oncology

THe nurse is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care?

"I empty the urinary collection bag when it is two-thirds full" (one-third full to prevent pulling)

as part of chemotherapy education, the nurse teaches a female client about the risk of bleeding and self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which statement?

"I'm going to take aspirin for my headaches when I go home" (d/t antiplatelet activity)

A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication. When implementing the plan, the nurse should make which statement to the client?

"You need to consult with the primary healthcare provider before receiving immunizations."

A client is diagnosed as having a intestinal tumor. The nurse should monitor the client for which complication of this type of tumor? Select all

1. peritonitis 2. hemorrhage 3. fistula formation 4. bowel perforation

The nurse has provided discharge instructions to a client who has had cryosurgery to remove a malignant skin lesion. The nurse determines that the client understands the instructions if the client makes which statements? select all

1. I need to clean the site as prescribed to prevent infection 2. I need to expect some swelling and increased tenderness of the treated area.

A client is having a diagnostic workup for colorectal cancer. Which factors in the client's history place the client at increased risk for this type of cancer? Select all that apply.

1. a diet high in fats 2. a diet high in carbohydrates 3. a hx of inflammatory bowel disease

A client who is receiving chemotherapy for breast cancer develops myelosuppression. Which instructions should the nurse include in the client's discharge teaching plan? Select all that apply.

1. avoid contact sports 2. wash hands frequently 3. avoid crowded places such as shopping malls 4. avoid people who have received live attenuated vaccines

The community health nurse is creating a poster for an educational session for a group of women and will be discussing the risk factors associated with breast cancer. Which risk factors for breast cancer should the nurse list on the poster?

1. early menarche 2. family hx 3. high-dose radiation exposure to chest 4. previous cancer of the breast, uterus, ovaries

Which interventions are the most appropriate for a client who is experiencing thromboyctopenia (platelets low, coagulation abnormal)? Select all

1. check secretions for frank or occult blood 2. encourage fluid intake to avoid constipation 3. provide oral sponges or a soft toothbrush for oral care

Which are warning signs of head and neck cancer? Select all that apply.

1. difficulty swallowing 2. lump in the mouth, neck, or throat 3. persistent or unexplained oral bleeding

A client with bladder cancer has undergone surgical removal of the bladder with creation of an ileal conduit. Which assessment findings indicate that the client is developing complications? Select all that apply.

1. dusky appearance of the stoma 2. stoma protrusion from the skin 3. sharp abdominal pain with rigidity

The nurse should include which intervention in the care of a client who has undergone a vaginal hysterectomy for the treatment of cancer? Select all that apply.

1. encourage ambulation as prescribed 2. remova antiembolism stockings twice daily 3. assist with range-of-motion (ROM) leg exercises 4. check placement of penumatic compression boots

The nurse is caring for a client with lung cancer and bone metastasis. What signs and symptoms would the nurse recognize as indications of a possible oncological emergency? select all that apply

1. faical edema in the morning 2. serum calcium level of 12 mg/dl 3. numbness and tingling of the lower

The nurse is reviewing the record of a client admitted to the hospital with a diagnosis of Hodgkin's disease. Which assessment findings noted in the client's record are associated with this diagnosis? Select all that apply.

1. fever 2. weight loss 3. night sweats 4. enlarged, painless lymph nodes

the nurse is conducting a history and monitoring lab values on a client with multiple myeloma. What assessment findings should the nurse expect to note? Select all that apply

1. pathological fracture 2. urinalysis positive for nitrites 3. serum creatinine level of 2.0 mg/dl

The community health nurse is preparing an educational class on ovarian cancer for a group of women. Which signs and symptoms should the nurse include in the presentation? Select all that apply.

1. having urinary urgency or frequency 2. experiencing pelvic or abdominal swelling 3. sense of feeling that something is "falling out"

The nurse is reviewing a plan of care for a client with cancer of the cervix who is undergoing treatment with a cesium (radiation) implant. Which nursing interventions are most appropriate for this client? select all that apply

1. maintain the client on bed rest 2. plaec the client on a low-fiber diet 3. stand at the entrance of the room to communicate to client when possible

The nurse is preparing a list of home care instructions regarding stoma and laryngectomy care for a client with laryngeal cancer who had a laryngectomy. Which instructions should be included in the list?

