oncology

which statements are true when caring for a client post lung resection surgery? SATA a. Place client on strict bedrest so they do not exert too much effort b. Education the client on the important of pulmonary hygiene c. Have client ambulate asap d. Perform frequent CPT e. Check the clients pulse oximetry every 4 hours f. Encourage the client to use the incentive spirometry at least once during your shift lung cancer

B, C and D e - should be on continuous f - should be 10x per hour

Herceptin is a form of ______ chemotherapy. It is a ___ which is effective in the treatment of ______________ positive _ ________ cancer.

BIOLOGIC or TARGETED MONOCLONAL ANTIBODY HER-2 BREAST

A patient undergoing chemotherapy has been hospitalized due to severe nausea and vomiting. Which of the following drugs would be most appropriate to manage their symptoms? a. Ondansetron IV b. Maalox PO c. Ranitidine IV d. Metoclopramide PO

a Intravenous ondansetron (Zofran) is the drug of choice. PO medications are contraindicated if a patient is already vomiting, as they are likely to vomit the medication. IV Ranitidine is used to reduce stomach acid and does not reduce nausea/vomiting.

The nurse is teaching a patient about leuprolide. Which side effect will the nurse include in the teaching? a. flushing. b. dizziness. c. infection. d. incontinence. prostate cancer

a - Hormonal therapy that causes androgen deprivation think menopause

The spouse of a client with multiple myeloma reports that the client sleeps most of the day, is confused when awake, and complains of nausea and constipation. The nurse recognizes that these are signs and symptoms of which oncologic emergency? a. Hypercalcemia b. Tumor Lysis Syndrome c. Spinal Cord Compression d. Superior Vena Cava Syndrome oncological emergencies

a - lethargy, confusion, nausea and constipation

the nurse understands that the American Cancer Society classifies all of the following as warning signs of cancer EXCEPT? a) unintentional weight loss b) a sure that does not heal c) unusual bleeding or discharge d) nagging cough or hoarseness overview of cancer dx & staging

a) unintentional weight loss CAUTION acronym helps nurses and individuals remember 7 major warning signs of cancer

1. Which of the following risk factors place the patient at higher than normal risk for cancer? SATA a. Increased abdominal adiposity b. 3 alcoholic drinks per night c. Oral tobacco use d. Younger than 45 years of age e. Breast feeding f. Sedentary lifestyle cancer treatments

a, b, c & f a - fat holds onto estrogen, so higher estrogen exposure; higher exposure to free radicals not e - breast feeding lowers exposure to estrogen

1. The nurse is education the patient on the importance of pulmonary hygiene post thoracic surgery. Which topics should the nurse include in the teaching? SATA a. Deep breathing b. Correct use of incent incentive spirometer c. Positioning head of bed no more than 30 degrees i. Head of bed up 30 - 45 degrees (promote postural drainage) d. Frequent coughing e. Chest physiotherapy f. Ensuring the patient is resting as much as possible lung cancer

abde c - HOB up 30-45 degrees (promotes postural drainage)

A key difference between cell cycle specific and cell cycle nonspecific chemotherapeutic agents used in the treatment of cancer is: a. Cell cycle specific agents have fewer adverse effects than nonspecific agents b. Cell cycle nonspecific agents are dosed less frequently, while cell cycle specific agents are dosed continuously c. Nonspecific agents are more likely to cause alopecia d. Cycle specific agents allow for longer periods of recovery between doses.

b Cell cycle nonspecific agents are dosed intermittently and allow for periods of recovery between doses (more systemic affects) Cycle specific agents are delivered daily for a period of days to weeks and do not allow for rest periods between doses.

A client is incontinent of urine following a radical retropubic prostatectomy. The nurse will plan to teach the client: a. to restrict oral fluid intake. b. pelvic floor muscle exercises. c. to perform intermittent self-catheterization. d. the use of belladonna and opium suppositories. prostate cancer

b a - want them to increase drinking to flush UT c - don't want because retraumatization

A nurse is reviewing neutropenic precautions with a client. Which client statement indicates to the nurse that additional teaching is needed? a. "I will check my temperature twice daily and call my doctor if it is above 100.4oF" b. "I will order rare steak tonight for dinner to boost my protein and iron intake. c. "I will watch the Phillies game on TV today instead of going to the game." d. "I will have my wife clean the litter box for our cat when I return home."

b d - having wife clean instead is appropriate nursing care and considerations

1. Cell cycle specific chemotherapeutic agents work through various mechanisms to kill cancer cells. One such mechanism is: a. Producing antibodies that attack tumors b. Interfering with folic acid metabolism c. Antagonizing receptors for estrogen or testosterone d. Interfering with tumor angiogenesis

b antimetabolites! Interfering with folic acid metabolism is a cell cycle specific mechanism. This is the mechanism of cell cycle specific agents such as Methotrexate, Hydroxyurea, and 5 Fluorouracil. Drugs that cause the production of antibodies are biologic or targeted therapies; they are cell cycle nonspecific. Drugs that antagonize receptors and drugs that interfere with angiogenesis are also cell cycle nonspecific.

