cancer

The nurse is conduction a history and monitoring laboratory values on a client with multiple myeloma. What assessment findings should the nurse expect to note? Select all that apply a. pathological fracture b. urinalysis positive for nitrites c. hemoglobin level of 15.5 g/dL (155 mmol/L) d. calcium level of 8.6 mg/dL (2.15 mmol/L) e.serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

a. pathological fracture b. urinalysis positive for nitrites e. serum creatinine level of 2.0 mg/dL (176.6 mcmol/L) rationale: Multiple myelomea is a B-cell neoplastic condition characterized by abnormal malignant proliferation of plasma cells and the accumulation of mature plasma cells in the bone marrow. The client with malignant melanoma may experience pathological fractures, hypercalcemia, anemia, recurrent infections, and renal failure. A serum calcium level of 8.6 mg/dL ( 2.15 mmol/L) and a hemoglobin level of 15.5 g/dL (155mmol/L) are normal values. Therefore, the correct answers are pathological fractures, positive urinalysis for nitrites, and serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

The patient is on neutropenic precautions. these may include (select all that apply): a. practice good handwashing b. avoid injections to prevent bleeding c. wear a mask when providing patient care d. avoid being around ill people e. monitor temperature every 4 hours and prn f. avoid undercooked meats and eggs.

a. practice good handwashing d. avoid being around ill people e. monitor temperature every 4 hours and prn f. avoid undercooked meats and eggs. Rationale: Neurtopenic precautions include good handwashing, avoid being around ill people, monitoring temperature every 4 hours and prn, and avoiding the use of pepper (as it is loaded with pathogens). It is not necessary to wear a mask when providing care and avoidance of injections is not needed because bleeding is not the concern with neutropenia.

The nurse is assessing the colostomy of a client who has has an abdominal perineal resection for a bowel tumor. Which assessment finding indicates that the colostomy is beginning to function? a. the passage of flatus b. absent bowel sounds c. the client's ability to tolerate food d. bloody drainage from the colostomy

a. the passage of flatus rationale: Following abdominal perineal resection, the nurse would expect the colostomy to begin to function within 72 hours after surgery, although it may take up to 5 days. The nurse should assess for a return of peristalsis, listen for bowel sounds and check for the passage of flatus. absent bowel sounds would not indicate the return of peristalsis. The client would remain NPO until bowel sounds return and the colostomy is functioning. Bloody drainage is not expected from a colostomy

All of the following are necessary for normal immune function except: a. inflammation b. 1:1 hemoglobin to iron ratio c. humoral immunity d. cell-mediated immunity

b. 1:1 hemoglobin to iron ratio rationale: Inffamation, humoral immunity (B-cell/antibodies) and cell-mediated immunity (T-cell) are all needed to function normally for a person to be immunocompetent. A 1:1 hemoglobin to iron ratio is not needed for immunity but is necessary for a RBC to fully transport oxygen.

A client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication? a. Glucose level b. Calcium level c. Potassium level d. Prothrombin time

b. Calcium level rationale: Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of therapy, a complete blood count, platelet count, and serum calcium level should be assessed. These blood levels, along with cholesterol and triglyceride levels, should be monitored periodically during therapy. The nurse should assess for hypercalcemia while the client is taking this medication. Signs of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, hypotonicity of muscles, and deep bone and flank pain.

The nurse is assessing the perineal wound in a client who has returned from the operating room following an abdominal perineal resection and notes serosanguineous drainage from the wound. Which nursing intervention is most appropriate? a. clamp the surgical drain b. change the dressing as prescribed c. notify the health care provider d. remove and replace the perineal packing

b. Change the dressing as prescribed rationale: Immediately after surgery, profuse serosnguineous drainage from the perineal wound is expected. Therefore, the nurse should change the dressing as prescribed. A surgical drain should not be clamped because this action will cause the accumulation of drainage within the tissue. The nurse doesn not need to notify the HCP at this time. Drains and pacing are removed gradually over a period of 5 to 7 days as prescribed. The nurse should not remove the perineal packing.

