Oncology PrepU

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."

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 client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse?

Tumor pressure against normal tissues

A nurse is performing a home visit for a client who received chemotherapy within the past 24 hours. The nurse observes a small child playing in the bathroom, where the toilet lid has been left up. Based on these observations, the nurse modifies the client's teaching plan to include:

chemotherapy exposure and risk factors

A nurse is administering daunorubicin through a peripheral I.V. line when the client complains of burning at the insertion site. The nurse notes no blood return from the catheter and redness at the I.V. site. The client is most likely experiencing which complication?

extravasation

A decrease in circulating WBCs is...

leukopenia

A nurse is teaching a community class about how to decrease the risk of cancer. Which food should the nurse recommend?

oranges

A client with a brain tumor is undergoing radiation and chemotherapy for treatment of cancer. The client has recently reported swelling in the gums, tongue, and lips. Which is the most likely cause of these symptoms?

stomatitis

The nurse evaluates teaching as effective when a female client states that she will

use sunscreen when outdoors

Which of the following would be inconsistent as a common side effect of chemotherapy?

weight gain

The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important?

Flush the toilet twice after every use.

The physician recommends that parents have their daughter vaccinated with HPV vaccine. What is this vaccine for?

Help prevent cervical cancer

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 client has received several treatments of bleomycin. It is now important for the nurse to assess

Lung sounds

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?

Prophylactic

After being seen in the oncology clinic, a client with severe bone marrow suppression is admitted to the hospital. The client's cancer therapy consisted of radiation and chemotherapy. When developing the care plan for this client, which nursing diagnosis takes priority?

Risk for infection

A nurse is caring for a client receiving chemotherapy. Which nursing action is most appropriate for handling chemotherapeutic agents?

Wear disposable gloves and protective clothing.

The oncologist advises a client with an extensive family history of breast cancer to consider a mastectomy. This procedure would be considered which type of surgery?

prophylactic

You are a clinic nurse. One of your clients has found she is at high risk for breast cancer. She asks you what can be done to reduce her risk. What is a means of reducing the risk for breast cancer?

prophylactic surgery

A serum sodium concentration lower than 115 mEq/L (115 mmol/L) is associated with

seizure

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?

An aunt and uncle diagnosed with cancer

A nurse is caring for a client receiving chemotherapy. Which assessment finding places the client at the greatest risk for an infection?

Stage 3 pressure ulcer on the left heel

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?

"Benign tumors don't usually cause death."

A patient with cancer who developed neutropenia several days ago has consequently been placed in a single-bed room that has positive pressure. His daughter has just come to visit her father after arriving from her home in another state and has asked you for his room number. You notice that the daughter has reddened eyes, sniffles, and a dry cough. What instruction should you provide to the daughter?

"Even though it might be difficult, it's best for your father's health if you get well before visiting him in person, since he's so vulnerable right now."

A nurse is caring for a client who is receiving chemotherapy and has a platelet count of 30,000/mm3. Which statement by the client indicates a need for additional teaching?

"I floss my teeth every morning."

You are caring for a client who has just been told that they have stage IV colon cancer. The client asks you what "stage IV" means. What would be your best response?

"Stage IV means that the cancer has spread to other organs of the body."

A patient is scheduled for cryosurgery 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?

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

A client with advanced cancer makes the following comment to the nurse: "Why are you bathing me? I am going to die no matter what." What is the most appropriate response of the nurse?

"Would you like to talk about what you are feeling?"

While doing a health history, a client tells the nurse that her mother, grandmother, and sister died of cancer. The client wants to know what she can do to keep from getting cancer. What would be the nurse's best response?

"You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is."

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 normal reaction to the diagnosis of cancer.

Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode will the nurse anticipate?

Adjuvant therapy is likely.

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

Adminisering metoclopramide and dexamethasone as ordered.

A client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis is appropriate for this client?

Anticipatory grieving

5-Fluorouracil (5FU) is classified as which type of antineoplastic agent?

Antimetabolite

Which of the following is a term used to describe the process of programmed cell death?

