Chapter 7 PrepU
A client who is diagnosed with breast cancer asks the nurse if cancer cells ever die. Which statement is the nurse's best response? "You need to ask your doctor about this." "Knowing this is not that important and you should not worry about that." "Cancer cells differ from normal cells by being immortal and have an unlimited life span." "It really does not matter as it is more important to work on killing them."
"Cancer cells differ from normal cells by being immortal and have an unlimited life span."
A client who is being screened for cancer due to a family history asks the nurse what is meant by "tumor suppressor genes"? Which statement would be the nurse's best response? "These genes play no role in the development of cancer." "It is a category associated with gene underactivity, which by being less active creates an environment in which cancer is promoted." "It is a category associated with gene normal activity, which increases the risk of cancer." "It is a category associated with gene overactivity, which leads to decreased risk of cancer."
"It is a category associated with gene underactivity, which by being less active creates an environment in which cancer is promoted."
Which screening test is used to detect prostate cancer? Pap smear Self-examination Mammography PSA
PSA
A nursing instructor who is teaching students about the effects of cancer identifies a need for further instruction when one of the students says which of the following? "Many body functions are not affected by cancer." "As cancer grows it can erode blood vessels." "Cancer can cause ulcerations and necrosis." "Cancer disrupts tissue integrity."
"Many body functions are not affected by cancer."
A nursing student is caring for a client who was recently diagnosed with breast cancer. The student is explaining what the doctor meant when the term "sentinel node" was mentioned. What will the student tell the client? "Sentinel node is used to describe the initial lymph node to which the primary tumor drains." "Sentinel node is used to describe the last lymph node to which the primary tumor will drain." "Sentinel node is used to describe that all lymph nodes will be affected." "Sentinel node is used to describe which node the cancer goes to last."
"Sentinel node is used to describe the initial lymph node to which the primary tumor drains."
A nurse caring for a client with progressive cancer notes that the client has experienced significant loss of skeletal muscle and fat. The nurse documents this as: Anorexia Cachexia Anemia Waning syndrome
Cachexia
A woman is surprised to read on the Internet that certain infections can cause cancer, and has sought clarification from her family physician during an office visit. How can the physician bestrespond to the woman's query? "Most cancers that cannot be attributed to family history or lifestyle are in fact associated with viruses." "There are many viruses, but only a very few of them have been shown to cause cancer in humans." "This is true; for example, HIV has been shown to cause cancer in some clients. "Though it's not particularly common, it's true that certain bacteria and viruses can lead to cancer."
"There are many viruses, but only a very few of them have been shown to cause cancer in humans."
A 41-year-old female with a family history has had a baseline mammogram. She states that she performs monthly self breast exams but really has a hard time evaluating her lumps since she has numerous cysts. At her annual mammogram, the technician views a suspicious area and refers her to the radiologist. She asks the nurse in the office, "How can a lump appear so quickly?" The nurse's response is based on which principle? Many tumor cells never leave the M phase of the cell cycle. Cancer cells are undifferentiated and come in various shapes and sizes. A tumor is undetectable until it has doubled 30 times and contains at least 1 billion cells. If the breast has a lot of cysts, then the fluid within those sacs makes it hard to feel the hard lumps of a cancer.
A tumor is undetectable until it has doubled 30 times and contains at least 1 billion cells.
