NU310: Cancer

A client is admitted to the medical surgical floor with a hemoglobin level of 5.0 g/dL (50 g/dL). The nurse should anticipate which findings? Select all that apply. a. Coarse crackles b. Dyspnea c. Pallor d. Respiratory depression e. Tachycardia

b. Dyspnea c. Pallor e. Tachycardia

A nurse is caring for a client 1 day after a left-sided mastectomy with lymph node dissection. Which nursing intervention is the priority in caring for this client? a. Apply an ice pack to the left shoulder b. Elevate the affected arm on a pillow c. Help the client ambulate frequently d. Obtain a pneumatic compression sleeve

b. Elevate the affected arm on a pillow

Which client is at greatest risk for pulmonary embolism? a. A client 6 hours postoperative cesarean section b. A client in atrial fibrillation c. A client with a subdural hematoma d. A client with pneumonia

a. A client 6 hours postoperative cesarean section

A client diagnosed with head and neck cancer has developed mouth sores related to external radiation therapy. The nurse teaches the client to use which of the following oral hygiene practices? Select all that apply. a. Apply a water-soluble lubricating agent to moisturize mouth tissue b. Brush teeth with a soft bristle toothbrush c. Cleanse the mouth with normal saline after meals and at bedtime d. Do not drink hot liquids or eat foods that are spicy or acidic e. Rinse with alcohol-based antiseptic mouthwash to decrease mouth odor f. Use palifermin as prescribed to alleviate oral pain

a. Apply a water-soluble lubricating agent to moisturize mouth tissue b. Brush teeth with a soft bristle toothbrush c. Cleanse the mouth with normal saline after meals and at bedtime d. Do not drink hot liquids or eat foods that are spicy or acidic

The nurse is caring for a client with severe chronic obstructive pulmonary disease (COPD). The nurse anticipates which laboratory results for this client? a. Anemia b. Neutropenia c. Polycythemia d. Thrombocytopenia

c. Polycythemia

A male client has terminal Metastatic disease. He arrives at the emergency department with respirations of 6/min and an advance directive indicating to withhold resuscitative efforts. What should the nurse's response be? a. Apply oxygen at 2 L by nasal cannula b. Ask he client if he wants to change his mind c. Ask the spouse what she wants done d. Determine who has medical power of attorney

a. Apply oxygen at 2 L by nasal cannula

A client with throat receives throat cancer receives radiation therapy to the head and neck. What strategies are appropriate to increase oral intake? Select all that apply. a. Avoid irritants such as acidic, spicy foods b. Discourage the use of topical analgesics c. Encourage liquid nutritional supplements d. Perform oral hygiene once a day e. Use artificial salvia to control dryness

a. Avoid irritants such as acidic, spicy foods c. Encourage liquid nutritional supplements e. Use artificial salvia to control dryness

The nurse recognizes which of the following conditions as an oncologic emergency. Select all that apply a. Cardiac Tamponade b. Leukopenia c. Syndrome of Inappropriate Antidiuretic Hormone (SIADH) d. Hypercalcemia e. Hypophosphatemia f. Tumor Lysis Syndrome (TLS)

a. Cardiac Tamponade d. Hypercalcemia f. Tumor Lysis Syndrome (TLS)

After receiving report, which client should the nurse assess first? a. Client on a heparin infusion with platelet count of 86,000/mm3 (86 x 10^9/L) b. Client with dehydration with blood urea nitrogen of 24 mg/dL (8.57 mmol/L) c. Client with myelodysplastic syndrome with white blood cell count of 2,000/mm3 (2.0 x 10^9/L) d. Client with sickle cell disease with hemoglobin of 7.9 g/dL (79 g/L) and hematocrit of 24% (0.24)

a. Client on a heparin infusion with platelet count of 86,000/mm3 (86 x 10^9/L)

The nurse is caring for a client diagnosed with endometrial cancer who is receiving brachytherapy (Internal Radiation). Which interventions should the nurse implement while caring for this client? Select all that apply. a. Cluster care to limit each staff member's time in the room to 30 minutes a shift b. Instruct the client to be up and around in the room but not to leave the room c. Keep the door to the room closed as radiation is emitting constantly from the client d. Teach family members and visitors stay at least 6 feet away from the client e. Use a lead apron when providing direct care to reduce exposure to radiation f. Wear a radiation film-badge whole in the client's room to monitor radiation

a. Cluster care to limit each staff member's time in the room to 30 minutes a shift d. Teach family members and visitors stay at least 6 feet away from the client e. Use a lead apron when providing direct care to reduce exposure to radiation f. Wear a radiation film-badge whole in the client's room to monitor radiation

The nurse is caring for a client who is dying from pancreatic cancer. The client is now unresponsive. Which of the following would the nurse expect to find on assessment in a client who is nearing death? Select all that apply. a. Cool, dusky arms and legs b. Light-colored urine c. Low blood sugar d. Mouth hanging open e. Uneven breathing patter with periods of apnea

a. Cool, dusky arms and legs d. Mouth hanging open e. Uneven breathing patter with periods of apnea

