Ch. 15: Oncology- Nursing Management in Cancer Care

A nurse is caring for a client who is receiving chemotherapy and has a platelet count of 30,000/mm3. Which statement by the client indicates a need for additional teaching?

"I floss my teeth every morning."

A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed?

"I guess the doctor could not remove the entire tumor."

Which statement by a client undergoing external radiation therapy indicates the need for further teaching?

"I'm worried I'll expose my family members to radiation."

The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia?

"The hair loss is temporary."

A patient is scheduled for cryosurgery for cervical cancer and tells the nurse, "I am not exactly sure what the doctor is going to do." What is the best response by the nurse?

"The physician is going to use liquid nitrogen to freeze the area."

Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode will the nurse anticipate?

Adjuvant therapy is likely.

The nurse is conducting a screening for familial predisposition of cancer. Which of the following should the nurse note as a possible indication of hereditary cancer syndrome?

An aunt and uncle diagnosed with cancer

Which of the following is a term used to describe the process of programmed cell death?

Apoptosis

Which type of vaccine uses the patient's own cancer cells, which are prepared for injection, back into the patient?

Autologous

Which of the following does a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure?

Blood studies

A client diagnosed with acute myelocytic leukemia has been receiving chemotherapy. During the last 2 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?

Closely observe the client's skin for petechiae and bruising.

Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth?

Control

Which of the following is a type of procedure that uses liquid nitrogen to freeze tissue and cause cell destruction?

Cryosurgery

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.

The client is receiving a vesicant anti neo plastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action?

Extra vasation

A nurse is administering daunorubicin through a peripheral I.V. line when the client complains of burning at the insertion site. The nurse notes no blood return from the catheter and redness at the I.V. site. The client is most likely experiencing which complication?

Extravasation

The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important?

Flush the toilet twice after every use.

What foods should the nurse suggest that the patient consume less of in order to reduce nitrate intake because of the possibility of carcinogenic action?

Ham and bacon

For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan?

Inspecting the skin for petechiae once every shift

Which of the following is a characteristic of a malignant tumor?

It gains access to the blood and lymphatic channels.

What does the nurse understand is the rationale for administering allopurinol for a patient receiving chemotherapy?

It lowers serum and uric acid levels.

A decrease in circulating white blood cells (WBC) is referred to as which of the following?

Leukopenia

A client has received several treatments of bleomycin. It is now important for the nurse to assess

Lung sounds

The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest?

Malignant tumor

In which phase of the cell cycle does cell division occur?

Mitosis

The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant?

Monitor the client closely to prevent infection.

Which type of surgery is utilized in an attempt to relieve complications of cancer?

Palliative

During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior?

Progression

The nurse at the clinic explains to the patient that the surgeon will be removing a mole on the patient's back that has the potential to develop into cancer. The nurse informs the patient that this is what type of procedure?

Prophylactic

You are a clinic nurse. One of your clients has found she is at high risk for breast cancer. She asks you what can be done to reduce her risk. What is a means of reducing the risk for breast cancer?

Prophylactic surgery

A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis?

Red, open sores on the oral mucosa

After being seen in the oncology clinic, a client with severe bone marrow suppression is admitted to the hospital. The client's cancer therapy consisted of radiation and chemotherapy. When developing the care plan for this client, which nursing diagnosis takes priority?

Risk for infection

A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication?

Serum potassium level of 2.6 mEq/L

What should the nurse tell a female client who is about to begin chemotherapy and anxious about losing her hair?

She should consider getting a wig or cap before she loses her hair.

A nurse is caring for a client receiving chemotherapy. Which assessment finding places the client at the greatest risk for an infection?

Stage 3 pressure ulcer on the left heel

A patient with brain tumor is undergoing radiation and chemotherapy for treatment of cancer. Of late, the patient is complaining of swelling in the gums, tongue, and lips. Which of the following is the most likely cause of these symptoms?

Stomatitis

The physician is attending to a 72-year-old patient with a malignant brain tumor. The physician recommends immediate radiation therapy. Which of the following is a reason for the physician's recommendation?

To prevent the formation of new cancer cells

The nurse evaluates teaching as effective when a female client states that she will

Use sunscreen when outdoors.

The nurse is to administer a vesicant chemotherapeutic drug to a client who had a right mastectomy and inserts the intravenous line

With a soft, plastic catheter

A decrease in circulating white blood cells is

leukopenia.

A serum sodium level lower than 110 mEq/L is associated with

seizure.

The oncology nurse is giving chemotherapy to a client in a short stay area. The client confides that they are very depressed. The nurse recognizes depression as which of the following?

A normal reaction to the diagnosis of cancer.

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 care plan?

Avoiding using soap on the irradiated areas

A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: TIS, N0, M0. What does this classification mean?

Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis

Which of the following occurs when there is accumulation of fluid in the pericardial space that compresses the heart?

Cardiac tamponade

Which of the following is true about a malignant tumor?

Gains access to the blood and lymphatic channels

The nurse is working with a patient who has had an allohematopoietic stem cell transplant (HSCT) and notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the patient has symptoms of which of the following?

Graft-versus-host disease

When caring for a client who is receiving external beam radiation, which is the key point for the nurse to incorporate into the plan of care?

Inspect the skin frequently.

The nurse is caring for a patient undergoing an incisional biopsy. Which of the following statements does the nurse understand is true about an incisional biopsy?

It removes a wedge of tissue for diagnosis.

Which of the following is a growth-based classification of tumors?

Malignant

A patient with metastatic pancreatic cancer underwent surgery for removal of a malignant tumor in his pancreas. Despite the tumor being removed, the physician informs the patient that he needs to start chemotherapy. Which of the following may be a reason for the physician to opt for chemotherapy?

Metastasis

According to the tumor-node-metastasis (TNM) classification system, T0 means there is which of the following?

No evidence of primary tumor

The nurse is evaluating the client's risk for cancer and recommends changes when the client states she:

eats red meat such as steaks or hamburgers every day

According to the TNM classification system, T0 means there is

no evidence of primary tumor.

A client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis is appropriate for this client?

Anticipatory grieving

The drug interleukin-2 is an example of which type of biologic response modifier?

Cytokine

A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention?

The I.V. site is red and swollen.

A nurse is performing a home visit for a client who received chemotherapy within the past 24 hours. The nurse observes a small child playing in the bathroom, where the toilet lid has been left up. Based on these observations, the nurse modifies the client's teaching plan to include:

chemotherapy exposure and risk factors.

The lethal tumor dose is defined as the dose that will eradicate what percentage of the tumor yet preserve normal tissue?

95%