Pathophysiology 2A

A client diagnosed with cancer presents with Cushing syndrome secondary to excessive adrenocorticotropic hormone secretion. Which term will the nurse use to describe this process? Ionizing Hypocalcemia Opportunistic infection Paraneoplastic syndrome

4

A client has a high risk for ovarian cancer. Which gene alteration did the nurse observe on the client's chart? Rb p53 APC BRCA1

4

A client is diagnosed with cancer of the jaw from B lymphocytes (Burkitt lymphoma). Which genetic change should the nurse suspect as being the cause for this pathology? Point mutation Gene amplification Loss of heterozygosity Chromosomal translocation

4

A client diagnosed with cancer presents with Cushing syndrome secondary to excessive adrenocorticotropic hormone secretion. Which term will the nurse use to describe this process? a. Ionizing b. Hypocalcemia c. Opportunistic infection d. Paraneoplastic syndrome

d

A client has a benign new cellular growth. Which term will the nurse use in the change-of-shift report to describe this condition? Lipoma Cancer Apoptosis Neoplasm

d

A client has a benign new cellular growth. Which term will the nurse use in the change-of-shift report to describe this condition? a. Lipoma b. Cancer c. Apoptosis d. Neoplasm

d

A client is diagnosed with cancer of the jaw from B lymphocytes (Burkitt lymphoma). Which genetic change should the nurse suspect as being the cause for this pathology? Point mutation Gene amplification Loss of heterozygosity Chromosomal translocation

d

A client is experiencing a paraneoplastic syndrome. Which information indicates the nurse has a correct understanding of this syndrome? a. It is caused by cancer treatment, such as bone marrow suppression. b. It facilitates the progression of metastasis, such as hormone responsiveness. c. It is produced by the specific location of the tumor, such as dyspnea from lung cancer. d. It involves widespread effects, such as hypercalcemia due to circulating factors.

d

A client with cancer received chemotherapy and now has a deficiency in circulating platelets. Which term will the nurse use in the change-of-shift report to describe this condition? Anemia Leukopenia Granulocytopenia Thrombocytopenia

d

A nurse hears in an interdisciplinary team meeting that a client has a tumor-suppressor gene mutation that caused cancer. How should the nurse interpret this finding? The client has gene amplification. The client has chromosomal translocation. The client has excessive amounts of caretaker genes. The client has deletion of both copies of the tumor-suppressor gene.

d

Upon review of a client's chart, the nurse finds the client has a BRCA1 mutation. How should the nurse interpret this finding? a. The client has colon adenomas. b. The client is dying of neurofibromatosis. c. The client has inherited Li-Fraumeni syndrome. d. The client is at increased risk for breast cancer.

d

Which term can the nurse use to describe a tumor-suppressor gene during change-of-shift report? Oncogene RAS gene Anti-oncogene Proto-oncogene

3

A client has a strong family history of cancer and is thinking about undergoing genetic testing. "If I have the family mutation that causes the proto-oncogenes to become abnormal and turn on too much, then I am at very high risk for developing cancer. Is that right?" Choose the nurse's response. Yes, you are correct. No, that is not correct. Yes, proto-oncogenes are already abnormal, causing cells to die and increasing your cancer risk. No, proto-oncogenes suppress cell growth, so turning them on too much would not cause cancer.

1

A client has a strong family history of cancer and is thinking about undergoing genetic testing. "If I have the family mutation that causes the proto-oncogenes to become abnormal and turn on too much, then I am at very high risk for developing cancer. Is that right?" Choose the nurse's response. Yes, you are correct. No, that is not correct. Yes, proto-oncogenes are already abnormal, causing cells to die and increasing your cancer risk. No, proto-oncogenes suppress cell growth, so turning them on too much would not cause cancer.

1

A client has cancer not from just a single gene but from an entire intracellular signalling networks being affected. Which pathophysiologic process can cause this cancer? The miRs have changed. An oncogene is inactivated. A tumor-suppressor gene is activated. An inherited defect occurs in the caretaker genes.

