Ch. 15 Cancer

6. A patient who is diagnosed with cervical cancer that is classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is most appropriate? a. "The cancer involves only the cervix." b. "The cancer cells look almost like normal cells." c. "Further testing is needed to determine the spread of the cancer." d. "It is difficult to determine the original site of the cervical cancer."

The cancer involves only the cervix

13. A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. The nurse teaches the patient about management of the skin reaction. Which statement, if made by the patient, indicates the teaching was effective? a. "I can buy some aloe vera gel to use on the area." b. "I will expose the treatment area to a sun lamp daily." c. "I can use ice packs to relieve itching in the treatment area." d. "I will scrub the area with warm water to remove the scales."

a. I can buy some aloe vera gel to use on the area.

22. Interleukin-2 (IL-2) is used as adjuvant therapy for a patient with metastatic renal cell carcinoma. Which information should the nurse include when explaining the purpose of this therapy to the patient? a. IL-2 enhances the immunologic response to tumor cells. b. IL-2 stimulates malignant cells in the resting phase to enter mitosis. c. IL-2 prevents the bone marrow depression caused by chemotherapy. d. IL-2 protects normal cells from the harmful effects of chemotherapy.

a. IL-2 enhances the immunologic response to tumor cells

37. The nurse assesses a patient with non-Hodgkin's lymphoma who is receiving an infusion of rituximab (Rituxan). Which assessment finding would require the most rapid action by the nurse? a. Shortness of breath b. Temperature 100.2° F (37.9° C) c. Shivering and complaint of chills d. Generalized muscle aches and pains

a. shortness of breath

25. The nurse teaches a patient with cancer of the liver about high-protein, high-calorie diet choices. Which snack choice by the patient indicates that the teaching has been effective? a. Lime sherbet b. Blueberry yogurt c. Cream cheese bagel d. Fresh strawberries and bananas

b. blueberry yogurt

The patient has osteosarcoma of the right leg. The UAP reports that the patients vital signs are normal, but the patient says he still has pain in his leg and it is getting worse. Which question would best determine treatment measures for the patients pain. a. where is the pain b. is the pain getting worse c. what does the pain feel like d. Do you use medications to relieve the pain

c. what does the pain feel like

Which item would be most beneficial when providing oral care to a patient with metastatic cancer who is at risk for oral tissue injury secondary to chemotherapy. a. firm-bristle toothbrush b. hydrogen peroxide rinse c. alcohol based mouthwash d. 1 tsp salt in 1 L water mouth rinse

d. 1 tsp salt in 1 L water mouth rinse

The nurse is caring for a patient suffering from anorexia secondary to chemotherapy. Which strategy would be most appropriate to increase the patients nutritional intake. a. Increase intake of liquids at mealtime to stimulate appetite b. Serve three large meals per day plus snacks between each meal c. Avoid the use of liquid protein supplements to encourage eating at mealtimes d. Add items such as skim milk powder, cheese, honey, or peanut butter to selected foods.

d. Add items such as skim milk powder, cheese, honey, or peanut butter to selected foods.

Patients may reduce the risk of developing cancer using health promotion strategies. Identify strategies which can reduce the risk of developing cancer. Select all. a. control weight. b. genetic testing c. immunizations d. use sunscreen e. stop smoking f. limit alcohol intake

a, b, c, d, e, f

Previous administrations of chemotherapy agents to a cancer patient have resulted in diarrhea. Which dietary modification should the nurse recommend? a. A bland, low fiber diet. b. A high-protein, high calorie diet. c. A diet high in fresh fruits and vegetables. d. A diet emphasizing whole and organic foods.

a. A bland, low fiber diet. rationale: patients experiencing diarrhea secondary to chemotherapy or radiation therapy often benefit from a diet low in seasonings and roughage before the treatment

2. A patient develops neutropenia after receiving chemotherapy. Which information about ways to prevent infection will the nurse include in the teaching plan (select all that apply)? a. Cook food thoroughly before eating. b. Choose low fiber, low residue foods. c. Avoid public transportation such as buses. d. Use rectal suppositories if needed for constipation. e. Talk to the oncologist before having any dental work done.

a. cook food thoroughly before eating c. avoid public transportation such as buses e. talk to the oncologist before having any dental work done.

23. The home health nurse cares for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient indicates a need for further assessment? a. "I have frequent muscle aches and pains." b. "I rarely have the energy to get out of bed." c. "I experience chills after I inject the interferon." d. "I take acetaminophen (Tylenol) every 4 hours."

b. I rarely have the energy to get out of bed.

