cancer

risk factors

-carcinogens -carcinogenesis -environment -hormones -lifestyle -infectious disease -medications -immune status -nutrition

pain control

-interprofessional team -palliative care

diagnosis

-laboratory tests -imaging -biopsy -endoscopic procedures

prevention

-primary prevention -secondary prevention -tertiary prevention

types of cancer

-solid tumor malignancies -hematological malignancies

clinical presentation

-CAUTION symptoms -constitutional signs -malignancy-specific signs and symptoms

oncological emergencies

-acute clinical complications -structural, metabolic, or hematological -organ dysfunction may be present

nursing management

-all subspecialties of med-surg -variety of care settings -pain control

c temporary prostheses are fitted soon after surgery. preparing the child for a prosthesis will help the child cope with the transition.

a nurse is caring for a child following an above-the-knee amputation. which of the following actions should the nurse take? a) avoid discussing the amputation. b) administer aspirin for phantom pain. c) prepare the child for a prosthesis fitting. d) maintain the affected limb in the dependent position.

c, d, e offering soft foods decreases the amount of chewing needed and possible irritation. a soft toothbrush allows for adequate cleaning of the mouth and decreases irritation. a warm saline mouthwash is effective in soothing mucositis.

a nurse is caring for a child who has oral mucositis. which of the following actions should the nurse take? (select all that apply.) a) swab the mucosa with lemon glycerin swabs. b) apply viscous lidocaine. c) offer soft foods. d) use a soft, disposable toothbrush for oral care. e) encourage gargling with a warm saline mouthwash.

a, d the child who has thrombocytopenia is at risk for bleeding. monitoring for findings of bleeding and avoiding venipunctures are appropriate actions for the nurse to take.

a nurse is caring for a child who has thrombocytopenia. which of the following actions should the nurse take? (select all that apply.) a) monitor for manifestations of bleeding b) administer routine immunizations. c) obtain rectal temperatures. d) avoid peripheral venipunctures. e) limit visitors.

a, c, d constipation, foot drop, and jaw pain are manifestations of neuropathy.

a nurse is caring for a child who is experiencing neuropathy due to chemotherapy. which of the following are manifestations of neuropathy? (select all that apply.) a) constipation b) skin breakdown c) foot drop d) jaw pain e) hemorrhage cystitis

c absent bowel sounds are an indication that gastrointestinal motility is absent and a reason to continue with NPO status.

a nurse is caring for a child who is postoperative following surgical removal of a wilms' tumor. which of the following assessments is an indication to continue NPO status? a) abdominal girth 1 cm larger than yesterday b) report of pain at the operative site c) absent bowel sounds d) passing of flatus every 30 min

staging & grading of cancer

T = tumor size -TX -T0 -Tis -T1, T2, T3, and T4 N = lymph node involvement -NX -N0 -N1, N2, and N3 M = metastasis -MX -M0 -M1 well-differentiated undifferentiated

1, 2, 5, 6 cancer is a common cause of SIADH. in SIADH, excessive amounts of water are reabsorbed by the kidney and put into the systemic circulation. the increased water causes hyponatremia and some degree of fluid retention. the syndrome is managed by treating the condition and cause and usually includes fluid restriction, increased sodium intake, and medication with a mechanism of action that is antagonistic to antidiuretic hormone. sodium levels are monitored closely because hypernatremia can develop suddenly as a result of treatment. the immediate institution of appropriate cancer therapy, usually radiation or chemotherapy, can cause tumor regression so that antidiuretic hormone synthesis and release processes return to normal.

a client with carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone as a complication of the cancer. the nurse anticipates that the primary health care provider will request which prescriptions? select all that apply. 1) radiation 2) chemotherapy 3) increased fluid intake 4) decreased oral sodium intake 5) serum sodium level determination 6) medication that is antagonistic to antidiuretic hormone

kidney & bladder cancer

bladder cancer -intravesical chemotherapy -intravesical immunotherapy -bacillus calmette-guerin renal cancer -cryoablation -nephrectomy

ovarian & uterine cancer

chemotherapy -traditional I -intraperitoneal radiation therapy -brachytherapy

4 clinical manifestations of ovarian cancer include abdominal distention, urinary frequency and urgency, pleural effusion, malnutrition, pain from pressure caused by the growing tumor and the effects of urinary or bowel obstruction, constipation, ascites with dyspnea, and ultimately general severe pain. abnormal bleeding, often resulting in hypermenorrhea, is associated with uterine cancer.

