Quiz II- Cancer

What cancer leads in causing death?

Lung Cancer

Tertiary Prevention

Monitoring for and preventing recurrence of the primary cancer as well as screening for development of secondary malignancies.

Toxic effects on Hematopoetic System

Myleosuppression(depression of bone marrow function), decreased WBCs (leukopenia), decreased granulocytes, RBCs, and platelets, increased risk for infection and bleeding.

Toxic effects on the GI system

Nausea and vomiting

Toxic effects on Cardiopulmonary system

Patient's who are older than 65 years are at risk, those with a history of preexisting cardiopulmonary disease, tobacco use, renal/hepatic dysfunction.

External radiation

Radiation is directed from a machine outside the body onto cancerous cells within the body

Primary Prevention

Reducing the risks of disease through health promotion and risk reduction strategies.

Secondary Prevention

Screening and early detection activities that seek to identify early stage cancer in individuals who lack signs and symptoms suggestive of cancer.

Progression

The altered cells exhibit increasingly malignant behavior.

Metastasis

The dissemination or spread of malignant spread of malignant cells from the primary tumor to distant sites by direct spread of tumor cells to body cavities or through lymphatic and blood circulation. Tumors growing in or penetrating body cavities may shed cells or emboli that travel within the bod cavity and seed the surfaces of other organs.

Hormonal

Tumor growth may be promoted by disturbances in the hormonal balance, either by the body's own (endogenous) hormone production or by administration or exogenous hormones.

Anaplasia

a pattern of growth in which cells lack normal characteristics and differ in shape and organization with respect to their cells of origin. Is associated with increased malignant potential.

Benign

(noncancerous)

A nurse is teaching a client about maintaining a diet that may prevent certain cancers. the nurse should inform the client that the intake of which of the following may be beneficial? (Select all that apply) A. Low saturated fats. B. Fiber C. Red Meats. D. Simple Carbohydrates E. Fish

A, B, E

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 care.

A. Identify own perception of cancer and set realistic goals

Which type of surgery is utilized in an attempt to relieve complications of cancer. A. Palliative B. Prophylactic C. Reconstructive D. Salvaged

A. Palliative

The nurse is caring for a patient with a benign breast tumor the nurse plans care for the patient whose tumor has which of the following characteristics. A. slow rate of growth B. Ability to invade other tissues C. Undifferentiated cells D. Causes generalized symptoms

A. Slow rate of growth

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 calorie intake C. Observe proper wound healing D. Assess BUN and creatinine

A. Weigh the patient daily

A patient is undergoing chemotherapy treatment for prostate cancer and has lost considerable weight due to n/v. which of the following nursing interventions is appropriate for the patient? A. Administer beta-blockers. B. Adjusting mealplans before and after chemo. C. Decreasing dietary fluids 2 days prior to chemo. D. Increasing fresh fruits in patient's diet.

B. Adjusting meal plans before and after chemo.

Which of the following terms refers to cells which lack normal cellular characteristics and differ in shape and organization with respect to their size and origin. A. Displasia B. Anaplasia C. Hyperplasia D. Neoplasia

B. Anaplasia

Which of the following classes of antineoplastic agents is cell-cycle specific? A. Nitrosoreas B. Antimetabolites C. Alkylating agents D.. Antitumor abts.

B. Anti-metabolites.

The nurse is conducting a community education program using the american cancer society's colorectal screening guidelines. The nurse determines that the participants understand the teaching when they identify that the people over the age of 50 should which of the following screening tests q 10 years.

B. Colonoscopy

A patient with a brain tumor is undergoing radiation and chemotherapy for tx of CA. Of late, the patient is complaining of swelling of gums, tongue and lips. Which of the following is the most likely cause of these symptoms? A. Extravasation B. Nadir C. Stomatitis D. Neutropenia

C. Stomatitis

Apoptosis

Cell senescence

Role of the immune system

Cells of the immune system can detect the development of transformed cells and destroy them before cell growth becomes uncontrolled.

