Cancer Exam

The nurse is caring for a client with the diagnosis of colon cancer with metastasis to the liver. Which statement made by the client indicates an understanding of the diagnosis?

"My cancer has now spread to my liver."

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 negative biopsy report?

A wide excision of lump will be performed.

A nurse is planning care for a client who has malnutrition due to cancer. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A. Advise the client to keep a food diary. B. Encourage the client to brush teeth before and after meals. C. Assess the laboratory report of ferritin. D. Monitor for changes in mental status. E. Instruct the client to drink fluids between meals.

A. Advise the client to keep a food diary. B. Encourage the client to brush teeth before and after meals. C. Assess the laboratory report of ferritin.

Which of the following advice does the nurse offer clients who are undergoing unsealed radiation therapy to reduce exposure?

Avoid kissing and sexual contact.

The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise?

Avoid spicy and fatty foods.

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? A. Chemotherapy via a central venous access device B. Radiation to the tumor from an external source C. Precise delivery of high-dose radiation after tumor imaging D. Radioactive infusions or insertions into or near the tumor

Correct Answer: D. 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 is a chemical approach to killing cancer cells. Brachytherapy is not chemotherapy. B. This intervention is teletherapy, not brachytherapy. C. This intervention is stereotactic body radiotherapy, not brachytherapy.

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? A. Offer graham crackers as a snack B. Avoid foods containing citrus C. Rinse the mouth with an alcohol-based mouthwash before eating D. Use gravies or sauces to soften food

Correct Answer: D. 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 client should avoid eating dry, coarse foods such as graham crackers. This type of food can make the client's mouth feel more dry and unpleasant. B. The client should consume foods containing citrus to stimulate saliva. C. The client should rinse the mouth with an alcohol-free mouthwash before eating. Alcohol-based mouthwash can make the client's mouth drier.

A nurse is planning 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.) A. Mix powdered skim milk into liquid milk B. Add a raw egg to fruit smoothies C. Add a slice of cheese to hot vegetables D. Add honey to hot tea E. Mix yogurt into fresh fruit

Correct Answers: A. Mix powdered skim milk into liquid milk C. Add a slice of cheese to hot vegetables E. Mix yogurt into fresh fruit

Which nursing interventions are most important when implementing care for a client receiving temporary internal sealed radiation therapy? Select all that apply. A. Count wires, threads, or needles every shift B. Maintain indelible skin markings. C. Administer treatment through IV access port. D. Provide rest periods between treatments. E. Avoid standing in direct path of implants. F. Time, distance, and shielding

Count wires, threads, or needles every shift. Maintain indelible skin markings. Avoid standing in direct path of implants. Time, distance, and shielding

Which of the following can be considered carcinogens?

Dietary substances

A newly diagnosed cancer client is crying and states the following to the nurse, "I promised God that I will be a better person if I can just get better." What is the appropriate assessment of this comment by the nurse?

The cancer is viewed as a punishment from past actions.

Which of the following laboratory findings, would be identified by the nurse as the greatest risk for a cancer client scheduled for implantable port?

Platelet count 98,000/mm3

When the client complains of increased fatigue following radiotherapy, the nurse knows this is most likely to be related to which factor?

Radiation can result in myelosuppression.

The client has finished the first round of chemotherapy. Which statement made by the client indicates a need for further teaching by the nurse?

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

A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed?

"I guess the doctor could not remove the entire tumor."

The nurse is caring for a client who is scheduled for chemotherapy followed by autologous stem cell transplant. Which of the following statements by the client indicates a need for further teaching?

"I hope they find a bone marrow donor who matches."

An elderly client has been diagnosed with metastatic cancer and has a poor prognosis of survival. The family asks the nurse for advice on whether to tell the client of the diagnosis or to keep it quiet. Which is the best response from the nurse?

"In my experience, clients who know are more likely to be involved with their plan of care."

A client with a 4-cm breast mass is scheduled for biopsy with frozen section followed by lumpectomy and possible mastectomy. The client asks the nurse, "Why can't the doctor tell me specifically whether I will need to have my entire breast removed"? Which is the best response from the nurse?

