Ch 44: Oncologic Disorders-Brain & Spinal Cord PrepU

The community health nurse is conducting a home visit with a client who was discharged from hospital 3 days ago after surgical resection of a brain tumor and radiation therapy. The client is accompanied by his partner during the nurse's visit. During the visit, the client's partner becomes tearful. How should the nurse respond? "It is okay to say you give up. Are you worried you will not be able to continue to provide care for your partner?" "Going through this experience with your partner has been very difficult for you, I'm sure. Can you tell me about your experience so far?" "Sometimes people are unhappy about the way they were treated in the hospital. Were you happy with the care your partner received in the hospital?" "Many caregivers experience burnout. Are you experiencing symptoms depression and anxiety?"

"Going through this experience with your partner has been very difficult for you, I'm sure. Can you tell me about your experience so far?"

A client with a malignant glioma is scheduled for surgery. The client demonstrates a need for additional teaching about the surgery when he states which of the following? "There will be less cancer left that might be resistant to chemotherapy." "My headache and nausea should be lessened somewhat." "The surgeon will be able to remove all of the tumor." "Any tissue that was dead will be removed."

"The surgeon will be able to remove all of the tumor."

A client whose physical findings suggest a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal hypophysectomy. The evening before the surgery, the nurse reviews preoperative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize? "You must restrict your fluid intake." "You must report ringing in your ears immediately." "You must lie flat for 24 hours after surgery." "You must avoid coughing, sneezing, and blowing your nose."

"You must avoid coughing, sneezing, and blowing your nose."

A client with cerebral metastasis suddenly experiences a seizure for which phenytoin 10 mg/kg intravenously is ordered as an initial loading dose. The client weighs 132 pounds. How many milligrams of phenytoin should the client receive? Enter the number ONLY.

600

A client with cerebral metastasis suddenly experiences a seizure for which phenytoin 10 mg/kg intravenously is ordered as an initial loading dose. The client weighs 165 pounds. How many milligrams of phenytoin should the client receive? Enter the number ONLY.

750

Which medication classification should be avoided in the treatment of brain tumors? Anticonvulsants Osmotic diuretics Anticoagulants Corticosteroids

Anticoagulants

The nurse is caring for a client who was diagnosed with a glioma 5 months ago. Today, the client was brought to the emergency department by his caregiver because he collapsed at home. The nurse suspects late signs of rising intracranial pressure (ICP) when which blood pressure and pulse readings are noted? BP = 175/45 mm Hg; HR = 42 bpm BP =130/80 mm Hg; HR = 55 bpm BP = 90/50 mm Hg; HR = 75 bpm BP = 150/90 mm Hg; HR = 90 bpm

BP = 175/45 mm Hg; HR = 42 bpm

A patient diagnosed with a tumor in the cerebellar region would expect to have changes in which of the following? Cognition Balance and coordination Vision Hearing

Balance and coordination

Extensive diagnostic testing has resulted in a patient's diagnosis of a benign brain tumor. When providing care for this patient, the nurse should be cognizant of which of the following characteristics of benign brain tumors? Benign brain tumors can slowly grow into an area of vital brain function. Benign brain tumors constitute a risk factor for possible metastasis. Benign brain tumors have no physiological effect but should be closely monitored. Benign brain tumors typically become malignant within 1 to 2 years.

Benign brain tumors can slowly grow into an area of vital brain function.

A client comes to the clinic for evaluation because of complaints of dizziness and difficulty walking. Further assessment reveals a staggering gait, marked muscle incoordination, and nystagmus. A brain tumor is suspected. Based on the client's assessment findings, the nurse would suspect that the tumor is located in which area of the brain? Frontal lobe Occipital lobe Motor cortex Cerebellum

Cerebellum

Which of the following diagnostic studies provides visualization of cerebral blood vessels? Cytologic studies of cerebrospinal fluid (CSF) Cerebral angiography Computer-assisted stereotactic biopsy Positron emission tomography (PET)

Cerebral angiography

The nurse is caring for a client who underwent surgery to remove a spinal cord tumor. When conducting the postoperative assessment, the nurse notes the presence of a bulge at the surgical site. The nurse suspects the client is experiencing what complication from the surgery? Growth of a secondary tumor Infection at the surgical site Impaired tissue healing Cerebrospinal fluid leakage

Cerebrospinal fluid leakage

The nurse is caring for a client who is postoperative from surgery for a brain tumor resection. The client has a visitor at the bedside who lowers the head of the bed below 30 degrees. The nurse assesses the client has decreased level of consciousness. What actions should the nurse take? Select all that apply. Check for leaks on the surgical site dressing Check the client's blood pressure Assess the client for headache Review chart to check for high white blood cell count Assess for presence of visual changes

