Cancer Part 2

A patient presents to the emergency department with syndrome of inappropriate antidiuretic hormone (SIADH) because of breast cancer metastasis to the brain. Which finding would the nurse expect in the laboratory results? Select all that apply. A. Hyperkalemia B. Hyponatremia C. Hypercalcemia D. Hyperuricemia E. Hypophosphatemia

B

At the beginning of the shift, a patient with multiple myeloma reports nausea, vomiting, and bone pain. After noticing the patient has hypoactive bowel sounds, which laboratory result would the nurse review? A. Sodium B. Calcium C. Uric acid D. Creatinine

B

By monitoring for fluid overload in a patient with a cancer-associated syndrome of inappropriate antidiuretic hormone, which complication is the nursing trying to prevent? A. Infection B. Heart failure C. Hypovolemic shock D. Deep vein thrombosis

B

Which chemotherapy agent inhibits cell division in cancer cells by cross-linking their DNA and preventing the synthesis of DNA and ribonucleic acid (RNA)? A. Antimetabolites B. Alkylating agents C. Antimitotic agents D. Antitumor antibiotics

B

Which chemotherapy drug is an alkylating agent? A. Erlotinib B. Cisplatin C. Everolimus D. Capecitabine

B

Which complication would the nurse expect to find in a patient diagnosed with multiple myeloma? A. Amnesia B. Hypercalcemia C. Superior vena cava syndrome D. Syndrome of inappropriate antidiuretic hormone

B

Which drug classification is used for the treatment of cancer-induced spinal cord compression? A. Diuretics B. Corticosteroids C. Bisphosphonates D. Xanthine oxidase inhibitor

B

Which drug would the nurse administer to prevent acute kidney injury from tumor lysis syndrome when caring for a patient beginning high-dose chemotherapy for the treatment of leukemia? A. Tamoxifen B. Allopurinol C. Anastrozole D. Darbepoetin

B

Which information would the nurse include when teaching a patient beginning chemotherapy for leukemia on ways to prevent tumor lysis syndrome (TLS)? Select all that apply. A. Avoid crowded areas. B. Consume 3000 mL/day of fluids. C. Elevate lower extremities. D. Refrain from taking NSAIDs. E. Take sodium polystyrene sulfonate.

B

Which method of radiation treatment delivery uses radioactive isotopes either in solid form or within body fluids? A. Teletherapy B. Brachytherapy C. Stereotactic body radiotherapy (SBRT) D. Intensity-modulated radiation therapy (IMRT)

B

Which oncologic emergency is a positive sign of the effectiveness of chemotherapy? A. Hypercalcemia B. Tumor lysis syndrome C. Spinal cord compression D. Superior vena cava syndrome

B

A patient has developed syndrome of inappropriate antidiuretic hormone (SIADH) because of cancer treatment. If the patient has a sodium level of 122 mEq/L, which finding indicates a need for immediate health care provider (HCP) notification? Select all that apply. A. Muscle weakness B. Distended neck veins C. Oxygen saturation 86% D. Crackles in all lung fields E. Hypoactive bowel sounds

B, C, D

Which manifestation may indicate spinal cord compression (SCC) in a patient with cancer? Select all that apply. A. Cyanosis B. Back pain C. Hemorrhage D. Muscle weakness E. Sensation of heaviness in arms and legs

B, D, E

Which manifestation may occur if superior vena cava syndrome is left untreated? Select all that apply. A. Edema of the face B. Engorged blood vessels C. Tightness of blouse or shirt D. Erythema of the upper body E. Edema in the arms and hands

B, D, E

Which precaution would the nurse take when providing care to patients with sealed radioactive implants? Select all that apply. A. Use a shared dosimeter film badge for the patient. B. Assign the patient to a private room with a private bath. C. Remove linens and dressings from the room immediately after use. D. After 12 weeks of pregnancy, pregnant nurses may care for these patients. E. Wear a lead apron during care, keeping the apron between the nurse and the patient.

B, E

A patient receiving radiation for cancer treatment has cloudy urine, flank pain, muscle weakness, and vomiting. Which occurrence would the nurse suspect as the reason for these findings? A. Decreased blood platelet count B. Compression of the superior vena cava C. Large number of destroyed tumor cells D. Collapse of vertebrae from tumor degradation

C

During the infusion of rituximab, it is essential for the nurse to observe for which side effect? A. Fever B. Chills C. Allergy D. Alopecia

C

Which cancer therapy may alter taste and cause fatigue? A. Chemotherapy B. Surgical therapy C. Radiation therapy D. Molecularly targeted therapy

C

Which component is released into the bloodstream after the destruction of tumor cells? A. Calcium B. Sodium C. Potassium D. Magnesium

C

Which intervention would the nurse utilize to prevent disseminated intravascular coagulation (DIC)? A. Monitor platelets. B. Administer packed red blood cells. C. Use strict aseptic technique to prevent infection. D. Administer low-dose heparin therapy for patients on bedrest.