The nurse is caring for a patient who is receiving palliative radiation therapy to the hip for pain related to metastatic lung cancer. Which client statement(s) indicates a need for re-education? Select all that apply. a. "I can expect my hip pain to get better over the next seven to 10 days." b. "I need stay away from my grandchildren until my radiation treatments are completed." c. "I may develop fevers from a drop in my white cell count from the radiation treatment." d. "I can expect to feel sick and vomit because I am getting radiation treatment." cancer treatments

b & c b - not radioactive bc external radiation therapy c - pt likely to experience BM suppression, so WBC count will drop causing pt to feel sick hint: keep femur and function of femur in mind not a - they should feel relief since cancer cells are dying & will most likely experience dermatitis, but deep bone aching pain will improve not d - targeting hip wont effect GI tract

The nurse is providing care for a client with a chest tube. The drainage chamber has filled with 475mL of serosanguinous fluid in the last hour. Which action is MOST appropriate? a. Document your findings as normal b. Notify provider about the drainage c. Encourage the pt to cough, deep breath, and use incentive spirometer d. Position the patient on their operative side lung cancer

b - 200-300 ml/hr

A client tells the nurse, "I understand that I have stage II breast cancer and I need to decide on a surgery, but I feel overwhelmed. What do you think I should do?" Which response by the nurse is best? a. "I would have a lumpectomy, but you need to decide what is best for you." b. "Tell me what you understand about the surgical options that are available." c. "It would not be appropriate for me to make a decision about your health." d. "There is no need to make a decision rapidly; you have time to think about this." breast cancer

b - Help them think through solution without providing solution ourselves

A client is receiving her first dose of IV chemotherapy when suddenly she develops difficulty breathing, flushing of the skin and complains that she feels that her heart is racing. What action would the nurse perform FIRST? a. Notify the physician and monitor vital signs every 15 minutes. b. Stop the chemotherapy and keep the IV line open with normal saline. c. Apply oxygen via nasal cannula and have the patient take deep breaths. d. Administer IV diphenhydramine and hydrocortisone within 5 minutes. oncological emergencies

b - Will do # 1 and maybe ¾ but first you stop infusion

A patient who is being treated for stage IV lung cancer tells the nurse about new-onset back pain. Which action should the nurse take first? a. Give the patient the prescribed PRN opioid. b. Assess for sensation and strength in the legs c. Notify the health care provider about the symptoms. d. Teach the patient how to use relaxation to reduce pain. oncological emergencies

b - do this before calling HCP nursing process

The nurse understands that the process known as angiogenesis is problematic for patients who have cancer because: a) It serves no real purpose in the treatment of cancer b) New blood vessels supply the tumor with nutrients and oxygen c) It delivers tumor necrosis factor to the nucleus of the tumor d) It facilitates the development of the tumor nucleus cancer & risk factors

b) New blood vessels supply the tumor with nutrients and oxygen

Disposal of chemotherapy supplies such as intravenous tubing and bottles, should include: a. returning all supplies to the pharmacy department for disposal. b. placing them in the patient's trash to avoid contamination to other patients. c. placing them in the receptacle label Chemotherapy Toxic Waste. d. double bagging all supplies and placing them in the in the utility room. cancer tx

c

The nurse is caring for a patient who will receive external radiation therapy. The patient asks the nurse why the ugly ink marks and tattoos over the area to be radiated are necessary. The best response by the nurse is: a. "The markings indicate where the technician should focus treatments." b. "The markings let you know the exact location of the cancer" c. "Exact markings are critical to limit damage to healthy tissues" d. "Exact markings indicate potentially salvageable tissue" cancer tx

c

The primary aim of palliative surgery in cancer patients is to improve: a. cosmetic appearance. b. chance of cure. c. comfort level. d. rehabilitation. cancer tx

c

A patient undergoing chemotherapy has a platelet count of 45,000/microliter. Which of the following nursing interventions would be the priority intervention when caring for this patient? a. Thorough handwashing b. Monitoring pulse oximetry c. Limiting blood draws and invasive procedures d. Providing teaching on side effects of chemotherapy

c Patients with platelet counts less than 50,000 are considered thrombocytopenic. These patients are at risk for bleeding due to low platelet levels rendering them unable to clot effectively. These patients should avoid invasive procedures and blood draws which may result in uncontrolled bleeding.

A female patient's most recent laboratory values are as follows: Hemoglobin (Hgb)= 15 g/dl; Platelets= 300,000 cu/mm; and Absolute Neutrophil Count (ANC)= 500 / mm3. Which of the following medications should the nurse prepare to administer? Identify that ANC is problematic a. Epoetin Alfa (Epogen) b. Darbepoetin Alfa (Aranesp) c. Filgrastim (Neupogen) d. Oprelvekin (Neumega) nursing care and considerations

c a. Epoetin Alfa (Epogen) - no Hb was good no RBC stimulation needed in BM b. Darbepoetin Alfa (Aranesp) - no Hb was good no RBC stimulation needed in BM c. Filgrastim (Neupogen) - stimulates neutrophil production in BM d. Oprelvekin (Neumega) - not related medication

1. While undergoing radiation therapy a patient develops dry, itchy, flaky skin. The nurse should tell the patient to: a. Request radiation therapy less frequently to allow the area to heal b. Apply ice to the irritated area to reduce inflammation c. Cleanse the area with lukewarm water to avoid tissue damage d. Use an exfoliating scrub to remove dead cells from the skin's surface

c The area should be cleansed with lukewarm water to avoid further damage. Applying ice and exfoliating could cause further damage to the skin. Radiation should not be postponed.

