Chapter 15: Oncology (PrepU/Workbook)

5-Fluorouracil (5FU) is classified as which type of antineoplastic agent? a. Antimetabolite b. Alkylating c. Nitrosoureas d. Mitotic spindle poisons

a. Antimetabolite

Which grade of tumor is also known as a well-differentiated tumor? a. Grade I b. Grade II c. Grade III d. Grade IV

a. Grade I

a patient, age 67 years, is admitted for diagnostic studies to rule out cancer. the patient is caucasian, has been employed as a landscaper for 40 years, and has a 36 year history of smoking a pack of cigarettes a day. what significant risk factors does the nurse recognize this patient has? (select all that apply) a. age b. cigarette smoking c. occupation d. race e. martial status

a. age b. cigarette smoking c. occupation

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. a. dietary substances b. environmental factors c. gender d. age e. viruses

a. dietary substances b. environmental factors e. viruses

a patient will be having an endoscopic procedure with a diagnostic biopsy. what type of biopsy does the nurse explain will remove and entire piece of suspicious tissue? a. excisional biopsy b. incisional biopsy c. needle biopsy d. punch biopsy

a. excisional biopsy

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? a. "it allows time for you to cope with the treatment" b. "it will allow time for the repair of healthy tissue" c. "it will decrease the incidence of leukopenia and thrombocytopenia" d. "it is not really understood why you have to go for 6 weeks of treatment?

b. "it will allow time for the repair of healthy tissue"

Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode will the nurse anticipate? a. No further treatment is indicated. b. Adjuvant therapy is likely. c. Palliative care is likely. d. Repeat biopsy is needed before treatment begins.

b. Adjuvant therapy is likely.

A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells? a. colon b. liver c. reproductive tract d. white blood cells (WBCs)

b. liver

a patient is taking vincristine, a plant alkaloid for the treatment of cancer. what system should the nurse be sure to assess for symptoms of toxicity? a. gastrointestinal system b. nervous system c. pulmonary system d. urinary system

b. nervous system

Which of the following would be consistent with a benign neoplasm? a. grows by invasion b. usually progressive and slow c. gains access to the blood and lymph channels to metastasize d. cells are undifferentiated

b. usually progressive and slow

After a bone marrow transplant (BMT), the client should be monitored for at least a. 30 days b. 14 days c. 100 days d. 60 days

c. 100 days

The nurse is conducting a screening for familial predisposition to cancer. Which element should the nurse note as a possible indication of hereditary cancer syndrome? a. An aunt and uncle diagnosed with cancer b. A second cousin diagnosed with cancer c. A first cousin diagnosed with cancer d. Onset of cancer after age 50 in family member

a. An aunt and uncle diagnosed with cancer

a patient with uterine cancer is being treated with internal radiation therapy. what would the nurse's priority responsibility be for this patient? a. explain to the patient that she will continue to emit radiation for approximately 1 week after the implant is removed b. maintain as much distance as possible from the patient while in the room c. alert family members that she should restrict their visiting to 5 minutes at one time d. wear a lead apron when providing direct patient care

a. explain to the patient that she will continue to emit radiation for approximately 1 week after the implant is removed

A nurse caring for a client who has just received chemotherapy infusion is wearing a disposable gown, gloves, and goggles for protection. The nurse knows that accidental exposure to chemotherapy agents can occur through: a. inhalation of aerosols. b. absorption through the gown. c. absorption through the gloves. d. absorption through the goggles.

a. inhalation of aerosols.

A patient will be having an endoscopic procedure with a diagnostic biopsy. What type of biopsy does the nurse explain will remove an entire piece of suspicious tissue? a. Incisional biopsy b. Excisional biopsy c. Needle biopsy d. Punch biopsy

b. Excisional biopsy

the nurse assesses that extravasation of a chemotherapy agent has occurred. what should the initial action of the nurse be? a. apply a warm compress to the area b. discontinue the infusion c. inject an antidote, if required d. place ice over the site of infiltration

b. discontinue the infusion

A client has just received stem cell transplantation as treatment for leukemia. What are the post procedural nursing interventions for clients receiving any form of stem cell transplantation? a. Closely monitor the client for at least 3 months. b. Closely monitor the client for at least 5 months. c. Closely monitor the client for at least 3 days. d. Closely monitor the client for at least 4 weeks.

a. Closely monitor the client for at least 3 months.

