Cancer

The client diagnosed with cancer of the prostate tells the nurse, "I caused this by being promiscuous when I was young and now I have to pay for my sins." Which statement is the nurse's most therapeutic response? A. "Why would you think prostate cancer is caused by sex?" B. "You feel guilty about some of your actions when you were young?" C. "Well, there is nothing you can do about that behavior now." D. "Have you told the HCP and been checked for an AIDS infection?"

B. "You feel guilty about some of your actions when you were young?"

A 36 year old female is scheduled to received external radiation therapy and a cesium implant for cancer of the cervix. Which of the following statement would be most accurate to include in the teaching plan about the potential effects of radiation therapy on sexuality? a. "You can have sexual intercourse while the implant is in place." b. "You may notice some vaginal dryness after treatment is completed." c. "You may notice some vaginal relaxation after treatment is completed." d. "You will continue to have normal menstrual periods during treatment."

B. "You may notice some vaginal dryness after treatment is completed."

The nurse is caring for a client with Chronic Lymphocytic Leukemia and knows the importance of staying active. Which of the following masks would be best to help achieve this goal? A. A non-rebreather mask B. A HEPA mask C. A surgical mask D. A nasal cannula

B. A HEPA mask

A male client comes to the physician's office for treatment of severe sunburn. The nurse takes this opportunity to discuss the importance of protecting the skin from the sun's damaging rays. Which instruction would best prevent skin damage? A. "Minimize sun exposure from 1 to 4 p.m. when the sun is strongest." B. "Use a sunscreen with a sun protection factor of 6 or higher." C. "Apply sunscreen even on overcast days." D. "When at the beach, sit in the shade to prevent sunburn."

C. "Apply sunscreen even on overcast days."

Which of the following are possible signs and symptoms of prostate cancer? A. Frequent urination B. Weakness or straining during urination C. Bilateral lower extremity pain D. Nocturia E. Diarrhea

A. Frequent urination B. Weakness or straining during urination D. Nocturia

The nurse is educating a group of students on skin cancer prevention, which of the following statements by a student shows an understanding of learning? A. "So the most important thing I can do is avoid direct sunlight exposure?" B. "Scrubbing my skin well to slough off the dead cells after being in the sun will help reduce my risk of getting skin cancer." C. "I can use a tanning booth to help avoid the harsh rays that cause cancer." D. "Sunscreen only helps if it is SPF 100. Anything below that doesn't help."

A. "So the most important thing I can do is avoid direct sunlight exposure?"

The nurse is caring for a patient who is experiencing severe chemotherapy-induced nausea. Which actions can the nurse take to try to reduce the patient's nausea? (Select all that apply.) A. Instruct the patient to limit intake of spicy foods. B. Instruct the patient to avoid room temperature foods. C. Determine the best time for the patient to eat and drink. D. Encourage the patient to take small, frequent sips of water. E. Administer sedatives as ordered while antineoplastic drugs are being administered.

A. Instruct the patient to limit intake of spicy foods. C. Determine the best time for the patient to eat and drink. D. Encourage the patient to take small, frequent sips of water. E. Administer sedatives as ordered while antineoplastic drugs are being administered.

A male client schedule for a skin biopsy is concerned and asks the nurse how painful the procedure is. The appropriate response by the nurse is: A. "There is no pain associated with this procedure." B. "The local anesthetic may cause a burning or stinging sensation." C. "A preoperative medication will be given so you will be sleeping and will not feel any pain." D. "There is some pain, but the physician will prescribe an opioid analgesic following the procedure."

B. "The local anesthetic may cause a burning or stinging sensation."

Which client problem does the nurse set as the priority for the client experiencing chemotherapy-induced peripheral neuropathy? A Potential for lack of understanding related to side effects of chemotherapy B Potential for injury related to sensory and motor deficits C Potential for ineffective coping strategies related to loss of motor control D Altered sexual function related to erectile dysfunction

B Potential for injury related to sensory and motor deficits

The client diagnosed with cancer of the prostate has been placed on luteinizing hormone-releasing hormone (LHRH) agonist therapy. Which statement indicates the client understands the treatment? A. "I will be able to function sexually as always." B. "I may have hot flashes while taking this drug." C. "This medication will cure the prostate cancer." D. "There are no side effects with this medication."