1

A client with cancer has a rapid pulse rate, blood pressure of 170/110 mm Hg, sweating, and tremors. Which tumor marker will help diagnose the client's condition? Blood catecholamine Blood alpha-fetoprotein Blood prostate-specific antigen Blood carcinoembryonic antigen

1

A nurse is assisting the primary healthcare provider in determining the size of the tumor and the extent to which its cells have spread in a client. Which process is being described? Staging Grading Cachexia Angiogenesis

1

A nurse reads on the chart that a client has developed alopecia from chemotherapy. What should the nurse expect to find upon assessment of the client? Hair loss Pinkish urine Yellow sclerae Redness of skin

1

A nurse reads on the chart that a client has developed alopecia from chemotherapy. What should the nurse expect to find upon assessment of the client? Hair loss Pinkish urine Yellow sclerae Redness of skin

1

Which information indicates the nurse has an accurate understanding of tumors? Tumors are cancerous. Most neoplasms are cancerous. Cancer refers to a malignant tumor. Malignant tumors have controlled growth.

3

A nurse is teaching about typical characteristics of cancer cells. Which concepts should the nurse include in the teaching session? Autocrine stimulation Development of immortality Insensitivity to antigrowth signals Loss of cellular self-destruct mechanisms Decreased responsiveness to growth factors

1, 2, 3, 4

Which factors contribute to the development of anemia in clients with cancer? Anorexia Chronic bleeding Decreased erythropoietin Increased iron absorption Malignant cells in the bone marrow

1, 2, 3, 5

Which information from the staff indicates successful teaching by the nurse regarding caretaker genes? Caretaker genes are guardians of the genome. Inherited mutations cannot disrupt caretaker genes. Loss of function of caretaker genes results in increased mutation rates. Loss of function of caretaker genes can cause increased rates of specific cancers. Caretaker genes encode proteins that repair damaged deoxyribonucleic acid (DNA).

1, 3, 4, 5

A cancer cell reactivates the gene for telomerase. Which action does the nurse expect to occur in the client's cells? Evade apoptosis Unlimited replication Loss of contact inhibition Anchorage independence

2

A client has cancer of the blood-forming cells. The nurse is caring for which client? A client with sarcoma A client with leukemia A client with carcinoma A client with lymphoma

2

A client has xeroderma pigmentosum. Which defect has occurred in the client to promote this condition? Repair of DNA helicase Repair of DNA pyrimidine dimers Repair of DNA double-strand breaks Repair of DNA base pair mismatches

2

A client with cancer has received treatment to shrink the cancer before surgery. Which term should the nurse use to describe the treatment to shrink the cancer? Adjuvant Neoadjuvant Brachytherapy Immunotherapy

2

A nurse is caring for a client with colorectal cancer and learns that a point mutation occurred in the RAS gene. Which pathophysiologic process should the nurse consider while planning care? A tumor-suppressor gene became activated. A proto-oncogene converted to an oncogene. A tumor-suppressor gene became inactivated. A proto-oncogene converted to a regulated gene.

2

After reviewing the laboratory and diagnostic reports of a client, the nurse finds that the client's cancer is anaplastic. How should the nurse interpret this finding? The cancer will be benign. It will be poorly differentiated. The cancer cells will be similar in size and shape. It will be similar in appearance to its tissue of origin.

2

The nurse is reviewing the medical history of several clients. What does the nurse expect from these findings? Client A has a risk of melanoma. Client C has a risk of genital warts. Client B has a risk of cholangiocarcinoma. Client D has a risk of mucosa-associated lymphoid tissue (MALT) lymphoma.

2

Which assessment finding will indicate to the nurse that a client with cancer has early satiety? Stomatitis occurs. The client feels full after a few bites. Saliva decreases, causing dry mouth. Hyperglycemia occurs quickly after eating.