A nurse is teaching a group of clients about causes/risk factors for cancer, which include which factors? Select all that apply. Environment Genetics Financial status Heredity Age
Age Environment Genetics Heredity
Tumor markers are used for screening, establishing prognosis, monitoring treatment, and detecting recurrent disease. Which serum tumor markers have been proven to be among the most useful in clinical practice? Chorionic gonadotropin and cyclin-dependent kinases Deoxyribonucleic acid and carcinoembryonic antigen Prostate-specific antigen and deoxyribonucleic acid Alpha-fetoprotein and human chorionic gonadotropin
Alpha-fetoprotein and human chorionic gonadotropin
A 61-year-old male client is scheduled to begin chemotherapy for the treatment of his bone cancer shortly. Staff at the cancer center have educated the man and his wife about the goals, course, and expectations of his treatment. Which medications and treatments might the man anticipate needing during and after his course of treatment? Analgesia and corticosteroids Antiemetics and packed red blood cell (PRBC) transfusions Whole blood transfusion and antiplatelet aggregators Diuretics and selective serotonin reuptake inhibitors (SSRIs)
Antiemetics and packed red blood cell (PRBC) transfusions
The nurse is conducting a community class on the importance of early recognition of cancer. Screening mechanisms are available for which cancers? Select all that apply. Pancreatic Cervical Breast Lung Prostate
Cervical Prostate Breast
The nurse is conducting a community class on the importance of early recognition of cancer. Screening mechanisms are available for which cancers? Select all that apply. Prostate Lung Pancreatic Cervical Breast
Cervical Prostate Breast
A nurse is providing education on treatment options to the parents of a child with cancer. The nurse should include which of the following as the most widely used treatment modality for childhood cancers? Radiation Transplantation Surgery Chemotherapy
Chemotherapy
A client who has recently attended a talk on healthy tips for preventing cancer identifies which foods/compounds to be carcinogenic in humans? Select all that apply. Cantaloupes Nickel compounds Sweet potatoes Cigarette smoke Smoked foods
Cigarette smoke Nickel compounds Smoked foods
Unbeknownst to her or her care team, a 51-year-old woman's breast cancer has an etiology rooted in the fact that tumor suppressing genes are present but have been silenced. Consequently, she has not synthesized normal cancer-suppressing proteins and neoplasia has resulted. What process has accounted for the woman's cancer? Epigenetic mechanisms A DNA repair defect. Chromosomal translocation The "two-hit" hypothesis of carcinogenesis
Epigenetic mechanisms
A nursing student who is studying cancer correctly identifies which of the following as a method for classifying cancers? Point system Face scale Three levels of seriousness Grading
Grading
A nursing student who is studying cancer cells identifies which of the following to be the bestdefinition of anaplasia? Increased cell differentiation in cancerous tissue Rapid proliferation of cancer cells Decreased proliferation of cancer cells Loss of cell differentiation in cancerous tissue
Loss of cell differentiation in cancerous tissue Explanation: The term "anaplasia" is the loss of cell differentiation in cancerous tissue. Rapid proliferation of cancer cells refers to a rapid increase in number of cells, while decreased proliferation is a decrease in the growth or decrease in the number of cells. An increase in cell differentiation refers to the process by which a less specialized cell becomes a more specialized cell type. This is not what happens during anaplasia.
Which cancer is the leading cause of cancer death? Colon Lung Breast Prostate
Lung
In some cancers, the presenting factor is an effusion, or fluid, in the pleural, pericardial, or peritoneal spaces. Research has found that almost 50% of undiagnosed effusions in people not known to have cancer turn out to be malignant. Which cancers are often found because of effusions? Colon and rectal cancers Breast and colon cancers Ovarian and rectal cancers Lung and ovarian cancers
Lung and ovarian cancers Lung cancers, breast cancers, and lymphomas account for about 75% of malignant pleural effusions. Complaints of abdominal discomfort, swelling, and a feeling of heaviness and an increase in abdominal girth, which reflect the presence of peritoneal effusions or ascites, are the most common presenting symptoms in ovarian cancer, occurring in up to 65% of women with the disease.
The nursing student who is studying about cancer correctly identifies which type to be the leading cause of cancer death in both men and women? Skin cancer Lung cancer Breast cancer Prostate cancer
Lung cancer
The nurse is conducting cancer risk assessment at a community health fair. A client states that he smokes and drinks considerable amounts of alcohol. The nurse concludes that the client is at risk for which type of cancer? Select all that apply. Oral Esophageal Testicular Laryngeal Colorectal
Oral Laryngeal Esophageal
A big difference in the treatment of childhood cancer as opposed to adult cancer is that chemotherapy is the most widely used treatment therapy for childhood cancer. What is the reason for this? Children do not tolerate other forms of therapy as well as adults do. Children think losing their hair is "cool." Children do not complain about the nausea and vomiting caused by chemotherapy like adults do. Pediatric tumors are more responsive to chemotherapy than adult cancers.