B. "I may have hot flashes while taking this drug." Rationales: The client may have hot flashes because these drugs increase hypothalamic activity, which stimulates the thermoregulatory centers of the body.

The client is diagnosed with metastatic prostate cancer to the bones. Which nursing intervention should the nurse implement? A. Prepare for a transurethral resection of the prostate. B. Keep the foot of the bed elevated at all times. C. Place the client on a scheduled bowel regimen. D. Discuss the client's altered sexual functioning.

C. Place the client on a scheduled bowel regimen.

The nurse is preparing a care plan for a 45 y.o. pt. who has had a radical prostatectomy. Which psychosocial and physiological problem should be included in the plan? A. Altered coping B. High risk for hemorrhage C. Sexual impotence D. Risk for electrolyte imbalance

C. Sexual impotence

The nurse is aware that a chest X-ray cannot rule out pneumonia in a patient with leukemia because.. A. Patients with leukemia cannot produce white blood cells B. These patients may have secondary pneumonia C. The delayed response of neutrophils delays the radiologic changes D. Chemotherapy will make chest X-rays inaccurate

C. The delayed response of neutrophils delays the radiologic changes

A client who is undergoing chemotherapy for cancer reports problems with concentration and memory. Which nursing intervention is indicated at this time? A Explain that this occurs in some clients and is usually permanent. B Inform the client that a small glass of wine may help her relax. C Protect the client from infection. D Allow the client an opportunity to express her feelings.

D Allow the client an opportunity to express her feelings.

Which of the following is an expected finding in a patient with leukemia? A. Increased platelet count and increased erythrocyte count B. Decreased platelet count and increased erythrocyte count C. Increased platelet count and decreased erythrocyte count D. Decreased platelet count and decreased erythrocyte count

D. Decreased platelet count and decreased erythrocyte count

A client, age 41, visits the gynecologist. After examining her, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer? A. Onset of sporadic sexual activity at age 17 B. Spontaneous abortion at age 19 C. Pregnancy complicated with eclampsia at age 27 D. Human papillomavirus infection at age 32

D. Human papillomavirus infection at age 32

The client is eight (8) hours post-transurethral prostatectomy for cancer of the prostate. Which nursing intervention is priority at this time? A. Control postoperative pain. B. Assess abdominal dressing. C. Encourage early ambulation to prevent DVT. D. Monitor fluid and electrolyte balance.

D. Monitor fluid and electrolyte balance.

The client is diagnosed with early cancer of the prostate. Which assessment data would the client report? A. Urinary urgency and frequency. B. Retrograde ejaculation during intercourse. C. Low back and hip pain. D. No problems have been noticed.

D. No problems have been noticed.

A female client is hospitalized for insertion of an internal cervical radiation implant. While giving care, the nurse finds the radiation implant in the bed. The initial action by the nurse is to: A. Call the physician B. Reinsert the implant into the vagina immediately C. Pick up the implant with gloved hands and flush it down the toilet D. Pick up the implant with long-handled forceps and place it in a lead container.