during the admission assessment of a client with advanced ovarian cancer, the nurse recognizes which manifestation as typical of the disease? 1) diarrhea 2) hypermenorrhea 3) abnormal bleeding 4) abdominal distention

pancreatic cancer

presentation -boring back and abdominal pain that radiates to the back, that is sometimes relieved by sitting up and more severe at night -fatigue -anorexia -pruritus -weight loss -palpable abdominal mass, enlarged gallbladder and liver -hepatomegaly, splenomegaly -jaundice -clay colored stools -dark, frothy urine -ascites -early satiety -glucose intolerance -gastrointestinal bleeding -flatulence diagnosis -biopsy -endoscopic retrograde cholangiopancreatography -abdominal paracentesis -imaging -tumor markers -other laboratory testing treatment -open whipple procedure -partial pancreatectomy -total pancreatectomy -chemotherapy, radiation -targeted therapy -opioid medications

colorectal cancer

presentation -changes in stool consistency or shape -blood in stool -cramps and/or gas -palpable mass -weight loss and fatigue -vomiting -abdominal fullness, distention or pain -abnormal bowel sounds indicative of obstruction -rectal pain -sensation of bowel fullness after defecation diagnosis -guaiac-based fecal occult blood testing -fecal immunochemical test -stool DNA -biopsy -endoscopy: colonoscopy, sigmoidoscopy -double contrast barium enema -CBC -carcinoembryonic antigen -CT, MRI treatment -chemotherapy -targeted medication therapy -adjuvant therapy -radiation therapy -surgical interventions -palliative care

3 hyperuricemia is especially common following treatment for leukemias and lymphomas, because chemotherapy results in massive cell kill.

the nurse is analyzing laboratory results of a client with leukemia who has received a regimen of chemotherapy. which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy? 1) anemia 2) decreased platelets 3) increased uric acid level 4) decreased leukocyte count

1, 3, 6 oncological emergencies include sepsis, disseminated intravascular coagulation, syndrome of inappropriate antidiuretic hormone, spinal cord compression, hypercalcemia, superior vena cava syndrome, and tumor lysis syndrome. blockage of blood flow to the venous system of the head resulting in facial edema is a sign of superior vena cava syndrome. a serum calcium level of 12 mg/dL indicates hypercalcemia. numbness and tingling of the lower extremities could be a sign of spinal cord compression. mild hypokalemia and weight loss are not oncological emergencies. a sodium level of 136 mg/dL is a normal level.

the nurse is caring for a client with lung cancer and bone metastasis. what signs and symptoms would the nurse recognize as indications of a possible oncological emergency? select all that apply. 1) facial edema in the morning 2) weight loss of 20 lb in 1 month 3) serum calcium level of 12 mg/dL 4) serum sodium level of 136 mg/dL 5) serum potassium level of 3.4 mg/dL 6) numbness and tingling of the lower extremities

lung cancer

presentation -fatigue, weight loss, or anorexia -fever -persistent cough, with or without hemoptysis -hoarseness -altered breathing pattern: dyspnea, prolonged exhalation alternated with shallow breaths, rapid, shallow breaths -altered breath sounds -diminished or absent breath sounds -chest pain or tightness -chest wall masses -muffled heart sounds -pleural friction rub -clubbing of fingers -increased work of breathing -decreased bone density diagnosis -cyologic testing -thorascopy, bronchoscopy, mediastinoscopy, x-ray, CT scan -thoracentesis with pleural biopsy; MRI, PET scan -pulmonary function tests and arterial blood gases treatment -bronchodilators and corticosteroids -chemotherapy -photodynamic therapy -radiation therapy -radiofrequency ablation -targeted therapy -surgical interventions palliative care -thoracentesis or pleurodesis -laser therapy and photodynamic therapy -pericardiocentesis or pericardial window -oxygen therapy

