Cancer and Sickle Cell Disorder PrepU quiz
A client has just been diagnosed with lung cancer. After the physician discusses treatment options and leaves the room, the client asks the nurse how the treatment is decided upon. What would be the nurse's best response?
"The type of treatment depends on the client's age and health status." "The type of treatment depends on what the client wants when given the options." "The type of treatment depends on the cell type of the cancer, the stage of the cancer, and the client's health status." "The type of treatment depends on the discussion between the client and the physician of which treatment is best."
A patient with a diagnosis of acute myeloid leukemia (AML) is being treated with induction therapy on the oncology unit. What nursing action should be prioritized in the patient's care plan?
Protective isolation and vigilant use of standard precautions Provision of a high-calorie, low-texture diet and appropriate oral hygiene Including the family in planning the patient's activities of daily living Monitoring and treating the patient's pain
The nurse is collaborating with a community group to develop plans to reduce the incidence of lung cancer in the community. Which of the following would be most effective?
Public service announcements on television to promote the use of high-efficiency particulate air (HEPA) filters in homes Advertisements in public places to encourage cigarette smokers to have yearly chest x-rays Classes at community centers to teach about smoking cessation strategies Legislation that requires homes and apartments be checked for asbestos leakage
A nurse is planning the care of a client with a diagnosis of sickle cell disease who has been admitted for the treatment of an acute vaso-occlusive crisis. What nursing diagnosis should the nurse prioritize in the client's plan of care?
Risk for disuse syndrome related to ineffective peripheral circulation Functional urinary incontinence related to urethral occlusion Ineffective tissue perfusion related to thrombosis Ineffective thermoregulation related to hypothalamic dysfunction
During a breast examination, which finding most strongly suggests that a client has breast cancer?
Slight asymmetry of the breasts A fixed nodular mass with dimpling of the overlying skin Bloody discharge from the nipple Multiple firm, round, freely movable masses that change with the menstrual cycle
The nurse is assessing a client's skin when the client points out a mole. The nurse brings the mole to the physician's attention when which characteristic is noted?
Symmetrical appearance Distinct borders Uniform light brown color Diameter exceeding 6 mm
A nurse is leading a health promotion workshop that is focusing on cancer prevention. What action is most likely to reduce participants' risks of basal cell carcinoma (BCC)?
Teaching participants to improve their overall health through nutrition Encouraging participants to identify their family history of cancer Teaching participants to limit their sun exposure Teaching participants to control exposure to environmental and occupational radiation
A client is seen in the emergency department with severe pain related to a sickle cell crisis. What does the nurse understand is occurring with this client?
The client has a decreased tolerance of pain related to the chronic nature of the illness. Bone marrow decreases the erythrocyte production causing decrease in hypoxia. Overhydration enlarges the red blood cells. Vascular occlusion in small vessels decreasing blood and oxygen to the tissues.
The nurse is assessing an older adult female who has not seen her physician in 2 years. The nurse is assisting the patient into a gown and notices that the patient has edema and pitting of the skin on the right breast. What does the nurse understand is the significance of this finding?
It may result from inflammation due to mastitis while the patient is breastfeeding. This finding is not uncommon and is significant only when of recent origin. It may result from a neoplasm blocking lymphatic drainage, giving the skin an orange-peel appearance, a classic sign of advanced breast cancer. This finding is most likely related to benign cysts of the breast in the nipple area.
A health care provider tells a breast cancer client that he is going to prescribe hormone therapy that has been found to significantly reduce mortality. Which drug would most likely be prescribed?
Lapatinib Bevacizumab Tamoxifen Trastuzumab
A nurse is caring for a client with thrombocytopenia. What is the best way to protect this client?
Limit visits by family members. Encourage the client to use a wheelchair. Use the smallest needle possible for injections. Maintain accurate fluid intake and output records.
A client with sickle cell crisis is admitted to the hospital in severe pain. While caring for the client during the crisis, which is the priority nursing intervention?
Limiting the client's intake of oral and IV fluids Administering and evaluating the effectiveness of opioid analgesics Encouraging the client to ambulate immediately Limit foods that contain folic acid
A client is undergoing a left modified radical mastectomy for breast cancer. Postoperatively, blood pressure should be obtained from the right arm, and the client's left arm and hand should be elevated as much as possible to prevent which condition?
Lymphedema Trousseau's sign IV infusion infiltration Muscle atrophy
A client's absolute neutrophil count (ANC) is 440/mm3 but the nurse's assessment reveals no apparent signs or symptoms of infection. What action should the nurse prioritize when providing care for this client?
