Oncologic Disorder

5-Fluorouracil (5FU) is classified as which type of antineoplastic agent? Alkylating Mitotic spindle poisons Antimetabolite Nitrosoureas

Antimetabolite

A nurse is assessing a 75-year-old woman who had a total hysterectomy when she was 30 years old and normal Pap test results for the past 10 years. The client asks about continuing the Pap test. What is the best response by the nurse? "You will need to continue for the rest of your life." "You may choose to discontinue this test." "You could have stopped immediately after your hysterectomy." You need to continue obtaining a Pap test for only the next 5 years."

You may choose to discontinue this test." Explanation: The American Cancer Society recommendations for women 66+ years or older who have had normal Pap tests for 10 years and who have had a total hysterectomy may choose to stop having Pap tests for cervical cancer screening.

The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant? Monitor the client's heart rate. Monitor the client's physical condition. Monitor the client's toilet patterns. Monitor the client closely to prevent infection.

Monitor the client closely to prevent infection.

The nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice? eats red meat such as steaks or hamburgers every day works as a secretary at a medical radiation treatment center uses the treadmill for 30 minutes on 5 days each week drinks one glass of wine at dinner each night

eats red meat such as steaks or hamburgers every day

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? No evidence of primary tumor, no abnormal regional lymph nodes, and no evidence of distant metastasis Carcinoma in situ, no demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis Can't assess tumor or regional lymph nodes and no evidence of metastasis Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis

Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis

A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the best teaching by the nurse? It lowers serum and uric acid levels. It prevents alopecia. It treats drug-related anemia. It stimulates the immune system against the tumor cells.

It lowers serum and uric acid levels.

A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells? Reproductive tract Colon White blood cells (WBCs) Liver

Liver

The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest? Benign fibrocystic disease Normal finding Malignant tumor Malignant tumor with metastasis to surrounding tissue

Malignant tumor

During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior? Initiation Progression Promotion Prolongation

Progression Explanation: Progression is the third step of carcinogenesis, in which cells show a propensity to invade adjacent tissues and metastasize. During promotion, repeated exposure to promoting agents causes the expression of abnormal genetic information, even after long latency periods. During initiation, initiators such as chemicals, physical factors, and biologic agents escape normal enzymatic mechanisms and alter the genetic structure of cellular DNA. No stage of cellular carcinogenesis is termed prolongation. Reference:

A patient is admitted for an excisional biopsy of a breast lesion. What intervention should the nurse provide for the care of this patient? Provide aseptic care to the incision postoperatively. Counsel the patient about the possibility of losing her breast. Clarify information provided by the physician. Provide time for the patient to discuss her concerns.

Provide time for the patient to discuss her concerns.

A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis? White, cottage cheese-like patches on the tongue Red, open sores on the oral mucosa Yellow tooth discoloration Rust-colored sputum

Red, open sores on the oral mucosa

What should the nurse tell a client who is about to begin chemotherapy and is anxious about hair loss? The client should consider getting a wig or cap prior to beginning treatment. The hair will grow back within 2 months post therapy. The hair will grow back the same as it was before treatment. Alopecia related to chemotherapy is relatively uncommon.

The client should consider getting a wig or cap prior to beginning treatment.

The nurse instructs a client receiving chemotherapy on actions to prevent the development of stomatitis. Which client statement indicates to the nurse that teaching has been effective? "I will limit alcoholic beverages to one a day." "I will reduce smoking to after meals only." "I will brush my teeth after every meal." "I will eat spicy foods with a cool beverage.

"I will brush my teeth after every meal." Explanation: Stomatitis is an inflammatory process of the mouth, including the mucosa and tissues surrounding the teeth. Manifestations of stomatitis include changes in sensation, erythema, and edema, or if severe, painful ulcerations, bleeding, and infection. It commonly develops within 3 to 14 days after receiving certain chemotherapeutic agents. Actions to prevent the development of stomatitis include brushing the teeth with a soft toothbrush for 90 seconds after every meal. Smoking dries oral tissues and should be avoided. Spicy foods can irritate the oral tissues and should be avoided. Alcohol is drying to the oral tissues and should be avoided.

Which statement by a client undergoing external radiation therapy indicates the need for further teaching? "I'll wash my skin with mild soap and water only." "I'll wear protective clothing when outside." "I'll not use my heating pad during my treatment." "I'm worried I'll expose my family members to radiation."

"I'm worried I'll expose my family members to radiation."