prostate cancer

sipuleucel-T -a vaccine against cancer hormone therapy -leuprolide -flutamide chemotherapy -can be used on clients whose cancer has spread or who have had minimal improvement with other therapies radiation -internal -external beam

treatment

surgical treatment -surgical resection of a tumor -debulking of tumor mass -redirection of vital functions -reconstitution radiation therapy -external -internal -systemic chemotherapy -route of administration -complications hormone therapy -LH-RH agonists -androgen antagonists -bicalutamide -estrogen antagonists -tamoxifen -anastrozole immunotherapy -interleukins -interferons targeted therapy -based on mechanism of action

breast cancer

symptoms -breast change -breast pain or soreness -skin changes -dimpling -breast tumors -increased vascularity, erythema -nipple discharge -nipple retraction or ulceration -enlarged lymph nodes -male clients often report a mass around the areola that is hard and painless, nipple inversion, ulceration or swelling of the chest treatment -complementary and integrative therapies -hormone therapy -chemotherapy/radiation therapy -surgical interventions -other procedures

liver cancer

targeted therapy -a multi-tyrosine kinase inhibitor taken orally and used to treat advanced liver cancer hepatic arterial infusion -the direct infusion of chemotherapy via a catheter into the tumor hepatic artery embolization -chemoembolization -radioembolization ablation procedures -radiofrequency ablation -percutaneous alcohol injections -cryotherapy -microwave thermotherapy liver transplantation -can be an option for clients who have small primary tumors

4 an adverse effect specific to vincristine is peripheral neuropathy, which occurs in almost every client. peripheral neuropathy can be manifested as numbness and tingling in the fingers and toes. depression of the achilles tendon reflex may be the first clinical sign indicating peripheral neuropathy. constipation rather than diarrhea is most likely to occur with this medication, although diarrhea may occur occasionally. hair loss occurs with nearly all antineoplastic medications. chest pain is unrelated to this medication.

a client with ovarian cancer is being treated with vincristine. the nurse monitors the client, knowing that which manifestation indicates an adverse effect specific to this medication? 1) diarrhea 2) hair loss 3) chest pain 4) peripheral neuropathy

4 an adverse effect specific to etoposide is orthostatic hypotension. etoposide should be administered slowly over 30 to 60 minutes to avoid hypotension. the client's blood pressure is monitored during the infusion. hair loss occurs with nearly all antineoplastic medications. chest pain and pulmonary fibrosis are unrelated to this medication.

a client with small cell lung cancer is being treated with etoposide. the nurse monitors the client during administration, knowing that which adverse effect is specifically associated with this medication? 1) alopecia 2) chest pain 3) pulmonary fibrosis 4) orthostatic hypotension

a the client will receive a dye or colloid as a tracer to help identify lymph nodes during a sentinel lymph node biopsy.

a nurse in a clinic is talking with a client scheduled for a sentinel lymph node biopsy. which of the following information should the nurse include? a) dye is used during the procedure. b) the lymph nodes closest to the tumor are removed during the biopsy. c) a small amount of chemotherapy is used to test the lymph node response. d) a 2 mm plug of tissue is removed during the biopsy.

b, c, e anorexia, petechiae, and unsteady gait are early manifestations of leukemia.

a nurse is assessing a child who has leukemia. which of the following are early manifestations of leukemia? (select all that apply.) a) hematuria b) anorexia c) petechiae d) ulcerations in the mouth e) unsteady gait

b, c, d, e a child who has metastatic neuroblastoma will have bone pain, periorbital ecchymoses, proptosis, and weight loss.

a nurse is assessing a child who has neuroblastoma of the adrenal gland. which of the following are manifestations of metastasis from the primary site? (select all that apply.) a) weight gain b) bone pain c) periorbital ecchymoses d) proptosis e) weight loss

a, b, d palpable neck lymph nodes, pain, and epistaxis are manifestations of rhabdomyosarcoma of the nasopharynx.

a nurse is assessing a child who has rhabdomyosarcoma of the nasopharynx. which of the following are manifestations of rhabdomyosarcoma? (select all that apply.) a) enlarged neck lymph nodes b) pain c) vomiting d) epistaxis e) diplopia

a, c, e pain, lymph node enlargement, and palpable mass are expected findings of rhabdomyosarcoma of an extremity.

