Prep-U Cancer
Which statement by a client undergoing external radiation therapy indicates the need for further teaching?
Answer: "I'm afraid I'll expose my family members to radiation."
A client diagnosed with leukemia asks the nurse why he must undergo bone marrow aspiration. Which response by the nurse is best?
Answer: "To determine what type of leukemia you have; your physician will explain the procedure to you in more detail." Rationale:Bone marrow aspiration identifies the type of white blood cell involved, which helps determine the type of leukemia and guide treatment. The nurse should offer a simple explanation of why the procedure is being performed, and tell the client that the physician will explain the procedure fully before informed consent is obtained.
As part of a primary cancer prevention program, an oncology nurse speaks to the public at a health fair. When someone asks about laryngeal cancer, which statement by the nurse would be most helpful?
Answer: "To reduce the risk of developing laryngeal cancer you shouldn't smoke or drink alcohol."
A client in the final stages of terminal cancer tells his nurse: "I wish I could just be allowed to die. I'm tired of fighting this illness. I have lived a good life. I only continue my chemotherapy and radiation treatments because my family wants me to." What is the nurse's best response?
Answer: "Would you like to meet with your family and your physician about this matter?" Rationale: The nurse has a moral and professional responsibility to advocate for clients who experience decreased independence, loss of freedom of action, and interference with their ability to make autonomous choices. Coordinating a meeting between the physician and family members may give the client an opportunity to express his wishes and promote awareness of his feelings as well as influence future care decisions.
A client is undergoing a left modified radical mastectomy for breast cancer. Postoperatively, blood pressure should be obtained from the client's right arm, and the left arm and hand should be elevated as much as possible to prevent which condition?
Answer: Lymphedema
An oncology nurse educator is speaking to a women's group about breast cancer. Questions and comments from the audience reveal a misunderstanding of some aspects of the disease. Various members of the audience have made all of the following statements. Which statement is accurate?
Answer: Men can develop breast cancer.
Which finding is an early indicator of bladder cancer?
Answer: Painless, intermittent hematuria
The nurse in a long-term care facility notes a change in the color, shape, and texture of a nevus located on a client's shoulder. The nurse knows that this finding might suggest:
Answer: malignant melanoma.
The nurse is reviewing the chart of a client receiving chemotherapy for lung cancer. She is alarmed to note that the client has developed thrombocytopenia. Which precaution should the nurse implement to ensure the clients safety?
Answer: Provide the client with an electric razor.
Which nursing intervention is most appropriate for a client with multiple myeloma?
Answer: Preventing bone injury Rationale: When caring for a client with multiple myeloma, the nurse should focus on relieving pain, preventing bone injury and infection, and maintaining hydration.
During chemotherapy, an oncology client has a nursing diagnosis of Impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis?
Answer: Providing a solution of hydrogen peroxide and water for use as a mouth rinse
During a breast examination, which finding most strongly suggests that the client has breast cancer?
Answer: A fixed nodular mass with dimpling of the overlying skin
The ABCD method offers one way to assess skin lesions for possible skin cancer. What does the A stand for?
Answer: Asymmetry
A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of Risk for impaired skin integrity. Which intervention should be part of this client's plan of care?
Answer: Avoiding using soap on the irradiated areas
Several days before admission, a client reports finding a small lump in the left breast near the nipple. What should the nurse tell the client to do?
Answer :Inform the physician immediately.
A client suspected of having gallbladder cancer is admitted to the hospital for a series of diagnostic testing. What objective data collected by the nurse would be indicative of gallbladder cancer? Select all that apply.
Answer: • Jaundice • Weight loss of 10 kg in 2 months
The nurse is caring for a client with bronchogenic carcinoma. Which nursing interventions are essential in the care of the client receiving a chemotherapeutic regimen? Select all that apply.
Answer: • Maintain a patent airway. • Alleviate anxiety by explaining procedures and care delivery. • Instruct the client on signs and symptoms of infection. Rationale: Maintaining a patent airway is the first concern in a client with a condition that may compromise the airway. Therefore, ineffective airway clearance related to obstruction by a tumor or secretions takes highest priority and should be monitored at all times, especially during chemotherapy. All care should be explained prior to performing so that the client has alleviation of anxiety related to the care.
A client seeks care for hoarseness that has lasted for 1 month. To elicit the most appropriate information about this problem, the nurse should ask which question?
Answer: "Do you smoke cigarettes, cigars, or a pipe?" Rationale: persistent hoarseness may signal throat cancer, which is commonly associated with tobacco use. To asses the client's risk for throat cancer, the nurse should ask about smoking habits.
A 45-year-old client receiving radiation therapy for thyroid cancer reports mouth and throat pain. While inspecting the mouth and throat, the nurse notices white patches and ulcerations in the oral mucosa. What do these findings suggest?
Answer: Candidiasis Rationale: White patches and ulcers in the mouth and throat suggest candidiasis. Candidiasis is common in immunocompromised clients and in clients receiving radiation therapy.
A client diagnosed with acute myelocytic leukemia (AML) has been receiving chemotherapy. During the last two 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?
