Evolve - Cancer Treatment and Care

The nurse is performing an assessment on a patient who has been receiving chemotherapy and radiation for breast cancer. The patient's most recent complete blood count (CBC) results are shown in the chart. Considering the patient's CBC results, which of these additional assessment findings is of most concern? Refer to the chart.

Temperature of 101.8° F

A nurse discusses chemotherapy treatment with a patient with colon cancer. Which body system does the nurse tell the patient is most susceptible to the side effects of commonly used antineoplastic drugs?

Bone marrow

A nurse is caring for a patient undergoing brachytherapy for prostate cancer. What actions should the nurse take to protect his or herself from radiation hazards?

Use shielding when providing any care to the patient. Organize care to limit the time spent in direct contact with the patient. Limit close proximity to the patient to only those care tasks that must be performed near the source.

The nurse provides instructions regarding markings on the skin to a patient who is undergoing radiation therapy. What explanation should the nurse provide regarding the markings?

They should be protected because they are landmarks for the radiation therapy.

The nurse is discussing the effects of chemotherapy with a patient who has a new diagnosis of cancer. Which statement by the patient reflects an adequate understanding of the teaching?

"I will join a support group after my therapy is finished to help me get back on my feet."

A patient who is undergoing a diagnostic workup for cancer expresses anxiety about the results. Which is the best nursing response?

"Let's talk about your concerns."

A patient who has undergone a modified radical mastectomy sees the surgical site for the first time. The patient appears shocked and exclaims, "I look horrible! Will it ever look better?" Which response by the nurse is most appropriate?

"You're shocked by the change in your appearance from the surgery?"

The patient is receiving biologic 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? Multiple choice question

Acetaminophen

The nurse is caring for a patient with anorexia secondary to chemotherapy. Which strategy would be most appropriate for the nurse to use to increase the patient's nutritional intake? Multiple choice question

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

The nurse caring for a patient undergoing chemotherapy finds that the patient has a low white blood cell (WBC) count. Which is an appropriate intervention?

Administer white blood cell growth factors.

A patient with cancer develops sudden onset of chest heaviness, shortness of breath, tachycardia, hoarseness, and a reduced level of consciousness with muted heart sounds. The nurse expects that the immediate treatment plan for this patient will include what interventions?

Administration of IV hydration Administration of oxygen therapy Placement of a pericardial catheter Surgical establishment of a pericardial window

A nurse is caring for a patient with lung cancer. The patient's laboratory reports reveal a platelet level of 19,000/μL. What nursing actions will help prevent bleeding complications associated with this lab finding?

Avoid invasive procedures. Obtain a prescription for a platelet transfusion. Instruct the patient to avoid activities that increase the risk of injury.

A patient undergoing outpatient chemotherapy reports feeling lonely and isolated and expresses the desire to resume normal activities, such as socialization with friends. Which precaution should the nurse recommend when allowing the patient to resume these activities?

Avoiding crowds

A nurse assesses that a patient undergoing radiotherapy has developed erythema and desquamation. Which should the nurse include when educating the patient about skin care in the radiation treatment area?

Gently cleanse the skin using a mild soap, tepid water, and a soft cloth.

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 this patient is at risk for tumor lysis syndrome (TLS) and will monitor the patient closely for which abnormality associated with this oncologic emergency?

Hypocalcemia

When caring for the patient with cancer, what does the nurse determine is the response of the immune system to antigens of the malignant cells?

Immunologic surveillance

A patient has been advised to undergo an autologous bone marrow transplant. A nurse explains the procedure to the patient. Which patient statement indicates that the teaching has been understood? Multiple choice question

It involves transfusing stem cells harvested from myself."

The patient is told that the adenoma tumor is encapsulated, but has normally differentiated cells and that surgery will be needed. The patient asks the nurse what this means. What should the nurse tell the patient? Multiple choice question

It is probably benign.

A patient with ovarian cancer is receiving radiation therapy. A nurse finds that the patient has developed anemia as a side effect of radiation therapy. What interventions are appropriate for this patient?

Monitor hemoglobin and hematocrit levels. Administer iron supplements and erythropoietin. Promote foods that increase hemoglobin levels

When caring for a patient undergoing chemotherapy, which nursing actions should the nurse take to manage fatigue in the patient?