a nurse is assessing a child who has rhabdomyosarcoma of the upper arm. which of the following findings should the nurse expect? (select all that apply.) a) pain b) discoloration of the skin c) lymph node enlargement d) easy bruising e) palpable mass

b blood glucose should be monitored during the first 24 to 48 hr following a liver lobectomy due to decreased gluconeogenesis and stress to the liver from surgery.

a nurse is caring for a client 24 hr following a liver lobectomy for hepalocellular carinoma. which of the following laboratory reports should the nurse monitor? a) urine specific gravity b) blood glucose c) serum amylase d) D-dimer

d monitor the client for dizziness. instruct the client to avoid driving until medication effects are known.

a nurse is caring for a 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

a remove the client's hair before applying the electrodes from the TENS unit to the skin.

a nurse is caring for a client who has cancer and has a prescription for transcutaneous electric nerve stimulation for pain management. which of the following actions should the nurse take? a) remove hair before applying the electrodes from the TENS unit on the skin. b) apply alcohol to the client's skin before attaching the electrodes from the tens unit. c) attach the electrodes from the TENS unit over painful incisions or skin damage. d) avoid other pain medications when using the TENS unit.

a, b, c visitors should remain for no more than 30 min at a time and maintain a distance of at least 6 ft. pregnant individuals should not enter the room of a client receiving brachytherapy. healthcare personnel should wear a dosimeter when there is potential exposure to radiation, such as in the radiology department or in the room of a client receiving brachytherapy.

a nurse is caring for a client who has cervical cancer and is scheduled for brachytherapy. which of the following actions should the nurse take? (select all that apply.) a) permit visitors to stay with the client 30 min at a time. b) warn pregnant individuals to visit the room only once daily. c) wear a dosimeter when in the client's room. d) place soiled dressings in a biohazard bag before discarding in the regular trash. e) dispose soiled linens in the hamper outside the client's room.

a, b, c, e respiratory depression, hypotension, sedation, and sensory blockage are adverse effects of epidural analgesics.

a nurse is caring for a client who has chronic cancer pain and has a permanent epidural catheter for administration of a fetanyl/bupivacaine solution. the nurse should monitor the client for which of the following findings? (select all that apply.) a) respiratory depression b) hypotension c) sedation d) muscle spasticity e) sensory blockage

a, b, d behavioral changes, a client report of headache, and a client report of nausea indicate cerebral edema due to SIADH and should be reported to the provider.

a nurse is caring for a client who has lung cancer and is exhibiting manifestations of syndrome of inappropriate antidiuretic hormone. which of the following findings should the nurse report to the provider? (select all that apply.) a) behavioral changes b) client report of headache c) urine output 40 mL/hr d) client report of nausea e) increased urine specific gravity

c, e a lesion with asymmetric borders and a lack of uniformity of pigmentation of a mole are considered suspicious for a melanoma.

a nurse is caring for a client who has multiple types of skin lesions. which of the following skin lesions are indicative of a malignant melanoma? (select all that apply.) a) diffuse vesicles b) uniformly colored papule c) area with asymmetric borders d) rough, scaly patch e) irregular colored mole

c obtain a culture of the oral lesions to identify pathogens and determine appropriate treatment.

a nurse is caring for a client who is receiving chemotherapy and has mucositis. which of the following actions should the nurse take? a) use a glycerin-soaked swab to clean the client's teeth. b) encourage increased intake of citrus fruit juices. c) obtain a culture of the lesions. d) provide an alcohol-based mouthwash for oral hygiene.

c several small meals a day are usually better tolerated by the client who has nausea.

a nurse is caring for a client who is undergoing chemotherapy and reports severe nausea. which of the following statements should the nurse make? a) "your nausea will lessen with each course of chemotherapy." b) "hot food is better tolerated due to the aroma." c) "try eating several small meals throughout the day." d) "increase your intake of red meat as tolerated."

a inform the client that neurolytic ablation causes permanent destruction of the nerves that transmit pain from a specific area and is a last resort after other methods have been unsuccessful.