The nurse is providing medication instructions to a client with breast cancer who is receiving cyclophosphamide. The nurse should tell the client to take which action? a. Take the medication with food b. Increase fluid intake to 2000 to 3000 mL daily c. Decrease sodium intake while taking the medication d. Increase potassium intake while taking the medication

b. Increase fluid intake to 2000 to 3000 mL daily rationale: Hemorrhagic cystitis is an adverse effect that can occur with the use of cyclophosphamide. The client needs to be instructed to drink copious amounts of fluid during the administration of this medication. Clients also should monitor urine output for hematuria. The medication should be taken on an empty stomach, unless gastrointestinal upset occurs. Hyperkalemia can result from the use of the medication; therefore, the client would not be instructed to alter sodium intake.

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

b. That the best time for the examination is after a shower rationale: 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.

A client with acute myelocytic leukemia is being treated with busulfan. Which laboratory value would the nurse specifically monitor during treatment with this medication? a. Clotting time b. Uric acid level c. Potassium level d. Blood glucose level

b. Uric acid level rationale: Busulfan can cause an increase in the uric acid level. Hyeruricemia can produce uric acid nephropathy, renal stones, and acute kidney injury. Options a, c, and d are not specifically related to this medication

The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm? a. placing cool compresses on the affected arm b. elevating the affected arm on a pillow above heart level c. avoiding arm exercises in the immediate postoperative period d. maintaining an intravenous site below the antecubital area on the affected side.

b. elevating the affected arm on a pillow above the heart level. rationale: Following mastectomy, the arm should be elevated above the level of the heart. Simple arm exercises should be encouraged. No blood pressure readings, injections, intravenous lines, or blood draws should be performed on the affected arm. Cool compresses are not a suggested measure to prevent lymphedema from occuring.

The nurse is reviewing the history of a client with bladder cancer. The nurse expects to note documentation of which most common s/s of this type of cancer? a. dysuria b. hematuria c. urgency on urination d. frequency of urination

b. hematuria rationale: The most common sign in clients with cancer of the bladder is hematuria. The client also may experience irritative voiding symptoms such as frequency, urgency, and dysuria, and these symptoms are associated with carcinoma in situ. Dysuria, urgency, and frequency of urination are also symptoms of a bladder infection.

When caring for a client with an internal radiation implant, the nurse should observe which principals? Select all that apply a. limiting the time with the client to 1 hour per shift b. keeping pregnant women out of the client's room c. placing the client in a private room with a private bath d. wearing a lead shield when providing direct client care e. Removing the dosimeter film badge when entering the client's room f. allowing individuals younger than 16 year old in the room as long as they are 6 feet away from the client.

b. keeping pregnant women out of the client's room c. placing the client in a private room with a private bath d. wearing a lead shield when providing direct client care rationale: The time that the nurse spends in the room of a client with an internal radiation implant is 30 mins. per 8-hour shift. The client must be placed in a private room with a private bath. Lead shielding can be used to reduce the transmission of radiation. The dosimeter film badge must be worn when in the client's room. Children younger than 16-years-old and pregnant women are not allowed in the client's room.

a client is diagnosed as having a bowel tumor. The nurse should monitor the client for which complications of this type of tumor?: select all that apply a. flatulence b. peritonitis c. hemorrhage d. fistula formation e. bowel perforation f. lactose intolerance.

b. peritonitis c. hemorrhage d. fistula formation e. bowel perforation Rationale: Complications of bowel tumors include bowel perforation, which can lead to hemorrhage and peritonitis. Other complications include bowel obstruction and fistula formation. Flatulence can occur but is not a complication; lactose intolerence also is not a complication of intestinal tumor.

The primary function of white blood cells is to: a. assist with clotting b. provide immunity c. transport oxygen d. store iron

b. provide immunity rationale: The primary function of WBCs is to provide immunity. The function of RBCs is to transport oxygen and platelets is to assist with clotting. None of them store iron.