D. Pick up the implant with long-handled forceps and place it in a lead container.

The nurse writes a problem of 'impaired gas exchange' for a client diagnosed with cancer of the lung. Which interventions should be included for the plan of care? Select all that apply. a. Apply O2 via nasal cannula b. Have the dietician plan for 6 small meals per day c. Place the client in resp. isolation d. Assess vital signs for fever e. Listen to lung sounds every shift

a. Apply O2 via nasal cannula b. Have the dietician plan for 6 small meals per day d. Assess vital signs for fever e. Listen to lung sounds every shift

Which clinical manifestation would the nurse expect to find in newly diagnosed Lung Cancer? a. Chronic dry persistent cough b. Weight loss c. Fatigue d. Fever

a. Chronic dry persistent cough

Aside from smoking cessation, what is the most effective way to boost lung cancer survival? a. Lung cancer screening b. Lobectomy c. Sublobar resection d. All of the above

a. Lung cancer screening

2. Maria refuses to acknowledge that her breast was removed. She believes that her breast is intact under the dressing. The nurse should a). Reinforce Kathy's belief for several days until her body can adjust to stress of surgery. b). Recognize that Kathy is experiencing denial, a normal stage of the grieving process c.) Call the MD to change the dressing so Kathy can see the incision d.)Remind Kathy that she needs to accept her diagnosis so that she can begin rehabilitation exercises.

b). Recognize that Kathy is experiencing denial, a normal stage of the grieving process

The nurse is conducting a cancer risk assessment for a middle aged client. Which environmental factor increases the risk of cancer? a. Gender b. Nutrition c. Immunologic status d. Age

b. Nutrition

7. The client diagnosed with breast cancer is considering whether to have a lumpectomy or a more invasive procedure, a modified radical mastectomy. Which info should the nurse discuss? a.) Ask if she is afraid of general anesthesia. b.) Ask how she feels about radiation and chemotherapy. c.) Tell her that she will need reconstruction with either procedure. d.) Find out if she has BC in her family.

b.) Ask how she feels about radiation and chemotherapy.

A client at risk for lung cancer asks about the reason for having a CT scan as part of the initial exam. What is the nurse's best response? "A CT scan is... a. Far superior to MRI for evaluating lymph node metastasis." b. Noninvasive and readily available." c. Useful for distinguishing small differences in tissue density and detecting nodal involvement." d. Used to distinguished a malignant from a non-malignant adenopathy."

c. Useful for distinguishing small differences in tissue density and detecting nodal involvement."

A client with stage IV lung cancer in a hospice program has increasing pain. The nurse and client should collaborate to schedule analgesics to provide: a. Doses of analgesic when pain is a 5 on a scale of 1-10 b. Enough analgesic to keep the client semisomnolent c. An analgesia free period so that the client can carry out daily hygienic activities d. Around the clock routine administration of analgesics for continuous pain relief

d. Around the clock routine administration of analgesics for continuous pain relief

The client with lung cancer tells the nurse, "I am so tired of all this. I will l just end it all." Which should be the nurse's first response? a. "This must be hard for you. Would you like to talk?" b. Tell the HCP of the client's statement. c. Refer client to social worker. d. Find out if the client has a plan to carry out suicide.

d. Find out if the client has a plan to carry out suicide.

Which is the American Cancer Society's recommendation for the early detection of cancer of the prostate? A. A yearly PSA level and DRE beginning at age 50. B. A biannual rectal examination beginning at age 40. C. A semiannual alkaline phosphatase level beginning at age 45. D. A yearly urinalysis to determine the presence of prostatic fluid.

A. A yearly PSA level and DRE beginning at age 50. Rationales: A. The American Cancer Society recommenders all men have a yearly prostate-specific antigen (PSA) blood level, followed by a digital rectal examination (DRE) beginning at age 50. Men in the high-risk group, including all African American men, should begin at age 45.

