Oncologic Disorders

A nurse is working with a dying client and the client's family. Which communication technique is most important to use?

Use active listening and silence when communicating

While changing bed linens the nurse notices a metal object on the bottom sheet of a client with radiation seeds implanted in the bladder. Which action should the nurse take? Select all that apply.

Walk away from the item Notify the radiation department

A client is to have radiation therapy after a modified radical mastectomy. What instructions should the nurse teach the client about caring for the skin at the site of the radiation therapy?

Wash the area with water

When reporting to the outpatient cancer center for their first chemotherapy treatment, a client appears anxious and apprehensive. Which statement by the nurse may help allay the client's anxiety?

"As a precaution, we wear gowns, goggles, and gloves to administer the medication."

Which statement indicates that the client needs further teaching about taking medication to control cancer pain?

"I should skip doses periodically so I don't get hooked on my drugs."

A client who will have the final chemotherapy cycle in 11 days becomes neutropenic. The client understands the condition by making which statement? Select all that apply.

"I'll monitor my temperature frequently and go to the nearest emergency department if my temperature rises above 100.4° F (38° C)." "I need to avoid going to the movies or eating out while receiving my cancer treatment." "I will carry hand sanitizer with me and use it often."

The nurse is instructing a client on how to care for skin that has become dry after radiation therapy. Which statement by the client indicates that the client understands the teaching?

"It's safe to apply a non-perfumed lotion to my skin."

A 52-year-old client is scheduled for a total abdominal hysterectomy for cervical cancer. When discussing the potential impact of this procedure on the client's sexuality, how should the nurse respond to the client?

"Most women have concerns about their sexuality after this type of surgery. Do you have any concerns or questions?"

Which nursing goal is appropriate for the nurse to make with a client who has multiple myeloma?

Achieve effective management of bone pain.

After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention?

Administering metoclopramide and dexamethasone as ordered

The client is diagnosed with benign fibrocystic breast disease. Interventions to reduce discomfort from this disease include teaching the client to:

Avoid caffeine

For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan?

Inspecting the skin for petechiae once every shift

A nurse is assessing a client with bone cancer pain. Which part of a thorough pain assessment is most significant for this client?

Intensity

During a routine checkup, a nurse assesses a client with acquired immunodeficiency syndrome (AIDS) for signs and symptoms of cancer. What is the most common AIDS-related cancer?

Kaposi's sarcoma

A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells?

Liver

A client with pancreatic cancer, who has been bed-bound for 3 weeks, has just returned from having a left subclavian, long-term, tunneled catheter inserted for administration of analgesics. The nurse has not yet received radiographic results for confirmation of placement. The client becomes restless and dyspneic and has chest pain radiating to the middle of the back. Physical assessment reveals tachycardia and absent breath sounds in the left lung. What should the nurse further assess?

Pneumothorax

Which nursing intervention is most appropriate for a client with multiple myeloma?

Prevent bone injury

A client is taking doxorubicin and is distressed about hair loss. What should the nurse do?

Provide resources for a wig selection prior to hair loss

After the physician explains the risks and benefits of a clinical trial to a client, the client agrees to participate. Later that day, the client requests clarification of the process involved in the clinical trial. As a member of the multidisciplinary team, how should the nurse respond?

Provide the information requested.

During chemotherapy, an oncology client has a nursing diagnosis of Impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis?

Providing a solution of viscous lidocaine for use as a mouth rinse

The nurse is caring for a client who will be undergoing a mastectomy. What would the nurse include in preoperative teaching?

Teach about the Jackson-Pratt drain, pressure dressing, and deep-breathing exercises

Correct palpation for breast self-exam

Up and down vertical pattern

When explaining hospice care, what should the nurse should tell the client? "Hospice care:

offers end-of-life care that includes palliative care and focuses on the client's physical, emotional, and spiritual needs."

After a transsphenoidal adenohypophysectomy, a client is likely to undergo hormone replacement therapy. A transsphenoidal adenohypophysectomy is performed to treat which type of cancer?

pituitary carcinoma

Which client has the highest risk of ovarian cancer?

45-year-old woman who has never been pregnant

After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/µl. What term should the nurse use to describe this low platelet count?

Thrombocytopenia

A client who is dying of acquired immunodeficiency syndrome (AIDS) is admitted to the inpatient psychiatric unit because he attempted suicide. His close friend recently died of AIDS. The client begins to talk about his feelings related to his illness and the loss of his friend. He begins to cry. Which response by the nurse would be most appropriate?

Give the client some tissues, and tell him it is okay to cry

When conducting a focused assessment of the respiratory system, what should the nurse note as an early sign of laryngeal cancer?

Persistent mild hoarseness

A nurse is caring for a client with bronchogenic carcinoma. Which nursing intervention takes highest priority?

Removing pulmonary secretions

A client who is in the end-stages of cancer is increasingly upset about receiving chemotherapy. Which approach by the nurse would likely be most helpful in gaining the client's cooperation?

Tell the client how the tx can be expected to help

A young female client is receiving chemotherapy and mentions to the nurse that she and her husband are using a diaphragm for birth control. Which information is most important for the nurse to discuss?

Infection control

A client with a diagnosis of cancer is frequently disruptive and challenges the nurse. This behavior may be caused by which factor?

Uncertainty and an underlying fear of recurrence

A client states, "I don't want any more tests. Who cares what kind of leukemia I have? I just want to be treated now." Which is the nurse's best response?

"Your treatment can be more effective if it is based on more specific information about your disease."

An adult recently diagnosed with Hodgkin's disease is admitted for staging by undergoing a bone marrow aspiration and biopsy. To obtain more information about the client's nutritional status, the nurse should review the results of which test?

