loss, a fever, and pruritus. The disease can spread to adjacent lymph nodes and then outside the lymph nodes to the lungs, liver, bones, or bone marrow. The spread of Hodgkin's lymphoma is usually in an ordered pattern. Incorrect Answers: A. Bone pain may be a late manifestation sign of metastasis. Bone and joint pain are early manifestations of leukemia and multiple myeloma, not Hodgkin's lymphoma. C. Intermittent blood in the urine might be an indication of bladder cancer. D. A nonproductive cough may occur because of narrowed airways from swollen lymph glands. A productive cough may be an indication of lung cancer.

A nurse is caring for a client who has lung cancer that has metastasized. Which of the following findings indicates the client is developing superior vena cava syndrome?

Facial edema Superior vena cava syndrome is a medical emergency resulting from a partial occlusion of the superior vena cava, leading to a decreased blood flow through the vein. Most cases of superior vena cava syndrome are associated with cancers involving the client's upper chest, such as advanced lung and breast cancers and lymphoma. The earliest manifestations of superior vena cava syndrome are facial and upper extremity edema. Death can result if the compression is not corrected. Incorrect Answers: A. Superior vena cava syndrome is a partial occlusion of the superior vena cava. It leads to alterations in client's vascular flow, not cardiac arrhythmias. B. Superior vena cava syndrome is a partial occlusion of the superior vena cava. Numbness in the client's hands is a manifestation of spinal cord compression that can result if cancer spreads to the spinal cord. C. Superior vena cava syndrome is a partial occlusion of the superior vena cava. Muscle cramps might indicate the client has syndrome of inappropriate antidiuretic hormone (SIADH) and might occur with cancer metastasis to the brain.

A nurse is contributing to the plan of care for a client who is postoperative following a modified radical mastectomy. Which of the following invasive devices should the nurse expect the client to have?

Jackson-Pratt drain The nurse should expect this client who is post modified radical mastectomy to have 1 or 2 Jackson-Pratt drains. Jackson-Pratt drains are placed under the skin flaps to promote drainage of fluid. Even for short hospital stays, the drains are usually kept in place for 1 to 3 weeks following discharge. Incorrect Answers: A. The nurse should not expect the client to have a chest tube. Chest tubes are inserted to remove air and fluid from the chest cavity (e.g. in the treatment of a pneumothorax). B. The nurse should not expect the client to have an indwelling urinary catheter. Clients are discharged promptly following a modified radical mastectomy, often the same day or after 1 night, and the client should not need an indwelling urinary catheter. C. The nurse should not expect the client to have a nasogastric tube.

A nurse is caring for a client who is receiving brachytherapy. Which of the following measures should the nurse contribute to the client's plan of care?

Keep the door to the client's room closed Brachytherapy is a type of radiation therapy in which the radiation source is in direct contact with the client's tumor. During the therapy, the client emits radiation and is potentially hazardous to others. The client should be in a private room with a private bathroom, and the nurse should keep the door to the client's room closed. Incorrect Answers: A. The nurse should organize tasks to limit the time spent with the client. B. Brachytherapy does not involve chemotherapy medications; however, if a client is also receiving chemotherapy, this is an essential precaution. D. The nurse should limit each visitor to 30 minutes per day and caution visitors to stay at least 1.8 m (6 feet) away from the client.

A nurse is caring for a client who is receiving radiation therapy for breast cancer and reports a metallic taste in the mouth. Which of the following dietary recommendations should the nurse relay?

Offer mints The nurse should encourage the client to suck on mints. Mints can overcome the metallic taste the client is experiencing as a result of the radiation therapy. Incorrect Answers: A. The nurse should encourage the client to eat with plastic utensils to prevent an increase in the metallic taste. B. The nurse should encourage the client to add coffee to sweet beverages or milk to cut the sweet taste for a client who reports a metallic taste in the mouth. C. The nurse should encourage the client to consume foods that contain citrus or that have a tart flavor. This overcomes the metallic taste.

A nurse is collecting data from a female client who is undergoing screening for breast cancer. Which of the following factors places the client at an increased risk for developing breast cancer?

Over 50 years of age A female client who is over 50 years of age has a high risk of developing breast cancer. Incorrect Answers: A. Obesity places a client at a low but increased risk for developing breast cancer. B. Oral contraceptive use places a client at a low but increased risk of developing breast cancer. C. The risk from alcohol use is dose-dependent. Consumption of 3 to 14 drinks a week creates a slight risk of developing breast cancer.

