Chap 15-Oncology: Nursing Management in Cancer Care

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? a) Onset of cancer after age 50 in family member b) A second cousin diagnosed with cancer c) A first cousin diagnosed with cancer d) An aunt and uncle diagnosed with cancer

d) An aunt and uncle diagnosed with cancer

Which of the following terms refers to cells that lack normal cellular characteristics and differ in shape and organization with respect to their cells of origin? Dysplasia Neoplasia Hyperplasia Anaplasia

d) Dysplasia

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? a) Check the client's history for a congenital link to thrombocytopenia. b) Perform a cardiovascular assessment every 4 hours. c) Closely observe the client's skin for petechiae and bruising. d) Monitor daily platelet counts.

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

Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth? a) Prevention b) Palliation c) Control d) Cure

c) Control

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? 1. Erythema 2. Flare 3. Extravasation 4. Thrombosis

c) Extravasation

A young female client has received chemotherapeutic medications and asks about any effects the treatments will have related to her sexual health. The most appropriate statement by the nurse is a) "You will be unable to have children." b) "You will continue having your menses every month." c) "You will need to practice birth control measures." d) "You will experience menopause now."

c) "You will need to practice birth control measures."

You are an oncology nurse giving chemotherapy in a short stay area. One client confides to you that they are very depressed. What is depression? a) A psychiatric diagnosis everyone has at one time or another. b) A side effect of the neoplastic drugs. c) A normal reaction to the diagnosis of cancer. d) An aberrant psychologic reaction to the chemotherapy.

c) A normal reaction to the diagnosis of cancer.

Which is a sign or symptom of septic shock? Increased urine output Hypertension Altered mental status Warm, moist skin

c) Altered mental status

The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise? 1. Eat wholesome meals. 2. Avoid intake of fluids. 3. Avoid spicy and fatty foods. 4. Eat warm or hot foods.

c) Avoid spicy and fatty foods.

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? a) Removing thoracic skin markings after each radiation treatment b) Wearing a lead apron during direct contact with the client c) Avoiding using soap on the irradiated areas d) Applying talcum powder to the irradiated areas daily after bathing

c) 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? a) No evidence of primary tumor, no abnormal regional lymph nodes, and no evidence of distant metastasis b) Carcinoma in situ, no demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis c) Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis d) Can't assess tumor or regional lymph nodes and no evidence of metastasis

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

A patient with a diagnosis of renal cell carcinoma is being treated with chemotherapy. During a previous round of chemotherapy, the patient's tumor responded well to treatment but the chemotherapy caused intense nausea and vomiting. How should the patient's potential nausea and vomiting be addressed during this current round of treatment? Administer antiemetics in anticipation of the patient's nausea. Prioritize nonpharmacological treatments over medications. Provide the patient with antiemetics at his first complaint of nausea. Administer antiemetics if the patient vomits or believes he will soon vomit.

a) Administer antiemetics in anticipation of the patient's nausea.

Mrs. Unger is a 53-year-old woman who was diagnosed with breast cancer following a process that began with abnormal screen mammography results. Mrs. Unger, her oncologist, and surgeon have agreed on a mastectomy as treatment and have discussed the importance of rigorously assessing whether her cancer has metastasized. What action will best detect possible metastasis of Mrs. Unger's breast cancer? Biopsy of the axillary lymph nodes Careful grading of the tumor cells Gauging her response to radiation therapy Serial bone marrow biopsies

a) Biopsy of the axillary lymph nodes

Which of the following is a characteristic of a malignant tumor? a) It gains access to the blood and lymphatic channels. b) It is usually slow growing. c) It demonstrates cells that are well differentiated. d) It grows by expansion.

a) It gains access to the blood and lymphatic channels.

The nurse evaluates teaching as effective when a female client states that she will a) Exercise 30 minutes 3 times each week. b) Decrease tobacco smoking from one pack/day to half a pack/day. c) Obtain a cancer history from her parents. d) Use sunscreen when outdoors.

d) Use sunscreen when outdoors.

What does the nurse understand is the rationale for administering allopurinol for a patient receiving chemotherapy? It lowers serum and uric acid levels. It stimulates the immune system against the tumor cells. It prevents alopecia. It treats drug-related anemia.

a) It lowers serum and uric acid levels.

When the client complains of increased fatigue following radiotherapy, the nurse knows this is most likely to be related to which factor? a) The cancer cells are dying in large numbers. b) Radiation can result in myelosuppression. c) Fighting off infection is an exhausting venture. d) The cancer is spreading.

b) Radiation can result in myelosuppression.

In which phase of the cell cycle does cell division occur? G1 phase S phase Mitosis G2 phase

c) 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? a) Monitor the client closely to prevent infection. b) Monitor the client's physical condition. c) Monitor the client's heart rate. d) Monitor the client's toilet patterns.

a) Monitor the client closely to prevent infection.