Check the client's blood pressure Assess the client for headache Assess for presence of visual changes

Magnetic resonance imaging has confirmed a diagnosis of glioblastoma multiforme (GBM) in a 56-year-old male patient. The nurse who is planning this patient's care should prioritize which of the following nursing actions? Teaching the patient about the importance of healthy lifestyle in recovery from GBM Liaising with community agencies to organize long-term rehabilitation Choosing psychosocial interventions that are relevant to the patient's poor prognosis Teaching the patient about the pharmacological interventions relevant to his treatment

Choosing psychosocial interventions that are relevant to the patient's poor prognosis

Which of the following outcomes would be most appropriate to include in the plan of care for a client diagnosed with a muscular dystrophy? Client describes the importance of diagnostic follow-up to evaluate the disorder. Client verbalizes understanding of the chronic nature of the disorder. Client demonstrates understanding of the need to adhere to medication therapy. Client participates in activities of daily living using adaptive devices.

Client participates in activities of daily living using adaptive devices.

A patient has been diagnosed with a lipoma. The nurse explains to the patient that this tumor is located in the part of the brain known as the: Brainstem. Cerebrum. Corpus callosum. Optic chiasm.

Corpus callosum.

The nurse reviews the patient's drug regimen for treatment of a brain tumor. She explains to the patient why one of the following drugs would not be prescribed, even though it might have therapeutic benefits. Which drug would not be prescribed for this patient? Coumadin Paclitaxel Dilantin Decadron

Coumadin

What is the most common type of brain neoplasm? Glioma Meningioma Neuroma Angioma

Glioma

A 37-year-old mother of three has just been diagnosed with a grade I meningioma. As part of patient education, the nurse tells the patient that: The tumor is malignant and aggressive. The tumor will cause pressure on the eighth cranial nerve. Growth is slow and symptoms are caused by compression rather than tissue invasion. Surgery, which can result in complete removal of the possible tumor, should be done as soon as possible.

Growth is slow and symptoms are caused by compression rather than tissue invasion.

A patient diagnosed with a pituitary adenoma has arrived on the oncology unit. Based upon the nurse's initial assessment, the patient is most likely to exhibit: Restlessness Decreased level of consciousness Decreased intracranial pressure (ICP) Headache

Headache

A client is diagnosed with a brain angioma. When teaching the client about the risks associated with this type of brain tumor, the nurse would educate about signs and symptoms associated with which condition? Hemorrhagic stroke Thyroid disorders Visual loss Hearing loss

Hemorrhagic stroke

The nursing instructor gives their students an assignment of making a plan of care for a client with Huntington's disease. What would be important for the students to include in the teaching portion of the care plan? How to exercise How to perform household tasks How to take a bath How to facilitate tasks such as using both hands to hold a drinking glass

How to facilitate tasks such as using both hands to hold a drinking glass

Which disease is a chronic, progressive, hereditary disease of the nervous system that results in progressive, involuntary dancelike movements and dementia? Creutzfeldt-Jakob disease Huntington disease Parkinson disease Multiple sclerosis

Huntington disease

A nurse is providing care to a client who has been diagnosed with metastatic brain cancer. When developing the client's plan of care, which outcome would the nurse most likely identify? Removal of all or part of the tumor Reduced incidence of recurrence Improved quality of life Elimination of distressing signs and symptoms

Improved quality of life

Nurses are performing hourly neurological assessments of a patient who is postoperative day 1 following spinal surgery that was performed to treat spinal cord compression (SCC). The nurse's most recent assessment shows a marked reduction in motor and sensory function. How should the nurse best follow-up this assessment finding? Inform the care provider promptly about this sudden change. Document these findings and have a colleague confirm the assessment. Reassess the patient in 15 minutes. Contact the anesthesiologist to discuss possible residual effects of anesthesia.

Inform the care provider promptly about this sudden change.

The nurse is assessing a client who was brought to the emergency department due to a severe headache with sudden onset, lowered level of consciousness and slurred, non-sensical speech. The client completed chemotherapy and radiation treatment for a glioma-type brain tumor 6 months ago. The client has been taking low molecular weight heparin since completing treatment. The nurse should be prepared to provide care for which possible problem? Intracerebral hemorrhage Pulmonary embolism Deep vein thrombosis Spinal metastasis

Intracerebral hemorrhage

The nurse is caring for a client with increased intracranial pressure (ICP) after surgical resection of a brain tumor. The nurse recognizes the client is demonstrating late signs of ICP when which sign is observed? Hypotension Tachycardia Low pulse pressure Irregular respirations