The drug interleukin-2 is an example of which type of biologic response modifier? a. cytokine b. monoclonal antibodies c. retinoids d. antimetabolites

a. cytokine

what can the nurse do to meet the challenges in caring for a patient with cancer? a. identify own perception of cancer and set realistic goals b. set the same goals for all patients with cancer c. tell the patient about the things the patient has done to cause cancer d. ensure that the patient has the financial means to afford their care

a. identify own perception of cancer and set realistic goals

A client is receiving the cell cycle-nonspecific alkylating agent thiotepa (Thioplex), 60 mg weekly for 4 weeks by bladder instillation as part of chemotherapy regimen to treat bladder cancer. The client asks the nurse how the drug works. How does thiotepa exert its therapeutic effects? a. It interferes with deoxyribonucleic acid (DNA) replication only. b. It interferes with ribonucleic acid (RNA) transcription only. c. It interferes with DNA replication and RNA transcription. d. It destroys the cell membrane, causing lysis.

c. It interferes with DNA replication and RNA transcription.

the nurse at the clinic explains to the patient that the surgeon will be removing a mole on the patient's back that has the potential to develop into cancer. the nurse informs the patient that this is what type of procedure? a. diagnostic b. palliative c. prophylactic d. reconstructive

c. prophylactic

a patient is admitted for an excisional biopsy of a breast lesion. what intervention should the nurse provide for care of this patient? a. clarify information provided by the physician b. provide aseptic care to the incision postoperatively c. provide time for the patient to discuss their concerns d. counsel the patient about the possibility of losing her breast

c. provide time for the patient to discuss their concerns

Based on the understanding of the effects of chemotherapy, the nurse would anticipate which of the following clinical findings in a client 2 weeks post therapy? a. Change in hair color b. Elevated temperature c. Elevated white blood cells count d. Ease of bruising

d. Ease of bruising

what does the nurse understand is the rationale for administering allopurinol for a patient receiving chemotherapy? a. it stimulates the immune system against the tumor cells b. it treats drug-related anemia c. it prevents alopecia d. it lowers serum and uric acid levels

d. it lowers serum and uric acid levels

The nurse is caring for a client with a benign breast tumor. The tumor may have which characteristic? a. ability to invade other tissues b. causes generalized symptoms c. slow rate of growth d. undifferentiated cells

c. slow rate of growth

A patient with uterine cancer is being treated with internal radiation therapy. What would the nurse's priority responsibility be for this patient? a. Explain to the patient that she will continue to emit radiation while the implant is in place. b. Maintain as much distance as possible from the patient while in the room. c. Alert family members that they should restrict their visiting to 5 minutes at any one time. d. Wear a lead apron when providing direct patient care.

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

what intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen? a. encourage fluid intake to dilute the urine b. take measures to acidify the urine and prevent uric acid crystallization c. withhold medication when the blood urea nitrogen level exceeds 20mg/dL d. limit fluids to 1,000 mL daily to prevent accumulation of the drug's end products after cell lysis

a. encourage fluid intake to dilute the urine

a patient is to receive Bacille Calmette-Guerin (BCG), a nonspecific biologic response modifier. why would the patient receive this form of treatment? a. for cancer of the bladder b. for cancer of the breast c. for cancer of the lungs d. for skin cancer

a. for cancer of the bladder

what is the best way for the nurse to assess the nutritional status of a patient with cancer? a. weigh the patient daily b. monitor daily caloric intake c. observe for proper wound healing d. assess BUN and Cr levels

a. weigh the patient daily

a patient is scheduled for cyrosurgery for cervical cancer and tells the nurse "i am not exactly sure what the doctor is going to do." what is the best response by the nurse? a. "the physician is going to use medication to inject the area" b. "the physician is going to use liquid nitrogen to freeze the area" c. "the physician is going to use a laser to remove the area" d. "the physician is going to use radiofrequency to ablate the area"

b. "the physician is going to use liquid nitrogen to freeze the area"

