EXAM 5

1. A client prescribed tamoxifen (Nolvadex) for breast cancer treatment asks the nurse how the medication works. What is the best response by the nurse? a. "Tamoxifen works by blocking estrogen receptors on breast tissue." b. "Tamoxifen works by inhibiting the cellular mitosis of breast cancer." c. "Tamoxifen works by inhibiting the metabolism of breast cancer cells." d. "Tamoxifen works by inhibiting the metabolism of breast cancer cells."

A

7. Which form of breast cancer is the most malignant form? a. Inflammatory carcinoma of the breast b. Paget disease c. Carcinoma of the mammary ducts D. Infiltrating ductal carcinoma

A

A young school-age boy is admitted with newly diagnosed acute lymphocytic leukemia. The multidisciplinary team is meeting to plan care for this child and family. Which statement by the parents should receive priority in the nursing planning process? a. "We are afraid that he will dislodge his central line at school." b. "His brother is upset about the amount of time we are away from home." c. "Can we plan a trip out of town sometime this summer?" d. "How are we going to pay for his treatment?

A

A nurse is caring for a child who has thrombocytopenia. Which of the following actions should the nurse take?

- Monitor manifestations of bleeding - Avoid peripheral venipuncture

The nurse is caring for a client with thrombocytopenia. Which bleeding precautions will the nurse implement? Select all that apply. 1. .Avoid intramuscular (IM) injections 2.Encourage use of slippers when out of the bed 3.Keep the area free of clutter 4.Instruct the client to blow nose only when necessary 5.Encourage the client to floss teeth frequently

1234

The nurse is caring for a 42-year-old male client who was recently diagnosed with prostate cancer. What characteristic of the prostate cancer does the nurse need to be aware of for a client of this age compared to older men with prostate cancer? A. The cancer will likely be more aggressive for the younger client. B. The cancer will likely not metastasize as quickly in the younger client. C. The cancer will likely grow more slowly in the younger client. D. The cancer will likely be more responsive to treatment in the younger client.

A

The nurse is caring for a client with leukemia who is experiencing neutropenia as a result of chemotherapy. Which action should the nurse include in the plan of care for this client? A. Restrict visitors with communicable illnesses. B. Restrict fluid intake. C. Replace hand hygiene with gloves. D. Insert an indwelling urinary catheter to prevent skin breakdown.

A

The nurse is providing education regarding screening for prostate cancer. Which age should the nurse instruct the men with low risk factors to initiate prostate cancer screening? A. 50 B. 35 C. 65 D. 40

A

The nurse is caring for a thin, older adult client who is diagnosed with cancer and is receiving aggressive chemotherapy. The client is experiencing severe side effects from the therapy and has lost 10 pounds in the past week. What should the nurse teach the client to do? Select all that apply. -A Drink liquid supplements to increase intake of nutrients -B Purchase fast foods and prepared foods. -C Keep a food diary and record intake -D Eat cold foods rather than hot foods -E Eat large frequent meals high in calories

A, C,D

The nurse is caring for a client who is diagnosed with cancer. Which diagnostic tests may be helpful to assist with treatment options? Select all that apply. A) Tumor markers B) Urinalysis C) Physical assessment D) MRI E) Stool analysis

A,B,D

The nurse instructs a group of community members on the difference between benign and malignant neoplasms. Which participant statements indicate that teaching has been effective? Select all that apply. A. Benign tumors grow slowly. B. Benign tumors stay in one area C. Malignant tumors are easy to remove D. Malignant tumors crowd out surrounding tissue E. Malignant tumors can grow back

A,B,E

A nurse working in the Pediatric Intensive Care Unit (PICU) is caring for a child with leukemia. What is the most common type of leukemia in children?

Acute lymphocytic (lymphoblastic) leukemia

What is the most common cause of skin cancer? A) Exposure to melanin B) UV radiation from sunlight C) Damage from chemicals D) Inflammation from psoriasis

B

The nurse is speaking with a client who wants information regarding colorectal cancer. Which statement indicates the client understood the information presented by the nurse? A. The risk of colorectal cancer decreases with age. B. Colorectal cancer can be detected in early stages by measuring the level of the carcinogenic embryonic antigen (CEA). C. Colorectal cancer occurs more frequently in clients who have a history of inflammatory bowel disease. D. Colorectal cancer has no symptoms in the early stage and there are no definitive diagnostic tests.