2

A nurse is teaching a client the difference between normal cells and cancer cells. Which information should the nurse include? Cancer cells exhibit contact inhibition. Cancer cells induce angiogenesis. Cancer cells evade growth suppressors. Cancer cells regulate cellular energetics. Cancer cells have sustaining proliferative signaling.

2, 3, 5

A nurse is teaching a client the difference between normal cells and cancer cells. Which information should the nurse include? Cancer cells exhibit contact inhibition. Cancer cells induce angiogenesis. Cancer cells evade growth suppressors. Cancer cells regulate cellular energetics. Cancer cells have sustaining proliferative signaling.

2,3,5

A client has chronic Helicobacter pylori infection and is at most risk for which type of cancer? Colon Breast Gastric Bladder

3

A client has stage 3 cancer. How should the nurse interpret this finding? The client's cancer is a benign tumor. The client's cancer is only locally invasive. The client's cancer has spread to lymph nodes. The client's cancer has been confined to the organ of origin.

3

A client is newly diagnosed with cervical carcinoma in situ and asks the nurse to explain what this means. What is the nurse's response about the cancer cells? They have become malignant. They have metastasized to another organ. They have not invaded the surrounding tissue. They have invaded the surrounding tissue but have not yet metastasized.

3

A client is receiving chemotherapy. Which complication should the nurse closely monitor for because it is the most deadly? Anemia Clotting Infection Bleeding

3

A client with cancer develops thrombocytopenia from chemotherapy. Which complication should the nurse monitor for in this client? Anemia Infection Hemorrhage Granulocytopenia

3

A client's cancer has caused a release of vascular endothelial growth factor. Which process does the nurse expect to happen in the client's body? Apoptosis Immortality Angiogenesis Reverse Warburg effect

3

A female client received radiation from sources placed into the cervix. The nurse will report the client had which type of treatment? Surgery Induction Brachytherapy Chemotherapy

3

A nurse is caring for a client who is receiving radiation therapy for metastatic cancer. Which assessment finding does the nurse recognize as evidence of a paraneoplastic syndrome? Appears cachectic "I have no appetite." Serum calcium elevated "I am very tired all the time."

3

Which assessment finding indicates to the nurse that the client is exhibiting the most frequently reported symptom of cancer? Pain Fever Fatigue Anxiety

3

A client with a malignant tumor says, "The primary healthcare provider said my tumor is growing really quickly. Why does it grow so fast?" Which principle is the basis for the response that a nurse should provide? Malignant cells are mortal. Malignant cells exhibit apoptosis. Malignant cells prohibit angiogenesis. Malignant cells lack contact inhibition.

4

A nurse hears in an interdisciplinary team meeting that a client has a tumor-suppressor gene mutation that caused cancer. How should the nurse interpret this finding? The client has gene amplification. The client has chromosomal translocation. The client has excessive amounts of caretaker genes. The client has deletion of both copies of the tumor-suppressor gene.

4

A nurse is checking medication administration records for several clients receiving molecular-era anticancer drugs. Which client prescription will cause the nurse to notify the healthcare provider? Client A Client B Client C Client D

4

A nurse is teaching the staff about genes that normally inhibit cellular proliferation in the normal state of the cell. Which type of gene is the nurse describing? Telomeres Oncogenes Proto-oncogenes Tumor-suppressor genes

4

A nurse reviews the laboratory result and discovers a client with chronic myeloid leukemia (CML) has the Philadelphia chromosome. Which genetic change does this represent to the nurse? Point mutation Gene amplification Histone modification Chromosome translocation

4

A nurse reviews the laboratory result and discovers a client with chronic myeloid leukemia (CML) has the Philadelphia chromosome. Which genetic change does this represent to the nurse? Point mutation Gene amplification Histone modification Chromosome translocation

4

A nurse will encourage a woman who is infected with which virus to undergo periodic screening for cervical cancer? Epstein-Barr virus Herpes simplex virus Varicella zoster virus Human papillomavirus

4

Upon review of a client's chart, the nurse finds the client has a BRCA1 mutation. How should the nurse interpret this finding? The client has colon adenomas. The client is dying of neurofibromatosis. The client has inherited Li-Fraumeni syndrome. The client is at increased risk for breast cancer.