a nurse is caring for a client who will undergo a neurolytic ablation. the client asks the nurse the reason for this procedure. which of the following responses should the nurse make? a) "it should provide permanent pain relief." b) "it reduces the adverse effects of your pain medication." c) "it increases your ability to fight infections." d) "it increases cells that stop bleeding."

b removal of the tumor occurs within 24 to 48 hr after admission. preparation for surgery should be included in the plan of care.

a nurse is caring for a toddler who has a wilms' tumor. which of the following actions should the nurse take? a) palpate the child's abdomen to identify the size of the tumor. b) prepare the child for surgery. c) teach the parents about dialysis. d) obtain a 24-hr urine specimen from the child.

c be available to answer the client's questions and to listen to any concerns.

a nurse is caring for an adolescent who has a new diagnosis of osteosarcoma. which of the following actions should the nurse take first? a) ensure that the adolescent has a referral for a psychiatrist visit. b) prepare a teaching plan to educate the adolescent in detail about the diagnosis and treatment. c) spend time with the adolescent to answer any questions. d) perform a mental status examination to assess the adolescent's thought patterns.

b, c, d, e a sore that does not heal, difficulty swallowing, the presence of unusual discharge, and weight gain or loss can indicate possible cancer.

a nurse is collecting information from a client in a provider's office. which of the following findings should the nurse identify as an indication of possible cancer? (select all that apply.) a) temperature 102 F for more than 48 hr b) sore that does not heal c) difficulty swallowing d) unusual discharge e) weight gain 4 lb in 2 weeks

a implement bleeding precautions for the client who has thrombocytopenia.

a nurse is planning care for a client who has a platelet count of 10,000/mm3. which of the following interventions should the nurse include in the plan of care? a) apply prolonged pressure to puncture site after blood sampling. b) administer epoetin alfa as prescribed. c) place the client in a private room. d) have the client use an oral topical anesthetic before meals.

a, b, c, e the use of a food diary assists in monitoring changes in eating habits that occur in malnutrition due to cancer. oral hygiene before and after meals promotes increased salivation and improves taste perception. ferritin is an indicator of the protein intake of a client who has malnutrition due to cancer. encourage the client to limit drinking fluids with meals because fluids can cause early satiety and decrease adequate intake of food, causing malnutrition, when the client has cancer. some fluids are needed to treat dry mouth and thickened saliva.

a nurse is planning care for a client who has malnutrition due to cancer. which of the following interventions should the nurse include in the plan of care? (select all that apply.) a) advise the client to keep a food diary. b) encourage the client to brush teeth before and after meals. c) assess the laboratory report of ferritin. d) eat nutrient-dense foods last at meal time. e) encourage the client to limit drinking fluids during meals.

a a signed informed consent form should be obtained prior to the procedure.

a nurse is planning care for a client who is scheduled for genetic testing for suspected cancer. which of the following interventions should the nurse include in the plan of care? a) determine the need for informed consent. b) send testing results to the client's insurance agency. c) verify the prescription for a tumor marker assay. d) ensure the client is placed in a recovery position after testing.

b, c, d, e neutropenic precautions include the client not having contact with flowers and plants, having the client wear a mask when leaving the room, having equipment available that is only for use in caring for the client, and avoiding consuming raw foods.

a nurse is planning care for a client who is undergoing chemotherapy and is on neutropenic precautions. which of the following interventions should be included in the plan of care? (select all that apply.) a) encourage a high-fiber diet. b) eliminate standing water in the room. c) have the client wear a mask when leaving the room. d) have client-specific equipment remain in the room. e) eliminate raw foods from the client's diet.

c restraining the the infant during the procedure to prevent movement will decrease the potential for injury. it is an appropriate action for the nurse to take.

a nurse is planning care for an infant who is scheduled to have a lumbar puncture. which of the following actions should the nurse include in the plan of care? a) cleanse the thoracic area of the infant's back with an antiseptic solution. b) apply a eutectic mixture of local anesthetic cream just before the procedure begins. c) restrain the infant during the procedure to prevent movement. d) position the infant with his head extended and chin raised.

a, b, c manifestations of infection, bleeding precautions, and hand hygiene should be included in the teaching.