A client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing which condition? a. rupture of the bladder b. the development of a vesicovaginal fisitula c. extreme stress caused by the diagnosis of cancer d. altered perineal sensation as a side effect of radiation therapy

b. the development of vesicovaginal fisitula rationale: the vesicovaginal fistula is a genital fistula that occurs between the bladder and vagina. The fistula is an abnormal opening between these 2 body parts and , if this occurs, the client may experience drainage of urine through the vagina. The client's complaint is not associated with options a, c, or d.

The nurse is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care? a. "I change my pouch every week" b. "I change the appliance in the morning" c. "I empty the urinary collection bag when it is two-thirds full." d. "When I'm in the shower I direct the flow of water away from my stoma"

c. "I empty the urinary collection bag when it is two-thirds full" rationale: The urinary collection bag should be changed when it is one-third full to prevent pulling of the appliance and leakage. The remaining options identify correct statements about the care of a urinary stoma.

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 nadir). The nurse understands that further teaching is needed if the client makes which statement? a. "I should avoid blowing my nose." b. "I may need a platelet transfusion if my platelet count is too low." c. "I'm going to take aspirin for my headache as soon as I get home." d. "I will count the number of pads and tampons I use when menstruating."

c. "I'm going to take aspirin for my headache as soon as I get home." Rationale: During the period of greatest bone marrow suppression (the nadir), the platelet count may be low, less than 20,000 cells mm3 (20.0 X 10-9/L). The correct option describes an incorrect statement by the client. Aspirin and nonsteriodal antiinflammatory drugs and products that contain aspirin should be avoided because of their antiplatelet activity. Options a, b, and d are correct statements by the client to prevent and monitor bleeding.

A female patient's complex symptomatology over the past year has led to a diagnosis of systemic lupus erythematorsus (SLE). Which statement demonstrates the patient's need for further teaching about the disease? a. "I'll try my best to stay out of the sun this summber." b. "I know that I probably have a high chance of getting arthritis." c. " I'm hoping that surgery will be an option for me in the future" d. "I understand that I'm going to be vulnerable to getting infection."

c. "I'm hoping that surgery will be an option for me in the future"

Tamoxifin citrate is prescribed for a client with metastatic breast carcinoma. The client asks the nurse if her family member with bladder cancer can also take this medication. The nurse most appropriately responds by making which statement? a. "This medication can be used only to treat breast cancer" b. "Yes, your family member can take this medication for bladder cancer as well" c. "This medication can be taken to prevent and treat clients with breast cancer" d. "This medication can be taken by anyone with cancer as long as their health care provider approves it"

c. "This medication can be taken to prevent and treat clients with breast cancer" rationale: Tamoxifen is an antineoplastic medication that competes with estradiol for binding to estrogen in tissues containing high concentrations of receptors. Tamoxifen is used to treat metastatic breast carcinoma in women and men. Tamoxifen is also effective in delaying the recurrence of cancer following mastectomy and for preventing breast cancer in those that are high risk.

A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication. When implementing the plan, the nurse should make which statement to the client? a. "You can take aspirin as needed for headache" b. "You can drink beverages containing alcohol in moderate amounts each evening" c. "You need to consult with the health care provider (HCP) before receiving immunizations" d. "It is fine to receive a flu vaccine at the local health fair without HCP approval because the flu is so contagious."

c. "You need to consult with the health care provider (HCP) before receiving immunizations" rationale: Because antineoplastic medications lower the resistance of the body, clients must be informed not to receive immunizations without the HCP's approval. Clients also need to avoid contact with individuals who have recently received a live virus vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side/adverse effects.