39. The nurse is caring for a patient with left-sided lung cancer. Which finding would be most important for the nurse to report to the health care provider? a. Hematocrit 32% b. Pain with deep inspiration c. Serum sodium 126 mEq/L d. Decreased breath sounds on left side

c. serum sodium 126 mEq/L

21. A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective? a. The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale). b. The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness. c. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs. d. The patient states that nonopioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief.

c. the patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.

2. The nurse is caring for a patient receiving intravesical bladder chemotherapy. The nurse should monitor for which adverse effect? a. Nausea b. Alopecia c. Mucositis d. Hematuria

d. Hematuria

The patient is receiving an IV vesicant chemotherapy drug. The nurse notices swelling and redness at the site. What should the nurse do first. a. Ask the patient if the site hurts. b. Turn off the Chemotherapy infusion c. Call the ordering HCP d. Administer sterile saline to the reddened area.

b. turn off the chemotherapy

Which nursing diagnosis is most appropriate for a patient experiencing myelosuppression secondary to chemotherapy for cancer treatment a. acute pain b. hypothermia c. powerlessness d. risk for infection

d. risk for infection rationale: myelosuppression is accompanied by a high of infection and sepsis.

A 70 yr old man who has end stage lung cancer is admitted to the hospital with confusion and oliguria for 2 days. Which finding would the nurse report immediately to the HCP a. Weight gain of 6 lb b. nausea and vomiting c. urine specific gravity of 1.004 d. serum sodium level of 118 mEq/L

d. serum sodium level of 118 mEq/L

The patient and his family are upset that the patient is going through procedures to diagnose cancer. What nursing actions should the nurse use first to facilitate their coping with this situation a. maintain hope b. exhibit a caring attitude c. plan realistic long term goals d. give them antianxiety medications e. be available to listen to fears and concerns. f. Teach them about the types of cancer that could be diagnosed.

a, b, e,

The nurse assesses a 76-yr-old man with chronic myeloid leukemia receiving chemotherapy using a kinase inhibitor medication. Which question is most important for the nurse to ask? a. Have you had a fever b. Have you lost any weight? c. has diarrhea been a problem d. have you noticed any hair loss

a. have you had a fever rationale: an adverse effect of kinase inhibitors is neutropenia.

12. The nurse is caring for a patient with colon cancer who is scheduled for external radiation therapy to the abdomen. Which information obtained by the nurse would indicate a need for patient teaching? a. The patient swims a mile 3 days a week. b. The patient snacks frequently during the day. c. The patient showers everyday with a mild soap. d. The patient has a history of dental caries with amalgam fillings.

a. the patient swims a mile 3 days a week

20. A widowed mother of four school-age children is hospitalized with metastatic ovarian cancer. The patient is crying and tells the nurse that she does not know what will happen to her children when she dies. Which response by the nurse is most appropriate? a. "Why don't we talk about the options you have for the care of your children?" b. "I'm sure you have friends that will take the children when you can't care for them." c. "For now you need to concentrate on getting well and not worrying about your children." d. "Many patients with cancer live for a long time, so there is still time to plan for your children."

a. why dont we talk about the options you have for the care of your children

34. The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention? a. The UAP flushes the toilet once after emptying the patient's bedpan. b. The UAP stands by the patient's bed for 30 minutes talking with the patient. c. The UAP places the patient's bedding in the laundry container in the hallway. d. The UAP gives the patient an alcohol-containing mouthwash to use for oral care.

b. The UAP stands by the patients bed for 30 minutes talking with the patient

38. A patient who is being treated for stage IV lung cancer tells the nurse about new-onset back pain. Which action should the nurse take first? a. Give the patient the prescribed PRN opioid. b. Assess for sensation and strength in the legs. c. Notify the health care provider about the symptoms. d. Teach the patient how to use relaxation to reduce pain.

b. assess for sensation and strength in the legs

16. A chemotherapy drug that causes alopecia is prescribed for a patient. Which action should the nurse take to maintain the patient's self-esteem? a. Tell the patient to limit social contacts until regrowth of the hair occurs. b. Encourage the patient to purchase a wig or hat and wear it once hair loss begins. c. Teach the patient to gently wash hair with a mild shampoo to minimize hair loss. d. Inform the patient that hair usually grows back once the chemotherapy is complete.

b. encourage the patient to purchase a wig or hat and wear it once hair loss begins

11. A patient with Hodgkin's lymphoma who is undergoing external radiation therapy tells the nurse, "I am so tired I can hardly get out of bed in the morning." Which intervention should the nurse add to the plan of care? a. Minimize activity until the treatment is completed. b. Establish time to take a short walk almost every day. c. Consult with a psychiatrist for treatment of depression. d. Arrange for delivery of a hospital bed to the patient's home.

b. establish time to take a short walk almost every day.