"The frozen section will determine presence of cancer and type of surgery required."

The nurse is caring for a client who is scheduled for chemotherapy. Which is the beststatement the nurse can make about the client experiencing chemotherapy-induced alopecia?

"The hair loss is usually temporary."

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?

"Tumor removal will promote comfort."

A client with advanced cancer makes the following comment to the nurse, "Why are you bathing me? I am going to die no matter what." What is the most appropriate response of the nurse?

"Would you like to talk about what you are feeling?"

While obtaining a health history, a client tells the nurse that her mother, grandmother, and sister died of cancer. The client wants to know what she can do to keep from getting cancer. What would be the nurse's best response?

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

A nurse is caring for a client who has lung cancer and is exhibiting manifestations of syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following Findings should the nurse report to the provider? A. Behavioral changes B. Client report of headache C. Urine output 40 mL/hr D. Client report of nausea E. Increased urine specific gravity

A. Behavioral changes B. Client report of headache D. Client report of nausea

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

Adjuvant therapy is likely.

The nurse recognizes which of the following alternative therapies as appropriate in the care of cancer clients? Select all that apply. A. Reminiscing B. Hot and cold therapy C. Patient-controlled analgesia D. Epidural stimulators E. Alternating analgesics F. Nonopioid use

Reminiscing Hot and cold therapy

The nurse knows that interferon agents are used in association with chemotherapy to produce which effects in the client?

Shorten the period of neutropenia

A nurse is teaching a client who is scheduled for nuclear imaging for suspected cancer. Which of the following statements should the nurse give? A. "The presence of a liver enzyme will be identified." B. "you will be given an injection of a radioactive substance." C."An endoscope will be inserted through your mouth." D."The tumor will be aspirated."

B. "you will be given an injection of a radioactive substance."

A nurse is teaching a female adult client about screening prevention for cancer. Which of the following statements by the client indicates an understanding of the teaching? A. "I will need to have a mammogram every 2 years beginning at age 45." B. "I should have a colonoscopy every 15 years beginning at age 60." C."I will need to have an annual breast examination every year after 40." D."I should have a fecal occult test done every 3 years."

C."I will need to have an annual breast examination every year after 40."

A cancer client makes the following statement to the nurse, "I guess I will tell my doctor 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?

Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.

A nurse is providing teaching to a client who has cervical cancer and is scheduled to receive brachytherapy in an ambulatory care clinic. Which of the following statements by the client indicates an understanding of the teaching? A. "I need to lie still in bed during my brachytherapy treatment." B. "I will have an implant placed once a month during my brachytherapy treatment." C. "I must stay at least 3 feet away from others between brachytherapy treatments." D. "I should expect some blood in my urine after each brachytherapy treatment."

Correct Answer: A. "I need to lie still in bed during my brachytherapy treatment." The nurse should confirm that the client understands the need to remain on bed rest with limited movement while the radioactive implant is in place to prevent dislodgment.

A nurse is assessing a client who has a new diagnosis of mastoiditis. Which of the following manifestations should the nurse expect? A. Swelling behind the affected ear B. Facial drooping on the affected side C. Nystagmus on the affected side D. Pearly gray color of the affected eardrum

Correct Answer: A. Swelling behind the affected ear Mastoiditis refers to an inflammation of the temporal bone behind the ear. Manifestations of mastoiditis include swelling and pain behind the ear. Incorrect Answers: B. Facial drooping can be a manifestation of a tympanoplasty, but it is not a manifestation of mastoiditis. C. Bilateral nystagmus can be a manifestation of labyrinthitis, but it is not a manifestation of mastoiditis. D. A pearly gray eardrum indicates a healthy eardrum. A red, thick eardrum is a manifestation of mastoiditis.

The nurse is invited to present a teaching program to parents of school-aged children. Which topic would be of greatest value for decreasing cancer risks?

Sun safety and use of sunscreen

A nurse is caring for a client who is receiving brachytherapy. Which of the following measures should the nurse include in the client's plan of care? A. Plan to spend extra time with the client to provide emotional support. B. Ensure that chemotherapy medications do not extravasate into the client's tissues. C. Keep the door to the client's room closed. D. Encourage family members and friends to visit for at least 1 hr per day.