The nurse plans discharge teaching for a client newly diagnosed with polycythemia vera (a blood cancer that begins in bone marrow and the marrow makes too many red blood cells). Which action will the nurse include in the teaching plan? Select all that apply. a. Elevate the legs and feet when sitting b. Increase dietary intake of foods rich in iron c. Increase fluid intake during exercise and hot weather d. Increase water temperature to reduce post-bath itching e. Report swelling or tenderness in the legs

a. Elevate the legs and feet when sitting c. Increase fluid intake during exercise and hot weather e. Report swelling or tenderness in the legs

What are the usual signs and symptoms a male would present with for prostate cancer? Select all that apply a. Increased prostate size b. Decreased PSA c. Increased urinary frequency d. Sexual dysfunction e. Constipation

a. Increased prostate size c. Increased urinary frequency d. Sexual dysfunction

A client is hospitalized for a broken leg. The client has a history of breast cancer and is receiving outpatient chemotherapy; the last infusion was about a week ago. Which staff members can safely care for this client? Select all that apply. a. Nurse floated from another medical-surgical floor b. Nurse who is 24 weeks pregnant c. Nurse with erythematous rash and honey-color crusts on the hand d. Unlicensed assistive personnel who just received the yearly injectable flu vaccination e. Unlicensed assistive personnel with cold

a. Nurse floated from another medical-surgical floor b. Nurse who is 24 weeks pregnant d. Unlicensed assistive personnel who just received the yearly injectable flu vaccination

The public health nurse identifies which of the following clients as being at high risk for developing cancer? Select all that apply. a. A 28-year-old female client with a body mass index of 38 kg/m² b. A 38-year-old male client with a 15-year history of ulcerative colitis c. A 48-year-old male client whose father has a history of colorectal cancer d. A 58-year-old male client who consumes a diet high in fruit and vegetables e. A 68-year-old female client with a 40-year history of cigarette smoking

b. A 38-year-old male client with a 15-year history of ulcerative colitis c. A 48-year-old male client whose father has a history of colorectal cancer e. A 68-year-old female client with a 40-year history of cigarette smoking

A home health nurse is visiting a client who underwent right-sided mastectomy with lymph node removal. The client is concerned about swelling in her arm on the affected side. Which instructions should the nurse discuss with the client? Select all that apply. a. Avoid massaging the area b. Avoid receiving vaccinations in the affected arm c. Elevate the arm above the head d. Perform isometric exercises e. Use an intermittent pneumatic compression sleeve

b. Avoid receiving vaccinations in the affected arm c. Elevate the arm above the head d. Perform isometric exercises e. Use an intermittent pneumatic compression sleeve

The nurse is caring for an adult client at the clinic who asks the nurse to look at a "black skin lesion". What assessment findings would be a classic indication of a potential malignant skin neoplasm? Select all that apply a. Blanches with manual pressure b. Half of the lesion is raised and half is flat c. History of purulent drainage d. Lesion the size of a nickel e. Various color shades are present

b. Half of the lesion is raised and half is flat d. Lesion the size of a nickel e. Various color shades are present

An elderly client reports shortness of breath with activity for the past 2 weeks. The nurse reviews the admission laboratory result and identifies which value as the most likely cause of the client's symptoms? a. Brain natriuretic peptide 70pg/mL (70pmol/L) b. Hematocrit 21% (0.21) c. Leukocytes 3,500/mm3 d. Platelets 105,000/mm3 (105 x 10^9/L)

b. Hematocrit 21% (0.21)

The nurse is teaching general skin care guidelines to a client receiving teletherapy (external beam radiation therapy). Which statements does the client make that indicate proper understanding of teaching? Select all that apply. a. "I may apply an ice pack to the treatment site if it begins to burn" b. "I will rub baby oil after each treatment to prevent dry skin" c. "I will use extra measures to protect my skin from sun exposure" d. "I will wash the treatment site with lukewarm water and mild soap" e. "I will wear soft, loose-fitting clothing"

c. "I will use extra measures to protect my skin from sun exposure" d. "I will wash the treatment site with lukewarm water and mild soap" e. "I will wear soft, loose-fitting clothing"

Which statements made by a group community clients communicate to the nurse a potential warning sign of cancer? Select all that apply. a. "For the past 2 years, I have had a productive cough or 3 months out of the year" b. "I seem to have heartburn an hour after I eat eggs and sausage and drink whole milk" c. "Last month when I was doing my self-breast examination, I noticed a lump the size of a marble" d. "My mole is itchy and the borders have become uneven with a blackish to bluish color" e. "Recently I have noticed that my bowel movements appear black"

c. "Last month when I was doing my self-breast examination, I noticed a lump the size of a marble" d. "My mole is itchy and the borders have become uneven with a blackish to bluish color" e. "Recently I have noticed that my bowel movements appear black"