Meticulous hand hygiene Timely administration of antibiotics Provision of a nutrient-dense diet Maintaining a sterile care environment
A nurse is caring for a patient who has a diagnosis of acute leukemia. What assessment most directly addresses the most common cause of death among patients with leukemia?
Monitoring for infection Monitoring nutritional status Monitor electrolyte levels Monitoring liver function
A nursing instructor is evaluating a student caring for a neutropenic client. The instructor concludes that the nursing student demonstrates accurate knowledge of neutropenia based on which intervention?
Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential Monitoring the client's breathing and reviewing the client's arterial blood gases Monitoring the client's heart rate and reviewing the client's hemoglobin Monitoring the client's blood pressure and reviewing the client's hematocrit
What assessment finding best indicates that the client has recovered from induction therapy?
Neutrophil and platelet counts within normal limits Vital signs within normal ranges No evidence of edema Absence of bone pain
Which statement best describes the function of stem cells in the bone marrow?
They are active against hypersensitivity reactions. They defend against bacterial infection. They produce all blood cells. They produce antibodies against foreign antigens.
A nurse is doing a physical examination of a child with sickle cell anemia. When the child asks why the nurse auscultates the lungs and heart, what would be best the response by the nurse?
To detect the abnormal sounds suggestive of acute chest syndrome and heart failure To detect the evidence of infection such as fever and tachycardia To detect the evidence of dehydration that might have triggered a sickle cell crisis To detect the motor strength and stroke-related signs and symptoms
The clinic nurse is caring for a client diagnosed with leukopenia. What does the nurse know this client has?
Too many erythrocytes A decrease in granulocytes A general reduction in all white blood cells A general reduction in neutrophils and basophils
Breast cancers are usually found in which area of the breast?
Upper outer quadrant Lower inner quadrant Middle Posterior
The medical nurse is aware that patients with sickle cell anemia benefit from understanding what situations can precipitate a sickle cell crisis. When teaching a patient with sickle cell anemia about strategies to prevent crises, what measures should the nurse recommend?
Using prophylactic antibiotics and performing meticulous hygiene Maximizing physical activity and taking OTC iron supplements Limiting psychosocial stress and eating a high-protein diet Avoiding cold temperatures and ensuring sufficient hydration
A nurse is teaching a client about breast self-examination and instructs the client to perform the examination at which time?
One to two days before her menses start After her menses, about the 5th to 7th day At the time of ovulation At anytime during her menstrual cycle
The nurse is assessing a patient who has a 35 pack-year history of cigarette smoking. In light of this known risk factor for lung cancer, what statement should prompt the nurse to refer the patient for further assessment?
"Lately, I have this cough that just never seems to go away." "I find that I don't have nearly the stamina that I used to." "I seem to get nearly every cold and flu that goes around my workplace." "I never used to have any allergies, but now I think I'm developing allergies to dust and pet hair."
The nurse is caring for four clients on the medical-surgical unit of the hospital. What client is mostly likely to be receiving treatment for sickle cell crisis?
A 29-year-old Caucasian male A 19-year-old African American male A 24-year-old Native American female A 36-year-old Eastern European female
A patient with acute myeloid leukemia (AML) is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. In which complication do the donor's lymphocytes recognize the patient's body as foreign and set up reactions to attack the foreign host?
Acute respiratory distress syndrome Graft-versus-host disease Remission Bone marrow depression
A client has completed induction therapy and has diarrhea and severe mucositis. What is the appropriate nursing goal?
Address issues of negative body image. Place the client in reverse isolation. Administer pain medication. Maintain nutrition.
A patient with renal failure has decreased erythropoietin production. Upon analysis of the patient's complete blood count, the nurse will expect which of the following results?
An increased hemoglobin and decreased hematocrit A decreased hemoglobin and hematocrit A decreased mean corpuscular volume (MCV) and red cell distribution width (RDW) An increased MCV and RDW
A suspicious breast lump is noted on a mammogram. The client asks the nurse which diagnostic test confirms if the lump is cancerous or benign. Which response by the nurse is most correct?
An ultrasound A biopsy A magnetic resonance imaging (MRI) A clinical breast exam
After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/mm3. What term should the nurse use to describe this low platelet count?
Anemia Leukopenia Thrombocytopenia Neutropenia
A nurse is caring for a client who is being treated for leukemia in the hospital. The client was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, the nurse should implement what intervention?
Arrange for total parenteral nutrition (TPN). Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube. Provide the client with several small, soft-textured meals each day. Assign responsibility for the client's nutrition to the client's friends and family.
A client with AML has pale mucous membranes and bruises on the legs. What is the primary nursing intervention?