The nurse is monitoring the laboratory results of a client receiving an antineoplastic medication by the IV route. The nurse plans to initiate bleeding precautions if which laboratory result is noted? a. A clotting time of 10 minutes b. An ammonia level of 10 mcg/dL (6mcmol/L) c. A platelet count of 50000 mm 3 (50 X 10-9/L) d. A white blood cell count of 5000mm3 (5.0 X 10-9/L)

c. A platelet count of 50000 mm 3 (50 X 10-9/L) rationale; Bleeding precautions need to be initiated when the platelet count decreases. The normal platelet count is 150,000 to 450,000 mm3 (150-400 X 10-9/L). When the platelet count decreases, the client is at risk for bleeding, The normal WBC count is 5000 to 10,000 mm 3 (5.0 -10.0 X 10-9/L). When the WBC count drops, neutropenic precautions need to be implemented. The normal clotting time is 8 to 15 minutes. The normal ammonia value is 10 to 80 mcg/dL (6-47 mcmol/L)

when performing an assessment of a client with early Hodgkin's lymphoma. the nurse is most likely to find that the client's lymph nodes are: a. Small and firm b. Swollen and tender c. Enlarged and painless d. Fixed and hard

c. Enlarged and painless

The nurse should plan to implement which intervention in the care of a client experiencing neutropenia as a result of chemotherapy? a. Restrict all visitors b. Restrict all fluids c. Teach the client and family about the need for hand hygiene d. Insert an indwelling urinary catheter to prevent skin breakdown

c. Teach the client and family about the need for hand hygiene rationale: 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 an indwelling urinary catheter should be avoided to prevent infection

A client is admitted to the unit with disseminated intravascular coagulation (DIC associated with an infection, which assessment information has the most immediate implications for client care? a. There is no palpable radial or pedal pulse b. The client complains of chest pain c. The clients oxygen saturation is 85% d. There is mottling of the hands and feet

c. The clients oxygen saturation is 85%

A gastrectiomy is performed on a client with gastric cancer. In the immediate postoperative period, the nurse notes bloody drainage from the nasogastric tube. The nurse should take which most appropriate action? a. measure abdominal girth b. irrigate the naogastric tube c. continue to monitor drainage d. Notify the health care provider

c. continue to monitor drainage. rationale: Following gastrectomy, drainage from the nasogastric tube is normally bloody for 24 hours postoperative, changes to brown-tinged, and is then yellow or clear. Because bloody drainage is expected in the immediate postoperative period, the nurse should continues to monitor the drainage. The nurse does not need to notify the health care provider at this time. Measuring abdominal girth is performed to detect the development of distention. Following gastrectomy, a nasogastric tube should not be irrigated unless there are specific HCP prescriptions to do so

The nurse is analyzing the 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? a. anemia b. decreased platelets c. increased uric acid level d. decreased leukocyte count

c. increased uric acid level rationale: Hyperuricemia is especially common following treatment for leukemias and lymphomas because chemotherapy results in massive cell kill. Although options a, b, and d also may be noted, an increased uric acid level is related specifically to cell destruction.

Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administering chemotherapy? a. measure the client's abdominal girth b. Calculate the client's body mass index c. measure the client's current weight and height. d. Ask the client about his or her weight and height.

c. measure the client's weight and height rationale: 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 (before each medication administration). Asking the client about his/her height and weight for BSA 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.

The nurse is monitoring a client for s/s related to superior vena cava syndrome. Which is an early sign of this oncological emergency? a. cyanosis b. arm edema c. preiorbital edema d. mental status change

c. preiorbital edema rationale: Superior vena cava syndrome occurs when the superior vena cava is compressed or obstructed by tumor growth. Early s/s generally occur in the morning and include edema of the face, especially around the eyes, and client complaints of tightness of a shirt or blouse collar. As the compression worsens, the client experiences edema of the hands and arms. Cyanosis and mental status changes are late signs.