Pace activities in accordance with energy level. Maintain usual lifestyle patterns as much as possible. Reassure the patient that fatigue is a common side effect.

A patient with lung cancer develops headaches, facial edema, periorbital edema, and distention of the veins in the head, neck, and chest. The nurse expects that what will be included in the patient's treatment plan?

Prepare the patient for radiation therapy. Inform the patient that chemotherapy may be required.

A patient with breast cancer who recently had extensive surgical procedures develops hypotension, tachycardia, and decreased urinary output. Which nursing actions would be useful for management of this patient?

Replace fluids and electrolytes. Administer plasma protein replacement.

A nurse is collecting health history information from a patient who states, "I had cancer in the cartilage of my leg." What does the nurse recognize this type of malignancy in the connective tissue is called?

Sarcoma

A patient is receiving an infusion of monoclonal antibodies (MoAb) for non-Hodgkin's lymphoma. The nurse determines the patient is experiencing an anaphylactic reaction. Which action should the nurse perform first? Multiple choice question

Stop the infusion.

A patient on chemotherapy for eight weeks started at a weight of 130 lb. The patient now weighs 125 lb and complains that he or she cannot taste food anymore. Which nursing interventions would be a priority? Multiple choice question

Suggest that the patient try foods with various spices and seasonings that are not spicy.

The nurse is reviewing the role of the immune system in cancer development. Which of these statements explains the primary protective role of the immune system related to malignant cells?

The immune system provides surveillance for cells with tumor-associated antigens (TAAs).

A patient with advanced metastatic lung cancer experiences fatigue, weakness, nausea, and vomiting. The patient's blood report shows a high level of calcium in the blood. How should the nurse interpret this lab finding?

The patient has a metabolic emergency.

The nurse is administering a vesicant chemotherapy agent to a patient who has colon cancer. During rounds, the nurse notes that the intravenous site is reddened and swollen, and the patient reports that it is painful. What is the first action the nurse will take?

Turn off the infusion.

A patient is being treated with radioactive iodine ( 131I) for thyroid cancer. For what major source of contamination from this patient should the nurse take precautions?

Urine

A patient undergoes modified radical mastectomy with axillary node dissection. After the surgical incision is sufficiently healed, the patient is to undergo radiation therapy. What instruction should the nurse give the patient regarding care of the skin at the site of radiation therapy?

Wash the area gently with lukewarm water and lightly pat it dry

A nurse is caring for a patient with lung cancer who is being treated with chemotherapy. The patient reports anorexia. How should the nurse ensure an adequate nutritional status of the patient?

Weigh the patient regularly. Provide nutritional supplements. Provide high-calorie, high-protein food. Manage nausea and vomiting if present.

A patient with a long history of psychosis has been diagnosed with metastatic brain cancer. What therapeutic methods can the nurse implement to help the patient cope with this diagnosis?

Listen actively to the patient's fears and concerns.

A patient with cancer is undergoing chemotherapy. The nurse suspects an IV infiltration of mechlorethamine hydrochloride. What action should the nurse take immediately? Multiple choice question

Stop the infusion and leave the IV cannula in place.

The nurse is reviewing the laboratory test results for a patient with cancer. The total serum protein level is 6.4 mg/dL. What does the nurse interpret this finding to mean for the patient?

The protein level is normal, and therefore the patient does not have malnutrition.

The patient is being treated with brachytherapy for cervical cancer. What factors of protection must the nurse be aware of when caring for this patient?

The time the nurse spends with the patient and at what distance

A patient is treated with radiation therapy for lung cancer. The nurse observes that the patient has dry desquamation of the skin. How should the nurse prevent infection and facilitate healing of the skin?

Avoid constricting garments. Avoid the use of heating pads. Avoid rubbing the affected area.

A nurse caring for a patient with breast cancer receiving chemotherapy has developed alopecia and is noticeably upset. Which nursing actions are appropriate for this patient?

Suggest the patient use scarves and wigs. Suggest the patient cut long hair before therapy. Instruct the patient to avoid the use of hair dryers.

The nurse is caring for a patient newly admitted reporting fever and chills. The patient was diagnosed four months ago with pancreatic cancer, is undergoing radiation treatment, takes fentanyl for pain, and has a medical port. The patient appears anxious and is sweating. What are the priority nursing assessments?