C

The nurse is caring for a client with colorectal cancer who is postoperative from a transverse colostomy placement. What area of the bowel is involved? a. C b. B c. A (3) d. D e. E

C A (3) TOP MIDDLE

to suspect that the client has prostate cancer? Select all that apply. A. Scrotal edema B. Upper extremity weakness C. Hematuria D. Fatigue E. Back pain

C,D,E

In the carcinogenic process, what happens during the initiation stage? -A A carcinogen causes permanent damage to the DNA -B A gene is activated that promotes cell proliferation -C DNA changes are passed on to more cells during cell replication -D A carcinogen acts repeatedly on cells with damaged DNA

D

The nurse is assisting the healthcare provider with bone marrow aspiration and biopsy on a client who has leukemia. The client also has thrombocytopenia. Upon completing the test, which intervention is a priority for the nurse? A. Label and refrigerate the specimen obtained by the physician. B. Dispose of the equipment used and clean the area properly. C. Make certain the client understands the purpose of the test. D. Hold pressure on the wound for approximately 5 minutes.

D

The nurse is discussing the most common symptom associated with diagnosis of advanced prostate cancer. Which symptom would the nurse include? A. Nausea B. Edema C. Diarrhea D. Pain

D

The nurse is talking to a group of young adults about decreasing the risk for skin cancer. A young woman asks the nurse about the safety of ultraviolet light tanning salons. Which response by the nurse is most appropriate? A) "Using tanning beds without clothing contaminates skin and leads to infections." B) "Tanning from ultraviolet light is safer than sunshine." C) "Using sunscreen will prevent skin cancers, even in tanning beds." D) "Exposure to ultraviolet light used in tanning beds can cause skin cancer."

D

The nurse is caring for a patient who is scheduled for a lobectomy for a diagnosis of lung cancer. While assisting with a subclavian vein central line insertion, the nurse notes the clients oxygen saturation rapidly dropping. The patient complains of shortness of breath and becomes tachypneic. The nurse suspects a pneumothorax has developed. Further assessment findings supporting the presence of a pneumothorax include what? A)Diminished or absent breath sounds on the affected side B)Paradoxical chest wall movement with respirations C)Sudden loss of consciousness D)Muffled heart sounds

Diminished or absent breath sounds on the affected side

The nurse is caring for a patient receiving an initial dose of chemotherapy to treat a rapidly growing metastatic colon cancer. The nurse is aware that this patient is at risk for tumor lysis syndrome (TLS) and will monitor the patient closely for which abnormality associated with this oncologic emergency? A. Hypokalemia B. Hypouricemia C. Hypocalcemia D. Hypophosphatemia

Hypouricemia

Only one environmental risk factor has been significantly linked to ALL or AML - what is it?

Ionizing radiation

While performing a health history, the patient tells the nurse that he has benign prostatic hyperplasia (BPH). Which assessment finding in the health history supports this diagnosis? - Elevated white blood cell (WBC) count - Nocturia - Decreased time to void - Fever

Nocturia

Most environmental risk factors (EMFs, cigarette smoking) have been weakly or inconsistently associated with either form of childhood leukemia TRUE

TRUE

A client who presents with complaints of easily bruising, bleeding gums, and petechiae may be suffering from what complication of leukemia?