4

A nurse is teaching the staff about cancer. Which information from the staff indicates successful teaching? Anaplasia means more well-differentiated cells. Malignant tumors have the potential to kill the host. The definition for metastasis is less differentiated cells. Benign tumors grow more rapidly than malignant ones. The greater the undifferentiated cell count, the more invasive the cancer.

Malignant tumors have the potential to kill the host. The greater the degree of anaplasia, the more cellular disorganization and hence the more invasive the malignant tumor. Anaplasia is a lack of cellular differentiation. Benign tumors usually grow more slowly and predictably than malignant ones. Metastasis is the spread of cancer to other sites (often distant sites) regardless of the degree of cellular differentiation. p. 234

A client asks the nurse to describe the difference between carcinoma and sarcoma. Which information should the nurse share with the client? a. Carcinomas arise from epithelial tissue. b. Carcinomas arise from lymphatic tissue. c. Carcinomas arise from connective tissue such as bone or cartilage. d. Carcinomas arise from glandular tissue such as the duct linings in the breast.

a

A client has cancer in the connective tissue. Which diagnosis will the nurse observe written on the chart? a. Sarcoma b. Leukemia c. Carcinoma d. Lymphoma

a

A client has cancer of the blood-forming cells. The nurse is caring for which client? A client with sarcoma A client with leukemia A client with carcinoma A client with lymphoma

a

A client has retinoblastoma. Which gene mutation will the nurse observe written in the chart? a. RB1 b. APC c. WT1 d. TP53

a

A nurse is asked what the purpose of the TNM classification system is. How should the nurse respond? a. It provides a common standardization scheme for staging. b. It provides information for ongoing research efforts to develop a cure for cancer. c. It enables accurate involvement of the family and client in treatment decisions. d. It enables the primary healthcare provider to determine the underlying cause of the malignancy.

a

A nurse is teaching a client about inflammation and cancer. Which information should the nurse include in the teaching plan? a. Inflammation and cancer can work together to spread the cancer. b. Inflammation can help the cancer cell to resist chemotherapeutic agents. c. During inflammation, damaged cells divide more frequently, increasing the rate of cancer growth. d. Chronic inflammation decreases continued growth of cells by inhibiting new blood vessel growth to enhance mutations. e. Tumor-suppressor genes become activated during inflammation, which can lead to development of cancer-causing mutations.

a, b, c

A nurse teaches the staff about typical characteristics of benign tumors. Which information from the staff indicates successful teaching? a. The tumor has few mitotic cells. b. The tumor has numerous undifferentiated cells. c. Benign tumors tend to invade surrounding tissue. d. Benign tumors often are surrounded by a capsule. e. Cells in the tumor occasionally metastasize to lymph nodes.

a, d

Which assessment finding indicates to the nurse that the client is exhibiting the most frequently reported symptom of cancer? Pain Fever Fatigue Anxiety

c

A cancer cell reactivates the gene for telomerase. Which action does the nurse expect to occur in the client's cells? a. Evade apoptosis b. Unlimited replication c. Loss of contact inhibition d. Anchorage independence

b

A client is receiving cancer chemotherapy and radiation therapy. The nurse assesses the client for oral ulcers. What is the rationale for the nurse's behavior? a. These treatments alter red blood cells. b. These treatments cause a decreased cell turnover. c. These treatments are toxic when combined with acidic foods. d. These treatments interfere with adherence independence.

