ATI Cancer Related Disorders (Part of Unit 13 - Chapter 90, 91, 92, 93 94)

A nurse is assessing a client who has multiple skin lesions. Which of the following findings are manifestations of malignant melanoma? Select all that apply. A. Diffuse vesicles B. Uniformly colored papule C. Area with asymmetric borders D. Rough, bleeding patch E. Irregular colored mole

C. Area with asymmetric borders D. Rough, bleeding patch E. Irregular colored mole ***When recognizing cues, the nurse should identify that a lesion with asymmetric borders, a rough, bleeding patch, and an irregular-colored mole are manifestations of a malignant melanoma.

A nurse is making a poster for a health fair about screening guidelines for colorectal cancer. MATCH the following diagnostic tests with the recommended frequency for clients starting at age 45, who are at average risk, and without family history of colorectal cancer. 1. Flexible sigmoidoscopy 2. Fecal occult blood tests 3. Colonoscopy

1. Colonoscopy -> Every 10 yrs 2. Flexible sigmoidoscopy -> Every 5 yrs 3. Fecal occult blood tests -> Every yr ***When taking actions, the nurse should include in the poster that clients who are at average risk for colorectal cancer, without family history, should have a colonoscopy every 10 yrs, a flexible sigmoidoscopy every 5 yrs, or a fecal occult blood test every yr, starting at age 45, to screen for colorectal cancer.

A nurse is teaching a newly licensed nurse about urinary diversions. MATCH the urinary diversion with the method of urinary elimination. 1. Continent pouch 2. Ureterostomy 3.Ureterosigmoidostomy

1. Continuous drainage into an external pouch -> Ureterostomy 2. During a bowel movement -> Ureterosigmoidostomy 3. Intermittent catheterization -> Continent pouch ***When taking action, the nurse should instruct that a ureterostomy diverts urine through the ureters and exits through the skin to an external pouch. An ureterosigmoidostomy diverts urine through the large intestine and exits through the anus. Urine is expelled with stool. A continent pouch is a pouch created by the large intestine that diverts urine through a stoma in the abdomen and is eliminated during intermittent catheterization.

A nurse is teaching a class about nursing interventions for oncologic emergencies.​​​​​​​ MATCHING

1. Encourage fluid intake of 3 L (12.7 c) daily -> Tumor lysis syndrome 2. Obtain blood cultures -> Sepsis 3. Administer a bisphosphonate -> Hypercalcemia 4. Place the client in a semi-Fowler's position -> Superior vena cava syndrome 5. Administer high-dose IV corticosteroids -> Spinal cord compression ***When taking actions, the nurse should instruct to encourage clients who have tumor lysis syndrome to drink at least 3 L (12.7 c) of fluid daily. This intervention can reduce the risk of uric acid build up in the kidneys that can result in acute kidney injury. The nurse should instruct to obtain blood cultures on clients who have sepsis to identify the pathogen causing the infection and to determine the required treatment. The nurse should instruct to administer a bisphosphonate to clients who have hypercalcemia to block resorption of calcium in the bone and decrease serum calcium level. The nurse should instruct to place a client who has superior vena cava syndrome in a semi-Fowler's position to reduce edema and promote ventilation. The nurse should instruct to administer high-dose corticosteroids to clients who have spinal cord compression to reduce inflammation in the spinal cord.

The nurse is discussing alternative approaches to relieving pain with the client. MATCH the alternative therapy with the associated method. 1. Positive imagery 2. Massage therapy 3. Acupuncture 4. Hypnosis

1. Hypnosis -> Uses an altered state of awareness to redirect the perception of pain. 2. Acupuncture -> Small needles are inserted into the skin to stimulate and alter nerve pathways. 3. Massage therapy ->Soft tissue is manipulated to increase surface circulation. 4. Positive imagery ->Involves picturing a peaceful image. ***When taking actions, the nurse should include in the discussion that hypnosis uses an altered state of awareness to redirect the perception of pain. Acupuncture uses small needles are inserted into the skin to stimulate and alter nerve pathways. Massage therapy involves manipulation of soft tissue to increase surface circulation. Positive imagery involves picturing a peaceful image to reduce anxiety, stress, and pain.