Thrombocytopenia

The nurse is providing discharge instructions to a client being treated for cancer. For which symptoms should the client be instructed to call for help at home? Select all that apply. A. Significant increase in vomiting B. Desire to end life C. New onset of bleeding D. Improved sense of​ well-being E. Difficulty breathing

· Desire to end life · Significant increase in vomiting · Difficulty breathing - New onset of bleeding

Which complaint by the client should the nurse report to the physician as a potential indication of colorectal cancer? A. Diarrhea B. Constipation C. Abdominal pain D. Rectal bleeding

D

Which hormone(s) is (are) believed to have a role in the development of prostate cancer? A. Endorphins B. Prolactin C. Estrogens D. Androgens

D

Which screening test is used to detect prostate cancer? A. Mammography B. Sigmoidoscopy C. CA 125 D. PSA

D

1. The nurse instructs a client recovering from a mastectomy on ways to prevent lymphedema. Which client statement indicates that teaching has been successful? a. "I have to take no special precautions" b. "I should do the exercises on my affected arm every day." c. "I should avoid cleansing my skin with soap." d. "Eating fresh fruits and vegetables will prevent my arms from swelling."

B

A nurse is planning care for a client with leukemia. The nurse chooses "Risk for Bleeding" as the nursing diagnosis. Which interventions support this nursing diagnosis? Select all that apply.

Limit parenteral injections. Educate client to not strain during bowel movements.

"A client, diagnosed with chronic lymphocytic leukemia, is admitted to the hospital for treatment of hemolytic anemia. Which of the following measures, if incorporated into the nursing care plan, would best address the patient's needs?

Provide a quiet environment to promote adequate rest."

The nurse is caring for a client with leukemia who is experiencing neutropenia as a result of chemotherapy. Which action should the nurse include in the plan of care for this client? A) Replace hand hygiene with gloves. B) Restrict visitors with communicable illnesses. C) Restrict fluid intake. D) Insert an indwelling urinary catheter to prevent skin breakdown.

Restrict visitors with communicable illnesses

An older adult client with renal failure is diagnosed with anemia. Based on this data, which cause of anemia will the nurse plan for when providing care? A) Loss of the kidney hormone erythropoietin B) A loss of appetite related to elevated blood urea nitrogen (BUN) and creatinine levels C) The renal dialysis used to treat the chronic renal failure D) Loss of blood through the urine because the failing kidney does not function properly

A

dark-skinned client tells the nurse of plans to bask in the sun on an upcoming vacation. The nurse questions the client about sunscreen use. Which response indicates the client needs further education? A) "I don't need sunscreen because I am dark-skinned already. B) "I will avoid the sun between the peak hours of 10 a.m. and 4 p.m." C) "I can still experience sun damage despite my dark skin tones." D) "The melanocytes in my skin provide me with increased protection from the sun."

A

1. A client is receiving chemotherapy for acute lymphocytic leukemia. While providing care for this client, which clinical manifestations would indicate tumor lysis syndrome? Select all that apply a. Cardiac arrhythmia b. Upper-extremity edema c. Changes in urine output d. Respiratory distress e. Thrombocytopenia

A,C

A 73-year-old man was just diagnosed with stage II prostate cancer. The client's wife hears the word "cancer" and immediately begins crying. She says, "How long does he have to live?" Which response by the nurse is appropriate? A. "Don't worry about how long he will live. Just live every day to the fullest and enjoy the time you have left together." B. "Older men who are diagnosed with prostate cancer usually die from causes other than the cancer." C. "Prostate cancer is usually aggressive in older men, so he may only have a short time to live." D. "If we treat the cancer aggressively with surgery and radiation, he should live several more years."

B

A client with anemia is prescribed synthetic erythropoietin. When teaching the client about the therapeutic effect of this treatment, which is appropriate for the nurse to include? A) Increase in platelets B) Increase in red blood cells C) Decrease in white blood cells D) Decrease in lymph fluid

B

A nurse is caring for a client recovering from a wedge resection of the left lung for a tumor. What would be appropriate goals for the nursing diagnosis of ineffective airway clearance? Select all that apply. a. Express feelings and concerns. b. Minimize accumulation of fluid. c. Maintain a patent airway. d. Participation in care by the client e. Maintain current weight.