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 allows time for you to cope with the treatment." "It will allow time for the repair of healthy tissue." "It will decrease the incidence of leukopenia and thrombocytopenia." "It is not really understood why you have to go for 6 weeks of treatment."

"It will allow time for the repair of healthy tissue."

Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.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 psychiatric diagnosis everyone has at one time or another. A normal reaction to the diagnosis of cancer. An aberrant psychologic reaction to the chemotherapy. A side effect of the neoplastic drugs.

A normal reaction to the diagnosis of cancer.

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." "New hair growth will return without any change to color or texture." "Wigs can be used after the chemotherapy is completed." "Clients with alopecia will have delay in grey hair."

"The hair loss is usually temporary."

The drug interleukin-2 is an example of which type of biologic response modifier? Monoclonal antibodies Antimetabolites Retinoids Cytokine

Cytokine

The nurse is preparing to assess a client whose chart documents that the client experienced extravasation when receiving the vesicant vincristine during the previous shift. The documentation also notes that an antidote was administered immediately. The nurse prepares to assess for which conditions? Select all that apply. Sloughing tissue Effectiveness of the antidote Tissue necrosis Active bleeding

Extravasation of vesicant chemotherapeutic agents can lead to erythema, sloughing, and necrosis of surrounding tissue, muscle, and tendons. To reduce the likelihood and severity of symptoms due to extravasation of a vesicant, antidotes matched to the vesicant are administered. Nurses caring for a client who experienced extravasation of a vesicant should assess for sloughing tissue, tissue necrosis, erythema, and effectiveness of the antidote.

The nurse is invited to present a teaching program to parents of school-age children. Which topic would be of greatest value for decreasing cancer risks? Breast and testicular self-exams Hand washing and infection prevention Pool and water safety Sun safety and use of sunscreen

Sun safety and use of sunscreen

A serum sodium concentration lower than 115 mEq/L (115 mmol/L) is associated with myalgia. seizure. weight gain. anorexia.

seizure

Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth? Cure Palliation Prevention Control

A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis? White, cottage cheese-like patches on the tongue Red, open sores on the oral mucosa Yellow tooth discoloration Rust-colored sputum

A nurse is administering daunorubicin through a peripheral I.V. line when the client complains of burning at the insertion site. The nurse notes no blood return from the catheter and redness at the I.V. site. The client is most likely experiencing which complication? Extravasation Thrombosis Flare Erythema

Extravasation

The nurse is preparing a teaching tool about alopecia caused by cancer treatment. Which information will the nurse emphasize in this tool? Select all that apply. Use a hair dryer to quickly dry the hair. Cut long hair before treatment begins. Use shampoo and conditioner every day. Use a wide-tooth comb to style the hair. Avoid hair dyes or permanent wave solutions.

Hair loss can begin shortly after starting chemotherapy or radiation therapy as treatment for cancer. The teaching tool should include information that helps minimize hair loss to include cutting long hair before treatment begins as this will reduce the weight and manipulation of the hair. A wide-toothed comb protects the scalp and prevents accidental loss of hair through routine maintenance. Hair dyes and permanent solutions should be avoided as this will protect the scalp and prevent accidental hair loss and scalp irritation. Hair dryers should be avoided as this will protect the scalp from accidental injury. Daily use of shampoos and conditioners should be avoided as this will encourage hair loss and lead to potential scalp injury. Conditioners are unnecessary.

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?

You Selected: "I use an electric razor to shave." Correct response: "I floss my teeth every morning." Explanation: A client with a platelet count of 30,000/mm3 is at risk for bleeding and shouldn't floss his teeth. Flossing may increase the risk of bleeding in a client with a platelet count less than 40,000/mm3. Using an electric razor is appropriate because doing so helps minimize the risk of cutting when shaving. Taking a stool softener helps decrease potential trauma to the GI tract that may cause bleeding. Removing throw rugs from the house helps prevent falls, which could lead to uncontrolled bleeding.

A client returns to the surgeon's office for a report on a diagnostic procedure to determine the cell composition of the client's abdominal neoplasm. Which term is significant to indicate the likelihood of the tumor spreading? neoplasm lesion primary site benign

benign

The clinic nurse is caring for a client who has just been diagnosed with a tumor. The client says to the nurse "The doctor says my tumor is benign. What does that mean?" What is the nurse's best response? "Benign tumors grow very rapidly." "Benign tumors can spread from one place to another." "Benign tumors don't usually cause death." "Benign tumors invade surrounding tissue."