A nurse is collecting a health history from a client who has skin cancer. Which of the following findings in the client's history is the highest risk factor for developing skin cancer?

Overexposure to sunlight The nurse should apply the safety and risk-reduction priority-setting framework, which assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the risk posing the greatest threat is the highest priority. The nurse should use Maslow's hierarchy of needs, the ABC priority-setting framework, and/or nursing knowledge to identify which risk poses the greatest threat to the client. Therefore, the nurse should identify the client's overexposure to sun as the greatest risk factor for developing skin cancer. Incorrect Answers: A. Being over the age of 60 is a risk factor for skin cancer; however, there is a greater risk factor than age for developing skin cancer. B. A genetic predisposition is a risk factor for skin cancer; however, there is a greater risk factor than genetic predisposition for developing skin cancer. C. Being of a light-skinned race is a risk factor for skin cancer; however, there is a greater risk factor than race for developing skin cancer.

A nurse is contributing to the plan of care for a client who has cancer and is scheduled to receive internal radiation therapy. Which of the following actions should the nurse recommend?

Place the client in a private room The nurse should recommend placing the client in a private room during internal radiation therapy to prevent exposing other clients and visitors to radiation. Incorrect Answers: B. All staff assigned to care for the client should wear dosimeter badges to monitor radiation exposure. C. Staff should don a lead apron prior to entering the client's room to decrease radiation exposure. A cover gown provides protection from blood or body fluids but not radiation exposure. D. The nurse should recommend picking up dislodged implants with forceps and placing them in a lead container to prevent radiation exposure.

A nurse is planning a presentation in a community center about risk factors for cancer. Which of the following types of cancer should the nurse include when discussing familial clustering of specific types of cancer?

Prostate Types of cancers that typically demonstrate a familial tendency include breast, colorectal, ovarian, and prostate. Incorrect Answers: A. Skin cancer does not typically result from genetic risk. Breast cancer is an example of a type of cancer that has familial tendencies. C. Bone cancer does not typically pose a genetic risk. Ovarian cancer is an example of a type of cancer that has familial tendencies. D. Bladder cancer does not typically pose a genetic risk. Colorectal cancer is an example of a type of cancer that has familial tendencies.

A nurse is caring for a client who will receive brachytherapy to treat uterine cancer. The nurse should ensure the client understands that she will receive which of the following interventions?

Radioactive infusions or insertions into or near the tumor Brachytherapy is a type of radiation therapy during which the radiation source, either an implant or via infusion, is in direct contact with the client's tumor continuously for a specific duration. Incorrect Answers: A. "Chemotherapy via a central venous access device" Chemotherapy is a chemical approach to killing cancer cells. Brachytherapy is not chemotherapy. B. "Radiation to the tumor from an external source" This intervention is teletherapy, not brachytherapy. C. "Precise delivery of high-dose radiation after tumor imaging" This intervention is stereotactic body radiotherapy, not brachytherapy.

A nurse is assisting in planning care for a client who has cancer and has developed thrombocytopenia following chemotherapy. Which of the following precautions should the nurse offer to minimize the adverse effects of thrombocytopenia?

Remind the client to use an electric razor Thrombocytopenia is a decrease in the client's blood platelet count, which places the client at an increased risk of bleeding due to the blood's inability to clot. Therefore, the nurse should institute bleeding precautions, which includes the use of an electric razor. Incorrect Answers: A. "Monitor visitors for manifestations of infection" This client has thrombocytopenia, not neutropenia (a decreased WBC count). Neutropenia places a client at risk for infection, so visitors who might be ill should be prohibited. C. "Encourage frequent rest periods" The client has thrombocytopenia, not iron-deficiency anemia. Iron-deficiency anemia necessitates the encouragement of frequent rest periods secondary to fatigue. D. "Instruct the client to rinse the mouth daily with normal saline" Stomatitis, an inflammation of the mucous membranes of the mouth, is not a manifestation of thrombocytopenia. A client who has stomatitis should use bland rinses and avoid commercial mouthwashes that contain alcohol, which might cause further breakdown of the oral tissue.

A nurse is collecting data from a client who has cancer and is receiving chemotherapy by peripheral IV infusion. The client reports pain at the insertion site, and the nurse notes fluid leaking around the catheter. Which of the following actions should the nurse take first?