a nurse is providing home care instructions to a parent of a child who is receiving chemotherapy. which of the following instructions should the nurse include in the teaching? (select all that apply.) a) manifestations of infection b) bleeding precautions c) hand hygiene d) homeschooling e) airborne precautions

c fecal occult blood tests should be done annually by clients starting at age 50 years.

a nurse is providing teaching about colon cancer to a group of females 45 to 65 years of age. which of the following statements should the nurse include in the teaching? a) "colonoscopies for individuals with no family history of cancer should begin at age 40." b) "a sigmoidoscopy is recommended every 5 years beginning at age 60." c) "fecal occult blood tests should be done annually beginning at age 50." d) "an MRI provides a definitive diagnosis of colon cancer."

a, b, e chemotherapy and radiotherapy may be necessary for treatment. diagnostic testing for neuroblastoma includes a bone marrow biopsy. resection of the tumor is the treatment of choice.

a nurse is providing teaching to the parent of a child who has a neuroblastoma. which of the following statements should the nurse include in the teaching? (select all that apply.) a) "chemotherapy and radiotherapy may be necessary for treatment." b) "your child will need a bone marrow biopsy." c) "your child will be paralyzed because of this tumor." d) "your child will need surgery for resection of the tumor."

c the client should examine one testicle at a time to ensure that an abnormality is not missed.

a nurse is reviewing testicular self-examination with a client. which of the following client statements indicates understanding? a) "it is best to examine the testicles before bathing." b) "it is not necessary to report small lumps, unless they are painful." c) "i will examine one testicle at a time." d) "i will use my palms to feel for abnormalities."

a, b endometriosis and a family history of breast, ovarian, or colon cancer are risk factors for ovarian cancer.

a nurse is reviewing the medical record of a client who has suspected ovarian cancer. which of the following findings should the nurse identify as a risk factor for ovarian cancer? (select all that apply.) a) previous treatment for endometriosis b) family history of colon cancer c) first pregnancy at age 24 d) report of first period at age 14 e) use of oral contraceptives for 10 years

d the greatest risk to the client who has thrombocytopenia is injury due to bleeding. the priority action for the nurse to take is to monitor the client's platelet level to ensure it does not reach critical level. the nurse should institute bleeding precautions.

a nurse is reviewing the plan of care for a client who has leukemia and had developed thrombocytopenia. which of the following actions should the nurse take first? a) instruct the client to take rest periods throughout the day. b) encourage the client to reposition in bed every 2 hr. c) check temperature every 4 hr. d) monitor platelet counts.

c instruct the client that after the age of 40, they should have annual clinic breast exams.

a nurse is teaching a client about screening prevention for cancer. which of the following statements by the client indicates an understanding of the teaching? a) "i will need to have a mammogram every 2 years beginning at age 45." b) "i should have a colonoscopy every 15 years beginning at age 60." c) "i will need to have an annual breast examination every year after 40." d) "i should have a fecal occult test done every 3 years."

d a shave biopsy is a sampling of the outer skin layer using a scalpel or razor blade.

a nurse is teaching a client who is scheduled for a shave biopsy for suspected cancer. which of the following client statements indicates understanding of the procedure? a) "a test of my bone marrow will be performed." b) "a lymph node will be removed." c) "a needle will be inserted into the mass." d) "a small skin sample will be obtained."

b nuclear imaging involved the administration of an oral or IV radioactive tracer to identify cancerous tissue.

a nurse is teaching a client who is scheduled for nuclear imaging for suspected cancer. which of the following statements should the nurse give? a) "the presence of a liver enzyme will be identified." b) "you will be given an injection of a radioactive substance." c) "an endoscope will be inserted through your mouth." d) "the tumor will be aspirated."

c, d, e prompt removal of the tumor is best practice for treatment of wilms' tumor. palpating the tumor could cause rupture of the encapsulated tumor. chemotherapy and/or radiation are started immediately after surgery.

a nurse is teaching the parents of a child who has a wilms' tumor. which of the following statements should the nurse include in the teaching? (select all that apply.) a) "your child will need to have chemotherapy for 12 months." b) "wilms' tumors are typically genetic in nature." c) "surgery is usually done within 48 hours of diagnosis." d) "palpating the tumor could cause spread of the cancer." e) "further treatments will start immediately after surgery."