You are preparing for an early cancer prevention program. Which of following are risk factors for developing prostate cancer? Select all that apply. A. African American descent B. Family history C. Diet high in animal fats and low in fiber D. Anyone over the aged 50

A. African American descent B. Family history C. Diet high in animal fats and low in fiber

When assessing a lesion diagnosed as malignant melanoma, the nurse in-charge most likely expects to note which of the following? A. An irregular shaped lesion B. A small papule with a dry, rough scale C. A firm, nodular lesion topped with crust D. A pearly papule with a central crater and a waxy border

A. An irregular shaped lesion

A patient has recently been diagnosed with leukemia. Which of the following symptoms would a health care professional expect to see given this diagnosis? A. Bruising, fatigue and bone pain B. Bradycardia, hypotension and palpations C. Dyspnea, malaise, and hypotension D. Paresthesia, facial rash, and abdominal pain

A. Bruising, fatigue and bone pain

Nurse Cindy is caring for a client who has undergone a vaginal hysterectomy. The nurse avoids which of the following in the care of this client? A. Elevating the knee gatch on the bed B. Assisting with range-of-motion leg exercises C. Removal of antiembolism stockings twice daily D. Checking placement of pneumatic compression boots

A. Elevating the knee gatch on the bed Rationale: The client is at risk of deep vein thrombosis or thrombophlebitis after this surgery, as for any other major surgery. For this reason, the nurse implements measures that will prevent this complication. Range-of-motion exercises, antiembolism stockings, and pneumatic compression boots are helpful. The nurse should avoid using the knee gatch in the bed, which inhibits venous return, thus placing the client more at risk for deep vein thrombosis or thrombophlebitis.

What is a common side effect of radiation therapy that is not associated with the effect of radiation in the treatment field? A. Fatigue B. Bone marrow suppression C. Reddened skin D. GI disturbances

A. Fatigue

The nurse is conducting a history and monitoring laboratory values on a client with multiple myeloma. What assessment findings should the nurse expect to note? Select all that apply. A. Pathological fracture B. Urinalysis positive for nitrites C. Hemoglobin level of 15.5 g/dL (155 mmol/L) D. Calcium level of 8.6 mg/dL (2.15 mmol/L) E. Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

A. Pathological fracture B. Urinalysis positive for nitrites E. Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

A child with leukemia is being discharged after receiving chemotherapy. What instructions will the nurse include in the teaching plan for the parents of this child? A. Provide a diet low in protein and high in carbohydrates. B. Avoid unwashed fruits and vegetables C. Notify doctor if the child's temperature exceeds 102 F(39 C) D. Increase the use of humidifiers around the house

A. Provide a diet low in protein and high in carbohydrates.

The nurse is taking the social history of a client diagnosed with small cell lung cancer. Which is a risk factor for this disease? a. Worked with asbestos for a short time many years ago. b. Has no family Hx of this type of lung cancer. c. Has numerous tattoos on upper and lower arms. d. Has smoked 2 packs of cigarettes/day for 20 years.

d. Has smoked 2 packs of cigarettes/day for 20 years.

The nurse is speaking to a group of women about early detection of breast cancer. The average age of the women in the group is 47. Following the American Cancer Society (ACS) guidelines, the nurse should recommend that the women: a.) Have a physician conduct a clinical evaluation every 2 years b.) Perform breast self-examination annually c.) Have a hormonal receptor assay annually d.) Have a mammogram annually

d.) Have a mammogram annually

A 34-year-old female client is requesting information about mammograms and breast cancer. She isn't considered at high risk for breast cancer. What should the nurse tell this client? a.) When she begins having yearly mammograms, breast self-examinations will no longer be necessary. b.) She should have had a baseline mammogram before age 30. c.) She should perform breast self-examination during the first 5 days of each menstrual cycle. d.) She should eat a low-fat diet to further decrease her risk of breast cancer.

d.) She should eat a low-fat diet to further decrease her risk of breast cancer.