Pediatric tumors are more responsive to chemotherapy than adult cancers.
The nurse is explaining to a client the adverse side effects of cancer therapies. Which target of both chemotherapy and radiation treatment accounts for the adverse as well as therapeutic effects of these treatments? Blood vessels Cell-surface receptors Rapidly proliferating cells Circulating hormone levels
Rapidly proliferating cells
A nurse discussing screening options with a client at risk for colon cancer should include education about which screening methods? Select all that apply. Rectal examination Fecal occult blood test Transrectal ultrasonography Colonoscopy Prostate-specific antigen test
Rectal examination Fecal occult blood test Colonoscopy
Which characteristics could apply to healthy somatic cells rather than cancerous cells? The cells have a reduced tendency to cluster together. The cells are unable to proliferate except by mitotic division. A high rate of mutation exists in the cells. They remain viable and multiply without attachments to other cells and the extracellular matrix.
The cells are unable to proliferate except by mitotic division.
A 77-year-old male client with a diagnosis of stomach cancer has been found to have metastases in his liver. The client and his family are surprised at this turn of events, stating that they don't see how he could have developed cancer in his liver. Which fact would underlie the reply that the care team provides? The portal circulatory system brings venous blood from the GI tract into the liver. Hepatic stromal tissue shares characteristics with cancerous cells, including lack of anchorage dependence. The proximity of the liver to the stomach allows for direct spread of cancerous cells due to a lack of contact inhibition. The parenchymal tissue of the liver is particularly susceptible to secondary malignancies.
The portal circulatory system brings venous blood from the GI tract into the liver.
Following a biopsy, a 54-year-old man has been diagnosed as having a benign neoplastic tumor. Which characteristic most likely applies to his tumor? The well-differentiated, neoplastic cells are clustered together in a single mass. The tumor may secrete hormones, cytokines. The tumor is poorly approximated and has the potential to break loose. It has a rapid rate of growth and can induce ischemia.
The well-differentiated, neoplastic cells are clustered together in a single mass.
An oncologic client is scheduled to begin antiangiogenesis therapy. What is the goal of this type of treatment? To kill the tumor by removing its genetic material To limit the size of the tumor by slowing down the cell cycle in the transformed cells To limit the size of the tumor by limiting its ability to recruit blood vessels To kill the tumor directly by inactivating tumor-promoter genes
To limit the size of the tumor by limiting its ability to recruit blood vessels
The nursing student studying about cancer says the following: "A neoplasm, benign or malignant, represents a new growth." This statement is considered to be which of the following? False True
True
Select the option that best identifies how adult cancers differ in origin from childhood cancers. Adult cancers originate from: embryonic cells. neuronal tissues. epithelial cells. the hematopoietic system.
epithelial cells.
A client is diagnosed with an adenoma. The nursing student identifies this as a: benign tumor of bone tissue. benign tumor of glandular epithelial tissue. malignant tumor of glandular tissue. malignant tumor of bone tissue.
benign tumor of glandular epithelial tissue.
A cancer client has been prescribed 5-fluorouracil, an antimetabolite chemotherapy agent. This medication stops normal development and division by interrupting the S phase of the cell cycle. When teaching this client, the nurse explains that during the S phase of the cell cycle: the DNA synthesis stops but RNA synthesis continues. this is the phase of nuclear division within the cell. the cell is in a prolonged resting state and only leaves this state when cellular destruction is occurring. the synthesis of DNA occurs, causing two separate sets of chromosomes to develop.
the synthesis of DNA occurs, causing two separate sets of chromosomes to develop.
