Ch 18: Caring for Pts with Cancer

A young female client has received chemotherapeutic medications and asks about any effects the treatments will have related to her sexual health. The most appropriate statement by the nurse is

"You will need to practice birth control measures."

Following a bone marrow transplantation (BMT), the patient should be monitored for at least:

3 months

A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: Tis, N0, M0. What does this classification mean?

Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis

A nurse has agreed to draft a medication teaching plan for a patient who is taking the hormonal agent, Aromasin, an aromatase inhibitor for postmenopausal women with breast cancer. The nurse knows that a major teaching point is to tell the patient to:

Increase her intake of calcium-rich foods.

Chemotherapeutic agents have which effect associated with the renal system?

Increased uric acid excretion

The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the client is requesting a bilateral mastectomy. This surgery is an example of what type of oncologic surgery?

Prophylactic surgery

The nurse is completing an admission assessment for a client receiving interstitial implants for prostate cancer. The nurse documents this as

brachytherapy.

During a routine physical examination, a client confides that he is terrified of developing prostate cancer like his father. What are the warning signs of prostate cancer? Select all that apply.

pain in the upper thighs continuous pain in the lower back weak and interrupted urine flow

An oncologist advises a client with an extensive family history of breast cancer to consider a mastectomy. What type of surgery would the nurse include in teaching?

prophylactic

A 16-year-old female client experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. The nurse should determine that the client is meeting the goal of improved body image and self-esteem when the client:

requests that her family bring her makeup and wig.

A client has been diagnosed with a neoplasm and is seeking further information and possible treatment. The primary care physician described the neoplasm as "insidious." What does the word "insidious" mean?

slow-growing

The root cause of cancer is damage to cellular deoxyribonucleic acid (DNA) which can be caused by many factors, or carcinogens. What factors can be carcinogenic? Select all that apply.

viruses environmental factors dietary substances

The nurse is admitting an oncology client to the unit prior to surgery. The nurse reads in the electronic health record that the client has just finished radiation therapy. With knowledge of the consequent health risks, the nurse should prioritize assessments related to what health problem?

Impaired wound healing

What nursing action best demonstrates primary cancer prevention?

Teaching clients to wear sunscreen

Which statement by a client undergoing external radiation therapy indicates the need for further teaching?

"I'm worried I'll expose my family members to radiation."

A patient will be receiving radiation for 6 weeks for the treatment of breast cancer and asks the nurse why it takes so long. What is the best response by the nurse?

"It will allow time for the repair of healthy tissue."

A nurse provides care on a bone marrow transplant unit and is preparing a female client for a hematopoietic stem cell transplantation (HSCT) the following day. What information should the nurse emphasize to the client's family and friends?

"Do not visit if you've had a recent infection."

A patient with a diagnosis of renal cell carcinoma is being treated with chemotherapy. During a previous round of chemotherapy, the patient's tumor responded well to treatment but the chemotherapy caused intense nausea and vomiting. How should the patient's potential nausea and vomiting be addressed during this current round of treatment?

Administer antiemetics in anticipation of the patient's nausea.

The nurse is conducting a health education about cancer prevention to a group of adults. What menu best demonstrates dietary choices for potentially reducing the risks of cancer?

Baked apricot chicken and steamed broccoli

Mrs. Unger is a 53-year-old woman who was diagnosed with breast cancer following a process that began with abnormal screen mammography results. Mrs. Unger, her oncologist, and surgeon have agreed on a mastectomy as treatment and have discussed the importance of rigorously assessing whether her cancer has metastasized. What action will best detect possible metastasis of Mrs. Unger's breast cancer?

Biopsy of the axillary lymph nodes

The hospice nurse has just admitted a new client to the program. What principle guides hospice care?

Care addresses the needs of the client as well as the needs of the family.

Your patient has recently completed her first round of chemotherapy in the treatment of lung cancer. When reviewing this morning's blood work, what findings would be suggestive of myelosuppression?

Decreased platelets and red blood cells

The nurse manager is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, what action should the nurse manager emphasize?

Dispose of the antineoplastic wastes in the hazardous waste receptacle.

A client who is receiving chemotherapy for esophageal cancer complains of "feeling sick to my stomach all the time." What is the best suggestion the nurse can make to help alleviate this client's nausea?

Eat low-fat foods.

What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen?

Encourage fluid intake to dilute the urine.

A side-effect of chemotherapy is renal damage. To prevent this, the nurse should:

Encourage fluid intake, if possible, to dilute the urine.

A client on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in clients at risk for thrombocytopenia?

Epistaxis (nosebleed)

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

Progression

Which of the following is a characteristic of a malignant tumor?

It gains access to the blood and lymphatic channels

A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the best teaching by the nurse?

It lowers serum and uric acid levels.

An oncology nurse educator is providing health education to a client who has been diagnosed with skin cancer. The client's wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?

Malignant cells contain proteins called tumor-associated antigens.

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

Palliative

A nurse is creating a plan of care for an oncology client and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses a leading cause of infection-related death in oncology clients?

Provide skin care to maintain skin integrity.

A patient is admitted for an excisional biopsy of a breast lesion. What intervention should the nurse provide for the care of this patient?

Provide time for the patient to discuss her concerns.

The nurse on a bone marrow transplant unit is caring for a client with cancer who has just begun hematopoietic stem cell transplantation (HSCT). What is the priority nursing diagnosis for this client?

Risk for infection related to altered immunologic response

A 36-year-old man is receiving three different chemotherapeutic agents for Hodgkin's disease. The nurse explains to the client that the three drugs are given over an extended period because:

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

The home health nurse is performing a home visit for an oncology client discharged 3 days ago after completing treatment for non-Hodgkin lymphoma. The nurse's assessment should include examination for the signs and symptoms of what complication?

Tumor lysis syndrome (TLS)

The drug interleukin-2 is an example of which type of biologic response modifier?

cytokine

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

eats red meat such as steaks or hamburgers every day

The nurse is working with a client who has had an allo-hematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of

graft-versus-host disease.

A decrease in circulating white blood cells is

leukopenia

Cancer is the second leading cause of death in the United States, second only to heart disease. Half of all men and one third of all women will develop cancer during their lifetimes. Which types of cancer have the highest prevalence among both men and women?

lung and colon

According to the TNM classification system, T0 means there is

no evidence of primary tumor

A computed tomography (CT) scan has detected a "spot" on a patient's liver, and a subsequent liver biopsy has revealed cancer and been submitted for staging and grading. The patient has asked you about the purpose of staging, stating that her oncologist's explanation left her somewhat confused. How could you best respond to this patient's question?

"Staging allows the care team to determine how large and extensive your tumor is."

An oncology client has just returned from the postanesthesia care unit after an open hemicolectomy. This client's plan of nursing care should prioritize which of the following?

Assess the client's wound for dehiscence every 4 hours.

An oncology nurse is caring for a client who has developed erythema following radiation therapy. What should the nurse instruct the client to do?

Avoid using soap on the treatment area.

A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of Risk for impaired skin integrity. Which intervention should be part of this client's care plan?

Avoiding using soap on the irradiated areas

The nursing instructor is discussing the difference between normal cells and cancer cells with the pre-nursing class in pathophysiology. What would the instructor cite as a characteristic of a cancer cell?

The cell membrane of malignant cells contains proteins called tumor-specific antigens.

What should the nurse tell a client who is about to begin chemotherapy and is anxious about hair loss?

The client should consider getting a wig or cap prior to beginning treatment

A patient with uterine cancer is being treated with internal radiation therapy. What would the nurse's priority responsibility be for this patient?

Explain to the patient that she will continue to emit radiation while the implant is in place.