Which nursing action should be included in the plan of care for a patient following a left modified radical mastectomy with dissection of axillary lymph nodes? a. Obtain a breast prosthesis before the patient is discharged from the hospital. b. Teach the patient to use the ordered patient-controlled analgesia (PCA) every 10 minutes. c. Post a sign at the bedside warning against venipunctures or blood pressures in the left arm. d. Insist that the patient examine the surgical incision when the initial dressings are removed. breast cancer

c - Pt at risk bc no lymph nodes to provide drainage

The nurse preparing for the annual physical exam of a 50-year-old man will plan to teach the patient about: i. Endoscopy. ii. Colonoscopy iii. Prostate Specific Antigen (PSA) testing. iv. Carcinoembryonic antigen (CEA) testing. colorectal cancer

colonoscopy At age 50, individuals with an average risk for colorectal cancer (CRC) should begin screening for CRC. Colonoscopy is the gold standard for CRC screening. The other diagnostic tests are not recommended as part of a routine annual physical exam at age 50.

A client completing radiation treatment reports to the nurse that she has no energy after each treatment. Which intervention should the nurse suggest to the client? a. The client should sleep whenever she feels tired. b. The client should avoid exercise until completing radiation. c. The client should drink three caffeinated beverages daily. d. The client should reorganize daily activities as needed. nursing care and considerations

d

A patient undergoing chemotherapy has become neutropenic. Which of the following complications are they at highest risk for developing? a. Bleeding b. Hypoxia c. Fluid imbalance d. Opportunistic infection

d Neutropenia (low white blood cells) places patients at increased risk of infection. Remember, WBCs fight infection. Thorough hand hygiene, reverse isolation, limiting visitors, prohibiting flowers, plants, and fresh fruits, all lower exposure to pathogens and help protect neutropenic patients from infection.

1. A patient undergoing chemotherapy reports nausea and anorexia. Which of the following recommendations regarding meals should the nurse make for this patient? a. Only eat if you feel hungry b. Try to eat 1 large meal per day c. Eat only the foods you prefer in order to boost appetite d. Eat small frequent meals throughout the day

d Eating small frequent meals is an effective way of managing nausea and anorexia. Eating large meals does not reduce nausea, eating only when you are hungry is not recommended as patients have no appetite. Even foods that the patient once enjoyed may be unpalatable during chemo.

A nurse is preparing to administer chemotherapy to a patient with cancer. The patient asks why a combination of drugs is used to treat the cancer. The BEST response by the nurse would be: a. "You can go longer between treatments if you use a combination of drugs." b. "Combination therapy is more cost effective for patients." c. "Combination therapy does not produce side effects." d. "Combination therapy reduces the cancers' ability to become resistant to therapy."

d The rationale behind drug combinations is that they decrease the likelihood of drug resistance. Additionally, using a combination of drugs means that lower doses of each drug can be used, which will decrease side effects, and using multiple mechanisms of action increases the likelihood of effectiveness.

1. When administering an antiemetic to a patient undergoing intravenous chemotherapy, the nurse will administer the drug: a. When the patient reports nausea b. 30 minutes after beginning the infusion c. 1 hour after the chemotherapy begins infusing d. Prior to starting the chemotherapy infusion

d When administering chemotherapy known to cause nausea, antiemetics should be dosed prior to beginning therapy. Waiting until the patient is nauseous, for 30 minutes, or until after the infusion is finished is too late to prevent nausea.

The nurse is caring for a patient who developed mucositis following chemotherapy. Which of the following physical assessment findings should the nurse anticipate observing? a. Inflammation and purulent drainage from the stoma b. Erythematous mucous membranes across the entire body c. White, patchy areas in the mouth and throat d. Burning pain with swallowing and open lesions on the lips/oral cavity cancer treatment

d rationale: a. Inflammation and purulent drainage from the stoma - related to tracheostomy/colonostomy b. Erythematous mucous membranes across the entire body - not correct signs c. White, patchy areas in the mouth and throat - thrush, oral candiditysis d. Burning pain with swallowing and open lesions on the lips/oral cavity - What mucositis specifically looks like as systemic effect of chemotherapy

The nurse understands that patients older than 65 years of age are at higher risk for cancer because of: a) enhanced resistance b) familial risk factors c) living in warm environments d) lowered immune responses cancer & risk factors

d) lowered immune responses

Tamoxifen in a cell cycle _______ agent used in the treatment of ____ cancer, and it is a/an ____ receptor antagonist.

nonspecific breast estrogen