Which of the following is a characteristic of a malignant tumor? a. It demonstrates cells that are well differentiated. b. It gains access to the blood and lymphatic channels. c. t is usually slow growing. d. It grows by expansion.

b. It gains access to the blood and lymphatic channels.

what disadvantages of chemotherapy should the patient be informed about prior to starting the regimen? a. it attacks cancer cells during their vulnerable phase b. it functions against disseminated disease c. it causes a systemic reaction d. it targets normal body cells as well as cancer cells

d. it targets normal body cells as well as cancer cells

The client is to receive cyclophosphamide (Cytoxan) 50 mg/kg intravenously in divided doses over 5 days. The client weighs 176 pounds. How many mg of cyclophosphamide will the client receive each day?

800

Chemotherapeutic agents have which effect associated with the renal system? a. Hypokalemia b. Increased uric acid excretion c. Hypophosphatemia d. Hypercalcemia

b. Increased uric acid excretion

What are considered carcinogens? a. parasites b. medical procedures c. dietary substances d. inefective genes

c. dietary substances

The nurse is caring for a client newly diagnosed with cancer. Which of the following therapies is used to treat something other than cancer? a. surgery b. radiation therapy c. electroconvulsive therapy d. chemotherapy

c. electroconvulsive therapy

what foods should the nurse suggest that the patient consume less of in order to reduce nitrate intake because of the possibility of carcinogenic action? a. eggs and milk b. fish and poultry c. ham and bacon d. green, leafy vegetables

c. ham and bacon

The nurse is caring for a client who has had a nuclear scan to aid in the diagnosis of possible cancer. The scan showed a "hot spot". What does this mean? a. An area of increased concentrations of the tracer used in the scan. b. Distinguishes areas of tissue that are normal. c. An area of decreased concentrations of the tracer used in the scan. d. Distinguishes abnormal areas of tumor

a. An area of increased concentrations of the tracer used in the scan.

The nurse is caring for a client is scheduled for chemotherapy followed by autologous stem cell transplant. Which of the following statements by the client indicates a need for further teaching? a. "I hope they find a bone marrow donor who matches." b. "The doctor will remove cells from my bone marrow before beginning chemotherapy." c. "I will receive chemotherapy until most of the cancer is gone, and then I will get my own stem cells back." d. "I will need to be in protective isolation for up to 3 months after treatment."

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

The clinic nurse is caring for a client who has just been diagnosed with a tumor. The client says to the nurse "The doctor says my tumor is benign. What does that mean?" What is the nurse's best response? a. "Benign tumors don't usually cause death." b. "Benign tumors grow very rapidly." c. "Benign tumors can spread from one place to another." d. "Benign tumors invade surrounding tissue."

a. "Benign tumors don't usually cause death."

An oncology clinic nurse is reinforcing prevention measures for oropharyngeal infections to a client receiving chemotherapy. Which statement by the client indicates that teaching was successful? a. "I clean my teeth gently several times per day." b. "I replace my toothbrush every month." c. "I lubricate my lips with petroleum jelly." d. "I use an alcohol-based mouthwash every morning."

a. "I clean my teeth gently several times per day."

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? a. "Thank goodness the tumor is contained and curable." b. "I will be glad to finally be done with treatments for this thing." c. "I am so glad the doctor was able to remove the entire tumor." d. "I guess the doctor could not remove the entire tumor."