Correct Answer: C. Keep the door to the client's room closed. Brachytherapy is a type of radiation therapy during 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.

A nurse is monitoring 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? A. Take a photograph of the peripheral IV site B. Obtain and record the client's vital signs C. Stop the infusion D. Identify all medications administered through the IV site for the past 24 hr

Correct Answer: C. Stop the infusion When applying the urgent versus nonurgent priority-setting framework, the nurse should consider urgent needs to be 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, and/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 for documentation of 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 admitting a client who has multiple myeloma and a white blood cell count of 2,200/mm^3. Which of the following foods should the nurse prohibit the family members from bringing to the client? A. Fried chicken from a fast food restaurant B. A case of canned nutritional supplements C. A factory-sealed box of chocolates D. A fresh fruit basket

Correct Answer: D. A fresh fruit basket Raw fruits and vegetables are contraindicated for a client who has neutropenia, as the skin of these food items might harbor bacteria that can cause an infection. The nurse should prohibit these foods from entering the client's room.

A nurse is teaching a client how to perform a breast self-examination (BSE). The nurse should identify which of the following findings as an indication of breast cancer? A. Lumps that are mobile and tender on palpation prior to a menstrual period B. Multiple round masses that are tender and found in both breasts C. Bilaterally darkened areolas D. A nontender, hard lump that is palpated in a breast

Correct Answer: D. 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.

A nurse is providing teaching to 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? A. "I should use petroleum-based lotions on the areas being radiated." B. "I will dry the areas being radiated by rubbing in a circular pattern." C. "I will apply sunscreen to the areas being radiated when I spend time in the sun." D. "I should use my hand, instead of a washcloth, to wash the areas being radiated."

D. "I should use my hand, instead of a washcloth, to wash the areas being radiated."

Based on the understanding of the effects of chemotherapy, the nurse would anticipate which of the following clinical findings in a client 2 weeks posttherapy?

Ease of bruising

Chemotherapy has been used for the past 3 months to treat a client with pancreatic cancer. The CA 19-9 levels are rising. Which explanation would the nurse attribute as the most likely cause?

The cancer is growing despite the chemotherapy treatment.

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

Extravasation

A client is scheduled for a nerve-sparing prostatectomy. The emotional spouse confides in the nurse that the client will not talk about the cancer and/or upcoming surgery. Which nursing diagnosis will the nurse choose as primary diagnosis for this client?

Fear

The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important?

Flush the toilet twice after every use.

The nurse understands that the client should be vaccinated with human papilloma virus (HPV) vaccine per the health care provider's orders. What is this vaccine for?

Helps prevent cervical cancer

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

How they tend to grow and the cell type

When providing care for a client with stage IV cancer, the nurse knows to include which intervention in the plan of care?

Incorporating touching and listening

While completing an admission assessment, the client reports a family history of ovarian cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology?

Inherited gene mutation

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.

The nurse performs a breast examination on a client and finds a firm, nonmoveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest?

Malignant tumor

Cancer has many characteristics. What is one of the most discouraging characteristics of cancer?

Metastasis

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 the client closely to prevent infection.

The public health nurse is giving a talk on the warning signals of cancer to a local community group. Which of the following are the warning signals of cancer? Select all that apply. A. Persistent indigestion B. Sores that don't heal C. Yellow discoloration of body area D. Unusual bleeding or discharge E. Tenderness or pain

Persistent indigestion Sores that don't heal Unusual bleeding or discharge

The client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse?

Tumor pressure agains normal tissue.

The nurse is providing an educational presentation on dietary recommendations for reducing the risk of cancer. Which of the following food selections would demonstrate a good understanding of the information provided in the presentation? Select all that apply. A. Vegetable and cheddar quiche B. Turkey breast on whole wheat bread C. Crispy chicken Caesar salad D. Smoked salmon E. Steamed broccoli and carrots F. Egg white omelet with spinach and mushrooms

Turkey breast on whole wheat bread Steamed broccoli and carrots. Egg white omelet with spinach and mushrooms