Chapter 15

Which type of surgery is used in an attempt to relieve complications of cancer? Palliative Prophylactic Reconstructive Salvage

Palliative

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

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

A client is receiving radiation therapy and asks the nurse about oral hygiene. What teaching specific to the client's situation should the nurse include? Gargle after each meal. Floss before going to bed. Treat cavities immediately. Use a soft toothbrush and allow it to air dry before storing.

Use a soft toothbrush and allow it to air dry before storing.

A patient with uterine cancer is being treated with intracavitary radiation. The patient will emit radiation while the implant is in place. The nurse is aware of the precautions necessary for the provider of care and visitors. Which of the following are appropriate guidelines to follow? Select all that apply. The nurse can provide direct care for up to 60 minutes per 8-hour shift. Family members should stand about 6 feet from the patient. Plastic aprons should be worn to buffer the exposure. Visitors may stay for 30 minutes or less.

Family members should stand about 6 feet from the patient. Visitors may stay for 30 minutes or less.

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

Altered mental status

Which of the following is a term used to describe the process of programmed cell death? Apoptosis Mitosis Carcinogenesis Angiogenesis

Apoptosis

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

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

Avoiding using soap on the irradiated areas

Which occurs when fluid accumulates in the pericardial space and compresses the heart? Cardiac tamponade Superior vena cava syndrome (SVCS) SIADH DIC

Cardiac tamponade

Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth? Control Cure Palliation Prevention

Control

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

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. 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.

Encourage fluid intake to dilute the urine.

A client is scheduled for a nerve-sparing prostatectomy. The emotional spouse confides in the nurse that the client will not talk about the cancer and/or upcoming surgery. Which nursing diagnosis will the nurse choose as primary diagnosis for this client? Sexual Dysfunction Fear Knowledge Deficit Grieving

Fear

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 can be given at lower doses. The second and third drugs increase the effectiveness of the first drug. The first two drugs are toxic to cancer cells, and the third drug promotes cell growth. The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.

The three drugs have a synergistic effect and act on the cancer cells with different mechanisms.

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." "I use an electric razor to shave." "I take a stool softener every morning." "I removed all the throw rugs from the house."

"I floss my teeth every morning."

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? "I hope they find a bone marrow donor who matches." "The doctor will remove cells from my bone marrow before beginning chemotherapy." "I will receive chemotherapy until most of the cancer is gone, and then I will get my own stem cells back." "I will need to attend follow-up visits for up to 3 months after treatment."

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

A client receiving chemotherapy has a nursing diagnosis of Deficient diversional activity related to decreased energy. Which client statement indicates an accurate understanding of appropriate ways to deal with this deficit? "I'll play card games with my friends." "I'll take a long trip to visit my aunt." "I'll bowl with my team after discharge." "I'll eat lunch in a restaurant every day."

"I'll play card games with my friends."

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 usually temporary." "New hair growth will return without any change to color or texture." "Clients with alopecia will have delay in grey hair." "Wigs can be used after the chemotherapy is completed."

"The hair loss is usually temporary."

A patient is scheduled for cryoablation for cervical cancer and tells the nurse, "I am not exactly sure what the surgeon is going to do." What is the best response by the nurse? "The surgeon is going to use medication to inject the area." "The surgeon is going to use liquid nitrogen to freeze the area." "The surgeon is going to use a laser to remove the area." "The surgeon is going to use radiofrequency to ablate the area."

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

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 psychiatric diagnosis everyone has at one time or another. A side effect of the neoplastic drugs. A normal reaction to the diagnosis of cancer. An aberrant psychologic reaction to the chemotherapy.

A normal reaction to the diagnosis of cancer.

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

An aunt and uncle diagnosed with cancer

A client has just received stem cell transplantation as treatment for leukemia. What are the post procedural nursing interventions for clients receiving any form of stem cell transplantation? Closely monitor the client for at least 3 months. Closely monitor the client for at least 3 days. Closely monitor the client for at least 4 weeks. Closely monitor the client for at least 5 months.

Closely monitor the client for at least 3 months.

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.

Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.

A side-effect of chemotherapy is renal damage. To prevent this, the nurse should: Encourage fluid intake, if possible, to dilute the urine. Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL. Limit fluids to 1,000 mL/day to minimize stress on the renal tubules. Modify the diet to acidify the urine, thus preventing uric acid crystallization

Encourage fluid intake, if possible, to dilute the urine.