B,C

An adult client reports to the nurse an inability to tolerate usual exercise and the feeling of fatigue. The client states that these symptoms have been gradual over time. Which physical assessment findings, along with the client's verbal complaints, would indicate chronic lymphocytic leukemia (CLL)? Select all that apply. A) Joint pain B) Pallor C) Splenomegaly D) Abnormal bleeding E) Edema

B,C,E

The nurse is planning care to address ineffective airway clearance for a client with lung cancer. Which interventions should the nurse include in the client's plan of care? Select all that apply. A. Educate the client about smoking cessation. b. Provide chest percussion as ordered. c. Suction the airway as needed. d. Administer pneumococcal vaccine. e. Help the client turn, cough, and deep breathe as needed.

B,C,E

The nurse is planning care for a client scheduled for a prostatectomy. The client's spouse wants to know if the client will have any limitations after the surgery. Which complications is the client likely to have that should be incorporated into his plan of care? Select all that apply. A. Risk for Falls B. Impaired Urinary Elimination C. Constipation D. Gynecomastia E. Sexual Dysfunction

B,E

In formulating a nursing diagnosis of risk for infection for a client with chronic lymphoid leukemia (CLL), nursing measures should include: (Select all that apply.) "A. Maintaining a clean technique for all invasive procedures. B. Placing the client in protective isolation. C. Limiting visitors who have colds and infections. D. Ensuring meticulous handwashing by all persons coming in contact with the client."

B. Placing the client in protective isolation. C. Limiting visitors who have colds and infections. D. Ensuring meticulous handwashing by all persons coming in contact with the client

A client is scheduled to have a suspected cancerous lesion removed from the arm. When planning care for this client, which outcome would be a priority? A) The client will make nutritional changes. B) The client will experience minimal pain after healing. C) The client will heal without signs of infection. D) The client will not need to make lifestyle changes

C

Client presents to the primary care clinic for an annual physical. The nurse caring for the client notes that the client's healthcare provider uses the ABCD mnemonic to assess suspicious skin lesions. What does the "D" in ABCD represent? A) Diameter of lesion greater than 8 mm B) Distance of lesion to an additional lesion C) Diameter of lesion greater than 6 mm D) Depth of lesion

C

The nurse is caring for a client in a community clinic who wishes to quit smoking. The client asks the nurse, "If I quit smoking, will my risk of lung cancer be the same as a nonsmoker?" Which is the best response by the nurse? A. "Your risk of lung cancer will never drop because the damage has already been done." B. "Your risk of lung cancer will be equal to that of a nonsmoker." C. "Your risk of lung cancer will decline if you quit, but it will remain higher than a nonsmoker's."

C

The nurse is caring for a client who has recently been diagnosed with skin cancer. The client is tearful and states, "How did I get skin cancer? I don't believe in tanning!" Which response by the nurse is indicated at this time? A) "Can you tell me more about your feelings?" B) "This is unusual, as skin cancer normally only occurs in sunbathers." C) "Sun exposure can happen as we carry out our daily activities." D) "We frequently never find out why cancer strikes."

C

The nurse is teaching a group of community members about preventing skin cancer. Which participant would be at the greatest risk for skin cancer? A) A 25-year-old lifeguard at the community pool who wears sunscreen B) A baby underneath a large beach umbrella C) A 60-year-old farmer who wears a cap when working D) A teenager who wears a ski outfit when skiing

C

The nurse is assessing a client for symptoms of prostate cancer. Which symptoms would indicate the client is experiencing an enlarged prostate? Select all that apply. A. Fatigue B. Bone pain C. Hematuria D. Dysuria E. Weight loss

C,D

The nurse is caring for an older adolescent client diagnosed with malignant melanoma. Which nursing diagnoses would be appropriate when planning this client's care? Select all that apply. A. Risk for Acute Confusion B. Risk for Compromised Human Dignity C. Anxiety D. Impaired skin integrity E. Disturbed body image

C,D,E

4. The nurse is planning care for a client with acute myeloid leukemia (AML). Which diagnoses are priorities for this client to minimize the risk of complications associated with AML? Select all that apply a. Imbalanced Nutrition, Less than Body Requirements b. Fluid Volume Excess c. Risk for Bleeding d. Ineffective Thermoregulation e. Risk for Infection