While doing a health history, a client tells you that her mother, grandmother, and sister died of cancer. The client wants to know what she can do to keep from getting cancer. What would be your best response? 1. "With your family history, there is nothing you can do to prevent getting cancer." 2. "If you eat right, exercise, and get enough rest, you can prevent breast cancer." 3. "You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is." 4. "Cancer often skips a generation, so don't worry about it."

c) "You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is."

For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan? a) Providing for frequent rest periods b) Placing the client in strict isolation c) Inspecting the skin for petechiae once every shift d) Administering aspirin if the temperature exceeds 102° F (38.8°)

c) Inspecting the skin for petechiae once every shift

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? 1. Palliative 2. Diagnostic 3. Prophylactic 4. Reconstructive

c) Prophylactic

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? Eggs and milk Ham and bacon Fish and poultry Green, leafy vegetables

b) Ham and bacon

A decrease in circulating white blood cells (WBCs) is referred to as Granulocytopenia Leukopenia Thrombocytopenia Neutropenia

b) Leukopenia

A client with a brain tumor is undergoing radiation and chemotherapy for treatment of cancer. The client has recently reported swelling in the gums, tongue, and lips. Which is the most likely cause of these symptoms? Nadir Neutropenia Stomatitis Extravasation

c) Stomatitis

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? 1. "Benign tumors can spread from one place to another." 2. "Benign tumors don't usually cause death." 3. "Benign tumors grow very rapidly." 4. "Benign tumors invade surrounding tissue."

b) "Benign tumors don't usually cause death."

Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client? Prophylactic Autologous Therapeutic Allogeneic

b) Autologous

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? a) Hand washing and infection prevention b) Breast and testicular self-exams c) Sun safety and use of sunscreen d) Pool and water safety

c) Sun safety and use of sunscreen

The nurse is evaluating the client's risk for cancer and recommends changes when the client states she a) uses the treadmill for 30 minutes on 5 days each week b) drinks 1 glass of wine at dinner each night c) eats red meat such as steaks or hamburgers every day d) works as a secretary at a medical radiation treatment center

c) eats red meat such as steaks or hamburgers every day

A benign tumor of the blood vessels is a(n) neuroma. chondroma. hemangioma. osteoma.

c) hemangioma.

The client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse? Cells colonizing to distant body parts Emission of abnormal proteins Random, rapid growth of the tumor Tumor pressure against normal tissues

d) Tumor pressure against normal tissues

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? a) "I use an electric razor to shave." b) "I take a stool softener every morning." c) "I removed all the throw rugs from the house." d) "I floss my teeth every morning."

d) "I floss my teeth every morning."

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 Blood pressure of 120/64 to 130/72 mm Hg Sodium level of 142 mEq/L Urine output of 400 ml in 8 hours

a) Serum potassium level of 2.6 mEq/L

A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention? a) The I.V. site is red and swollen. b) The client begins to shiver. c) The laboratory reports a white blood cell (WBC) count of 1,000/mm3. d) The client states he is nauseous.

a) The I.V. site is red and swollen.

You are an oncology nurse caring for a client who tells you that their tastes have changed. They go on to say that "meat tastes bad". What is a nursing intervention to increase protein intake for a client with taste changes? Suck on hard candy during treatment. Encourage cheese and sandwiches. Stay away from protein beverages. Encourage maximum fluid intake.

b) Encourage cheese and sandwiches.

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? Prostate, colon, and breast Lungs, liver, and kidneys Eyes, breast, and prostrate Bone, breast, and thyroid

b) Lungs, liver, and kidneys

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? a) Anxiety b) Risk for infection c) Risk for injury d) Imbalanced nutrition: Less than body requirements

b) Risk for infection

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: signs and symptoms of infection. chemotherapy exposure and risk factors. expected chemotherapy-related adverse effects. reinforcement of the client's medication regimen.

b) chemotherapy exposure and risk factors.

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. signs and symptoms of infection. expected chemotherapy-related adverse effects. reinforcement of the client's medication regimen.

a) chemotherapy exposure and risk factors.

The nurse is caring for a client is scheduled for chemotherapy followed by autologous stem cell transplant. Which of the following statements by the client indicates a need for further teaching? "The doctor will remove cells from my bone marrow before beginning chemotherapy." "I will need to be in protective isolation for up to 3 months after treatment." "I hope they find a bone marrow donor who matches." "I will receive chemotherapy until most of the cancer is gone, and then I will get my own stem cells back."

c) "I hope they find a bone marrow donor who matches."

Your patient has recently completed her first round of chemotherapy in the treatment of lung cancer. When reviewing this morning's blood work, what findings would be suggestive of myelosuppression? A) Decreased sodium levels and decreased potassium levels B) Increased creatinine and blood urea nitrogen (BUN) C) Decreased platelets and red blood cells D) Increased white blood cells and c-reactive protein (CRP

c) Decreased platelets and red blood cells

What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen? 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. Encourage fluid intake to dilute the urine. Take measures to acidify the urine and prevent uric acid crystallization.

c) Encourage fluid intake to dilute the urine.