Assess the client's skin. Assess the client's hemoglobin and platelets. Assess the client's pulse and blood pressure. Check the client's history.
The nurse is caring for a patient who has just had a radical mastectomy and axillary node dissection. When providing patient education regarding rehabilitation, what should the nurse recommend?
Avoid exercise of the arm for next 2 months. Keep cuticles clipped neatly. Avoid lifting objects heavier than 10 pounds. Use a sling until healing is complete.
The most common route of regional spread is to which area?
Axillary lymph nodes Internal mammary nodes Supraclavicular nodes Thyroid nodes
Which term is used to refer to a primitive cell that is capable of self-replication and differentiation?
Band cell Spherocyte Reticulocyte Stem cell
Diagnostic testing has resulted in a diagnosis of acute myeloid leukemia (AML) in an adult patient who is otherwise healthy. The patient and the care team have collaborated and the patient will soon begin induction therapy. The nurse should prepare the patient for which of the following?
Daily treatment with targeted therapy medications Radiation therapy on a daily basis Hematopoietic stem cell transplantation An aggressive course of chemotherapy
A patient's blood work reveals a platelet level of 17,000/mm3. When inspecting the patient's integumentary system, what finding would be most consistent with this platelet level?
Dermatitis Petechiae Urticaria Alopecia
A nurse is caring for a client with bronchogenic carcinoma. Which nursing diagnosis takes highest priority?
Disturbed body image related to changes in body functions Ineffective airway clearance related to obstruction by a tumor or secretions Anxiety related to actual threat to health status and changes in family dynamics Imbalanced nutrition: Less than body requirements related to anorexia and vomiting secondary to chemotherapy
A 42 year-old patient tells the nurse that she has found a painless lump in her right breast during her monthly self-examination. She says that she is afraid that she has cancer. Which assessment finding would most strongly suggest that this patient's lump is cancerous?
Eversion of the right nipple and mobile mass A nonmobile mass with irregular edges A mobile mass that is soft and easily delineated Nonpalpable right axillary lymph nodes
Which is the primary preventable cause of skin cancer?
Fair skin Excess melanin Exposure to UV radiation Skin disease
Development of malignant melanoma is associated with which risk factor?
History of severe sunburn African American heritage Skin that tans easily Residence in the Northeast
The nurse is caring for a patient at risk for atelectasis. The nurse implements a first-line measure to prevent atelectasis development in the patient. What is an example of a first-line measure to minimize atelectasis?
Incentive spirometry Intermittent positive-pressure breathing (IPPB) Positive end-expiratory pressure (PEEP) Bronchoscopy
A nurse is planning the care of a patient with a diagnosis of sickle cell disease who has been admitted for the treatment of an acute vaso-occlusive crisis. What nursing diagnosis should the nurse prioritize in the patient's plan of care?
Risk for disuse syndrome related to ineffective peripheral circulation Functional urinary incontinence related to urethral occlusion Ineffective tissue perfusion related to thrombosis Ineffective thermoregulation related to hypothalamic dysfunction
Diagnosis of skin cancer is confirmed by which of the following diagnostic tests?
Skin scraping Blood culture Visual interpretation Biopsy
A client with multiple myeloma is complaining of severe pain when the nurse comes in to give a bath and change position. What is the priority intervention by the nurse?
Inform the client that the position must be changed, and then you will give her pain medication and omit the bath. Inform the client that she will feel better after receiving a bath and clean sheets. Obtain the pain medication and delay the bath and position change until the medication reaches its peak. Inform the client that the bath and positioning is an important part of client care and will be done right after pain medication administration.
At a public health fair, a nurse teaches a group of women about breast cancer awareness. Possible signs of breast cancer include:
fever. breast changes during menstruation. nipple discharge and a breast nodule. fever and erythema of the breast.
A nurse is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society guidelines, the nurse should recommend that the women:
perform breast self-examination annually. have a mammogram annually. have a hormonal receptor assay annually. have a physician conduct a clinical examination every 2 years.
Which nursing diagnosis should a nurse expect to see in a care plan for a client in sickle cell crisis?
Imbalanced nutrition: Less than body requirements related to poor intake Disturbed sleep pattern related to external stimuli Impaired skin integrity related to pruritus Acute pain related to sickle cell crisis
Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process due to thrombocytopenia in a client with leukemia?
Implementing neutropenic precautions Eliminating direct contact with others who are infectious Applying prolonged pressure to needle sites or other sources of external bleeding Monitoring temperature at least once per shift
Which is a characteristic of a breast cancer mass?
Occurs as disseminated masses Symmetrical mass Tender upon palpation Firm, hard, embedded in surrounding tissue