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 Fish and poultry Ham and bacon Green, leafy vegetables

Ham and bacon

When caring for an older client who is receiving external beam radiation, which is the key point for the nurse to incorporate into the plan of care? Time, distance, and shielding The use of disposable utensils and wash cloths Avoid showering or washing over skin markings. Inspect the skin frequently.

Inspect the skin frequently.

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

Inspecting the skin for petechiae once every shift

A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the best teaching by the nurse? It stimulates the immune system against the tumor cells. It treats drug-related anemia. It prevents alopecia. It lowers serum and uric acid levels.

It lowers serum and uric acid levels.

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's toilet patterns. Monitor the client closely to prevent infection. Monitor the client's physical condition. Monitor the client's heart rate.

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's toilet patterns. Monitor the client to prevent sepsis. Monitor the client's physical condition. Monitor the client's heart rate.

Monitor the client to prevent sepsis.

According to the tumor-node-metastasis (TNM) classification system, T0 means there is No evidence of primary tumor No regional lymph node metastasis No distant metastasis Distant metastasis

No evidence of primary tumor

A nurse assesses an oncology client with stomatitis during a chemotherapy session. Which nursing intervention would most likely decrease the pain associated with stomatitis? Recommend that the client discontinue chemotherapy. Provide a solution of viscous lidocaine for use as a mouth rinse. Monitor the client's platelet and leukocyte counts. Check regularly for signs and symptoms of stomatitis.

Provide a solution of viscous lidocaine for use as a mouth rinse.

The nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice? uses the treadmill for 30 minutes on 5 days each week eats red meat such as steaks or hamburgers every day works as a secretary at a medical radiation treatment center drinks one glass of wine at dinner each night

eats red meat such as steaks or hamburgers every day

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 nadir. graft-versus-host disease. metastasis. acute leukopenia.

graft-versus-host disease.

A side-effect of chemotherapy is renal damage. To prevent this, the nurse should: Encourage fluid intake, if possible, to dilute the urine. Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL. Limit fluids to 1,000 mL/day to minimize stress on the renal tubules. Modify the diet to acidify the urine, thus preventing uric acid crystallization.

Encourage fluid intake, if possible, to dilute the urine.

A nurse is receiving a client with a radioactive implant for the treatment of cervical cancer. What is the nurse's best action? Place the client in a private room. Place a chair next to the bed to allow the spouse to sit. Have visitors wear dosimeters for safety. Allow visitors to telephone only.

Place the client in a private room.

A patient is admitted for an excisional biopsy of a breast lesion. What intervention should the nurse provide for the care of this patient? Clarify information provided by the physician. Provide aseptic care to the incision postoperatively. Provide time for the patient to discuss her concerns. Counsel the patient about the possibility of losing her breast.

Provide time for the patient to discuss her concerns.

Which of the following would be inconsistent as a common side effect of chemotherapy? Weight gain Alopecia Myelosuppression Fatigue

Weight gain

Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode should the nurse anticipate? No further treatment is indicated. Adjuvant therapy is likely. Palliative care is likely. Repeat biopsy is needed before treatment begins.

Adjuvant therapy is likely.

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. Break needles after the infusion is discontinued. Disconnect I.V. tubing with gloved hands. Throw I.V. tubing in the trash after the infusion is stopped.

Wear disposable gloves and protective clothing.

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? Neutropenia Extravasation Nadir Stomatitis

Stomatitis

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? Decreasing dietary fluids 2 days before chemotherapy Adjusting the client's meal plan before and after chemotherapy Increasing fresh fruits in the client's diet Administering beta-blockers as ordered by the physician

Adjusting the client's meal plan before and after chemotherapy

After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? Serving small portions of bland food Encouraging rhythmic breathing exercises Administering metoclopramide and dexamethasone as ordered Withholding fluids for the first 4 to 6 hours after chemotherapy administration

Administering metoclopramide and dexamethasone as ordered

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 Incisional biopsy Needle biopsy Punch biopsy

Excisional biopsy

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? Erythema Flare Extravasation Thrombosis

Extravasation

The physician is attending to a 72-year-old client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation? To remove the tumor from the brain To prevent the formation of new cancer cells To analyze the lymph nodes involved To destroy marginal tissues

To prevent the formation of new cancer cells

Which of the following is the single largest preventable cause of cancer? Tobacco Pesticides Arsenic Asbestos

Tobacco

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? Random, rapid growth of the tumor Cells colonizing to distant body parts Tumor pressure against normal tissues Emission of abnormal proteins

Tumor pressure against normal tissues