C,E

The nurse is reviewing the medical records for several clients who will be seen in the clinic today. According to the ABCD rule, which client may require removal of the skin lesion? A) A client with a lesion that is symmetrical with an irregular border, a single color, and diameter change from 4 mm to 5 mm B) A client with a lesion that is symmetrical, with a smooth border, a single color, and diameter that has stayed the same C) A client with a lesion that is asymmetrical with a regular border, two colors, and diameter change from 4 mm to 3 mm D) A client with a lesion that is asymmetrical with an irregular border, two colors, and diameter change from 5 mm to 7 mm

D

The nurse instructs a group of community members about ways to reduce the development of cancer. Which participant statements indicate that teaching has been effective? Select all that apply A) "I should eat at least two servings of fruits or vegetables each day. B) "Sunscreen should be applied before spending time outdoors. C) "I need to cut down on my smoking. D) "I need to get my home tested for radon." E) "I need to minimize my child's exposure to secondhand smoke."

· "I need to get my home tested for radon." · "Sunscreen should be applied before spending time outdoors." · "I need to minimize my child's exposure to secondhand smoke."

The nurse has completed a seminar teaching a group in the community about ways to reduce cancer risks. The nurse returns a month later to evaluate the effectiveness of the seminar. Which statements made by members of the group indicate retention and application of the material presented by the nurse to reduce the risk of developing cancer? Select all that apply. A. ​"I am trying to quit​ smoking." B. ​"I have reduced my intake of​ fiber." C. ​"I began drinking two glasses of red wine a day with​ dinner." D. ​"I have increased the amount of fried fish in my​ diet." E. ​"I started using sunscreen when I work​ outside."

· "I started using sunscreen when I work outside." · "I am trying to quit smoking."

The nurse is caring for a 72-year-old client who was just diagnosed with early stage lung cancer. What is an important independent nursing intervention that can improve the client's prognosis? a. Encourage the client to form a strong support group b. Advocate for an immediate initiation of treatment c. Refer the client to a smoking cessation therapy group d. Provide client teaching related to a nutritional diet

B

The nurse is caring for a client who is undergoing diagnostic tests to rule out lung cancer. The client asks the nurse why a computed tomography (CT) scan was ordered. What is the best response by the nurse? A. "To rule out the possibility that your problems are caused by pneumonia." B. "It is more specific in diagnosing your condition." C. "The doctor prefers this test." D. "Why are you concerned about this test?"

B

What approach is appropriate for interpreting the prostate-specific antigen (PSA) level as a diagnostic factor for prostate cancer? A. A PSA level higher than 4.0 ng/mL indicates prostate cancer. B. An abnormal PSA level alone is not enough to diagnose prostate cancer. C. A PSA level lower than 4.0 ng/mL indicates prostate cancer. D. A fluctuating PSA level indicates prostate cancer.

B

What independent nursing intervention is important for the nurse to implement for clients who have alterations in cellular regulation? A) Administer pain and other medications B) Help the client identify support systems C) Design a diet that provides proper nutrition D) Suggest contacting the nurse's spiritual leader

B

The nurse provides an educational session for community members about the risk factors for colorectal cancer. Which participant statement indicates that teaching has been effective? Select all that apply. A. "Eating cereal fiber reduces the risk of developing colorectal cancer." B. "Eating a diet high in red meat reduces the risk for developing this type of cancer." C. "Taking aspirin and a multivitamin each day reduces the risk of colorectal cancer." D. "There is a genetic link in the development of colorectal cancer." E. "People with other bowel diseases are at increased risk for developing this cancer."

C,D,E

1. The nurse is instructing a group of women between the ages of 40 and 50 about early detection of breast cancer. What should the nurse include in this teaching? a. Have a yearly mammogram b. See a healthcare provider if there is a strong family hx of breast cancer c. Have a clinical breast exam performed by a healthcare provider every 5 years d. Perform monthly breast self-exams

a. Have a yearly mammogram

A client being treated for cancer has a tumor designation of Stage IV, T4, N3, M1. What does this staging indicate to the nurse? A. The tumor will respond to chemotherapy. B. The tumor is small in size. C. There is one single tumor to treat. D. The tumor has metastasized with lymph node involvement.

· The tumor has metastasized with lymph node involvement.