Irregular respirations

The nurse is providing postoperative care for a client who just underwent surgery to remove a metastatic intramedullary tumor. On postoperative day 3, the client states, "I am really looking forward to going running again, it had become too difficult because of the loss of feeling in my feet." Which should the nurse address in the client's care plan? Knowledge deficit Impaired cognition Anxiety Body image disturbance

Knowledge deficit

The nurse is caring for a client in the hospital emergency department who reports recent muscle weakness, sensory loss, aphasia, and visual changes accompanied by a sudden onset of complex partial seizures. The nurse anticipates which diagnostic test will be prescribed to rule out or confirm with high certainty the presence of a brain tumor? Cranial x-ray Computed tomography (CT) Magnetic resonance imaging (MRI) Positron emission tomography (PET)

Magnetic resonance imaging (MRI)

Which diagnostic is most commonly used for spinal cord compression? Magnetic resonance imaging (MRI) Positron emission tomography (PET) Computed tomography (CT) X-ray

Magnetic resonance imaging (MRI)

Which term is used to describe edema of the optic nerve? Angioneurotic edema Scotoma Papilledema Lymphedema

Papilledema

A client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. Which "related-to" phrase should the nurse add to complete the nursing diagnosis statement? Related to impaired balance Related to difficulty swallowing Related to visual field deficits Related to psychomotor seizures

Related to impaired balance

The nurse is aware that, when assessing a patient for symptoms of a brain tumor, the symptom most frequently found is: Sharp, unrelenting headaches. Simple to generalized seizures. Vertigo and fainting. Unilateral loss of motor coordination.

Simple to generalized seizures.

A client diagnosed with a malignant brain tumor is scheduled to receive chemotherapy intrathecally. When explaining this technique to the client, the nurse would describe the medication as being injected into which area? Central vein Implanted port Subarachnoid space Epidural space

Subarachnoid space

A client diagnosed with Huntington's disease has developed severe depression. What would be most important for the nurse to assess for? Emotional apathy Loss of bowel and bladder control Choreiform movements Suicidal ideations

Suicidal ideations

The nurse is providing discharge instructions for a client who was admitted to the oncology unit due to dehydration and anorexia after chemotherapy treatment. What information should the nurse provide to the client to promote improve the client's nutritional intake at home? Take prescribed pain medication prior to commencing a meal Eat uninterrupted by others to eliminate distractions Prepare the eating area with a pleasant room spray Avoid any oral care prior to eating

Take prescribed pain medication prior to commencing a meal

The nurse is providing education to a client who is being discharged with an outpatient treatment plan that includes taking a chemotherapeutic agent. What instructions should the nurse include? Select all that apply. The client should seek emergency help if nausea or vomiting occur. The client should seek emergency care if he or she develops a fever. Hair loss should be expected when taking the medication. The client should ensure no one else handles the medication. If a dose is missed, the client should take double the amount at the regular time the following day.

The client should seek emergency care if he or she develops a fever. Hair loss should be expected when taking the medication. The client should ensure no one else handles the medication.

Which statement describes the pathophysiology of post-polio syndrome? Post-polio syndrome is caused by long-term intake of a low-protein, high-fat diet in polio survivors. Post-polio syndrome is caused by an autoimmune response. The exact cause is unknown, but latent poliovirus is suspected. The exact cause is unknown, but aging or muscle overuse is suspected.

The exact cause is unknown, but aging or muscle overuse is suspected.

The nurse is planning the care of a patient who has been admitted to the hospital for surgical treatment of prostate cancer that has metastasized to his spine. When planning nursing care that is specific to this patient's spinal metastasis, what outcome should the nurse identify? The patient will perform activities of daily living comparable to his prediagnosis abilities. The patient will maintain full range of motion. The patient will explain the importance of exercise in his recovery. The patient will state that pain control is adequate.

The patient will state that pain control is adequate.

The nurse is seeing the mother of a client who states, "I'm so relieved because my son's doctor told me his brain tumor is benign." The nurse knows what is true about benign brain tumors? The prognosis is very poor. They are all metastatic. They do not require surgical removal. They can affect vital functioning.

They can affect vital functioning.

The nursing is assessing a client who has been diagnosed with a pituitary adenoma, but has not yet started treatment. The client reports having increased heart rate, hand tremors, difficulty sleeping, weight loss and hyperthermia. The nurse anticipates the client will require blood work to assess for overproduction of which hormone? Prolactin Adrenocorticotropic hormone Growth hormone Thyroid-stimulating hormone

Thyroid-stimulating hormone

The nurse is seeing a client who is suspected of having a glioblastoma multiforme tumor. The nurse anticipates the client will require which diagnostic test to confirm the client has this form of brain tumor? Tissue biopsy An increase in prolactin Weber and Rinne test Audible bruit over the skull

Tissue biopsy