The nurse is caring for a patient receiving an initial dose of chemotherapy to treat a rapidly growing metastatic colon cancer. The nurse is aware that the patient is at risk for tumor lysis syndrome (TLS) and will monitor for which abnormality associated with this oncologic emergency. a. hypokalemia b. hypocalcemia c. hypouricemia d. hypophosphatemia

b. hypocalcemia

4. The nurse should include which food choice when providing dietary teaching for a patient scheduled to receive external beam radiation for abdominal cancer? a. Fresh fruit salad b. Roasted chicken c. Whole wheat toast d. Cream of potato soup

b. roasted chicken

15. The nurse administers an IV vesicant chemotherapeutic agent to a patient. Which action is most important for the nurse to take? a. Infuse the medication over a short period of time. b. Stop the infusion if swelling is observed at the site. c. Administer the chemotherapy through a small-bore catheter. d. Hold the medication unless a central venous line is available.

b. stop the infusion if swelling is observed at the site.

The patient was told that he would have intraperitoneal chemotherapy. He asks the nurse when the IV will be started for the chemotherapy. What should the nurse teach the patient about this type of chemotherapy delivery. a. It is delivered via an Ommaya reservoir and extension catheter b. It is instilled in the bladder via a urinary catheter and retained for 1 to 3 hours. c. A Silastic catheter will be percutaneously placed in the abdomen for chemotherapy administration d. The arteries supplying the tumor are accessed with surgical placement of a catheter connected to an infusion pump

c. A Silastic catheter will be percutaneously placed in the abdomen for chemotherapy administration

A patient with breast cancer is having teletherapy radiation treatments after her surgery. What should the nurse teach the patient about the care of her skin. a. Use dial soap to feel clean and fresh b. Scented lotion can be used on the area. c. Avoid the heat and cold to the treatment area. d. Wear the new bra to comfort and support the area.

c. Avoid the heat and cold to the treatment area.

29. The nurse is caring for a patient who has been diagnosed with stage I cancer of the colon. When assessing the need for psychologic support, which question by the nurse will provide the most information? a. "How long ago were you diagnosed with this cancer?" b. "Do you have any concerns about body image changes?" c. "Can you tell me what has been helpful to you in the past when coping with stressful events?" d. "Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?"

c. can you tell me what has been helpful to you in the past when coping with stressful events.

10. External-beam radiation is planned for a patient with cervical cancer. What instructions should the nurse give to the patient to prevent complications from the effects of the radiation? a. Test all stools for the presence of blood. b. Maintain a high-residue, high-fiber diet. c. Clean the perianal area carefully after every bowel movement. d. Inspect the mouth and throat daily for the appearance of thrush.

c. clean the perineal area carefully after every bowel movement.

3. The nurse is caring for a patient who smokes 2 packs/day. To reduce the patient's risk of lung cancer, which action by the nurse is best? a. Teach the patient about the seven warning signs of cancer. b. Plan to monitor the patient's carcinoembryonic antigen (CEA) level. c. Discuss the risks associated with cigarettes during every patient encounter. d. Teach the patient about the use of annual chest x-rays for lung cancer screening.

c. discuss the risks associated with cigarettes during every patient encounter

8. The nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. Which patient statement indicates that the teaching has been effective? a. "After cancer has not recurred for 5 years, it is considered cured." b. "The cancer will be cured if the entire tumor is surgically removed." c. "Cancer is never considered cured, but the tumor can be controlled with surgery, chemotherapy, and radiation." d. "I will need to have follow-up examinations for many years after I have treatment before I can be considered cured."

d. I will need to have follow-up examinations for many years after I have treatment before I can be considered cured.

The patient is being treated with brachytherapy for cervical cancer. What factors must the nurse be aware of to protect herself when caring for this patient. a. The medications the patient is taking b. the nutritional supplements that will help the patient c. how much time is needed to provide the patients care d. The time the nurse spends at what distance from the patient.

d. The time the nurse spends at what distance from the patient.