The nurse is caring for a 50-year-old client in the clinic. The client's annual physical examination revealed a hemoglobin value of 10 g/dL (100g/dL) compared to 13 g/dL (130 g/dL) a year ago. What should be the nurse's initial action? a. Encourage intake of over-the-counter iron pills b. Encourage intake of red meat and egg yolks c. Facilitate a screening colonoscopy d. Facilitate another blood test in 6 months

c. Facilitate a screening colonoscopy

A client with terminal cancer is being discharged with a fentanyl patch and is to receive hospice care at home? What teaching related to this drug should the nurse include? Select all that apply. a. Apply local heat over the patch to aid drug absorption b. Cut the patch in half before application if less medication is needed c. Fold used patches in half so edges adhere and then discard it immediately d. Place patch 1 inch from the source of pain for maximum effectiveness e. Remove the old patch when applying a new patch every 72 hours

c. Fold used patches in half so edges adhere and then discard it immediately e. Remove the old patch when applying a new patch every 72 hours

A client is admitted to the hospital for chemotherapy complications. Laboratory results show an absolute neutrophil count of 450 cells/mm3 (0.45 x 10^9/L). what information contained in the admission history of this client will need to be addressed during discharge education? a. Eats steamed vegetables daily b. Enjoys eating grilled shrimp weekly c. Gardens as a hobby d. Takes a bath daily and applies moisturizer

c. Gardens as a hobby

A client has potential radiation contamination from a disaster. The nurse should monitor for which of the following related to this contamination? Select all that apply. a. Bitter almond smell on breath b. Fever and raised skin pustules c. Low blood cell counts d. Oral mucosal ulcerations e. Vomiting and diarrhea

c. Low blood cell counts d. Oral mucosal ulcerations e. Vomiting and diarrhea

The nurse receives report on the assigned team of clients on the oncology unit. All are receiving chemotherapy. Which client should the nurse check on first? a. Alopecia and oral mucositis noted on assessment b. Morning hemoglobin result is 8 g/dL (80g/L) c. New-onset back pain and weakness in legs d. Persistent vomiting and potassium results is 3.4 mEq/L (3.4 mmol/L)

c. New-onset back pain and weakness in legs

Thrombotic thrombocytopenic purpura is suspected due to the client's current platelet count of 2,000/mm3 (2 x 10^9/L). which client sign or symptom is the most concerning and requires immediate further nursing actions? a. Current oozing epistaxis b. Ecchymosis on leg since yesterday c. New-onset confusion d. Reported history of hematuria

c. New-onset confusion

A client with polycythemia vera comes into the clinic for a monthly treatment. The nurse knows that treatment for this condition will consist of which of the following? a. Blood transfusion b. Fluid bolus c. Phlebotomy d. Steroid injections

c. Phlebotomy

The nurse is admitting a client who had a mastectomy 6 months ago and is scheduled for elective surgery. During the physical assessment, the nurse notices a 0.5 cm mobile, firm, nontender lymph node in the upper arm. What action should the nurse take? a. Anticipate the scheduling of a biopsy b. Apply ice to the node c. Reassure the client that it is an expected finding d. Request an antibiotic

c. Reassure the client that it is an expected finding

The family practice clinic nurse is conducting client intake histories. Which client findings or histories indicate a need for heightened concern that the client may have cancer? Select all that apply. a. The 60-year-old client was just diagnosed with benign prostatic hyperplasia (BPH) b. The client reports a mobile, golf ball-sized lesion under the skin over the right thigh that feels doughy c. The client reports a nagging cough with hoarseness for the past 3 months d. The female client who weighed 150 lb (68.0 kg) has lost 15 lb (6.8 kg) in 3 months without dieting e. The male client reports a skin change on the breast that looks like an orange peel

c. The client reports a nagging cough with hoarseness for the past 3 months d. The female client who weighed 150 lb (68.0 kg) has lost 15 lb (6.8 kg) in 3 months without dieting e. The male client reports a skin change on the breast that looks like an orange peel

The nurse reviews the most current laboratory results of assigned clients. Which results should the nurse report to the health care provider immediately? a. Client who has cellulitis of the leg with a white blood cell (WBC) count of 13,000/mmc3 (13.0 x 10^9/L) b. client who has chronic kidney injury with a hematocrit of 28% (0.28) and hemoglobin of 9 g/dL (90g/L) c. Client who has type 2 diabetes mellitus with a 2-hour postprandial serum glucose of 165mg/dL (9.2 mmol/L) d. Client who is 1 month post kidney transplant with a urinalysis showing WBCs and bacteria

d. Client who is 1 month post kidney transplant with a urinalysis showing WBCs and bacteria

A hospitalized client is receiving chemotherapy. Based on today's lab results: White blood cell count 1,400/mm3 (1.4x109/L), Absolute neutrophil count 500/mm3 (0.5x109/L), Hemoglobin 10.5 g/dL (105 g/L), Platelets 150,000/mm3 (150x109/L), Serum potassium 3.4 mEq/L (3.4 mmol/L), what action should the nurse take? a. Assess for hematuria b. Check for peaked T waves c. Obtain prescription for epoetin alfa d. Place a mask on the client

d. Place a mask on the client