1. obtain a MedicAlert bracelet 2. prevent debris from entering the stoma 3. avoid exposure to people with infection 4. avoid swimming an duse care when showering

The nurse in the surgical care center will be assisting the primary health care provider to perform a punch biopsy of a client's skin lesion. Which interventions should be included in the preprocedure plan of care? Select all

1. obtain an informed consent 2. prepare to apply direct pressure to the biopsy site after the procedure. 3. tell the client that a small piece of tissue will be removed for examination.

The nurse is caring for a client who has undergone a radical neck dissection and creation of a tracheostomy because of laryngeal cancer and is providing discharge instructions to the client. Which should be included in the instructions? Select all that apply

1. protect the stoma from water 2. use a humidifier if dryness is a problem 3. keep powders and sprays away from the stoma site 4. apply a thin layer of non-oil-based ointment to the stoma to prevent cracking

The nurse has conducted an educational session about risk factors for bladder cancer with clients in the ambulatory care center. Which statements by the clients indicate that teaching was effective? Select all that apply.

1. quitting smoking will help to reduce my risk 2. I have to consider natural alternatives to dy my hair 3. I have to consult with primary health care provider about long-term use of cyclophosphamide medications.

A client with carcinoma of the lung develops syndrome of inappropriate atidiuretic hormone (SIADH) as a complication of the cancer. The nurse anticipates that the primary health care provider will request which prescriptions? Select all that apply

1. radiation 2. chemotherapy 3. serum sodium level determination 4. medication that is antagonistic to antidiuretic hormone

The nurse is reviewing the lab test results for a client receiving chemotherapy. The nurse notes that the white blood cell count is extremely low and places the client on neutropenic precautions. Which interventions are components of these types of precautions? select all

1. removing fresh-cut flowers from the client's room 2. instructing family members on the proper technique for hand washing 3. instructing family members to wear a mask when in client's room

A client with a medical diagnosis of breast cancer is undergoing chemotherapy. The client complains to the nurse about losing her hair and severe fatigue from the treatment. Which interventions should the nurse implement for this client? Select all that apply.

1. review side effects of chemotherapy and treatment with the client 2. teach the clinent to pace activities with rest so as to maintain strength. 3. offer information on available conseling services and support groups 4. inquire how the cancer diagnosis and treatment affect the client's normal routine

The community nurse is conducting a health promotion program at a local school and is discussing the risk factors associated with cervical cancer. Which are risk factors for cervical cancer? Select all that apply.

1. smoking 2. multiple sex partners 3. human papillomavirus infection 4. first intercourse before 17 yrs of age

The nurse is teaching a group of adults about the warning signs of cancer. Which signs and symptoms should the nurse mention to the group? Select all that apply.

1. sores that do not heal 2. nagging cough or hoarseness 3. indigestion or difficulty swallowing 4. chang ein bowel or bladder habits

The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm?

elevating the affected arm on a pillow above heart level.

A client with laryngeal cancer has undergone laryngectomy and is now receiving external radiation therapy to the head and neck. The nurse should monitor the client for which side and adverse effects of external radiation? Select all that apply.

1. stomatitis 2. dysgeusia 3. xerostomia

The nurse is monitoring the intravenous (IV) infusion of an antineoplastic medication to treat breast cancer. During the infusion, the client complains of pain at the insertion site. On inspection of the site, the nurse notes redness and swelling and that the infusion of the medication has slowed in rate. The nurse suspects extravasation and should take which actions? Select all that apply.

1. stop the infusion 2. prepare to apply ice or heat to the site 3. notify the primary health care provider (PHCP) 4. prepare to administer a prescribed antidote into the site

A 67-year-old man is receiving outpatient radiation treatments for carcinoma of the oropharynx and has developed dysphagia. The nurse develops a teaching plan regarding dysphagia and includes which interventions in the plan? Select all that apply.