As a home health nurse, you are taking an admission history on a client who has deep vein thrombosis and is taking warfarin (Coumadin) daily. Which statement by the client is the best indicator that additional teaching about warfarin may be needed? a. "I have started to eat more healthy foods, like green salads, and fruit" b. "The doctor said it is important to avoid becoming constipated." c. "Coumadin makes me a little nauseated unless I take it with food" d. "I will need to have blood testing done once or twice a week."

a. "I have started to eat more healthy foods, like green salads, and fruit."

The nurse is creating a plan of care for the client with multiple myeloma and includes which priority intervention in the plan? a. encourage fluids b. providing frequent oral care c. coughing and deep breathing d. monitoring the RBCs count

a. Encourage fluids rational: Hypercalcemia caused by bone destruction is a priority concern in the client with multiple myeloma. The nurse should administer fluids in adequate amounts to maintain a urine output of 1.5 to 2 L/day; this requires about 3 L of fluid intake per day. The fluid is needed not only to dilute the calcium overload but also to prevent protein from precipitating in the renal tubules. Options b, c, and d may be components of the plan of care but are not the priority in this client

The patient has been diagnosed with an autoimmune disease. This means that the patient's immune system: a. does not recognize foreign proteins b. responds to foreign antigens by creating antibodies c. recognizes its own body cells as foreign proteins d. is immunocompetent

c. recognizes its own body cells as foreign proteins rationale: With autoimmune diseases, the immune system becomes unable to differentiate between foreign proteins and the cells of the body, so it sees its own body cells as foreign proteins and attacks them. These patients are not immunocompetent. Although their bodies respond to foreign antigens by making antibodies, this id not the mechanism of autoimmune disease. Their bodies will also continue to recognize foreign proteins.

A transfusion of packed red blood cells (PRBCs) has been infusing for 5 minutes when the client becomes tachypenic and says,"I am having chills. Please get me a blanket" Which action should you take first? a. Obtain a warm blanket for the client b. Check the client's oral temperature c. stop the infusion d. administer oxygen

c. stop the infusion

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? a. at the onset of menstruation b. every month during ovulation c. weekly at the same time of day d. 1 week after menstruation begins

d. 1 week after menstruation begins Rationale: The breast self-examination should be performed regularly, 7 days after the onset of the menstruation and during ovulation, Hormonal changes can occur that may alter breast tissue.

A client with non-Hodgkin's lymphoma is receiving daunorubincin. Which finding would indicate to the nurse that the client is experiencing an adverse effect related to the medication? a. Fever b. Sores in the mouth and throat c. Complaints of nausea and vomiting d. Crackles on auscultation of the lungs

d. Crackles on auscultation of the lungs rationale: Cardiotoxicity noted by abnormal electrocardiographic findings or cardiomyopathy manifested as heart failure (lung crackles) is an adverse effect of daunorubicin. Bone marrow depression is also an adverse effect. Fever is a frequent side effect and sores in the mouth and throat can occur occasionally. Nausea and vomiting is a frequent side effect associated with the medication that begins a few hours after administration and lasts for 24 to 48 hours. Options a,b, and c are not adverse effects.

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?\ a. Alopecia b. Chest pain c. Pulmonary fibrosis d. Orthostatic hypotension

d. Orthostatic hypotension rationale: 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 ovarian cancer is being treated with vincristine. The nurse monitors the client, knowing that which manifestations indicates an adverse effect specific to this medication? a. Diarrhea b. Hair loss c. Chest pain d. Peripheral neuropathy

d. Peripheral neuropathy rationale: An adverse effect specific to vinecristine 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..

The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase, an antineoplastic agent. The nurse contact the health care provider before administering the medication if which disorder is documented in the client's history? a. Pancreatitis b. Diabetes mellitus c. Myocardial infarction d. Chronic obstructive pulmonary disease

a. Pancreatitis rationale: Asparaginas is contraindicated if hypersensitivity exists, in pancreatitis, or if the client has a history of pancreatitis. The medication impairs pancreatic function and pancreatic function tests should be performed before therapy begins and when a week or more has elapsed between dose administrations. the client need to be monitored for signs of pancreatitis, which include nausea, vomiting, and abdominal pain. The conditions noted in options b. c, and d are not contraindicated with this medication.