A nurse is teaching a newly licensed nurse about imaging studies. MATCH the study with the associated procedure. 1. Echocardiogram 2. Nuclear imaging 3. Ultrasound 4. MRI

1. MRI -> Uses a magnetic field to produce an image 2. Ultrasound -> High-energy sound waves are used to produce an image 3. Nuclear imaging -> A radioactive substance is used to locate cancer tissue 4. Echocardiogram -> Used to evaluate heart function ***When taking actions, the nurse should instruct that an MRI uses a magnetic field to produce an image. An ultrasound uses high-energy sound waves to produce an image. Nuclear imaging uses a radioactive substance to locate cancer tissue. An echocardiogram is used to evaluate heart function.

A nurse is planning to teach a class about screening prevention for cancer. MATCH the following tests with the recommended screening guideline. 1. PSA 2. Pap test 3. Colonoscopy 4. Mammogram

1. Mammogram -> Clients who are 45 to 54 years of age, every year 2. Colonoscopy -> Clients who are at average risk, every 10 years, beginning at age 45 3. Pap test -> Client who are 25-65 years of age, every 3 years 4. PSA -> Clients, who are at average risk, starting at 50 years of age, every 2 years (varies) ***When taking actions, the nurse should include the following recommendations for screening: mammogram every year for clients who are 45-54 years of age, colonoscopy every 10 years starting at 45 years of age for client who are at average risk. Pap test every 3 years for clients who are 25- 65 years of age, PSA for clients who 50 years of age and considered to be at average risk every 2 years depending upon the results of the PSA.

A nurse is teaching a class about diagnostic procedures for cancer. MATCH the following types of biopsies with the associated procedure. 1. Sentinel lymph node biopsy 2. Incisional biopsy 3. Needle biopsy 4. Shave biopsy

1. Shave biopsy -> Samples of outer skin layers are obtained 2. Needle biopsy -> Aspiration of tumor for fluid or tissue sampling 3. Incisional biopsy -> Skin is cut to remove part of a tumor 4. Sentinel lymph node biopsy -> Uses a dye to locate affected areas ***When taking actions, the nurse should instruct that samples of outer skin layers are obtained during a shave biopsy. A tumor is aspirated for fluid or tissue sampling during a needle biopsy. Skin is cut to remove part of a tumor during an incisional biopsy. Dye is used to locate affected nodes during a sentinel lymph node biopsy.

A nurse is teaching skin care to a client who is receiving external beam radiation therapy. Which of the following instructions should the nurse include? A. "Use your hand, rather than a washcloth, to clean your skin." B. "Remove ink markings when cleaning your skin." C. "Scrub skin with a towel, when drying." D. "Expose irradiated skin to the sun each day."

A. "Use your hand, rather than a washcloth, to clean your skin." ***When taking actions, the nurse should instruct the client to use their hand, rather than a washcloth, with mild soap and water, to clean the irradiated skin to reduce the risk of skin irritation.

A nurse is teaching a client about risk factors for gastric cancer. Which of the following risk factors should the nurse include? Select all that apply. A. Infection with H. pylori. B. High intake of processed foods C. History of gastritis D. Diet high in carbohydrates E. BMI 18

A. Infection with H. pylori. B. High intake of processed foods C. History of gastritis ***When taking actions, the nurse should instruct that an infection with H. pylori, a diet high in processed foods, and a history of gastritis are risk factors for developing gastric cancer.

A nurse is teaching a newly licensed nurse about leukemia and lymphoma. SORT the following findings into those associated with acute leukemia and those associated with Hodgkin's lymphoma. 1. Reed-Sternberg cells 2. Enlarged lymph node 3. Ecchymosis 4. Enlarged spleen

Acute leukemia ---> - Enlarged spleen - Ecchymosis Hodgkin's lymphoma ---> - Enlarged lymph node - Reed-Sternberg cells ***When taking actions, the nurse should instruct that the presence of Reed Sternberg cells in the lymph nodes and enlarged, painless lymph nodes are findings associated with Hodgkin's lymphoma. Ecchymosis and an enlarged liver and spleen are findings associated with acute leukemia.

