Cancer
The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. What response by the nurse would best reassure this patient?
"These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and X-ray studies." "These symptoms are part of your disease and can't be helped." "This is a good sign. It means that only the cancer cells are dying." "Don't be concerned about these symptoms. Everybody feels this way after having radiation therapy."
Your patient is receiving carmustine, a chemotherapy agent. A significant side effect of this medication is thrombocytopenia. What symptom would the nurse assess for in a patient at risk for thrombocytopenia?
Hot flashes Interrupted sleep pattern Increased weight Nose bleed
What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen?
It functions against disseminated disease. It attacks cancer cells during their vulnerable phase. It targets normal body cells as well as cancer cells. It causes a systemic reaction.
A 16-year-old female client experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. The nurse should determine that the client is meeting the goal of improved body image and self-esteem when the client:
reports less disruption from pain and discomfort. requests that her family bring her makeup and wig. cries openly when discussing her disease. begins to discuss the future with her family.
A client diagnosed with cancer makes the following statement to the nurse: "I guess I will tell my health care provider to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die." Which of the following facts supports the use of chemotherapy for this client?
Nausea and vomiting are only a factor for the first 24 hours after treatment. Most clients believe the discomfort is well worth the cure for cancer. Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects. Clinical trials are opening up new cancer treatments all the time.
The clinic nurse is caring for a client who has just been diagnosed with a tumor. The client says to the nurse "The doctor says my tumor is benign. What does that mean?" What is the nurse's best response?
"Benign tumors don't usually cause death." "Benign tumors grow very rapidly." "Benign tumors invade surrounding tissue." "Benign tumors can spread from one place to another."
The nurse is caring for a client with the diagnosis of colon cancer with metastasis to the liver. Which statement made by the client indicates an understanding of the diagnosis?
"Once the colon tumor is removed, I will be fine." "My cancer has now spread to my liver." "How could I be so unlucky to get cancer twice?" "I will be happy once all the cancer is cut out."
Which of the following would be inconsistent as a common side effect of chemotherapy?
Alopecia Fatigue Myelosuppression Weight gain
Which of the following is a term used to describe the process of programmed cell death?
Apoptosis
An oncology client has begun to experience skin reactions to radiation therapy, prompting the nurse to make the diagnosis Impaired Skin Integrity: erythematous reaction to radiation therapy. What intervention best addresses this nursing diagnosis?
Apply phototherapy PRN Apply an ice pack or heating pad PRN to relieve pain and pruritis Avoid skin contact with water whenever possible Avoid rubbing or scratching the affected area
The nurse is evaluating bloodwork results of a client with cancer who is receiving chemotherapy. The client's platelet count is 60,000/mm3. Which is an appropriate nursing action? Normal = 150,000-450,000
Avoiding the use of products containing aspirin Providing commercial mouthwash to the client Providing a razor so the client can shave Taking the client's temperature rectally
A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe?
Confusion Altered glucose metabolism Pruritis (itching) Nausea and vomiting
While a patient is receiving IV doxorubicin hydrochloride, the nurse observes that there is swelling and pain at the IV site. The nurse should:
Continue to administer but decrease the rate of infusion. Apply a warm compress to the site. Notify the patient's health care provider. Stop the administration of the drug immediately.
What can the nurse do to meet the challenges in caring for a patient with cancer?
Identify own perception of cancer and set realistic goals. Tell the patient about the things the patient has done to cause cancer. Set the same goals for all patients with cancer. Ensure that the patient has the financial means to afford their care
While completing an admission assessment, the client reports a family history of ovarian cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology?
Increased tumor suppressor genes Smoking and tobacco use Exposure to chemicals and spermicides Inherited gene mutation
A client is undergoing chemotherapy treatment for prostate cancer and has lost considerable weight due to nausea and vomiting. Which nursing intervention is appropriate for the client?
Increasing fresh fruits in the client's diet Adjusting the client's meal plan before and after chemotherapy Administering beta-blockers as ordered by the physician Decreasing dietary fluids 2 days before chemotherapy
A newly diagnosed cancer client is crying and states the following to the nurse: "I promised God that I will be a better person if I can just get better." What is the appropriate assessment of this comment by the nurse?
Loss is inevitable so client is making final plans. The cancer is viewed as a punishment from past actions. Anger directed toward nursing staff is not unusual in dealing with cancer clients. The client is just trying to protect self from potential loss.
A nurse is teaching a community class about how to decrease the risk of cancer. Which food should the nurse recommend?
