Oncologic Management
A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed?
"I guess the doctor could not remove the entire tumor."
The nurse is caring for a client is scheduled for chemotherapy followed by autologous stem cell transplant. Which of the following statements by the client indicates a need for further teaching?
"I hope they find a bone marrow donor who matches."
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 young female client has received chemotherapeutic medications and asks about any effects the treatments will have related to her sexual health. The most appropriate statement by the nurse is
"You will need to practice birth control measures."
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.
Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode will the nurse anticipate?
Adjuvant therapy is likely.
After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention?
Administering metoclopramide and dexamethasone as ordered
5-Fluorouracil (5FU) is classified as which type of antineoplastic agent?
Antimetabolite
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 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
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, no abnormal regional lymph nodes, and no evidence of distant metastasis
Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth?
Control
The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action?
Extravasation
Chemotherapeutic agents have which effect associated with the renal system?
Increased uric acid excretion
When caring for an older client who is receiving external beam radiation, which is the key point for the nurse to incorporate into the plan of care?
Inspect the skin frequently.
Which statement is true about malignant tumors?
They gain access to the blood and lymphatic channels.
A client is receiving radiation therapy and asks the nurse about oral hygiene. What teaching specific to the client's situation should the nurse include?
Use a soft toothbrush and allow it to air dry before storing.
Which of the following would be inconsistent as a common side effect of chemotherapy?
Weight gain
The nurse is conducting a community education program using the American Cancer Society's colorectal screening and prevention guidelines. The nurse determines that the participants understand the teaching when they identify that people over the age of 50 should have which screening test every 10 years?
colonoscopy
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
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 brush my teeth after every meal
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
Which of the following would be consistent with a benign neoplasm?
Usually progressive and slow
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
A client with a recent history of GI disturbance has been scheduled for a barium study. The physician ordered this particular test for this client because it will:
show movement of the GI tract.
The 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 dietary substances environmental factors
A nurse assesses an oncology client with stomatitis during a chemotherapy session. Which nursing intervention would most likely decrease the pain associated with stomatitis?
Provide a solution of viscous lidocaine for use as a mouth rinse.
A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the best teaching by the nurse?
Provide time for the patient to discuss her concerns.
Which type of surgery is used in an attempt to relieve complications of cancer?
Palliative
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.
A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells?
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?
Malignant tumor
A nurse is caring for a client after a bone marrow transplant. What is the nurse's priority in caring for the client?
Monitor the client to prevent sepsis.
According to the tumor-node-metastasis (TNM) classification system, T0 means there is
No evidence of primary tumor
After being seen in the oncology clinic, a client with severe bone marrow suppression is admitted to the hospital. The client's cancer therapy consisted of radiation and chemotherapy. When developing the care plan for this client, which nursing diagnosis takes priority?
Risk for infection
A male client has been unable to return to work for 10 days following chemotherapy as the result of ongoing fatigue and inability to perform usual activities. Laboratory test results are WBCs 2000/mm³, RBCs 3.2 x 10¹²/L, and platelets 85,000/mm³. The nurse notes that the client is anxious. Which of the following is the priority nursing diagnosis?
Risk for infection related to inadequate defenses
The nurse is caring for a client with a benign breast tumor. The tumor may have which characteristic?
Slow rate of growth
A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention?
The I.V. site is red and swollen.
A newly diagnosed cancer client is crying and states the following to the nurse: "I promised God that I will be a better person if I can just get better." What is the appropriate assessment of this comment by the nurse?
The cancer is viewed as a punishment from past actions.
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.
A client with advanced cancer makes the following comment to the nurse: "Why are you bathing me? I am going to die no matter what." What is the most appropriate response of the nurse?
"Would you like to talk about what you are feeling?"
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?
Ham and bacon
A nurse is caring for a client receiving chemotherapy. Which nursing action is most appropriate for handling chemotherapeutic agents?
Wear disposable gloves and protective clothing
Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure?
blood studies
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?
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
graft-versus-host disease.
Which is a growth-based classification of tumors?
malignancy
A client with ovarian cancer is ordered hydroxyurea, an antimetabolite drug. Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. What mechanism of action do antimetabolites interferes with?
normal cellular processes during the S phase of the cell cycle
An oncologist advises a client with an extensive family history of breast cancer to consider a mastectomy. What type of surgery would the nurse include in teaching?
prophylactic
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.
The drug interleukin-2 is an example of which type of biologic response modifier?
Cytokine
A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis?
Red, open sores on the oral mucosa