Side effects related to chemotherapy administration due to death of rapidly dividing normal cells may include: a. nausea and vomiting b. alopecia c. pancytopenia d. mucositis e. gastric ulcers

a. nausea and vomiting b. alopecia c. pancytopenia d. mucositis Rationale: Rationale: side effects of chemotherapy may include N/V, alopecia (hair loss), pancytopenia (decrease in RBCs, WBCs, and platelets), and mucositis (mouth sores), as a result of the death of rapidly dividing normal cells. A bowel obstruction is not a side effect of chemotherapy, nor are respiratory symptoms.

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? a. Call the health care provider (HCP) b. Reinsert the implant into the vagina c. Pick up the implant with gloved hands and flush it down the toilet d. Pick up the implant with long-handled forceps and place it in a lead container

d. Pick up with long-handled forceps and place it in a lead container rationale: 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 the nursing practice to insert a radiation implant

A client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed? a. Echocardiography b. Electrocardiography c. Cervical radiography d. Pulmonary function studies

d. Pulmonary function studies rationale: Bleomycin is an antineoplastic medication that can cause interstitial pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies along with hematological, hepatic, and renal function tests need to be monitored. The nurse needs to monitor lung sounds for dyspnea and crackles, which indicate are pulmonary toxicity. The medication needs to be discontinued immediately if pulmonary toxicity occurs. Options a, b, and c are unrelated to the specific use of this medication.

Megestrol acetate, and antineoplastic medication, is prescribed for a client with metastatic endometrial carcinoma. The nurse reviews the client's history and should contact health care provider if which diagnosis is documented in the clients history? a. Gout b. Asthma c. Myocardial infarction d. Venous thrombocmbolism

d. Venous thromboembolism Rationale: Megestrol acetate suppresses the release oof luteinizing hormone from the anterior pituitary by inhibiting pituitary function and regressing tumor size. Megestrol is used with caution if the client has a history of venous thromboembolism. Options a, b, and c are not contraindications for this medication.

During the admission assessment of a client with advanced ovarian cancer, the nurse recognizes which manifestation as typical of the disease? a. diarrhea b. hypermenorrhea c. abnormal bleeding d. abnormal distention

d. abnormal distention rationale: 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.

The nurse manager is teaching the nursing staff about s/s related to hypercalcemia in a client with metastatic prostate cancer, and tells the staff that which is a late s/s of this oncological emergency? a. headache b. dysphagia c. constipation d. electrocardiographic changes

d. electrocardiographic changes Rationale: Hyper calcemia is a manifestation of bone metastasis in late-stage cancer. Headache and dysphasia are not associated with hypercalcemia. Constipation may occur early in the process. Electrocardiogram changes include shortened ST segment and a widened Twave.

A client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment finding would the nurse expect to note specifically in the client? a. fatigue b. weakness c. weight gain d. enlarged lymph nodes

d. enlarged lymph nodes rationale: Hodgkin's disease is a chronic progressive neoplastic disorder of lymphoid tissues characterized by the painless enlargement of lymph nodes with progression to extralymphatic sites, such as the spleen and liver. Weight loss is most likely to be noted. Fatigue and weakness may occur but are not related significantly to the disease.

A client with carcinoma of the lung develops the syndrome of inappropriate antidiuretic hormone (SIADH) as a complication of the cancer. The nurse anticipates that which of the following may be prescribed? Select all that apply. a. Radiation b. Chemotherapy c. Increased fluid intake d. Decreased oral sodium intake e, Serum sodium blood levels f. Medication that is antagonistic to antidiuretic hormone (ADH)

a. Radiation b. Chemotherapy e. Serum sodium blood levels f. Medication that is antagonistic to antidiuretic hormone (ADH) Rationale: 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 (decreased serum sodium levels) 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 process return to normal.