32. The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which laboratory result is most important to report to the health care provider? a. Hematocrit of 30% b. Platelets of 95,000/µL c. Hemoglobin of 10 g/L d. White blood cell (WBC) count of 2700/µL

d. White blood cell (WBC) count of 2700/uL

A 33-yr-old patient has recently been diagnosed with stage II cervical cancer. Which statement by the nurse best explains the diagnosis? a. the cancer is found at the point of origin only b. Tumor cells have been identified in the cervical region c. The cancer has been identified in the cervix and the liver d. Your cancer was identified in the cervix and has limited local spread

d. Your cancer was identified in the cervix and has limited local spread

The patient is receiving immunotherapy and targeted therapy for ovarian cancer. What medication should the nurse expect to administer before therapy to combat the most common side effects of these medications a. morphine sulfate b. Ibuprofen (Advil) c. Ondansetron (Zofran) d. Acetaminophen (Tylenol)

d. acetaminophen is administered before therapy and every 4 hours to prevent or decrease the intensity of the severe flu-like symptoms

19. A patient has been assigned the nursing diagnosis of imbalanced nutrition: less than body requirements related to painful oral ulcers. Which nursing action will be most effective in improving oral intake? a. Offer the patient frequent small snacks between meals. b. Assist the patient to choose favorite foods from the menu. c. Provide teaching about the importance of nutritional intake. d. Apply the ordered anesthetic gel to oral lesions before meals.

d. apply the ordered anesthetic gel to oral lesions before meals

30. The nurse assesses a patient who is receiving interleukin-2. Which finding should the nurse report immediately to the health care provider? a. Generalized muscle aches b. Complaints of nausea and anorexia c. Oral temperature of 100.6° F (38.1° C) d. Crackles heard at the lower scapular border

d. crackles heard at the lower scapular border

17. A patient who has ovarian cancer is crying and tells the nurse, "My husband rarely visits. He just doesn't care." The husband indicates to the nurse that he never knows what to say to help his wife. Which nursing diagnosis is most appropriate for the nurse to add to the plan of care? a. Compromised family coping related to disruption in lifestyle b. Impaired home maintenance related to perceived role changes c. Risk for caregiver role strain related to burdens of caregiving responsibilities d. Dysfunctional family processes related to effect of illness on family members

d. dysfunctional family processes related to effect of illness on family members

A patient has been diagnosed with Burkitt's lymphoma. In the initiation stage of cancer, the cells genetic structure is mutated. Exposure to what may have functioned as a carcinogen for this patient. a. bacteria b. Sun exposure c. Most chemicals d. epstein-Barr virus

d. epstein-Barr virus

A patient has multiple myeloma and will be treated with autologous hematopoietic stem cell transplantation because a suitable donor has not been found. In which order will the following procedures occur. a. myeloablative chemotherapy is administered. b. stem cells are infused after chemotherapy has been eliminated from the body c. peripheral stem cells are obtained from the peripheral blood in an outpatient procedure. d. filgrastim, a granulocyte colony-stimulating factor, is administered with plerixafor (Mozobil) e. Stem cells are treated to remove undetected cancer cells then cryopreserved and stored until needed.

d. filgrastim, a granulocyte colony-stimulating factor, is administered with plerixafor (Mozobil) c. peripheral stem cells are obtained from the peripheral blood in an outpatient procedure. e. Stem cells are treated to remove undetected cancer cells then cryopreserved and stored until needed. a. myeloablative chemotherapy is administered. b. stem cells are infused after chemotherapy has been eliminated from the body

24. A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). The nurse will include which information in the patient's teaching plan? a. Transplant of the donated cells is painful because of the nerves in the tissue lining the bone. b. Donor bone marrow cells are transplanted through an incision into the sternum or hip bone. c. The transplant procedure takes place in a sterile operating room to minimize the risk for infection. d. Hospitalization will be required for several weeks after the stem cell transplant procedure is performed.

d. hospitalization will be required for several weeks after the stem cell transplant procedure is performed.

When caring for the patient with cancer, what does the nurse understand as the response of the immune system to antigens of the malignant cells. a. metastasis b. tumor angiogenesis c. immunologic escape d. immunologic surveillance

d. immunologic surveillance rationale: process in which lymphocytes check cell surface antigens and detect and destroy cells with abnormal or altered antigenic determinants to prevent these cells from developing into clinically detectable tumors.