A client has been diagnosed with bladder cancer and is meeting with the interdisciplinary team to determine a course of treatment. The client's disease is believed to be treatable with targeted cancer therapies. What should the client be taught about this form of cancer treatment? "This treatment has far less of an effect on healthy cells than chemotherapy or radiotherapy." "The adverse effects of targeted therapy are daunting, but results are sometimes achieved in as little as 5 to 7 days." "This treatment mobilizes and coordinates your own immune system to fight cancer cells." "One of the major benefits of targeted therapies is that they can both cure cancer and prevent its recurrence indefinitely."
"This treatment has far less of an effect on healthy cells than chemotherapy or radiotherapy."
The nurse has provided an educational session with a 56-year-old man newly diagnosed with a benign tumor of the colon. The nurse knows that the client needs further teaching when he makes which remark? "Benign tumors still produce normal cells different from other cells around them." "Even though benign tumors can't stop growing, they aren't considered cancer." "This tumor I have, will I die from it?" "This kind of tumor can't invade other organs or travel to other places in the body to start new tumors."
"This tumor I have, will I die from it?"
Which client of a primary care physician would not require extra screening for cancer? A 50-year-old male who is obese and has a low-fiber, high-fat diet. A 48-year-old man who takes immunosuppressant drugs following a kidney transplant. A 51-year-old woman whose grandmother died of breast cancer A 38-year-old female with Down syndrome and congenital scoliosis
A 38-year-old female with Down syndrome and congenital scoliosis
A biopsy of a client's liver has been taken because there is suspicion that his lung cancer may have metastasized. The results confirm that there are cancerous cells in the client's liver and the oncologist has estimated a high growth fraction in the sample. The nurse should draw what implication from this finding? The neoplastic cells in the tissue sample have achieved their maximum size. A large proportion of the cells in the sample are actively dividing. Embryonic stem cells are present in the sample and represent a high risk for tumor growth. The doubling time of the mass is increasing.
A large proportion of the cells in the sample are actively dividing.
A client with malignant melanoma has been prescribed alpha interferon, a biologic response modifier. Since this drug prolongs the cell cycle, increasing the percentage of cells in the G0phase, and stimulates NK cells and T-lymphocyte killer cells, the nurse can anticipate that they may experience which common side effects? Opportunistic infections like Candida Nausea, vomiting, and diarrhea Renal damage with an increased creatinine level Fever, chills, and fatigue
Fever, chills, and fatigue
A client whose mother and grandmother both have had cancer is at a higher risk for also developing the disease. Which tumor suppressor genes are associated with genetic susceptibility to breast cancer? Select all that apply. TGF-A BRCA1 BRCA2 TGF-B
BRCA1 BRCA2
A nurse interpreting a pathology report that indicates a client has an adenoma determines that the client's tumor is considered: Differentiated Malignant Benign Apoptotic
Benign
A nursing student has learned in class that with abdominal cancer the tumor may compress the viscera, which will cause which of the following? Hemorrhoids Polyps Rectal bleeding Bowel obstruction
Bowel obstruction
A client is being treated for stomach cancer. The client is in considerable and constant pain, and the family is asking why. How does soft tissue cancer cause pain? By transforming neurologic innervation, resulting in confused nociception. By putting physical pressure on adjacent organs. By obstructing the flow of contents into and out of the stomach. By compressing and eroding blood vessels, causing ulceration and necrosis, along with frank bleeding and sometimes hemorrhage.
By compressing and eroding blood vessels, causing ulceration and necrosis, along with frank bleeding and sometimes hemorrhage.
The nurse identifies the marker for thyroid cancer as which of the following? CA 125 Human chorionic gonadotropin (hCG) Carcinoembryonic antigen (CEA) Calcitonin
Calcitonin
The nurse in the oncology unit has just admitted a client with metastatic cancer. The client asks how cancer moves from one place to another in the body. What would the nurse answer? The cancer cells are not able to float around the original tumor in body fluids. Cancer cells enter the body's lymph system and thereby spread to other parts of the body. Cancer cells are moved from one place in the body to another by transporter cells. Cancer cells replicate and form a chain that spreads from the original tumor site to the site of the metastatic lesion.
