Management of Patients with Oncologic Disorders (Chapter 15)
A nurse is caring for a client who is receiving chemotherapy and has a platelet count of 30,000/mm3. Which statement by the client indicates a need for additional teaching?
"I floss my teeth every morning"
A nurse is teaching a client who is receiving radiation treatment for left lower lobe lung cancer. Which client statement indicates a need for further teaching?
"I'll use hats to protect my head from the sun when my hair falls out"
A patient will be receiving radiation for 6 weeks for the treatment of breast cancer and asks the nurse why it takes so long. What is the best response by the nurse?
"It will decrease the incidence of leukopenia and thrombocytopenia"
The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia?
"the hair loss is usually temporary"
A patient is scheduled for cryosurgery for cervical cancer and tells the nurse, "I am not exactly sure what the doctor is going to do." What is the best response by the nurse?
"the physician is going to use liquid nitrogen to freeze the area."
The lethal tumor dose is defined as the dose that will eradicate what percentage of the tumor yet preserve normal tissue?
95%
Which is a sign or symptom of septic shock?
Altered mental status
The oncology nurse is giving chemotherapy to a client in a short stay area. The client confides that they are very depressed. The nurse recognizes depression as which of the following?
a normal reaction to the diagnosis of cancer
After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention?
administering metoclopramide and dexamethasone as ordered
Which type of hematopoietic stem cell transplantation (HSCT) is characterized by cells from a donor other than the patient?
allogenic
The nurse is conducting a screening for familial predisposition to cancer. Which element should the nurse note as a possible indication of hereditary cancer syndrome?
an aunt and uncle diagnosed with cancer
Which of the following is a term used to describe the process by which a new blood supply is formed?
angiogenesis
A client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis is appropriate for this client?
anticipatory grieving
Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client?
autologous
A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of Risk for impaired skin integrity. Which intervention should be part of this client's care plan?
avoiding using soap on the irradiated areas
Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure?
blood studies
A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: TIS, N0, M0. What does this classification mean?
carcinoma in situ, nor abnormal regional lymph nodes, no evidence of distant metastasis
A cancer client makes the following statement to the nurse: "I guess I will tell my doctor to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die."Which of the following facts supports the use of chemotherapy for this client?
chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects
A client diagnosed with acute myelocytic leukemia has been receiving chemotherapy. During the last 2 cycles of chemotherapy, the client developed severe thrombocytopenia requiring multiple platelet transfusions. The client is now scheduled to receive a third cycle. How can the nurse best detect early signs and symptoms of thrombocytopenia?
closely observe the client's skin for petechiae and bruising
Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth?
control
While administering cisplatin (Platinol-AQ) to a client, the nurse assesses swelling at the insertion site. The first action of the nurse is to
discontinue the intravenous medication
The nurse is evaluating the client's risk for cancer and recommends changes when the client states she
eats red meat such as steaks or hamburgers every day
You are an oncology nurse caring for a client who tells you that their tastes have changed. They go on to say that "meat tastes bad". What is a nursing intervention to increase protein intake for a client with taste changes?
encourage cheese and sandwiches
What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen?
encourage fluid intake to dilute the urine
A side-effect of chemotherapy is renal damage. To prevent this, the nurse should:
encourage fluid intake, if possible, to dilute the urine
A patient will be having an endoscopic procedure with a diagnostic biopsy. What type of biopsy does the nurse explain will remove an entire piece of suspicious tissue?
excisional biopsy
A patient with uterine cancer is being treated with internal radiation therapy. What would the nurse's priority responsibility be for this patient?
explain to the patient that she will continue to emit radiation while the implant is in place
The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action?
extravasation
The nurse is working with a client who has had an allohematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of
graft-versus-host disease
The physician recommends that parents have their daughter vaccinated with HPV vaccine. What is this vaccine for?
help prevent cervical cancer
When malignant cells are killed (tumor lysis syndrome), intracellular contents are released into the bloodstream. This leads to which of the following? Select all that apply.
hyperkalemia, hyperuricemia, heyperphosphatemia
For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan?
inspecting the skin for petechiae once every shift
What does the nurse understand is the rationale for administering allopurinol for a patient receiving chemotherapy?
it lowers serum and uric acid levels
The nurse is caring for a client undergoing an incisional biopsy. Which statement does the nurse understand to be true about an incisional biopsy?
it removes a wedge of tissue for diagnosis
A decrease in circulating white blood cells is
leukopenia
Which is a growth-based classification of tumors?
malignancy
In which phase of the cell cycle does cell division occur?
mitosis
A client with ovarian cancer is ordered hydroxyurea (Hydrea), an antimetabolite drug. Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. The mechanism of action of antimetabolites interferes with
normal cellular processes during the S phase of the cell cycle
Which type of surgery is used in an attempt to relieve complications of cancer?
palliative
A client with a brain tumor is undergoing radiation and chemotherapy for treatment of cancer. The client has recently reported swelling in the gums, tongue, and lips. Which is the most likely cause of these symptoms?
stomatitis
A 36-year-old man is receiving three different chemotherapeutic agents for Hodgkin's disease. The nurse explains to the client that the three drugs are given over an extended period because:
the three drugs have synergistic effect and act on the cancer cells with different mechanisms
A client with metastatic pancreatic cancer underwent surgery to remove a malignant tumor in the pancreas. Despite the tumor being removed, the physician informs the client that chemotherapy must be started. Why might the physician opt for chemotherapy?
to prevent metastasis
The client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse?
tumor pressure against normal tissues
Your client is receiving radiation therapy. The client asks you about oral hygiene. What advice regarding oral hygiene should you offer?
use a soft toothbrush and avoid an electronic toothbrush