C

Which law or practice guideline did the Occupational Safety and Health Administration (OSHA) and the Oncology Nursing Society (ONS) establish? A. Patients have the right to be free of restraint in hospitals and nursing homes. B. Staff should stay at least 3 ft away from a patient with a droplet-borne infection. C. Personal protective equipment (PPE) should be used when handling chemotherapy drugs. D. Patients seen in an emergency department must have emergency medical screening examinations.

C

Which route of administration is preferable for chemotherapy treatment of ovarian cancer? A. Intrathecal B. Intravesicular C. Intraperitoneal D. Intraventricular

C

Which statement describes the mechanism by which chemotherapy can cure and increase survival time in individuals with cancer? A. "Fortunately, most chemotherapy agents have a special affinity for cancer cells." B. "Metastatic areas of cancer are difficult for chemotherapy to penetrate effectively." C. "The killing effect on cancer cells is related to the ability to damage DNA and interfere with cell division." D. "Slow-growing tumors are most sensitive to the DNA damage caused by chemotherapy agents."

C

Which therapy is effective in returning antidiuretic hormone production to normal levels in a patient with melanoma? A. Fluoxymesterone B. Medroxyprogesterone C. Cancer therapy with radiation D. IV infusions of glucose and insulin

C

When caring for a patient receiving cancer chemotherapy, which sign related to thrombocytopenia would the nurse report to the health care provider? Select all that apply. A. Pallor B. Fever C. Bruises D. Petechiae E. Epistaxis

C, D, E

A patient received chemotherapy 2 weeks ago and presents with possible septic shock. Which finding in the health record would support this diagnosis? Select all that apply. A. Periorbital edema B. Absent bowel sounds C. 100.4°F (38°C) temperature D. Serum sodium level 115 mEq/L E. White blood cell (WBC) count 0.8 cells/mm3

C, E

Which term would be used to describe the occurrence of when bone marrow activity and white blood cell counts are at their lowest levels after chemotherapy? A. Nadir B. Neutropenia C. Thrombocytopenia D. Bone marrow suppression

A

Which therapy is the best option for long-term control of the cancer that causes superior vena cava syndrome? A. Chemotherapy B. Oral hydration C. Erlotinib therapy D. Everolimus therapy

A

Which treatment strategy increases the risk for developing tumor lysis syndrome? A. Chemotherapy B. Antibiotic therapy C. Antiemetic therapy D. Benzodiazepine therapy

A

Which treatment would be provided to a patient with spinal cord compression to rearrange the bony tissue? A. Surgery B. Everolimus C. Epoetin alfa D. Parenteral fluid

A

Which occurrence is the most common cause of life-threatening infections in patients with bone marrow suppression? A. Overgrowth of the patient's own normal flora B. Exposure to individuals who harbor an infection C. Inadequate hand-washing when handling food products D. Poor hand hygiene when performing personal cleansing

A

Which drug is used in the treatment of superior vena cava (SVC) syndrome because of a tunneled central venous catheter? A. Warfarin B. Filgrastim C. Allopurinol D. Furosemide

A

Which term describes the administration of chemotherapy along with surgery or radiation? A. Adjuvant therapy B. Combination chemotherapy C. Intraperitoneal chemotherapy D. Curative intent chemotherapy

A

At the beginning of the shift, the nurse assesses a patient with superior vena cava (SVC) syndrome. Upon noting stridor when auscultating the lung fields, which action would the nurse take next? A. Notify the Rapid Response Team. B. Document intake and output. C. Administer IV diuretics. D. Obtain a CT scan

A

The laboratory report of a patient with cancer shows serum sodium levels of 108 mEq/L. Which complication would the nurse anticipate in the patient? A. Seizures B. Amnesia C. Neutropenia D. Somnolence syndrome

A

Which cytoprotectant is given to decrease bladder toxicity and prevent hemorrhagic cystitis from ifosfamide and high doses of cyclophosphamide? A. Mesna B. Sucralfate C. Amifostine D. Misoprostol

A

Which drug category does decitabine, an oral chemotherapeutic agent, belong to? A. Antimetabolite B. Multikinase inhibitor C. Tyrosine kinase inhibitor D. Topoisomerase inhibitor

A

Which role does pharmacogenomics play in cancer treatment? Select all that apply. A. It can assist with side effect management during therapy. B. It allows a more individualized approach to chemotherapy. C. It can determine the sensitivity to various therapeutic agents. D. It can determine the overall financial cost of planned therapy. E. Its role is still to be determined because of its experimental status.

A, B, C

Which personal protective equipment (PPE) is necessary when preparing, giving, or disposing of chemotherapy drugs? Select all that apply. A. Mask B. Gown C. Gloves D. Head gear E. Eye shield

A, B, C, E

Which potential side effect would the nurse include in the teaching plan for a patient undergoing radiation therapy for laryngeal cancer? Select all that apply. A. Fatigue B. Change in taste C. Difficulty swallowing D. Changes in color of hair E. Changes in skin of the neck

A, B, C, E

The effect of chemotherapy agents on normal cells in the body may affect which component? Select all that apply. A. Skin B. Hair C. Nerve tissue D. Intestinal tissue E. Spermatocytes F. Blood-forming cells

A, B, D, E, F

Which intervention would the nurse plan to implement when caring for a patient with neutropenia? Select all that apply. A. Assess for fever. B. Observe for bleeding. C. Administer pegfilgrastim. D. Do not permit fresh flowers or plants in the room. E. Do not allow the patient's 16-year-old child to visit. F. Teach the patient to omit raw fruits and vegetables from the diet.