Time of last pain medication and vital signs

The patient with breast cancer is having teletherapy radiation treatments after surgery. What should the nurse teach the patient about the care of the skin?

Avoid heat and cold to the treatment area

A patient with multiple myeloma presents with sudden onset of depression, fatigue, muscle weakness, polyuria, nocturia, and vomiting. The serum calcium level is in excess of 12 mg/dL. The nurse recognizes that which treatments could be helpful for the patient?

Adequate hydration Infusion of bisphosphonate zoledronate

A patient with lung cancer presents with intense, localized, persistent back pain and motor and sensory disturbances. What nursing interventions would be helpful to this patient? Multiple selection question

Administer corticosteroids. Prepare the patient for a laminectomy. Prepare the patient for radiation therapy.

Following a surgery for colorectal cancer, the patient still has persistent carcinoembryonic antigen (CEA) levels. Which is a correct interpretation of high CEA levels? Multiple choice question

The tumor has not been completely removed

A nurse is reviewing the biopsy report of a patient with cervical cancer. The report states that the patient has stage I cancer per the clinical staging. How should the nurse explain this to the patient?

The tumor is limited to the tissue of origin.

A patient with cancer of the esophagus presents with weight gain without edema, anorexia, and oliguria. Which nursing measures would help to relieve the patient's symptoms

Administer furosemide. Administer 0.9% saline solution. Administer 3% sodium chloride solution.

A nurse is caring for a patient with a benign breast tumor. What are the characteristics that differentiate a benign tumor from a malignant tumor?

Benign tumors are encapsulated. Benign tumors are well differentiated. Benign tumors have a low rate of recurrence.

A patient is being prepared for intraperitoneal chemotherapy and asks the nurse when the IV will be started for the chemotherapy. What is the best response by the nurse to educate the patient about this type of chemotherapy delivery?

A Silastic catheter will be placed percutaneously into the peritoneal cavity for chemotherapy administration.

Previous administrations of chemotherapy agents to a cancer patient have resulted in diarrhea. Which dietary modification should the nurse recommend?

A bland, low-fiber diet

A patient is scheduled for pelvic radiation therapy. The patient asks why the instructions state to go for radiation therapy with a full bladder. What explanation should the nurse give?

A full bladder moves the bowels out of the treatment field.

A nurse is caring for a patient with cancer of the neck. While assessing the vital signs of the patient, the nurse notices bleeding in the cancerous area. Which nursing action is a priority?

Apply pressure on the site

A nurse is caring for a patient experiencing severe side effects of chemotherapy. On examination, the nurse notices stomatitis. Which interventions should the nurse perform to relieve stomatitis?

Apply topical anesthetics. Encourage nutritional supplements. Discourage the use of oral irritants like tobacco.

A patient has been diagnosed with non-small cell lung cancer. Which type of targeted therapy most likely will be used for this patient to suppress cell proliferation and promote programmed tumor cell death?

Epidermal growth factor receptor-tyrosine kinase inhibitors

A patient with multiple myeloma is sleeping most of the day, has no energy or appetite, and does not seem to care about anything. The patient also reports nocturia. Which complication of cancer is this most likely caused by?

Hypercalcemia

A nurse is caring for a patient receiving chemotherapy for osteosarcoma of the tibia and experiencing nausea and vomiting. What explanation does the nurse give to the patient related to these side effects?

Release of intracell breakdown products Destruction of gastrointestinal (GI) lining

A nurse is caring for a patient with breast cancer. The primary health care provider has prescribed trastuzumab for the patient. How does this drug control cell growth in breast cancer?

The drug inhibits the abnormal growth of cells by targeting the human epidermal growth factor receptor2 (HER-2) protein

A patient who is undergoing external beam radiation therapy for cancer asks, "Will I be radioactive after the treatment?" What is an appropriate nursing response?

The patient will not be radioactive at any time.

The nurse is reviewing the medical record of a patient who has been newly diagnosed with testicular cancer. When considering the goal of curing cancer, the treatment is based on which of these principles?

Therapy will include a combination of treatment modalities.

The patient is receiving an intravenous (IV) vesicant chemotherapy drug. The nurse notices swelling and redness at the site. What should the nurse do first?

Turn off the chemotherapy infusion