Cancer cells enter the body's lymph system and thereby spread to other parts of the body.
A nurse reading a client's chart notes that the client's cancer is documented as carcinoma in situ of the cervix. Which term most accurately interprets what this means in terms of survival? Metastisizing Benign Curable Inoperable
Curable
A client has undergone a screening colonoscopy. The doctor removed several polyps that were sent to pathology and identified as benign. Select the best explanation of a polyp. Benign tumor arising in fibrous tissue Benign microscopic or macroscopic fingerlike projections Benign epithelial neoplasm of glandular tissue Growth that projects from a mucosal surface
Growth that projects from a mucosal surface
A nurse doing a presentation on cancer to a local community group identifies which factors to be high-risk and associated with cancer development? Select all that apply. Heredity Hormonal factors Immunologic mechanisms Low weight Environmental agents Number of siblings
Heredity Hormonal factors Environmental agents Immunologic mechanisms
A nurse doing a presentation on cancer to a local community group identifies which factors to be high-risk and associated with cancer development? Select all that apply. Immunologic mechanisms Number of siblings Environmental agents Heredity Hormonal factors Low weight
Heredity Hormonal factors Environmental agents Immunologic mechanisms
It is well known that cancer is not a single disease. It follows then that cancer does not have a single cause. It seems more likely that the occurrence of cancer is triggered by the interactions of multiple risk factors. What are some identified risk factors for cancer? Body type, age, and heredity Immunologic mechanisms, cancer-causing viruses, and color of skin Hormonal factors, chemicals, and immunologic mechanisms Radiation, cancer-causing viruses, and color of skin
Hormonal factors, chemicals, and immunologic mechanisms
A client received a liver transplant and is now taking immunosuppressant medication. The client has been told that a potential side effect of the therapy is the development of cancer. Select the option that best supports this information. "One-hit" hypothesis of carcinogenesis "Two-hit" hypothesis of carcinogenesis Dysregulation of brain serotonin hypothesis Immune surveillance hypothesis
Immune surveillance hypothesis
A client tells the nurse that he is receiving cancer treatment that involves strengthening the immune system. The nurse documents that the client is receiving which treatment? Procarcinogen therapy Promotor therapy Immunotherapy Antigen therapy
Immunotherapy
Which physiologic response increases an obese woman's risk for the development of breast cancer? Insulin resistance Chronic inflammation Exaggerated triglyceride formation Increased sex hormone production
Increased sex hormone production
The nursing student studying about cancer growth correctly identifies "cell proliferation" to mean which of the following? Apoptosis Increasing cell numbers by DNA replication Increasing cell numbers by mitotic cell division Programmed cell death
Increasing cell numbers by mitotic cell division
While studying cancer, nursing students learn about the process by which cancer-causing agents cause normal cells to become cancerous. This process is a multi-step mechanism that can be divided into three stages, which include which of the following? Select all that apply. Initiation Promotion Evaluation Termination Progression
Initiation Promotion Progression
A client has been diagnosed with cancer that was a result of dysfunctional apoptosis. The health care provider explains the process to the multidisciplinary client care team. Select the best explanation. It allows for DNA-damaged cells to survive. It increases the risk for mitochondrial dysfunction. Cells that go through apoptosis are the only ones that become cancerous. Apoptosis has no impact on malignant development.
It allows for DNA-damaged cells to survive.
Which statement represents the primary advantage of targeted cancer therapy? It can be administered on an outpatient basis. It uses drugs that selectively attack malignant cancer cells. It has a shorter course of treatment than other therapies. It is unlikely to cause nausea and vomiting.