A, C, D, F

Which radiation therapy-related information is important for the nurse to reinforce in a patient who has just completed combination radiation and chemotherapy? Select all that apply. A. Skin in the radiation's path remains more sensitive to sunburn; therefore avoid direct skin exposure for 1 year after therapy. B. Sexually active individuals should be certain to utilize adequate birth control measures to prevent risk to an unborn child. C. The combination of simultaneous chemotherapy and radiation therapy will provide assurance that the cancer will be eradicated. D. Fatigue may last for months after therapy ends; therefore continue to utilize energy conservation measures and exercise regularly. E. Tissue fibrosis and scarring can occur years after treatment because of the inflammatory response that occurred to the cancerous tissue in the tumor during the treatment.

A, D

Which adverse effect is observed when a vesicant agent extravasates during chemotherapy? Select all that apply. A. Pain B. Itching C. Redness D. Infection E. Tissue loss

A, D, E

Which occurrence is because of side effects of chemotherapy on bone marrow? Select all that apply. A. Anemia B. Alopecia C. Mucositis D. Neutropenia E. Thrombocytopenia

A, D, E

A patient has developed hypercalcemia secondary to cancer. Which drug would the nurse expect to administer to increase urine excretion of calcium? A. Calcitonin B. Allopurinol C. Furosemide D. Hydrochlorothiazide

C

Patients receiving hormonal chemotherapy agents are at risk for the development of which side effect? Select all that apply. A. Fatigue B. Arthralgia C. Hot flashes D. Sexual dysfunction E. Thromboembolism

All the Above

Which action would the nurse include in the plan of care for a patient with metastatic cancer diagnosed with new-onset spinal cord compression (SCC) who is unable to ambulate? Select all that apply. A. Provide skin care. B. Turn the patient every 2 hours. C. Initiate bladder training. D. Apply an external back brace. E. Administer corticosteroids.

All the Above

Which assessment finding would the nurse expect when caring for a patient with spinal cord compression (SCC)? Select all that apply. A. Back pain B. Incontinence C. Muscle weakness D. Decreased sensation E. Absent deep tendon reflexes

All the Above

Which principle guides the nurse in planning care for a patient receiving radiation therapy? Select all that apply. A. Radiation therapy is not regarded as a curative treatment for cancer. B. The inflammatory response to radiation can lead to internal tissue fibrosis and scarring that may cause changes years later. C. The skin reaction seen with external beam radiation therapy is short-term only; once it is healed there is little need for concern. D. Taste changes are only a concern for patients receiving radiation therapy to a field that includes the salivary glands in the mouth. E. Although the mechanism is not well understood, patients receiving radiation therapy even when focused to a specific field may experience significant fatigue.

B, E

Breast reconstruction after a mastectomy is an example of which surgery type? A. Palliative B. Prophylactic C. Second-look D. Reconstructive

D

Intraperitoneal chemotherapy is delivered to which part of the body? A. Lung B.Heart C. Veins of the legs D. Abdominal cavity

D

Which class of medications treats chemotherapy-induced nausea and vomiting? A. Diuretics B. Corticosteroids C. Bisphosphonates D. Serotonin antagonists

D

Which complication may occur as a result of bacterial sepsis in a patient with cancer? A. Pneumonia B. Gynecomastia C. Somnolence syndrome D. Disseminated intravascular coagulation

D

Which information would the nurse include when teaching a patient about radiation therapy for treating cancer? A. Drink 500 mL of fluid the day before the radiation therapy. B. Stay on NPO the day before the therapy. C. Avoid consuming alkaline fluids the day before the radiation therapy. D. Drink 3000 mL of fluid the day before and on the day of radiation therapy.

D

Which medication may be used to prevent severe anemia caused by chemotherapy? A. Oprelvekin B. Filgrastim C. Ondansetron D. Darbepoetin alfa

D

Which medication may be used to treat hypercalcemia temporarily in a patient who has cancer? A. Sunitinib B. Febuxostat C. Temsirolimus D. Bisphosphonate

D

Which occurrence is a manifestation of disseminated intravascular coagulation? A. Pruritus B. Muscle aches C. Penile atrophy D. Bowel necrosis

D

Which occurrence is an early manifestation of superior vena cava syndrome in a patient with cancer? A. Cyanosis B. Hemorrhage C. Hypotension D. Facial edema

D

Which risk is associated with a low leukocyte count after chemotherapy? A. Fatigue B. Hypoxia C. Bleeding D. Infection

D

Which treatment to reduce the symptoms of superior vena cava (SVC) syndrome would the nurse anticipate incorporating into a patient's plan of care? A. Bicalutamide B. Oral hydration C. Glucocorticoid D. High-dose radiation therapy

D