Oranges Smoked ham Low-fat hot dogs Medium-rare steak
Which of the following is the single largest preventable cause of cancer?
Pesticides Arsenic Asbestos Tobacco
A nurse is administering a chemotherapeutic medication to a client, who reports generalized itching and then chest tightness and shortness of breath. The nurse immediately
Places the client on oxygen by nasal cannula Gives prednisolone IV Administers diphenhydramine Stops the chemotherapeutic infusion
The nurse is invited to present a teaching program to parents of school-age children. Which topic would be of greatest value for decreasing cancer risks?
Pool and water safety Sun safety and use of sunscreen Breast and testicular self-exams Hand washing and infection prevention
A client received chemotherapy 24 hours ago. Which precautions are necessary when caring for the client?
Provide a urinal or bedpan to decrease the likelihood of soiling linens. Place incontinence pads in the regular trash container. Wear personal protective equipment when handling blood, body fluids, and feces. Wear sterile gloves.
Palliation refers to
relief of symptoms of disease and promotion of comfort and quality of life.
Which oncologic emergency involves the accumulation of fluid in the pericardial space?
Syndrome of inappropriate antidiuretic hormone release (SIADH) Tumor lysis syndrome Disseminated intravascular coagulation (DIC) Cardiac tamponade
A client calls the oncology office nurse and reports nausea and vomiting one week after receiving chemotherapy. What action should the nurse recommend?
Taking prescribed ondansetron Obtaining acupressure treatments Using imagery techniques Practicing relaxation techniques
You are admitting a client to your unit. While assessing the client, you find out that the client has had hoarseness of approximately 4 months duration. Why would you report this to the attending physician?
The client may have chronic laryngitis. The client is a smoker and has denied it. Persistent hoarseness means the client talks to much. Persistent hoarseness is a warning sign of cancer.
A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis?
Yellow tooth discoloration White, cottage cheese-like patches on the tongue Rust-colored sputum Red, open sores on the oral mucosa
To combat the most common adverse effects of chemotherapy, a nurse should administer an:
antibiotic. anticoagulant. antimetabolite. antiemetic.
According to the TNM classification system, T0 means there is
no regional lymph node metastasis. distant metastasis. no distant metastasis. no evidence of primary tumor.
The clinic nurse is caring for an adult oncology client who reports extreme fatigue and weakness after the first week of radiation therapy. Which response by the nurse would best reassure this client?
"These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer." "These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory studies and test results." "Try not to be concerned about these symptoms. Every client feels this way after having radiation therapy." "Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying."
What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen?
Encourage fluid intake to dilute the urine. Take measures to acidify the urine and prevent uric acid crystallization. Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL. Limit fluids to 1,000 mL daily to prevent accumulation of the drug's end products after cell lysis.
You are presenting a class on cancer for a local community group. You inform the attendees that chemical agents in the environment are believed to account for 75% of all cancers. Which organs are most susceptible to cancer caused by these chemical agents?
Bone, breast, and thyroid Eyes, breast, and prostrate Prostate, colon, and breast Lungs, liver, and kidneys
The patient diagnosed with thrombocytopenia is at risk for which of the following adverse effects:
Diminished reflexes Headache Stomatitis Bleeding
The nurse is caring for a client who has just been given a 6-month prognosis following a diagnosis of extensive stage small-cell lung cancer. The client states that he would like to die at home, but the team believes that the client's care needs are unable to be met in a home environment. What might the nurse suggest as an alternative?
Discuss a referral for rehabilitation hospital. Discuss a referral for hospice care. Discuss a referral for acute care. Panel the client for a personal care home.
The health care provider recommends that parents have their daughter vaccinated with HPV vaccine. What is this vaccine for?
Help prevent cervical cancer
A 36-year-old man is receiving three different chemotherapeutic agents for Hodgkin's disease. The nurse explains to the client that the three drugs are given over an extended period because:
The three drugs have a synergistic effect and act on the cancer cells with different mechanisms. The three drugs can be given at lower doses. The first two drugs are toxic to cancer cells, and the third drug promotes cell growth. The second and third drugs increase the effectiveness of the first drug.
A nurse is caring for a client receiving chemotherapy. Which nursing action is most appropriate for handling chemotherapeutic agents?
Wear disposable gloves and protective clothing. Throw I.V. tubing in the trash after the infusion is stopped. Disconnect I.V. tubing with gloved hands. Break needles after the infusion is discontinued.
