Oncology Review

Which interventions should a nurse discuss with a client for primary prevention of skin cancer from exposure to ultraviolet light? SATA. 1. Use sunscreen when outdoors 2. Stay in the shade when outdoors 3. Wear wide brimmed hats when outdoors 4. Plan to be outdoors between 10 am to 2 pm 5. Have an annual skin assessment by a dermatologist

1., 2. & 3. Correct: According to the Task Force on Community Preventive Services, using sunscreen, staying in shaded areas, and wearing wide brimmed hats are effective interventions to prevent skin cancer. 4. Incorrect: Spending time in the sun between 10 am to 2 pm, when ultraviolet rays are most intense, increases the risk for skin cancer. 5. Incorrect: Assessment by a dermatologist is not a primary prevention strategy. Early diagnosis is considered secondary prevention.

What signs and symptoms of ovarian cancer should a nurse include when educating women? SATA. 1. Urinary frequency. 2. Menstrual changes. 3. Watery vaginal discharge. 4. Increasing abdominal girth. 5. Pain radiating down the legs.

1., 2., & 4. Correct: Signs and symptoms of ovarian cancer include irregular menses, increasing premenstrual tension, menorrhagia with breast tenderness, early menopause, abdominal discomfort, dyspepsia, pelvic pressure and urinary frequency. Flatulence, fullness after a light meal, and increasing abdominal girth are significant symptoms. 3. Incorrect: Watery, vaginal discharge is a sign of advanced cervical cancer. 5. Incorrect: Pain will be in the abdomen and pelvis, that does not radiate down the legs.

What should a community health nurse include when planning a presentation on prevention and early detection of colon cancer? SATA. 1. Maintain a diet high in fruits, vegetables, and whole grains. 2. Exercise regularly. 3. Regular screening should begin at age 30. 4. Yearly guaiac-based fecal occult blood test beginning at age 50. 5. Flexible esophagogastroduodenoscopy every 5 years.

1., 2., & 4. Correct: A diet high in vegetables, fruits, and whole grains have been linked with a decreased risk of colorectal cancer, whereas, a diet high in red meats, processed meats, and frying can increase risk of colorectal cancer. There is a greater risk of developing colorectal cancer in individuals who live a sedentary life style. The guaiac-based fecal occult blood test detects blood in the stool through a chemical reaction. This test is done yearly. 3. Incorrect: If there is no identified risk factors (other than age), regular screening should begin at age 50. 5. Incorrect: A flexible esophagogastroduodenoscopy is not a recommended procedure for the early detection of cancer of the colon.

A client diagnosed with cancer has been losing weight. What should the nurse teach the client regarding methods for improving nutritional needs to maintain weight? SATA. 1. Add butter to foods 2. Spread peanut butter on toast 3. Use biscuits to make sandwiches 4. Put honey on top of hot cereal 5. Eat Caesar salads once per day

1., 2., 3., & 4. Correct: Butter and oil added to food will add calories. This client needs more calories and more protein. Spread peanut butter or other nut butters, which contain protein and healthy fats, on toast, bread, or crackers. Use croissants or biscuits to make sandwiches which provides more calories. Top hot cereal with brown sugar, honey, dried fruit, cream or nut butter. 5. Incorrect: This will not add calories for weight gain. Choose meat salads, such as chicken, ham, turkey, or tuna.

A client with a severe cough is suspected of having lung cancer. When preparing the client for testing to confirm a diagnosis of cancer, which tests should a nurse anticipate? SATA. 1. Chest x-ray 2. Arterial blood gas 3. Bronchoscopy 4. Computed tomography (CT) 5. Pulmonary function test

1., 3., & 4. Correct: Chest x-ray, bronchoscopy, and CT scan are evidenced-based tests used in the diagnosis of lung cancer due to the efficacy of the tests. 2. Incorrect: Arterial blood gas measures the quantity of oxygen in the blood and acid-base status. 5. Incorrect: Pulmonary function test is used to diagnose obstructive lung diseases, such as emphysema.

The nurse is caring for a client with bladder cancer who is 2 days post an ileal conduit. Assessment of the urinary output verifies that the urine has flecks of mucus and the hourly output has gone from 200 mL at 8:00 am to 140 mL at 10:00 am. What is the nurse's priority action? 1. Check for leakage from the stoma 2. Increase fluids to 2000 mL/24 hours 3. Monitor the site for signs of infection 4. Perform a bladder scan

2. Correct: Increase fluids. Why? Well we have a drop in output, but it's still well within normal range and the client is two days post-procedure (not immediate post-op, when we would be most concerned about bleeding). So increase fluids to see if the output picks back up. Also, high fluid intake is helpful to flush the ileal conduit. 1. Incorrect: This is an appropriate nursing action, but is not the priority and does not address the decreased urine output. 3. Incorrect: This is an appropriate nursing action but not the priority. It does not address the decreased urinary output. 4. Incorrect: We would scan the bladder if we were worried about urinary retention. It's a little premature for that, but we could scan the bladder after increasing fluids. Remember this is a priority question.

A client's absolute neutrophil count (ANC) is 750/mm3. Which measures should the nurse take to protect the client? SATA. 1. Prohibit the client from shaving. 2. Instruct the client to wear a mask when leaving the hospital room. 3. Remove fresh flowers and plants from the client's room. 4. Ask visitors to perform hand hygiene before entering the client's room. 5. Instruct client to avoid vigorous flossing of teeth.

2., 3. & 4. Correct: If a client's ANC is less than 1000/mm3, the client is at risk for infection. Instructing the client to wear a mask outside of the hospital room protects the client from infection. The soil in fresh flowers and plants can carry bacteria and fungi, which can cause infection. Performing hand hygiene is the best way to prevent the spread of infection. 1. Incorrect: Not allowing the client to shave would be an appropriate intervention for someone with a low platelet count. 5. Incorrect: Not allowing the client to vigorously floss the teeth would be an appropriate intervention for someone with a low platelet count.

A client's absolute neutrophil count (ANC) is 750/mm3. Which measure should the nurse take to protect the client? SATA. 1. Prohibit the client from shaving. 2. Instruct the client to wear a mask when leaving the hospital room. 3. Remove fresh flowers and plants from the client's room. 4. Ask visitors to perform hand hygiene before entering the client's room. 5. Instruct client to avoid vigorous flossing of teeth.

2., 3. & 4. Correct: Normal ANC is 1500-8000/mm3. If a client's ANC is less than 1000/mm3, the client is at risk for infection. Instructing the client to wear a mask outside of the hospital room protects the client from infection. The soil in fresh flowers and plants can carry bacteria and fungi, which can cause infection. Performing hand hygiene is the best way to prevent the spread of infection. 1. Incorrect: Not allowing the client to shave or vigorous flossing of teeth would be an appropriate intervention for someone with a low platelet count. This client has a low white cell count. 5. Incorrect: Not allowing the client to shave or vigorous flossing of teeth would be an appropriate intervention for someone with a low platelet count.