1. teach the man to examine his oral mucosa daily 2. encourage the man to use artificial saliva to manage dryness

The health education nurse provides instructions to a group of clients regarding measures that will assist in preventing skin cancer. Which instructions should the nurse provide?

1. use sunscreen when participating in outdoor activities 2. wear a hat, opaque clothing, sunglasses when in the sun 3. examine your body montly for any lesions that appear suspicious

The nurse is caring a plan of care for the client with multiple myeloma and includes which priority intervention in the plan?

encouraging fluids

The nurse is caring for a client with prostate cancer who is being treated with a hormone therapy (androgen deprivation). What should the nurse monitor for in order to evaluate the effect of this treatment?

A decline in the amount of circulating androgens

Multiple myeloma is a

B cell neoplastic condition characterized by abormal malignant proliferation of plasma cells and the accumulation of mature plasma cells in the bone marrow.

The oncology nurse is providing a teaching session for a group of nursing students regarding the risks and causes of bladder cancer. Which statement by a student would indicate a need for further teaching?

Bladder cancer most often occurs in women

For the client with stomatitis resulting from chemotherapy, the care plan should include which intervention?

encourage foods with neutral or cool temperatures

The nurse is teaching a client who has had a laryngectomy for laryngeal cancer how to use an artifical larynx. Which statement should the nurse include in the teaching?

Hold the device alongside the neck

A client calls the ambulatory care clinic and tells the nurse that she found an area that looks like the peel of an orange when performing breast self-examination (BSE) but found no other changes. What is the nurse's best response to this client?

I am glad you called to report this finding. Can you come into the clinic to see your primary health care provider tomorrow? (Peau d'orange or orange peel appearance of the skin over the breast is associated with late breast cancer)

The nurse is doing preoperative teaching with a client newly diagnosed with a stage I cervical cancer. which statement by the client indicates that education was effective?

I have carcinoma that is just in the cervix

The ambulatory care nurse is providing discharge instructions to a female client who underwent cryosurgery with laser therapy because of a positive Papanicolaou test. Which statement by the client indicates an understanding of the instructions?

I should expect the vaginal discharge to be clear and watery

The nurse has provided teaching for an adult client about screening for colon cancer. Which statement by the client indicates that education was effective?

I should have an annual fecal occult blood test

The nurse is reviewing the preoperative prescriptions for a client with a colon tumor who is scheduled for abdominal perineal resection and notes that the primary health care provider has prescribed neomycin for the client. After discussing a prescription for neomycin with the nursing student who is caring for the client, the nurse determines that the student understands the rationale for administration if which statement is made?

It will help to decrease the bacteria in the bowel

The client reports to the nurse that while performing testicular self-examination, he found a lump the size and shape of a pea. Which statement is the most appropriate response to the client?

That's important to report even though it might not be serious

the nurse is providing information to a client scheduled for a skin biopsy. The client asks the nurse how painful the procedure is. The nurse should make which response to the client?

The local anesthetic may cause a stinging sensation

what is hodgkin's disease?

a chronic progressive neoplastic disorder of lymphoid tissue characterized by the painless enlargement of lymph nodes with progression to extralymphatic sites suchs as the spleen/liver.

The nurse is caring for a client with cancer of the prostate who has undergone a prostatectomy. Which action should the nurse include in discharge instructions?

avoid lifting objects heavier than 20 lb for at least 6 weeks

The community health nurse is preparing an educational session for a group of women and will be discussing the primary prevention strategies and treatment measures for breast cancer. What information should the nurse include in the educational session?

Treatment decisions are based on a woman's overall health

The nurse is caring for a client undergoing external radiation. The client has developed a dry desquamation of the skin in the treatment area, and the nurse is teaching about management of the skin reaction. Which comment made by the client suggests understanding of the instructions?

When bathing I will use lukewarm water on the affected area

A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication to treat breast cancer. When implementing the plan, the nurse should make which statement to the client?