Stop the infusion The nurse should apply the urgent versus nonurgent priority-setting framework. Using this framework, the nurse should consider urgent needs the priority because they pose more of a threat to the client. The nurse might also need to use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent. Many chemotherapy medications are vesicants that can cause extensive tissue damage if extravasation occurs; therefore, the nurse's first action should be to stop the infusion immediately. Incorrect Answers: A. The nurse should take a photograph of the IV site to document potential harm from extravasation; however, there is another action that is the priority. B. The nurse should take and record the client's vital signs following extravasation of a chemotherapy agent; however, there is another action that is the priority. D. The nurse should identify all medications administered through the IV site for the past 24 hours; however, there is another action that is the priority.

A nurse is collecting data from a client. Which of the following findings is the highest risk factor for the client developing bladder cancer?

The client uses tobacco. The nurse should apply the safety and risk-reduction priority-setting framework, which assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the risk posing the greatest threat is the highest priority. The nurse should use Maslow's hierarchy of needs, the ABC priority-setting framework, and/or nursing knowledge to identify which risk poses the greatest threat to the client. Therefore, the nurse should identify the client's tobacco use as the greatest risk factor for developing bladder cancer. Incorrect Answers: A. Exposure to chemicals such as those used in hairdressing is a risk factor for developing bladder cancer; however, there is a greater risk to the client than chemical exposure. C. Being over the age of 60 is a risk factor for developing bladder cancer; however, there is a greater risk to the client than age. D. A history of UTIs is a risk factor for developing bladder cancer; however, there is a greater risk to the client than frequent UTIs.

A nurse is caring for a client who has testicular cancer and is experiencing peripheral neuropathy as an adverse effect of chemotherapy. Which of the following client manifestations is an expected finding of peripheral neuropathy?

Tingling of the hands and feet Several chemotherapeutic agents might cause peripheral neuropathy. One of the major manifestations of peripheral neuropathy is numbness and tingling of an extremity. Incorrect Answers: A. Thinning of the scalp hair is called alopecia, a known adverse effect of chemotherapy. This manifestation is not related to peripheral neuropathy. C. A reduced ability to concentrate reflects cognitive changes, a known adverse effect of chemotherapy. This manifestation is not related to peripheral neuropathy. D. Sores in the mucous membranes is called mucositis, a known adverse effect of chemotherapy. This manifestation is not related to peripheral neuropathy.

A nurse is caring for a client who is receiving radiation therapy for mouth cancer and reports a dry mouth. Which of the following dietary recommendations should the nurse provide?

Use gravies or sauces to soften food The nurse should instruct the client to use gravies or sauces to soften foods and make them easier to eat. Incorrect Answers: A. The nurse should instruct the client to avoid eating dry, coarse foods such as graham crackers. This type of food can make the client's mouth more dry and unpleasant. B. The nurse should instruct the client to consume foods containing citrus, which stimulates saliva. C. The nurse should instruct the client to rinse the mouth with an alcohol-free mouthwash before eating. Alcohol-based mouthwash can make the client's mouth drier.

A nurse is collecting data from a client who has cancer of the cervix. Which of the following manifestations should the nurse expect?

Vaginal bleeding The most common manifestation of cancer of the cervix is painless vaginal bleeding. Incorrect Answers: A. Unexplained weight loss is a manifestation of cervical cancer. B. Dysuria NOT oliguria is a manifestation of cervical cancer. C. Pelvic pain and chest pain NOT back pain are manifestations of cervical cancer.

A nurse is planning a presentation for a group of older adults at a senior community center about risk factors for cancer. Which of the following factors increases the risk of developing cancer after age 60?

Weakened immune responses After age 60, people are at higher risk for cancer due to hormonal changes, altered immune responses, and accumulation of free radicals. Age itself is a significant factor because the longer people have exposure to external carcinogenic factors (e.g. tobacco and alcohol use, environmental pollutants, and radiation), the greater their risk of developing cancer. Incorrect Answers: A. A high-fat, low-fiber diet is a risk factor for developing colon cancer. B. Although an insufficient intake of calcium and vitamin D can cause a loss of bone density, it is not a specific risk factor for developing cancer. C. Although a decline in muscle mass is common with aging, it is a risk factor for mobility problems, not for developing cancer.