Albumin level

A client is beginning external beam radiation therapy to the right axilla after a lumpectomy for breast cancer. Which information should the nurse include in client teaching?

Apply deodorant only under the left arm.

A nurse is teaching an older adult who has had a left modified radical mastectomy with axillary node dissection about lymphedema. What should the nurse tell the client about when lymphedema occurs?

At any time after surgery

The client who is receiving chemotherapy is not eating well but otherwise feels healthy. What should the nurse suggest the client eat?

Broiled chicken, green beans, and cottage cheese - carbs for energy, protein for muscle mass, and fat in small amounts for energy

A nurse is caring for a client with a long-term central venous catheter. Which steps should the nurse include in teaching how to care for the catheter at home?

Clean the port with an alcohol pad before administering I.V. fluid through the catheter.

A client with leukemia received induction chemotherapy 2 days ago and is now reporting severe diarrhea, decreased urination, cardiac dysrhythmias, and paresthesia with tetany. Laboratory reports reveal hyperkalemia, hyperuricemia, and hypocalcemia. Which action would the nurse anticipate?

I.V. fluids to increase urine output and allopurinol to inhibit uric acid

A client is struggling with the decision whether or not to continue chemotherapy. The client tells the nurse, "It's making me so sick and ruining whatever time I have with my family." What is the nurse's role when caring for this client?

Listen to the client's concerns

A client is struggling with the decision whether or not to continue chemotherapy. The client tells the nurse, "It's making me so sick and ruining whatever time I have with my family." What is the nurse's role when caring for this client?

Listen to the client's concerns.

A client with metastatic cancer of the liver tells the nurse about being concerned about the prognosis. How should the nurse respond to the client?

Place emphasis on providing symptomatic and comfort measures.

A client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. Which "related-to" phrase should the nurse add to complete the nursing diagnosis statement?

R/t impaired imbalance

When teaching a client about ovarian cancer, the nurse should include which information in the teaching plan? Select all that apply.

Staging and grading of cancer Procedure for dx if there is a pelvic mass

During the intravenous administration of a chemotherapeutic vesicant drug, the nurse observes that there is a lack of blood return from the intravenous catheter. What should the nurse do first?

Stop administering the drug

On discharge, a client who underwent left modified radical mastectomy expresses relief that "the cancer" has been treated. What is most important for the nurse to include in discharge teaching?

The need for continued breast self-examination on the right breast

The nurse at the gynecologic clinic is teaching the client about the results of her Papanicolaou test, which demonstrated dysplasia. Which represents the nurse's best intervention?

Explain that the results show cervical changes that require follow up.

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?

Avoid using deodorant soap on the irradiated areas

A hospitalized client with end-stage heart failure does not want to be resuscitated. The health care provider (HCP) has written the do-not-resuscitate (DNR) prescription on the client's record. The client has a cardiac arrest, and the wife tells the nurse she wants the client to be resuscitated and asks the nurse to "do something." What should the nurse do?

Discuss the DNR prescription with the wife

A client has been receiving chemotherapy for cancer treatment. The client is competent and has been actively involved in decisions regarding care; however, the client has now decided to refuse treatment. What should the nurse do when the client refuses the next dose of chemotherapy?

Document the client's choice and offer to discuss feelings about the chemotherapy.

A client who has had a total laryngectomy appears withdrawn and depressed. He keeps the curtain drawn, refuses visitors, and indicates a desire to be left alone. Which nursing intervention would be most therapeutic for the client?

Encouraging him to express his feelings nonverbally and in writing

After a lobectomy for lung cancer, the nurse instructs the client to perform deep breathing exercises. What is the expected outcome of these exercises?

Expand the alveoli and increase lung surface available for ventilation.

A client, who had intracavity radiation treatment for cervical cancer 1 month earlier, reports small amounts of vaginal bleeding. This finding most likely represents

Expected effect of radiation therapy

A 30-year-old client whose mother died of breast cancer at age 44 and whose sister has ovarian cancer, is concerned about developing cancer. As a member of the oncology multidisciplinary team, the nurse should suggest that the client ask the physician about which topic?

Genetic counseling

A client with lung cancer is being cared for by his wife at home. His pain is increasing in severity. The nurse recognizes that teaching has been effective when the wife uses which pain relief strategies? Select all that apply.

Gives her husband a long-acting or sustained-release oral pain medication regularly around the clock, uses an immediate-release medication (oxycodone) for breakthrough pain, has her husband use a pain-rating scale to measure the effectiveness at reaching his individual pain goal and uses music for distraction as well as heat or cold in combination with medications

A client diagnosed with acute myelocytic leukemia has been receiving chemotherapy. During the last two 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?

Monitor daily platelet counts

At a public health fair, a nurse teaches a group of women about breast cancer awareness. What is most important for the nurse to include in teaching about the warning signs of breast cancer?

Nipple discharge and a breast nodule Fixed nodular mass, breast pain, dimpling of the skin

A client has just begun treatment with busulfan, 4 mg by mouth daily, for chronic myelogenous leukemia. The client receives busulfan until their white blood cell (WBC) count falls to between 10,000/mm3 and 25,000/mm3. Then the drug is stopped. When should treatment resume?

When the WBC count rises to 50,000/mm3

The nurse is assessing a client who is suspected of being in the early symptomatic stages of human immunodeficiency virus (HIV) infection. Which indication of infection should the nurse detect during this stage?

Whitish yellow patches in the mouth

A 45-year-old single mother of three teenaged boys has metastatic breast cancer. Her parents live 750 miles (1,200 km) away and have only been able to visit twice since her initial diagnosis 14 months ago. The progression of her disease has forced the client to consider high-dose chemotherapy. She is concerned about her children's welfare during the treatment. When assessing the client's present support systems, the nurse will be most concerned about which potential problem?

Support systems and coping strategies