Chapter 12: oncologic management
A client with advanced cancer makes the following comment to the nurse: "Why are you bathing me? I am going to die no matter what." What is the most appropriate response of the nurse?
"Would you like to talk about what you are feeling?"
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
"You will need to practice birth control measures."
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 nurse understands that the client should be given human papillomavirus (HPV) vaccine per the health care provider's orders. What does this vaccine help prevent?
cervical cancer
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."
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.
Which statement is true about malignant tumors?
They gain access to the blood and lymphatic channels.
The physician is attending to a client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation
To prevent the formation of new cancer cells
Which is a sign or symptom of septic shock?
altered mental status
The nurse is providing education to a client with cancer radiation treatment options. The nurse determines that the client understands the teaching when the client states that which type of radiation aims to protect healthy tissue during the treatment?
brachytherapy
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 nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice
eats red meat such as steaks or hamburgers every day
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 working with a client who has had an allo-hematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of
graft-versus-host disease
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.
After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention?
Administering metoclopramide and dexamethasone as ordered
The nurse is conducting a screening for familial predisposition to cancer. Which element should the nurse note as a possible indication of hereditary cancer syndrome?
An aunt and uncle diagnosed with cancer
5-Fluorouracil (5FU) is classified as which type of antineoplastic agent?
Antimetabolite
The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise?
Avoid spicy and fatty foods.
A client is receiving external radiation to the left thorax to treat lung cancer. Which intervention should be part of this client's care plan?
Avoiding using soap on the irradiated areas
Which does a nurse thoroughly evaluate before a hematopoietic stem cell transplant (HSCT) procedure?
Blood studies
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
An oncology client has presented with the signs of possible cardiac tamponade with pericardial effusion. What diagnostic and medical procedures should the nurse prepare the client for? Select all that apply.
Chest x-ray Pericardiocentesis Computed tomography (CT) scan Echocardiogram
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.
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 bone marrow transplant?
Monitor the client closely to prevent infection.
A nurse is caring for a client after a bone marrow transplant. What is the nurse's priority in caring for the client?
Monitor the client to prevent sepsis.
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
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
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
Stops the chemotherapeutic infusion
Which type of surgery is used in an attempt to relieve complications of cancer?
palliative
An oncologist advises a client with an extensive family history of breast cancer to consider a mastectomy. What type of surgery would the nurse include in teaching?
prophylactic
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?
stomatitis
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?
Tumor pressure against normal tissues
A patient will be having an endoscopic procedure with a diagnostic biopsy. What type of biopsy does the nurse explain will remove an entire piece of suspicious tissue
excisional biopsy
A decrease in circulating white blood cells (WBCs) is referred to as
leukopenia
When a client receives vincristine, an antineoplastic agent that inhibits DNA and protein synthesis, the client needs to be informed to report which symptoms that would be expected side effects of motor neuropathy? Select all that apply.
muscle weakness cramps and spasms in the legs loss of balance and coordination
A patient is taking vincristine, a plant alkaloid for the treatment of cancer. What system should the nurse be sure to assess for symptoms of toxicity?
nervous system