Physical Agents

Exposure to sunlight or radiation, chronic irritation or inflammation and tobacco use.

Why do twice as many African American Men die from cancer than white men?

Factors include attitudes, knowledge, cultural beliefs, socioeconomic issues, level of education, insurance coverage, lifestyle choices such as the use of tobacco, misconceptions, communication skills, and other epidemiologic factors.

Toxic effects on the Renal System

Impair water secretion, leading to syndrome of inappropriate scretion of antidiuretic hormone (SIADH), decrease renal perfusion, precipitate end products after cell lysis, and cause interstitial nephritis.

Tumor Qualities that Facilitate Cancer Cell Invasion

-Ability to cause pressure atrophy - Ability to disrupt the basement membrane of normal cells -Motility -Response to chemical signals from adjacent tissues

Genetics

Approximately 5-10% of cancers in adults display a pattern of cancers suggestive of a familial predisposition.

The nurse is caring for clients on an oncology unit. Which neutropenic precautions should be implemented? A. Hold all venipuncture sites for at least 5 minutes. B. Limit fresh fruits and flowers. C. Place all clients in reverse isolation. D. Have clients use soft bristle toothbrush

B. Limit fresh fruits and flowers.

Which of the following is a type of procedure that uses liquid nitrogen to freeze tissue that causes cell destruction. A. Lazer surgery B. Chemo surgery C. Cryoablation D. Electrosurgery

C. Cryoablation

During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior. A. Prolongation B. Initiation C. Promotion D. Progression

D. Progression

Palliation refers to which of the following: A. Hair loss B. The lowest point of white blood cell depression after therapy that has toxic effects on the bone marrow. C. the spread of cancer cells from the primary to distant sites. D. Relief of symptoms and promotion of comfort and quality of life

D. Relief of symptoms and promotion of comfort and quality of life.

The physician is attending to a 72- year old patient with a malignant brain tumor, the physician recommends immediate radiation therapy. Which of the following is a reason for the physician's reccommendation. A. to remove the tumor from the brain. B. to analyze involved lymph nodes. C. to destroy marginal tissues D. to prevent the formation of new cancer cells.

D. to prevent the formation of new cancer cells.

Dietary

Dietary substances can be proactive, carcinogenic or cocarcinogenic.

What is the impact of lower education?

cancer death rates for individuals with the least education are more than twice those of the most educated.

Carcinogenesis (Malignant transformation)

3 step cellular process, involving initiation, promotion, and progression.

the nurse is completing an admission assessment on a patient receiving interstitial implants for his prostate CA. The nurse documents this as being which of the following. A. The brachitherapy B. External beam radiation therapy C. Systemic radiation D. Contact molds

A. Brachitherapy

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.

A patient, age 67, is admitted for diagnostic studies to rule out cancer. the patient is Caucasian. , has been employed as a landscaper for 40 yeas, and has a 36 year history of smoking a pack of cigarettes daily. 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. Marital Status

A, B, C

A nurse is caring for a client who has lung cancer and is exhiniting manifestations of syndrome of innapropriate antidiuretic hormone (SIADH) which of the following findings should the nurse report to the provider. A. Behavioral changes. B. Client report of headache C. Urine output of 40 ml/hr D. Client report of nausea E. Increased urine specific gravity

A, B, D

The nurse is conducting a screening for familial predisposition of CA. Which of the following should the nurse note as a possible indication of hereditary cancer syndrome. A. An aunt and uncle dx with CA B. Onset of CA after age 50 and family member C. A first cousin dx with CA D. A second cousin dx with CA.

A. An aunt and uncle dx with CA.

Which type of vaccine uses the patient's own cancer cells that are prepared for injection back into the patient. A. Autologous B. Prophylactic C. Therapuetic D. Allogenic

A. Autologous

the nurse is evaluating blood work results with a patient with chemotherapy. the patient's platelets is 60,000 which of the following is an appropriate nursing action. A. Avoiding use of ASA. B. taking patient's temp rectally. C. providing commercial mouth wash to patient. D. Providing patient with razor.