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

The nurse is completing an admission assessment for a client receiving interstitial implants for prostate cancer. The nurse documents this as a. a contact mold b. systemic radiation c. external beam radiation therapy d. brachytherapy

d. brachytherapy

A serum sodium concentration lower than 115 mEq/L (115 mmol/L) is associated with a. anorexia b. weight gain c. myalgia d. seizure

d. seizure

The client has finished the first round of chemotherapy. Which statement made by the client indicates a need for further teaching by the nurse? a. "I will eat clear liquids for the next 24 hours." b. "Hair loss may not occur until after the second round of therapy." c. "I can continue taking my vitamins and herbs because they make me feel better." d. "I will use birth control measures until after all treatment is completed."

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

The oncology nurse is giving chemotherapy to a client in a short stay area. The client confides that they are very depressed. The nurse recognizes depression as which of the following? a. A psychiatric diagnosis everyone has at one time or another. b. A side effect of the neoplastic drugs. c. A normal reaction to the diagnosis of cancer. d. An aberrant psychologic reaction to the chemotherapy.

c. A normal reaction to the diagnosis of cancer.

The nurse is caring for a client with cancer who is treating her cancer with deep-tissue massage in addition to radiation therapy. The nurse documents the use of which therapy on the client's chart? a. Alternative therapy b. Global medicine c. Integrative medicine d. Compliant medicine

c. Integrative medicine

A client with cancer is receiving chemotherapy and reports to the nurse that his mouth is painful and he has difficulty ingesting food. The nurse does which of the following: (Select all that apply) a. Asks the client to open his mouth to facilitate inspection of the oral mucosa b. Rinses the client's mouth with alcohol-based mouthwash every 2 hours c. Instructs the client to brush the teeth with a soft toothbrush d. Consults with the healthcare provider about use of nystatin (Mycostatin) e. Teaches the client to floss his teeth once every 24 hours

a. Asks the client to open his mouth to facilitate inspection of the oral mucosa c. Instructs the client to brush the teeth with a soft toothbrush d. Consults with the healthcare provider about use of nystatin (Mycostatin)

A male client has been unable to return to work for 10 days following chemotherapy as the result of ongoing fatigue and inability to perform usual activities. Laboratory test results are WBCs 2000/mm³, RBCs 3.2 x 10¹²/L, and platelets 85,000/mm³. The nurse notes that the client is anxious. Which of the following is the priority nursing diagnosis? a. Risk for infection related to inadequate defenses b. Fatigue related to deficient blood cells c. Activity intolerance related to side effects of chemotherapy d. Anxiety related to change in role function

a. Risk for infection related to inadequate defenses

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? a. Sexual Dysfunction b. Fear c. Knowledge Deficit d. Ineffective Coping

b. Fear

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: a. Report the unusual sign of nausea. b. Increase her intake of calcium-rich foods. c. Be alarmed if she notices fluid retention d. Report the unexpected sign of increased appetite and weight gain.

b. Increase her intake of calcium-rich foods.

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? a. Time, distance, and shielding b. Inspect the skin frequently. c. The use of disposable utensils and wash cloths d. Avoid showering or washing over skin markings.

b. Inspect the skin frequently.

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? a. "It allows time for you to cope with the treatment." b. "It will decrease the incidence of leukopenia and thrombocytopenia." c. "It is not really understood why you have to go for 6 weeks of treatment." d. "It will allow time for the repair of healthy tissue."

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

A patient is admitted for an excisional biopsy of a breast lesion. What intervention should the nurse provide for the care of this patient? a. Clarify information provided by the physician. b. Provide aseptic care to the incision postoperatively. c. Provide time for the patient to discuss her concerns. d. Counsel the patient about the possibility of losing her breast.

c. Provide time for the patient to discuss her concerns.

A client diagnosed with acute myelocytic leukemia has been receiving chemotherapy. During the last 2 cycles of chemotherapy, the client developed severe thrombocytopenia requiring multiple platelet transfusions. The client is now scheduled to receive a third cycle. How can the nurse best detect early signs and symptoms of thrombocytopenia? a. Perform a cardiovascular assessment every 4 hours. b. Check the client's history for a congenital link to thrombocytopenia. c. Monitor daily platelet counts. d. Closely observe the client's skin for petechiae and bruising.

d. Closely observe the client's skin for petechiae and bruising.