A nurse is teaching a client about testicular self-examination. Which of the following client statements indicates an understanding of the teaching?​​​​​​​ A. "It is best to examine my testicles before bathing." B. "It is not necessary to report small lumps, unless they are painful." C. "I will examine my testicles once each month." D. "I will use my palms to feel for abnormalities."

C. "I will examine my testicles once each month." ***When evaluating outcomes, the nurse should identify that the client understands to examine the testicles once each month to determine the presence of any lumps or swelling.

A nurse is performing a cancer screening assessment on several clients. Which of the following findings is a possible manifestation of cancer? Select all that apply. A. Temperature 36° C (96.8° F) B. Sore that does not heal C. Difficulty swallowing D. Blood in the urine E. Rhinitis

B. Sore that does not heal C. Difficulty swallowing D. Blood in the urine ***When recognizing cues, the nurse should identify that a sore that does not heal, difficulty swallowing, and blood in the urine are possible manifestations of cancer and require further actions to determine the cause.

The nurse is caring for the client who has a prescription for gabapentin for neuropathic pain. The nurse should monitor the client for which of the following adverse effects of this medication? A. Constipation B. Urinary retention C. Insomnia D. Dizziness

D. Dizziness ***When taking actions, the nurse should monitor the client for dizziness. The nurse should instruct the client to avoid alcohol and activities that require alertness until the medication effects are known.

The nurse is providing discharge teaching to the client who has a new prescription for two pain medications. SORT the following adverse effects into those that can occur with ibuprofen or with oxycodone. 1. Tinnitus 2. Respiratory depression 3. Gastrointestinal bleeding 4. Orthostatic hypotension

Ibuprofen ---> - Tinnitus - Gastrointestinal bleeding Oxycodone ---> - Respiratory depression - Orthostatic hypotension ***When taking actions, the nurse should instruct the client to monitor for tinnitus and gastrointestinal bleeding when taking ibuprofen for pain. The nurse should instruct the client to monitor for respiratory depression and orthostatic hypotension when taking oxycodone for pain.

A nurse is planning care for a client who is receiving chemotherapy and is at risk for nausea and mucositis. SORT the following nursing interventions into those implemented for nausea and those implemented for mucositis. 1. Provide the client with several small meals during the day 2. Have the client rinse their mouth with a solution of 0.9% sodium chloride 3. Instruct the client to avoid strong odors 4. Advise the client to use a soft-bristle toothbrush 5. Advise the client to avoid drinking fluids during meals 6. Advise the client to use an oral topical anesthetic prior to meals

Nausea ----> - Instruct the client to avoid strong odors - Advise the client to avoid drinking fluids during meals - Provide the client with several small meals during the day Mucositis ---> - Advise the client to use a soft-bristle toothbrush - Advise the client to use an oral topical anesthetic prior to meals - Have the client rinse their mouth with a solution of 0.9% sodium chloride ***When generating solutions, the nurse should plan to provide the client who has nausea with several small meals during the day to reduce nausea. The nurse should instruct the client to avoid strong odors and drinking fluids during meals to increase appetite and reduce nausea. The nurse should plan to have the client who has mucositis to rinse their mouth with a solution of 0.9% sodium chloride, use a soft-bristle toothbrush, and use an oral topical anesthetic prior to meals to reduce the discomfort.

A nurse is planning care for a client who is receiving chemotherapy. MATCH the adverse effect of chemotherapy with the possible pharmacological treatment. 1. Anorexia 2. Nausea 3. Anemia 4. Neutropenia

Neutropenia -> Filgrastim Anemia -> Epoetin alfa (iron) Nausea -> Ondansetron Anorexia -> Megestrol ***When generating solutions, the nurse should identify that filgrastim is administered to treat neutropenia. Epoetin alfa is administered to treat anemia. Ondansetron is administered to treat nausea. Megestrol is administered to treat anorexia.