b

A client with cancer has a hemoglobin level of 8 g/dl. Which prescribed treatment will the nurse provide? a. Administration of platelets b. Administration of erythropoietin c. Administration of white blood cells d. Administration of granulocyte colony-stimulating factor

b

A client with cancer has received treatment to shrink the cancer before surgery. Which term should the nurse use to describe the treatment to shrink the cancer? a. Adjuvant b. Neoadjuvant c. Brachytherapy d. Immunotherapy

b

A nurse hears in an interdisciplinary meeting that a client has cancer-causing mutations to protooncogenes. How should the nurse interpret this finding? a. The client will have increased apoptosis. b. The client will have increased cell growth and division. c. The client will have decreased cell responsiveness to growth factors. d. The client will have decreased production of monoclonal antibodies.

b

A nurse is caring for a client with colorectal cancer and learns that a point mutation occurred in the RAS gene. Which pathophysiologic process should the nurse consider while planning care? a. A tumor-suppressor gene became activated. b. A proto-oncogene converted to an oncogene. c. A tumor-suppressor gene became inactivated. d. A proto-oncogene converted to a regulated gene.

b

A nurse is explaining how a client's cancer cells accumulate faster than the client's normal neighboring cells. Which process is the nurse describing? a. Clonal mutation b. Clonal expansion c. Clonal stimulation d. Clonal reunification

b

After reviewing the laboratory and diagnostic reports of a client, the nurse finds that the client's cancer is anaplastic. How should the nurse interpret this finding? a. The cancer will be benign. b. It will be poorly differentiated. c. The cancer cells will be similar in size and shape. d. It will be similar in appearance to its tissue of origin.

b

Which information indicates the nurse has an accurate understanding of tumors? a. Tumors are cancerous. b. Most neoplasms are cancerous. c. Cancer refers to a malignant tumor. d. Malignant tumors have controlled growth.

c

A client has cachexia. While planning care, which pathophysiologic processes should the nurse consider? a. Late satiety b. Inflammation c. Altered liver function d. Decreased gut apoptosis e. Loss of appetite from alterations in taste

b, c, e

Which assessment findings are characteristic of a client with cachexia? a. Weight gain b. Early satiety c. Thermogenesis d. Increased appetite e. Altered metabolism

b, c, e

A nurse is teaching the staff about cancer. Which information from the staff indicates successful teaching? a. Anaplasia means more well-differentiated cells. b. Malignant tumors have the potential to kill the host. c. The definition for metastasis is less differentiated cells. d. Benign tumors grow more rapidly than malignant ones. e. The greater the undifferentiated cell count, the more invasive the cancer.

b, e

A client has chronic Helicobacter pylori infection and is at most risk for which type of cancer? a. Colon b. Breast c. Gastric d. Bladder

c

A client has leukopenia from cancer chemotherapy. Which goal becomes the priority? Prevent anemia Prevent cachexia Protect from infection Protect from bleeding

c

A client has stage 3 cancer. How should the nurse interpret this finding? The client's cancer is a benign tumor. The client's cancer is only locally invasive. The client's cancer has spread to lymph nodes. The client's cancer has been confined to the organ of origin.

c

A client with cancer has weight loss with inflammation affecting adipose tissue. Which term should a nurse use to describe this condition at change-of-shift report? a. Anemia b. Stomatits c. Cachexia d. Cushing syndrome

c

A client's cancer has caused a release of vascular endothelial growth factor. Which process does the nurse expect to happen in the client's body? a. Apoptosis b. Immortality c. Angiogenesis d. Reverse Warburg effect

c

A nurse is reviewing targeted cancer screening results of various clients. Which client will be most at risk for adenomas of the colon? A client with a NF1 mutation A client with a WT1 mutation A client with an APC mutation A client with a BRCA1 mutation

c

Which information indicates the nurse has an accurate understanding of distant metastasis in clients? a. Lack of proteases aids in metastasis. b. Fluid from ascites is the first step in metastasis. c. Increased cell-to-cell adhesion helps metastasis. d. Cells must gain access to blood and lymphatic vessels.

d