31. The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer. Which information about the patient alerts the nurse to discuss a possible change in therapy with the health care provider? a. Poor oral intake b. Frequent loose stools c. Complaints of nausea and vomiting d. Increase in carcinoembryonic antigen (CEA)

d. increase in carcinoembryonic antigen (CEA)

40. An older adult patient who has colorectal cancer is receiving IV fluids at 175 mL/hour in conjunction with the prescribed chemotherapy. Which finding by the nurse is most important to report to the health care provider? a. Patient complains of severe fatigue. b. Patient needs to void every hour during the day. c. Patient takes only 50% of meals and refuses snacks. d. Patient has audible crackles to the midline posterior chest.

d. patient has audible crackles to the midline posterior chest

The lab reports that the cells from the patients tumor biopsy are grade 2. What should the nurse know about this histologic grading? a. Cells are abnormal and moderately differentiated. b. cells are very abnormal and poorly differentiated c. Cells are immature, primitive, and undifferentiated. d. Cells differ slightly from normal cells and are well-differentiated.

a. Cells are abnormal and moderately differentiated.

33. When caring for a patient who is pancytopenic, which action by unlicensed assistive personnel (UAP) indicates a need for the nurse to intervene? a. The UAP assists the patient to use dental floss after eating. b. The UAP adds baking soda to the patient's saline oral rinses. c. The UAP puts fluoride toothpaste on the patient's toothbrush. d. The UAP has the patient rinse after meals with a saline solution.

a. The UAP assists the patient to use dental floss after eating

1. The nurse at the clinic is interviewing a 64-year-old woman who is 5 feet, 3 inches tall and weighs 125 pounds (57 kg). The patient has not seen a health care provider for 20 years. She walks 5 miles most days and has a glass of wine 2 or 3 times a week. Which topics will the nurse plan to include in patient teaching about cancer screening and decreasing cancer risk (select all that apply)? a. Pap testing b. Tobacco use c. Sunscreen use d. Mammography e. Colorectal screening

a. pap testing c. sunscreen use d. mammography e. colorectal screening

Which patient is statistically and medically at the highest risk for developing cancer. a. a 68 yr old woman who has a BRCA-1 gene and is obese. b. A 56 yr old African american man with Hep C who drinks alcohol daily c. An 18 yr old hispanic man who eats fast food once per week and drinks alcohol. d. An 80 yr old Asian woman with coronary artery disease on blood pressure medication

b. A 56 yr old African american man with Hep C who drinks alcohol daily

28. A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse would indicate a need for further teaching? a. The patient ambulates several times a day in the room. b. The patient's visitors bring in some fresh peaches from home. c. The patient cleans with a warm washcloth after having a stool. d. The patient uses soap and shampoo to shower every other day.

b. the patients visitors bring in some fresh peaches from home

7. The nurse teaches a patient who is scheduled for a prostate needle biopsy about the procedure. Which statement, if made by the patient, indicates that teaching was effective? a. "The biopsy will remove the cancer in my prostate gland." b. "The biopsy will determine how much longer I have to live." c. "The biopsy will help decide the treatment for my enlarged prostate." d. "The biopsy will indicate whether the cancer has spread to other organs."

c. the biopsy will help decide the treatment for my enlarged prostate

A female patient is having chemotherapy for brain metastasis. She is concerned about how she will look when she loses her hair. What is the best response by the nurse to this patient. a. When your hair grows back, it will be patchy. b. Dont use your curling iron, and that will slow down the loss. c. You can get a wig now to match your hair so you will not look different. d. You should contact "look good, feel better" to figure out what to do about this.

c. You can get a wig now to match your hair so you will not look different.

35. The nurse receives change-of-shift report on the oncology unit. Which patient should the nurse assess first? a. 35-year-old patient who has wet desquamation associated with abdominal radiation b. 42-year-old patient who is sobbing after receiving a new diagnosis of ovarian cancer c. 24-year-old patient who received neck radiation and has blood oozing from the neck d. 56-year-old patient who developed a new pericardial friction rub after chest radiation

c. a 24-yr-old patient who received neck radiation and has blood oozing from the neck

14. A patient with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. Which action, if taken by the nurse, is most appropriate? a. Have the patient eat large meals when nausea is not present. b. Offer dry crackers and carbonated fluids during chemotherapy. c. Administer prescribed antiemetics 1 hour before the treatments. d. Give the patient two ounces of a citrus fruit beverage during treatments.

c. administer prescribed antiemetics 1 hour before the treatments.