The nurse is teaching about breast awareness. Which of the following points should be included. (Select all that apply) A. Regular self-examination is needed to learn the normal appearance and feel of your breast. B. Abnormal changes should be reported to a medical provider C. Men can't be affected by breast cancer D. The major goal of self-examination is early detection of breast cancer E. If a mammography result was negative, there's no need to continue regular self examination

A. Regular self-examination is needed to learn the normal appearance and feel of your breast. B. Abnormal changes should be reported to a medical provider D. The major goal of self-examination is early detection of breast cancer

The healthcare provider is caring for a patient with acute myelogenous leukemia (AML). Which of the following best describes the characteristics of this type of leukemia? A. Leukocytes undergo increased differentiation B. Examination of peripheral blood will show excessive myeloblasts C. Mature leukocytes are transformed into immature cells D. The function of T-cells and B-cells is adversely affected

B. Examination of peripheral blood will show excessive myeloblasts

A client returns to clinic for follow up treatment following a skin biopsy of a suspicious lesion performed 1 week ago. The biopsy report indicates that the lesion is a melanoma. The nurse under- stands that melanoma has which characteristics? Select all that apply. A. Lesion is painful to touch B. Lesion is highly metastatic. C. Lesion is a nevus that has changes in color. Skin under the lesion is reddened and warm to touch. D. Lesion occurs in body area exposed to outdoor sunlight.

B. Lesion is highly metastatic. C. Lesion is a nevus that has changes in color. Skin under the lesion is reddened and warm to touch.

Which of the following is true regarding acute myeloid leukemia? A. AML develops gradually, with symptoms typically occurring over a period of months. B. Most signs and symptoms evolve from insufficient production of normal blood cells C. Proliferation of lymph nodes within organs leads to a variety of additional symptoms: pain from an enlarged liver or spleen, hyperplasia of the gums, and bone pain from expansion of marrow. D. Leukemic cells cannot infiltrate the gingiva or synovial spaces of joints

B. Most signs and symptoms evolve from insufficient production of normal blood cells

The nurse is caring for a client with end-stage ovarian cancer who needs clarification on the purpose of palliative surgery. Which outcome should the nurse teach the client is the goal of palliative surgery? A. Cure of the cancer B. Relief of symptoms or improved quality of life C. Allowing other therapies to be more effective D. Prolonging the client's survival time

B. Relief of symptoms or improved quality of life

When reviewing the lab results of a patient with leukemia the health care provider notes that the patient is also anemic. Which statement provides the best rationale for this problem? A. The increased number of lymphocytes is destroying the red blood cells at a rapid rate B. The overproductions of immature white blood cells occurs at the expense of other cells C. Chemotherapy induced osteoporosis has caused decreased erythropoiesis D. The patient has a poor appetite and has not been consuming adequate dietary iron

B. The overproductions of immature white blood cells occurs at the expense of other cells

Which statement made by a client allows the nurse to recognize whether the client receiving brachytherapy for ovarian cancer understands the treatment plan? A "I may lose my hair during this treatment." B "I must be positioned in the same way during each treatment." C "I will have a radioactive device in my body for a short time." D "I will be placed in a semiprivate room for company."

C "I will have a radioactive device in my body for a short time."

Which patient is at highest risk for cervical cancer? a. None of the patients are at risk for cervical cancer b. A 32 year old in a monogamous relationship who declined the HPV vaccine. c. A 21 year old who reports first sexual partner at the age of 14 and that she has had at least 10 sex partners. d. A 60 year old with history syphilis and cigarette smoking

C. A 21 year old who reports first sexual partner at the age of 14 and that she has had at least 10 sex partners.

6. Following a modified radical mastectomy, a client has an incisional drainage tube attached to Hemovac suction. The nurse determines the suction is effective when: a. The intrathoracic pressure is decreased, and the client breathes easier b. There is an increased collateral lymphatic flow toward the operative area c. Accumulated serum and blood in the operative area are removed. d. No adhesions are formed between the skin and chest wall in the operative area.