It uses drugs that selectively attack malignant cancer cells
The nurse has just completed a presentation to a group of senior citizens regarding health promotion and screening activities for the detection of cancer. The nurse realizes further teaching is necessary when a participant identifies a definitive test is available for which type of cancer? Cervical cancer Kidney cancer Breast cancer Prostate cancer
Kidney cancer
An oncology nurse recognizes that the cluster of differentiation (CD) antigen is present on leukocytes and is the tumor marker used in which cancers? Select all that apply. Breast cancer Colon cancer Liver cancer Leukemia Lymphoma
Leukemia Lymphoma
A nurse who is caring for a client with liposarcoma plans care for a client with: Malignant tumor of adipose tissue Malignant tumor of smooth muscle Benign tumor of fibrous tissues Benign tumor of the bone
Malignant tumor of adipose tissue
A client who has just recently been diagnosed with cancer asks the nurse what tumor markers are. Which answer would be the nurse's best response? Markers are enzymes released by the body to prevent cancer. Markers are doses of vitamins used to fight cancer. Markers are marks the physician places to show the site of the cancer. Markers are antigens expressed on the surface of tumor cells.
Markers are antigens expressed on the surface of tumor cells.
Cancer prognosis has improved most dramatically when treatment plans include which of the following? Surgical procedures Aggressive chemotherapy Pinpointed radiation Multiple types of treatment
Multiple types of treatment
The nursing student studying cancer identifies which term to refer to the "new growth" that comes about with cell differentiation and growth? Neoplasm Proliferation Hyperplasia Hypertrophy
Neoplasm
Which is an abnormal mass of tissue in which the growth exceeds and is uncoordinated with that of the normal tissues? Neoplasm Mutation Insertion Transformation
Neoplasm
A nursing student who describes cell characteristics that include regulated growth, genetic stability, limited lifespan, and growth factor dependence is talking about which type of cell? Both cancer and normal cells Cancer cells None of the above Normal cells
Normal cells
The nurse is conducting cancer risk assessment at a community health fair. A client states that he smokes and drinks considerable amounts of alcohol. The nurse concludes that the client is at risk for which type of cancer? Select all that apply. Esophageal Testicular Oral Laryngeal Colorectal
Oral Laryngeal Esophageal
One group of chemical carcinogens is called indirect-reacting agents. Another term for these agents is procarcinogens, which become active only after metabolic conversion. One of the most potent procarcinogens is a group of dietary carcinogens called: Diethylstilbestrol Aflatoxins Polycyclic aromatic hydrocarbons Initiators
Polycyclic aromatic hydrocarbons
The family of a 68-year-old man who is in the end stages of small-cell lung cancer are distraught at his visible body wasting that has worsened in recent weeks. Which phenomena best accounts for the client's anorexia and cachexia? High-fat losses coupled with preservation of muscle mass exaggerate the appearance of wasting. Inadequate food intake due to symptoms and treatment results in loss of both muscle and fat. Products of the tumor itself as well as a hypermetabolic state cause cachexia. Inadequate cellular metabolism of glucose results from tumor factors.
Products of the tumor itself as well as a hypermetabolic state cause cachexia.
A client has undergone extensive diagnostic testing and has been diagnosed with breast cancer staged as T3, N0, M0. What conclusion can the nurse draw from the staging of the client's breast cancer? The client has a tumor that does not have the potential for metastasis. The client's tumor is not considered to be neoplastic and it has not metastasized. The client has a sizable tumor but there is no lymphatic involvement. The client has a tumor that is estimated to be 3 mm in diameter.
The client has a sizable tumor but there is no lymphatic involvement.
A client has been diagnosed with cancer and will begin aggressive treatment. The client's course of treatment includes drug therapies that affect cyclins and cyclin-dependent kinases (CDKs). This drug will achieve a therapeutic effect by: aiding stem cells in the identification of neoplasms. hastening the differentiation of stem cells into healthy cells. reversing the process of uncontrolled cell growth by causing cell atrophy. affecting the progression of cells through the process of cell division.
affecting the progression of cells through the process of cell division
A client's tissue biopsy reveals the presence of cells that appear to have abnormalities in shape and size. Carcinoma is suspected because these cells possess the characteristics of: cohesiveness and adhesion. loss of differentiation. cell density-dependent inhibition. angiogenesis.
loss of differentiation.