26. A patient with cancer has a nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste sensation. Which nursing action is most appropriate? a. Add strained baby meats to foods such as casseroles. b. Teach the patient about foods that are high in nutrition. c. Avoid giving the patient foods that are strongly disliked. d. Add extra spice to enhance the flavor of foods that are served.

c. avoid giving the patient foods that are strongly disliked.

The patient is told that her adenoma tumor is not encapsulated but has normally differentiated cells and surgery will be needed. The patient asks the nurse what this means. What should the nurse tell the patient? a. It will recur b. It has metastasized c. It is probably benign d. It is probably malignant.

c. it is probably benign rationale: Benign tumors are usually encapsulated, have normally differentiated cells, and do not metastasize.

1. A patient who is scheduled for a right breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is correct? a. "Benign tumors do not cause damage to other tissues." b. "Benign tumors are likely to recur in the same location." c. "Malignant tumors may spread to other tissues or organs." d. "Malignant cells reproduce more rapidly than normal cells."

c. malignant tumors may spread to other tissues or organs

5. During a routine health examination, a 40-year-old patient tells the nurse about a family history of colon cancer. Which action should the nurse take next? a. Teach the patient about the need for a colonoscopy at age 50. b. Teach the patient how to do home testing for fecal occult blood. c. Obtain more information from the patient about the family history. d. Schedule a sigmoidoscopy to provide baseline data about the patient.

c. obtain more information from the patient about the family history

41. After change-of-shift report on the oncology unit, which patient should the nurse assess first? a. Patient who has a platelet count of 82,000/µL after chemotherapy b. Patient who has xerostomia after receiving head and neck radiation c. Patient who is neutropenic and has a temperature of 100.5° F (38.1° C) d. Patient who is worried about getting the prescribed long-acting opioid on time

c. patient who is neutropenic and has a temperature of 100.5F

27. During the teaching session for a patient who has a new diagnosis of acute leukemia the patient is restless and is looking away, never making eye contact. After teaching about the complications associated with chemotherapy, the patient asks the nurse to repeat all of the information. Based on this assessment, which nursing diagnosis is most appropriate for the patient? a. Risk for ineffective adherence to treatment related to denial of need for chemotherapy b. Acute confusion related to infiltration of leukemia cells into the central nervous system c. Risk for ineffective health maintenance related to anxiety about new leukemia diagnosis d. Deficient knowledge: chemotherapy related to a lack of interest in learning about treatment

c. risk for ineffective health maintenance related to anxiety about new leukemia diagnosis

A 64 yr old male patient who is receiving radiation to the head and neck as treatment for an invasive malignant tumor complains of mouth sores and pain. Which intervention should the nurse add to the plan of care? a. provide ice chips to soothe the irritation b. weigh the patient every month to monitor for weight loss. c. cleanse the mouth every 2 to 4 hours with hydrogen peroxide d. provide high protein and high calorie, soft foods every 2 hours.

d. provide high protein and high calorie, soft foods every 2 hours.

18. A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient? a. Remove food debris from the teeth and oral mucosa with a stiff toothbrush. b. Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth. c. Gargle and rinse the mouth several times a day with an antiseptic mouthwash. d. Rinse the mouth before and after each meal and at bedtime with a saline solution.

d. rinse the mouth before and after each meal and at bedtime with a saline solution

36. Which action should the nurse take when caring for a patient who is receiving chemotherapy and complains of problems with concentration? a. Teach the patient to rest the brain by avoiding new activities. b. Teach that "chemo-brain" is a short-term effect of chemotherapy. c. Report patient symptoms immediately to the health care provider. d. Suggest use of a daily planner and encourage adequate rest and sleep.

d. suggest use of a daily planner and encourage adequate rest and sleep

9. A patient with a large stomach tumor that is attached to the liver is scheduled to have a debulking procedure. Which information should the nurse teach the patient about the outcome of this procedure? a. Pain will be relieved by cutting sensory nerves in the stomach. b. Relief of pressure in the stomach will promote better nutrition. c. Tumor growth will be controlled by the removal of malignant tissue. d. Tumor size will decrease and this will improve the effects of other therapy.

d. tumor size will decrease and this will improve the effects of other therapy