"Benign tumors don't usually cause death."

A client is receiving external radiation to the left thorax to treat lung cancer. Which intervention should be part of this client's care plan? Avoiding using soap on the irradiated areas Removing thoracic skin markings after each radiation treatment Wearing a lead apron during direct contact with the client Applying talcum powder to the irradiated areas daily after bathing

Avoiding using soap on the irradiated areas

What foods should the nurse suggest that the patient consume less of in order to reduce nitrate intake because of the possibility of carcinogenic action? Fish and poultry Green, leafy vegetables Eggs and milk Ham and bacon

Ham and bacon Explanation: Dietary substances that appear to increase the risk of cancer include fats, alcohol, salt-cured or smoked meats, nitrate and nitrite-containing foods, and red and processed meats. Nitrates are added to cured meats, such as ham and bacon. Reference:

The physician is attending to a 72-year-old client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation? To analyze the lymph nodes involved To prevent the formation of new cancer cells To destroy marginal tissues To remove the tumor from the br

To prevent the formation of new cancer cells

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? Random, rapid growth of the tumor Cells colonizing to distant body parts Tumor pressure against normal tissues Emission of abnormal proteins

Tumor pressure against normal tissues

For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan? Administering aspirin if the temperature exceeds 102° F (38.8° C) Placing the client in strict isolation Inspecting the skin for petechiae once every shift Providing for frequent rest periods Inspecting the skin for petechiae once every shift

While administering cisplatin to a client, the nurse assesses swelling at the insertion site. What is the nurse's first action? Discontinue the intravenous medication. Administer a neutralizing solution. Apply a warm compress. Aspirate as much of the fluid as possibl Discontinue the intravenous medication.

The nurse is to administer a vesicant chemotherapeutic drug to a client who had a right mastectomy and inserts the intravenous line With a butterfly needle In the client's right forearm With a soft, plastic catheter In the client's left hand

With a soft, plastic catheter

A nurse is performing a home visit for a client who received chemotherapy within the past 24 hours. The nurse observes a small child playing in the bathroom, where the toilet lid has been left up. Based on these observations, the nurse modifies the client's teaching plan to include: signs and symptoms of infection. chemotherapy exposure and risk factors. expected chemotherapy-related adverse effects. reinforcement of the client's medication regimen.

chemotherapy exposure and risk factors.

he root cause of cancer is damage to cellular deoxyribonucleic acid (DNA) which can be caused by many factors, or carcinogens. What factors can be carcinogenic? Select all that apply. viruses gender age environmental factors dietary substances

environmental factors dietary substances virus

A client is scheduled for a nerve-sparing prostatectomy. The emotional spouse confides in the nurse that the client will not talk about the cancer and/or upcoming surgery. Which nursing diagnosis will the nurse choose as primary diagnosis for this client? Grieving Sexual Dysfunction Knowledge Deficit Fear

fear

The nurse is working with a client who has had an allo-hematopoietic 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 acute leukopenia. graft-versus-host disease. nadir. metastasis.

graft-versus-host disease.

The nurse is providing an educational presentation on dietary recommendations for reducing the risk of cancer. Which of the following food selections would demonstrate a good understanding of the information provided in the presentation? Select all that apply. Steamed broccoli and carrots Smoked salmon Vegetable and cheddar quiche Egg white omelet with spinach and mushrooms Turkey breast on whole wheat bread Crispy chicken Caesar Salad

• Egg white omelet with spinach and mushrooms • Steamed broccoli and carrots • Turkey breast on whole wheat bread

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? Punch biopsy Excisional biopsy Incisional biopsy Needle biopsy

Excisional biopsy Explanation: Excisional biopsy is most frequently used for small, easily accessible tumors of the skin, breast, and upper or lower gastrointestinal and upper respiratory tracts. In many cases, the surgeon can remove the entire tumor as well as the surrounding marginal tissues. The removal of normal tissue beyond the tumor area decreases the possibility that residual microscopic malignant cells may lead to a recurrence of the tumor. Incisional biopsy is performed if the tumor mass is too large to be removed. In this case, a wedge of tissue from the tumor is removed for analysis. Needle biopsy is performed to sample suspicious masses that are easily and safely accessible, such as some masses in the breasts, thyroid, lung, liver, and kidney. A core needle biopsy uses a specially designed needle to obtain a small core of tissue that permits histologic analysis.psy