3 during the period of greatest bone marrow suppression, the platelet count may be low, less than 20,000 cells mm3.

as part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of greatest bone marrow suppression. the nurse understands that further teaching is needed if the client makes which statement? 1) "i should avoid blowing my nose." 2) "i may need a platelet transfusion if my platelet count is too low." 3) "i'm going to take aspirin for my headache as soon as i get home." 4) "i will count the number of pads and tampons i use when menstruating."

3 to ensure that the client receives optimal doses of chemotherapy, dosing is usually based on the total BSA, which requires a current accurate height and weight for BSA calculation. asking the client about his or her height and weight may lead to inaccuracies in determining a true BSA and dosage. calculating body mass index and measuring abdominal girth will not provide the data needed.

chemotherapy dosage is frequently based on total body surface area, so it is important for the nurse to perform which assessment before administering chemotherapy? 1) measure the client's abdominal girth. 2) calculate the client's body mass index. 3) measure the client's current weight and height. 4) ask the client about his or her weight and height.

4 the breast self-examination should be performed regularly, 7 days after the onset of the menstrual period. performing the examination weekly is not recommended. at the onset of menstruation and during ovulation, hormonal changes occur that may alter breast tissue.

the community health nurse is instructing a group of young female clients about breast self-examination. the nurse should instruct the clients to perform the examination at which time? 1) at the onset of menstruation 2) every month during ovulation 3) weekly at the same time of day 4) one week after menstruation begins

1 the client's self-report is a critical component of pain assessment. the nurse should ask the client to describe the pain and listen carefully to the words the client uses to describe the pain. nonverbal cues from the client are important but are not the most appropriate pain assessment measure. the nurse's impression of the client's pain is not appropriate in determining the client's level of pain.

the home health care nurse is caring for a client with cancer who is complaining of acute pain. the most appropriate determination of the client's pain should include which assessment? 1) the client's pain rating 2) nonverbal cues from the client 3) the nurse's impression of the client's pain 4) pain relief after appropriate nursing intervention

2 the TSE is recommended monthly after a warm bath or shower when the scrotal skin is relaxed. the client should stand to examine the testicles. using both hands, with fingers under the scrotum and thumbs on top, the client should gently roll the testicles, feeling for any lumps.

the nurse is instructing a client to perform a testicular self-examination. the nurse should provide the client with which information about the procedure? 1) to examine the testicles while lying down 2) that the best time for the examination is after a shower 3) to gently feel the testicle with one finger to feel for a growth 4) that TSEs should be done at least every 6 months

a a T2 designation describes the size and extent of the ovarian tumor using the tumor-node-metastasis staging system. a T1 tumor is smallest in size, and a T4 tumor is largest.

the nurse is reviewing the medical 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 findings should the nurse identify as a supporting diagnosis? a) the tumor is moderate in size. b) no lymph nodes contain cancer cells. c) the tumor is receptive to current medication therapy. d) the cancer has metastasized to other areas in the body.

3 in the neutropenic client, meticulous hand hygiene education is implemented for the client, family, visitors, and staff. not all visitors are restricted, but the client is protected from persons with known infections. fluids should be encouraged. invasive measures such as and indwelling urinary catheter should be avoided to prevent infections.

the nurse should plan to implement which intervention in the care of a client experiencing neutropenia as a result of chemotherapy? 1) restrict all visitors. 2) restrict fluid intake. 3) teach the client and family about the need for hand hygiene. 4) insert an indwelling urinary catheter to prevent skin breakdown.

4 in the event that a radiation source becomes dislodged, the nurse would first encourage the client to lie still until the radioactive source has been placed in a safe, closed container. the nurse would use long-handled forceps to place the source in the lead container that should be in the client's room. the nurse should then call the radiation oncologist and document the event and the actions taken. it is not within the scope of nursing practice to insert a radiation implant.

while giving care to a client with an internal cervical radiation implant, the nurse finds the implant in the bed. the nurse should take which initial action? 1) call the primary health care provider. 2) reinsert the implant into the vagina. 3) pick up the implant with gloved hands and flush it down the toilet. 4) pick up the implant with long-handled forceps and place it in a lead container.