C. Accumulated serum and blood in the operative area are removed.

Which statement is correct about the rate of cell growth in relation to chemotherapy? A. Faster growing of cells are less susceptible to chemotherapy B. Non-dividing cells are more susceptible to chemotherapy C. Faster growing cells are more susceptible to chemotherapy D. Slower growing cells are more susceptible to chemotherapy

C. Faster growing cells are more susceptible to chemotherapy

The nurse is evaluating a central venous line before administering the client's chemotherapy. what observation would cause the nurse the most concern? A. Nurse is unable to withdraw blood into line. B. Dressing was changed 24 hours ago. C. Inflammation and exudate are present at the insertion site. D. Fluid infusing in D5W and 0.45% normal saline

C. Inflammation and exudate are present at the insertion site.

The nurse prepares discharge instructions for a male client following cryosurgery for the treatment of a malignant skin lesion. Which of the following should the nurse include in the instruction? A. Avoid showering for 7 to 10 days B. Apply ice to the site to prevent discomfort C. Apply alcohol-soaked dressing twice a day D. Clean the site with hydrogen peroxide to prevent infection

D. Clean the site with hydrogen peroxide to prevent infection

The nurse writes a client problem of urinary retention for a client diagnosed with Stage IV cancer of the prostate. Which intervention should the nurse implement first? A. Catheterize the client to determine the amount of residual. B. Encourage the client to assume a normal position for urinating. C. Teach the client to use the Valsalva maneuver to empty the bladder. D. Determine the client's normal voiding pattern.

D. Determining the client's normal voiding patterns.

Which medication is contraindicated for a client diagnosed with leukemia? A. Bactrim, a sulfa antibiotic B. Morphine, a narcotic analgesic C. Imatinib, a genetic blocking agent D. Epogen, a biologic response modifier

D. Epogen, a biologic response modifier

9. During a routine mammography, a mass was found in a client's breast that was not felt during the physical examination. Which of these procedures does the nurse know can be used to sample the mass for diagnostic testing. A. Fine needle aspiration B. Incisional biopsy C. Excisional biopsy D. stereotactic core biopsy

D. Stereotactic core biopsy

Which client is at greater risk for the development of skin cancer? A. The African American male who lives in the northeast B. The elderly Hispanic female who moved from Mexico as a child C. The client who has a family history of dementia D. The client with fair complexion who cannot get a tan

D. The client with fair complexion who cannot get a tan

Prior to surgery for a modified radical mastectomy, the client is extremely anxious and asks many questions. Which approach offers the BEST guide for the nurse to answer these questions? a. Tell the client as much as she wants to know and is able to understand b. Delay discussing the client's questions with her until she is convalescing c. Delay discussing the client's questions with her until her apprehension subsides. d. Explain to the client that she should discuss her questions first with the healthcare provider (HCP)

a) Tell the client as much as she wants to know and is able to understand

Following a simple mastectomy, the nurse is totaling the amount of drainage in 24 hours form a suction drain in the incision. The nurse notes there is 200 mL of serosanguinous drainage for the first 24 hours. The nurse should: a. Document the findings b. Notify the surgeon c. Remove the drain d. Place the client's arm in a dependent position

a. Document the findings

The client diagnosed with Lung Cancer is being discharged. Which statement made by the client indicates that more teaching is needed? a. It doesn't matter if I smoke now. I already have cancer. b. I should see the oncologist at my scheduled appt. c. If I begin to run a fever I should notify my HCP. d. I should plan for periods of rest throughout the day.

a. It doesn't matter if I smoke now. I already have cancer.

8. The client who has had a mastectomy tells the nurse, "My husband will leave me now that I am not a whole woman anymore." Which response is therapeutic? a.) Are you afraid that your husband will not find you sexually appealing? b.) Your husband should be grateful that you will be able to live and be with him. c.) Maybe your husband would like to attend a support group for spouses. d.) You don't know that's true. Give him a chance.

a.) Are you afraid that your husband will not find you sexually appealing?

When preparing to administer a chemotherapeutic agent to a client with SCLC, the nurse should: a. Recap all needles used to prepare agents b. Dispose of chemotherapy wastes in the client's bedside trash c. Use gloves and disposable long sleeved gowns when handling agents d. Administer only prepackaged agents from the manufacturer

c. Use gloves and disposable long sleeved gowns when handling agents