You need to consult with the primary health care provider (PHCP) before receiving immunizations

A client is receiving intravesical chemotherapy for cancer of the bladder. The nurse should plan to take which action after the completion of each treatment?

`encourage increased intake of oral fluids

The clinic nurse has conducted a health screening clinic to identify clients who are at risk for cervical cancer. The nurse is reviewing the assessment findings in the records of the clients who attended the clinic. Which client is at lowest risk for developing this type of cancer?

a single white client

chronic lymphocytic leukemia (CLL) causes

a slow increase in immature B cells

During the admission assessment of a client with advanced ovarian cancer, the nurse recognizes which manifestation as typical of the disease?

abdominal distention (urinary frequency/urgency, pleural effusion, malnutrition, pain)

The nurse is taking a history from a clinet suspected of having testicular cancer. Which data will be most helpful in determining the risk factors for this type of cancer?

age and race

The nurse is performing a skin assessment on a client diagnosed with malignant melanoma. The nurse should expect to note which characteristic of this type of skin lesion?

an irregularly shaped lesion

The nurse in the ambulatory care unit is providing home care instructions to a client after cryotherapy for the treatment of malignant skin lesions. Which statement would be most appropriate for the nurse to include in the home care instructions for this client?

apply a warm, deep washcloth if discomfort occurs

The nurse is caring for a client diagnosed with breast cancer receiving combination chemotherapy. Which nursing intervention is the most appropriate?`

avoid giving agents with the same nadirs and toxicities at the same time.

A cervical radiation implant is placed in a client who is undergoing treatment of cervical cancer. The nurse should initiate which activitiy prescription as the most appropriate for this client?

bed rest

A 27-year-old client is undergoing evaluation of lumps in her breasts. In determining whether the client could have fibrocystic breast disorder, the nurse should ask her whether the breast lumps seem to become more prominent or troublesome at which time?

before menses

The nurse is caring for a client with leukemia. In assessing the client for signs of leukemia, the nurse determines that what should be monitored?

bone marrow biopsy

The nurse is caring for a chemotherapy client with a low platelet aggregation level. Which likely caused this decreased platelet production?

bone marrow suppression

The nurse has conducted a cancer prevention seminar for clients in an ambulatory setting. The nurse determines that teaching was effective if the clients select which food item on the menu?

broccoli, baked fish, mashed potato

The nurse is reviewing the laboratory test results for a client with bladder cancer with bone metastasis. The nurse should contact the primary health care provider (PHCP) if which finding is noted?

calcium level of 15 mg/dl. (hypercalcemia occurs when serum calcium lever are greater than 10.5 mg/dl)

The nurse is caring for a client after intravesical instillation of an alkylating chemotherapeutic agent for the treatment of bladder cancer. What should the nurse instruct the client to do after the instillation?

change position every 15 minutes

The nurse is assessing the perineal wound in a client who has returned from the operating room following an abdominal perineal resection and notes serosangulneous drainage from the would. Which nursing intervention is most appropriate?

change the dressing as prescribed.

The nurse is admitting a client with laryngeal cancer to the nursing unit. What should the nurse assess for as the most common risk factor for this type of cancer?

cigarette smoking

The nurse is caring for the client who is suspected of having lung cancer. The nurse should assess the client for which most frequent early symptom of lung cancer?

cough

The nurse is performing an admission assessment of a client with a possible right colon tumor. Which sign or symptom should the nurse anticipate the client may report?

dull abdominal pain exacerbated by walking

The nurse manager is teaching the nursing staff about signs and symptoms related to hypercalcemia in a client with metaastatic prostate cancer and tells the staff that which is a late sign of symptom of this oncological emergency?

electrocardiographic changes (shortened ST segment/widened T wave)

The nurse has admitted a client to the clinical nursing unit after undergoing a right mastectomy. The nurse should plan to place the right arm in which position.

elevated on a pillow

A client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment finding would the nurse expect to note specifically in the client?

enlarged lymph nodes

The community health nurse has conducted a teaching session for community members about the risk factors for laryngeal cancer. Which statement by a person attending the session indicates that teaching was effective?

exposure to airborne carcinogens can cause cancer

A women has just been told by the primary health care provider that she has breast cancer. The woman responds, "oh, no! Does that mean i'm going to die?" the nurse interprets the woman's initial reaction as which response?

fear

The nurse is providing home care instructions to the client who just had surgery for squamous cell carcinoma. The nurse provides follow-up teaching and explains to the client to watch for which characteristics of this type of skin carcinoma?

firm, nodular lesion topped with a crust or with a central area of ulcertion.