A nurse is caring for a client who is postoperative following a modified radical mastectomy with axillary lymph node dissection. Which of the following actions should the nurse take? Select all that apply. A. Elevate the client's right arm on a pillow B. Take blood pressure readings on the client's right arm C. Begin exercises on the client's right arm one week after the procedure D. Have the client wear a sling on the right arm when ambulating E. Turn the client onto their left side when in bed

A. Elevate the client's right arm on a pillow D. Have the client wear a sling on the right arm when ambulating E. Turn the client onto their left side when in bed ***When taking actions for a client following right modified radical mastectomy, the nurse should elevate the client's right arm on a pillow, support the right arm with a sling when ambulating, and position the client on their left side when in bed. These actions promote drainage of lymphatic fluid and reduces stress on the incision.

A nurse is preparing to assess a client who has lung cancer and is experiencing superior vena cava syndrome. Which of the following findings should the nurse expect? Select all that apply. A. Facial edema B. Wheezing C. Cough D. Client report of nausea E. Increased urine specific gravity

A. Facial edema B. Wheezing C. Cough ***When recognizing cues, the nurse should identify manifestations of superior vena cava syndrome includes facial edema, wheezing, and cough.

A nurse is reviewing the medical record of a client. Which of the following findings are risk factors for ovarian cancer? Select all that apply. A. Previous history of endometriosis B. Family history of colon cancer C. First pregnancy at age 24 D. First period at age 14 E. Use of oral contraceptives for 10 years

A. Previous history of endometriosis B. Family history of colon cancer ***When analyzing cues, the nurse should identify that risk factors for ovarian cancer include previous history of endometriosis and a family history of breast, ovarian, or colon cancer are risk factors for ovarian cancer.

A nurse is caring for a client who has cancer and has a prescription for transcutaneous electrical nerve stimulation (TENS) for pain management. Which of the following actions should the nurse take? Select all that apply. A. Remove hair before applying electrodes on the client's skin. B. Apply electrodes on the client to areas of intact skin. C. Place electrodes over the client's chest. D. Avoid administering additional pain medications to the client when using the TENS unit. E. Inspect the client's skin under the electrodes for burns.

A. Remove hair before applying electrodes on the client's skin. B. Apply electrodes on the client to areas of intact skin. E. Inspect the client's skin under the electrodes for burns. ***When taking actions, the nurse should remove hair before applying electrodes and place them on clean intact skin. The nurse should inspect the skin under the electrodes for burns or irritation.

A nurse is reviewing the pathology report on a client who had a biopsy to stage and grade ovarian cancer. The report states the tumor is graded G1 and staged T2-N3-MX. The nurse should interpret which of the following information based on the pathology report?​​​​​​​ A. The tumor is moderate in size. B. The cancer has not spread to the lymph nodes. C. The tumor cells are poorly differentiated. D. The cancer has metastasized to other areas in the body.

A. The tumor is moderate in size. ***When analyzing cues, the nurse should identify that T2 indicates the tumor is moderate in size, N3 indicates high lymph node involvement, MX indicates no metastasis is detected, and G1 indicates well differentiated tumor cells.

A nurse is planning care for a client who is receiving chemotherapy and is at risk for myelosuppression. SORT the following nursing interventions into those implemented for neutropenia and those implemented for thrombocytopenia. 1. Place the client in a private room. 2. Apply prolonged pressure to puncture site after blood sampling. 3. Have client-specific equipment remain in the room. 4. Advise the client to use an electric razor to shave 5. Have the client wear a mask when leaving the room. 6. Administer a stool softener

Neutropenia ---> - Place the client in a private room. - Have the client wear a mask when leaving the room. - Have client-specific equipment remain in the room. Thrombocytopenia ---> - Advise the client to use an electric razor to shave - Administer a stool softener - Apply prolonged pressure to puncture site after blood sampling.