Apoptosis

Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client?

Autologous

Which of the following advice does the nurse offer clients who are undergoing unsealed radiation therapy to reduce exposure?

Avoid kissing and sexual contact.

The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise?

Avoid spicy and fatty foods

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

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

Which does a nurse thoroughly evaluate before a hematopoietic stem cell transplant (HSCT) procedure?

Blood studies

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 cancer client makes the following statement to the nurse: "I guess I will tell my doctor to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die."Which of the following facts supports the use of chemotherapy for this client?

Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.

The nurse is conducting a community education program using the American Cancer Society's colorectal screening and prevention guidelines. The nurse determines that the participants understand the teaching when they identify that people over the age of 50 should have which screening test every 10 years?

Colonoscopy

Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth?

Control

While administering cisplatin (Platinol-AQ) to a client, the nurse assesses swelling at the insertion site. The first action of the nurse is to

Discontinue the IV med

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?

Excisional biopsy

The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action?

Extravasation

A client diagnosed with cancer has their tumor staged and graded based on what?

How they tend to grow and the cell type

While completing an admission assessment, the client reports a family history of ovarian cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology?

Inherited gene mutation

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.

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

It gains access to the blood and lymphatic channels.

What does the nurse understand is the rationale for administering allopurinol for a patient receiving chemotherapy?

It lowers serum and uric acid levels.

According to the tumor-node-metastasis (TNM) classification system, T0 means there is

No evidence of primary tumor

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

Palliative

An important nursing function is monitoring factors that may indicate that bleeding is occurring. One serum indicator is a (an):

Platelet count of 60,000/mm3.

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.

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.

Which oncologic emergency involves the failure in the negative feedback mechanism that normally regulates the release of antidiuretic hormone (ADH)?

Syndrome of inappropriate antidiuretic hormone release (SIADH)

A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention?

The I.V. site is red and swollen.

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 client with metastatic pancreatic cancer underwent surgery to remove a malignant tumor in the pancreas. Despite the tumor being removed, the physician informs the client that chemotherapy must be started. Why might the physician opt for chemotherapy?

To prevent metastasis

The nurse is caring for a client newly diagnosed with cancer. Which of the following therapies is used to treat something other than cancer?

Electroconvulsive therapy

Which is a growth-based classification of tumors?

Malignancy

In which phase of the cell cycle does cell division occur?

Mitosis

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

cytokine

The nurse is working with a client who has had an allohematopoietic 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 benign tumor of the blood vessel is a...

hemangioma

The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. What response by the nurse would best reassure this patient?

"These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and X-ray studies."

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?

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

The root cause of cancer is damage to cellular deoxyribonucleic acid (DNA). Such damage results from multiple factors. Which of the following is a carcinogen?

Dietary substances, environmental factors, viruses, chemical agents, defective genes, medically prescribed interventions

You are a nurse working on a bone marrow transplant (BMT) unit. Your patient is scheduled to receive a bone marrow transplant. What information will you provide to the patient's visitors?

Don't visit if they've had a recent infection.

You are an oncology nurse caring for a client who tells you that their tastes have changed. They go on to say that "meat tastes bad". What is a nursing intervention to increase protein intake for a client with taste changes?

Encourage cheese and sandwiches.

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

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

The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant?

Monitor the client closely to prevent infection.

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?

Risk for infection related to inadequate defenses

The nurse is evaluating the client's risk for cancer and recommends changes when the client states she...

eats red meat such as steaks or hamburgers every day

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?

inspect the skin frequently

The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest?

malignant tumor

The physician is attending to a 72-year-old client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation?

To prevent the formation of new cancer cells

The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia?

The hair loss is usually temporary.

Which occurs when fluid accumulates in the pericardial space and compresses the heart?

cardiac tamponade

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?

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

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

Liver

When the client complains of increased fatigue following radiotherapy, the nurse knows this is most likely to be related to which factor?

Radiation can result in myelosuppression.

A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis?

Red, open sores on the oral mucosa

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 RBCs