The nurse is reviewing the record of a client who was admitted to the hospital with a diagnosis of ovarian cancer. A client has received an unsealed radioactive isotope for treatment of thyroid cancer. Which instruction is essential for the nurse to provide the client?

flush the toilet at least 3 times after use

A client has been hospitalized for removal of a cervical radiation implant used to treat cancer. The implant is removed, and the nurse provides home care instructions to the client. Which statement made by the client indicates a need for further instruction?

foul-smelling vaginal discharge is a sign of an infection (foul-smelling discharge is expected)

The nurse is analyzing the lab results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy?

increased uric acid level

The nurse is reviewing the history of a client with bladder cancer. The nurse expects to note documentation of which most common sign or symptom of this type of cancer?

hematuria

A client is admitted to the hospital with suspected bladder cancer. The nurse assesses the client for which early signs and symptoms of the disease

hematuria and absence of pain

A client with leukemia is receiving busulfan and allopurinol. The nurse should tell the client that the purpose of the allopurinol is to prevent which symptom?

hyperuricemia

the nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. which would the nurse expect to note specifically in this disorder?

increased calcium level

Cryotherapy involves

the local applciation of liquid nitrogen to the lesion; causing cell death and tissue destruction

The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy?

increased uric acid level

A community health nurse is providing an educational session on cancer of the cervix for wome living in the community. The nurse informs the community residents that which is an early sign of this type of cancer?

irregular vaginal bleeding or spotting

Characteristics of melanoma?

irregulary shaped, pigmented papules or plaques

The nurse conducted discharge teaching for the client diagnosed with melanoma. Which statement by a client indicates that education was effective?

it is highly metastatic

A client seeks treatment in an ambulatory clinic for a complaint of hoarseness that has lasted for 6 weeks. On the basis of this symptoms, the nurse should consider developing a plan of care for which possible medical diagnosis?

laryngeal cancer.

in the immunocompromised client, what type of diet is necessary

low-bacteria diet (avoiding intake of fresh fruits/vegetables)

The nurse is monitoring a client with chronic lymphocytic leukemia (CLL). Which sign should the nurse specifically monitor for and report to the primary health care provider?

lymphadenopathy

The nurse is providing care to a client who has undergone modified right mastectomy for the treatment of breast cancer. Which activity should the nurse incorporate into the plan of care?

maintain head of bed elevation at 30 degrees with right arm elevated on a pillow

Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administering chemotherapy?

measure the clien's current weight and height.

Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administering chemotherapy?

measure the client's current weight and height

with intravesical instillation,

normally the medicatio is injected into the baldder through a urethral catheter, the catheter is clamped for removed, and the client is asked to retain the fluid for 2 hours. The client changes positions every 15-30 minutes. The client voids and is instructed to drink water to flush the bladder

The nurse is caring for a client with metastatic breast cancer. The client describes a new and sudden sharp pain in the back. Based on this assessment finding, which is the priority nursing intervention?

notify the primary health care provider (PHCP)

the client has undergone mastectomy. The nurse determines that the client is making the best adjustment to the loss of the breast if which behavior is observed?

participating in the care of the surgical drain

The nadir is

period of greatest bone marrow suppression

The nurse monitoring an oncological client assesses for which early sign of vena cava syndrome?

periorbital edema

The nurse is monitoring a client for signs and symptoms related to superior vena cava syndrom. Which is an early sign of this oncological emergency?

periorbital edema (edema of face in AM)