Answer: Closely observe the client's skin for petechiae and bruising.
A client is receiving chemotherapy to treat breast cancer. Which data collection finding indicates a fluid and electrolyte imbalance induced by chemotherapy?
Answer: Dry oral mucous membranes and cracked lips
What should a male client older than age 50 do to help ensure early identification of prostate cancer?
Answer: Have a digital rectal examination and prostate-specific antigen (PSA) test done yearly.
Which of the following actions displayed by a grieving husband over his dying wife would cause the nurse to suggest counseling?
Answer: He refuses to acknowledge his wife's family and blames them for her current health problems.
A client with metastatic brain cancer is admitted to the oncology floor. According to the Patient Self-Determination Act of 1991 (PSDA), what is the hospital required to do concerning the execution of advance directives?
Answer: Inform the client or legal guardian of his right to execute an advance directive.
For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the plan of care?
Answer: Inspecting the skin for petechiae once every shift
A client has been receiving chemotherapy to treat cancer. Which data collection finding suggests that the client has developed stomatitis (inflammation of the mouth)?
Answer: Red, open sores on the oral mucosa
The nurse is caring for a client who has just had a modified radical mastectomy with immediate reconstruction. She's in her 30s and has two young children. Although she's worried about her future, she seems to be adjusting well to her diagnosis. What should the nurse do to support her coping?
Answer: Refer the client to the American Cancer Society's (Canadian Cancer Society's) Reach for Recovery program or another support program. Rationale: the nurse can refer her to talk to others who have had similar experiences through a support group.
A nurse is preparing a client for discharge after a prolonged hospitalization in which the client had a colon resection and colostomy formation for treatment of colon cancer. The client's family has concerns about managing his care at home. Which factor is most important in ensuring successful home care?
Answer: Support from friends and family Rationale: Home care success depends on a key factor: support from friends and family. Ability to care for the colostomy, the client's age, and the complexity of his care aren't as important to the success of home care as is the support from friends and family
A client with bladder cancer undergoes surgical removal of the bladder and construction of an ileal conduit. Which data collection findings indicate that the client is developing complications? Select all that apply.
Answer: The stoma appears dusky. • The stoma protrudes from the skin. • The client experiences sharp abdominal pain and rigidity. Rationale: A dusky appearance of the stoma indicates decreased blood supply; a healthy stoma should appear beefy red. Protrusion indicates prolapse of the stoma. Sharp abdominal pain and rigidity suggest peritonitis.
A client with metastatic cancer is experiencing neuropathic pain. Which alternative therapy is most beneficial in treating this type of pain?
Answer: Transcutaneous electrical nerve stimulation (TENS)
In assessing a postmastectomy client, the nurse determines that the client is in denial. The nurse can best respond by:
Answer: accepting the denial.
A client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the warning signs of cancer. What is another warning sign of cancer?
Answer: indigestion
A client with stage II ovarian cancer undergoes a total abdominal hysterectomy and bilateral salpingo-oophorectomy with tumor resection, omentectomy, appendectomy, and lymphadenectomy. During the second postoperative day, which data collection finding would raise concern in the nurse?
Answer: Shallow breathing and increasing lethargy Rationale: Shallow breathing with a change in level of consciousness such as increased lethargy may indicate a respiratory complication such as atelectasis or carbon dioxide retention.
The nurse is teaching a group of men about prostate health. Which of the following would be most important for the nurse to tell the men?
Answer: Starting at age 50, men should talk to a doctor about the pros and cons of PSA testing so they can decide if testing is the right choice for them"
On discharge, a client who underwent a left mastectomy expresses relief that "the cancer" has been treated. When discussing this issue with the client, the nurse should stress that she:
Answer: should continue to perform breast self-examination on her right breast.
A client is admitted to the hospital with severe bone marrow depression related to chemotherapy. What does the nurse include in the plan of care to decrease the risk of infection in this client? Select all that apply.
Answer: • Ensure the use of protective isolation protocol. • Wash hands before administering care.
The nurse is caring for a recently married, 29-year-old female client, who was diagnosed with acute lymphocytic leukemia (ALL). The client is preparing for an allogeneic bone marrow transplant. Which statement by the client demonstrates an understanding of the physician's description of the diagnosis and treatment?
Answer:"I'll only need chemotherapy therapy before receiving my bone marrow transplant."
A client undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should include which instruction?
Answer:"Keep the stoma moist."
A 65-year-old client is scheduled for a right lower lobectomy for lung cancer. During the admission assessment, the client asks for information about a living will and advance directive. The nurse knows that the client understands her teaching about the living will when he says:
Answer:"The advance directive allows me to state my health care wishes while I'm still able to do so."
The nurse is caring for a client who detected a lump in her right breast. The client asks the nurse " How do I find out if it's cancer?" Which statement by the nurse would be most appropriate?
Answer:"The physician will need to perform a fine needle aspiration and biopsy to confirm the diagnosis. Rationale: Fine needle aspiration and biopsy provide cells for histologic examination to confirm a diagnosis of cancer.