A. Avoiding use of ASA

What intervention should the nurse provide to reduce incidence of renal damage when a patient is taking chemo? A. Enc. fluid intake to dilute urine. B. Take measures to acidify the urine and prevent uric acid crystallization. C. Withhold med when BUN reaches 20. D. limit fluids to 1000 ml per day

A. Enc. fluid intake to dilute urine.

A patient will be having an endospocic proecedure with a diagnostic biopsy. What type of biopsy. does the nurse explain will removean entire piece of suspicious tisusue. A. Excisional Biopsy B. Incisional Biopsy. C. Needle Biopsy. D. Punch Biopsy

A. Excisional Biopsy

A Patient with uterine cancer is being treated with internal radiation therapy, What would the nurses' priority responsibility be for this patient. A. Explain to the patient that she will continue to emit readiation for approximately 1 week after the implant is removed. B.Maintain as much distance as possible. C. Alert family memmvers that they should restrict their time to 5 minutes.

A. Explain to the patient that she will continue to emit readiation for approximately 1 week after the implant is removed.

A patient is to receive BCG, a non-specific biologic response modifier. Why would the patient receive this type of tx? A. For CA of the bladder B. For CA of the breast C. For CA of the lungs D. For skin CA

A. For CA of the bladder

A nurse in an oncology clinic is reviewing the health record of a client who had surgery to stage ovarian cancer. The nurse reviews the following diagnostic notation on the pathology report: T2-N3-Mx. Which of the following is an expected finding that supports this diagnosis? A. The tumer is 4 cm in size and the size involving the ovary and adjacent tissues. B. No lymph nodes contain cancer cells. C. The tumor is receptive to current medication therapy. D. The cancer has metastasized to other areas of the body.

A. The tumor is 4 cm in size and the size involving the ovary and adjacent tissues.

The nurse is working with a patient who has had an Allohematopoetic stem cell transplant and notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the physician symptoms of which of the following. A. graft vs. host disease B. Nadir C. Acute leukopenia' D. Metastisis

A. graft vs. host

The nurse is preparing to assess a patient whose chart documents that the patient experienced extravasation when receiving the vesicant Vincristinge on the previous shift. The documentation also notes that an antidotes was administered immediately the nurse prepares to assess for which of the following. Select all that apply. A. Active bleeding B. Effectiveness of antidote C. Sloughing tissue D. tissue necrosis.

B, C, D

A patient will be receiving radiation for 6 weeks for the treatment of breast CA adn asks why it will take so long. What is the best response. A. It allows you to cope with treatment B. It will allow time for the repair of helathy 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 helathy tissue

The nurse writes a nurse writes a nursing problem of altered nutrition for a client diagnosed with leukemia who has received a treatment regimen of chemo and regimen. Which nursing intervention should be implemented? A. Administer anti- diarrheal prior to meals. B. Monitor client's serum albumin levels C. Assess for s/s of infection D. Provide skin care to irradiated areas.

B. Monitor client's serum albumin levels.

A patient is taking vincristine plant alkaloid for the treatment of cancer. What system should the nurse assess for s/s of toxicity? A. GI B. Nervous C. Pulmonary D. Urinary

B. Nervous

According to the tumor node metastisis classification system.

B. No evidence of primary tumor

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? A. The physician is going to use the med to inject the area. B. The physician is going to use a lazer to remove this area. C. The physician is going to use radiofrequency to ablate the area.

B. The physician is going to use a lazer to remove this area.

The nurse assesses that extrasation of a chemo agent has occurred . What should the inital action be? A. Apply warm compress. B. discontinue infusion C. Inject antidote, if required D. Place ice over infiltration.

B. discontinue infusion

Which of the following is true about a malignanttumor? A. Demonstrates cells that are well differentiated. B. Is usually slow growing. C. Gains access to blood and lymphatic channels. D. Grows by expansion.