The nurse is partcipating in a health screeing clinic and is preparing teaching materials about colorectal cancer. Which risk factor for colorectal cancer should the nurse include?

personal hisotry of ulcerative colitis or gastronintestinal polyps

The nurse is caring for a client with leukemia who is receiving IV chemo. The nurse reviews the lab results and notes that the WBC: 2000 mm3, platelet: 150,000 mm3, the clotting time is 10 mins, and the ammonia level is 20 mcg/dl. Which nursing action would be appropriate?

place the client on neutropenic precautions

The nurse should be prepared to institute bleeding precautions in the client receiving antineoplastic medication if which result was reported from the laboratory?

platelet count 50, 000 mm3

A client with liver cancer who is receiving chemotherapy tells the nurse that some foods taste bitter. The nurse would try to limit which food that is most likely to cause this bitter taste for the client?

pork

The nurse is reviewing the medical record for a client who has been diagnosed with Hodgkin's disease. The nurse should check which diagnostic test noted in the client's record to determine the stage of the disease?

positron emission topography (PET) scan

Hodgkin's diseases

reed-sternberg cells are present the lymph nodes, spleen and liver are involved the prognosis depends on the stage of the disease

The nurse is reviewing the laboratory test results for a client with a diagnosis of leukemia who is reveiving chemotherapy. The nurse notes that the client's platelet count is 20,000 mm3. The nurse should prepare to implement which action based on this finding?

remove the rectal thermometer from the patient's room

The home health care nurse is providing instructions to a client after a vulvectomy. Which instruction should the nurse provide to the client?

resume activities slowly, keeping in mind that walking is beneficial activity.

The clinic nurse prepares instructions for a client diagnosed with leukemia who developed stomatitis after the administration of a course of antineoplastic medications. The nurse should provide the client with which instruction?

rinse the mouth with a diluted solution of baking soda or saline.

characteristics of basal cell carcinoma?

small macules/papules with dry, rough, adherent yellow or brown scale

A client is receiving external radiation to the neck for cancer of the larynx. Which is the most likely expected effect?

sore throat

The nurse is preparing to care for a client with a diagnosis of metastatic cancer. The nurse notes documentation in the client's chart that the client is experiencing cachexia. Which should the nurse expect to note on assessment of the client?

sunken eyes and a hollow cheek appearance

The home health care nurse is visiting a client who has undergone a mastectomy. The nurse determines that the client demonstrates greatest adjustment to the loss of the breast if which behavior is noted?

the client looks at the surgical site

A client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing which condition?

the development of a vesicovaginal fistula

A client has undergone abdominal perineal resection for a bowel tumor. The nurse interprets that the client's colostomy is beginning to function if which sign is noted?

the passage of flatus

Which statement made by a client who will undergo cytoreductive (debulking) surgery for ovarian cancer indicates that teaching by the nurse was effective?

the surgery will help to reduce the size of the tumor

The nurse in the primary health care provider's office is performing a postoperative assessment of a client who underwent mastectomy of her right breast 2 weeks ago. The client tells the nurse that she is very concerned because she has numbness in the area of the surgery and along the inner side of the arm from the armpit to the elbow. The nurse should provide which information to the client about her complaint?

these sensations dissipate ove several months and usually resolve after 1 year.

The nurse has instructed the client in the correct technique for breast self-examination (BSE). For a portion of the examination, the client will lie down. The nurse should teach the client to put the pillow in which location for self-examination of the right breast?

under the right shoulder

The nurse is providing discharge instructions to a client who has undergone treatment of cervical cancer with a radiation (cesium) implant. Which instruction should the nurse provide to the client?

use a vaginal dilator 3 times a week (prevents vaginal narrowing/stenosis)

The client is preparing for discharge from the hospital after radical vulvectomy. The nurse should include which activity as appropriate for the client immediately after discharge?

walking

A client receiving chemotherapy is experiencing mucositis. The nurse should advise the client to use which item as the best substance to rinse the mouth?

weak salt and bicarbonate mouth rinse