The nurse is monitoring the intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. On inspection of the site, the nurse notes redness and swelling and that the infusion of the medication has slowed in rate. The nurse suspects extravasation and should take which actions? Select all that apply a. Stop the infusion b. Notify the HCP c. Prepare to apply ice or heat to the site d. Restart the IV at a distal part of the same vein e. Prepare to administer a prescribed antidote into the site f. Increase the flow rate of the solution to flush the skin and subcutaneous tissue

a. Stop the infusion b. Notify the HCP c. Prepare to apply ice or heat to the site e. Prepare to administer a prescribed antidote into the site rationale: Redness and swelling and a slowed infusion indicate signs of extravasation. If the nurse suspects extravasation during the IV administration of an antineoplastic medication, the infusion is stopped and the HCP is notified. Ice or heat may be prescribed for application to the site and an antidote may be prescribed to be administered into the site. Increasing the flow rate can increase damage to the tissues. Restarting the IV in the same vein can increase damage to the site and vein.

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? a. The client's pain rating b. Nonverbal cues from the client c. The nurse's impression of the client's pain d. Pain relief after appropriate nursing interventions.

a. The client's pain rating rationale: 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 level of pain is not appropriate in determining the client's level of pain Assessing pain relief is an important measure, but this option is not related to the subject of the question.

The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further education is necessary related to colorectal cancer if the client identifies which item as an associated factor? a. age younger that 50 b. history of colorectal polps c. family history of colorectal cancer d. chronic inflammatory bowel disease

a. age younger than 50 rationale: Colorectal cancer risk factors include age, older than 50 years, a family history of the disease, colorectal polyps, and chronic inflammatory bowel disease

The nurse is caring for a client who is postoperative following a pelvic exenteration and the health care provider changes the client's diet from NPO (nothing by mouth) status to clear liquids. The nurse should check which priority item before administering the diet? a. bowel sounds b. ability to ambulate c. incision appearance d. urine specific gravity

a. bowel sounds rationale: The client is kept NPO until peristalsis returns, usually in 4 to 6 days . When signs of bowel function return, clear fluids are given to the client. If no distention occurs, the diet is advanced as tolerated.. The most important assessment is to assess boewl sounds before feeding the client. Options b, c, and d are unrelated to the data in the question.

The nurse is caring for a client with lung cancer and bone metastasis. What s/s would the nurse recognize as indications of a possible oncological emergency? select all that apply a. facial edema in the morning b. weight loss of 20 lb (9 kg) in 1 month c. serum calcium level of 12 mg/dL (3.0 mmol/L d. serum sodium level of 136 mg/dL (136mmol/L) e. serum potassium level of 3.4 mg/dL (3.4 mmol/l) f. numbness and tingling of the lower extremities

a. facial edema in the morning c. serum calcium level of 12 mg/dL (3.0 mmol/L) f. numbness and tingling of the lower extremities rationale: Oncological emergencies include spesis, disseminated intravascular coagulation, syndrome of inappropriate antidiuretic hormone, spinal cord compression, hypercalcemia, superior vena cava syndrome, and tumor lysis syndrome. Blocage 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 (3.0 mmol/L) indicates hypercalcemia. Numbness and tingling of the lower extremities could be a sign on spinal cord compression. Mild hypokalemia and weight loss are not oncological emrerancies. A sodium level of 136 mg/dL ( 136 mmol/L) is a normal level.

The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would the nurse expect to note specifically in this disorder? a. increased calcium level b. Increased WBCs. c. Decreased blood urea nitrogen level d. Decreased number of plasma cells in the bone marrow

a. increased calcium level rationale: Findings indicative of multiple myeloma are an increased number of plasma cells in the bone marrow, anemia, hypercalcemia caused by the release of calcium from the deteriorating bone tissue, and an elevated blood urea nitrogen level. An increased WBC count may or may not be present and is not related specifically to multiple myeloma.