C. Gains access to blood and lymphatic channels

The nurse is caring for a patient with cancer who is treating her cancer with deep tissue massage in addition to radiation therapy. The nurse documents the use of which of the following on the patient's chart? A. Alternative therapy B. Compliant medicine C. Integrative medicine D. Global medicine

C. Integrative medicine

A patient with metastic pancreatic cancer underwent surgery for removal of malignant tumor in his pancreas. Despite tumor being removed, physician informs patient that he needs to start chemotherapy. Which of the following may be a reason for the physician to opt for chemo? A. Angiogenesis B. Fatigue C. Metasis D. Stomatitis

C. Metastisis

The nurse at the clinic explains the surgeon will be removing a mole on the patient's back that has the potential to develope intn o cancer. the nurse informs the patient that this is what type of procedure? A. Diagnostic B. Palliative C. Prophylactic D. reconsstructive.

C. Prophylactic

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 asceptic care to the incision post-op C. Provide time for the patient to discuss her concerns D. Counsel the patient about the possibiliy of loosing her breast.

C. Provide time for the patient to discuss her concern

Chemical agents

Carcinogens such as tobacco smoke and hazardous chemicals.

Toxic effects on Neurological system

Chemo-therapy induced neurotoxicity can affect CNS and PNS and cranial nerves. It's characterized by metabolic encephalopathy.

Which of the following does a nurse thouroughly evaluate before a hematopoetic stem cell transplant. A. Drug history B. Family history C. Allergy history D. Blood studies

D. Blood studies

The nurse is providing education to a patient with cancer radiation treatment options. The nurse determines that the patient understands when he or she states that which of the following radiation is aimed at protecting healthy tissue during the treatment? A. teletherapy B. Proton therapy C. External D. Brachitherapy

D. Brachitherapy

A nurse is teaching a client about the risk for cancer. Which of the following client statements indicates the need for further teaching? A. I see a dermatologist regularly for a mole on my thigh. B. I take Milk of Magnesia for occasional constipation. C. I tan using an indoor tanning lotion instead of laying out in the sun. D. I used to smoke but switched to chewing tobacco 3 years ago.

D. I used to smoke but switched to chewing tobacco 3 years ago.

What is the rationale for administering allupurinol for a patient during chemo? 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 patient undergoing an incisional biopsy. Which of the following statements does the nurse understand is true of an incisional biopsy? A. It removes an entire lesion and surrounding tissue B. It treats cancer with lymph node involvement C. It is used to remove the cancerous cells using a needle D. It removes a wedge of tissue for diagnosis.

D. It removes a wedge of tissue for diagnosis.

What disadvantages of chemo should the patient be informed of about prior to starting the regimen? A. It attacks cancer cells during their vulnerable phase B. It functions against disseminated disease C. It causes systemic reaction D. It targets normal body cells as well as cancer cells

D. It targets normal body cells as well as cancer cells

A decrease in circulating WBCs is referred to as which of the following. A. Neutropenia B. Granulocytopenia C. Thrombocytopenia D. Leukopenia

D. Leukopenia

The impact of chemo on energy level

Fatigue can last for months

Toxic effects on Cognitive functioning

Many patient's with cancer experience difficulty with remembering dates, multitasking, managing numbers and finances, organization, face or object recognition, inability to follow directions, feeling easily distracted, and motor and behavioral changes.

Toxic effects on the Reproductive system

May damage reproductive cells and cause sterility.

Malignant

Neoplasms, demonstrate uncontrolled cell growth that follows no physiologic demand (neoplasia)

Nursing management

Ongoing assessment in all fields.

Viruses and Bacteria

Viruses are associated with cancer in one of two ways. After infecting individuals, DNA viruses insert a part of their own DNA near the infected cell genes causing cell division.

Angiogenesis

the growth of new blood vessels from the host tissue stimulated by the release of growth factors such as vascular endothelial growth factor.