Chapter 15 - Management of Oncologic Disorders

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."

While doing a health history, a client tells the nurse that her mother, her grandmother, and her sister died of breast cancer. The client asks what she can do to keep from getting cancer. What is the best response by the nurse?

"Cancer prevention and detection can be done with blood analysis for tumor markers to measure your risk level."

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 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

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

Control

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

Which does a nurse thoroughly evaluate before a hematopoietic stem cell transplant (HSCT) procedure? Family History Drug history Blood Studies Allergy history

Blood studies

A side-effect of chemotherapy is renal damage. To prevent this, the nurse should:

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

Which grade of tumor is also known as a well-differentiated tumor? Grade I Grade II Grade III Grade IV

Grade I

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 You will continue having your menses every month You will experience menopause now You will be unable to have children

You will need to practice birth control measures

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 caring for a client with prostate cancer and assesses bleeding gums and hematuria. What serum indicator should the nurse relate the bleeding?

platelet count of 60,000/mm3

Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure?

Blood studies

Which occurs when fluid accumulates in the pericardial space and compresses the heart?

Cardiac tamponade

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 use of allopurinol with chemotherapy is to prevent renal toxicity. Tumor lysis syndrome occurrence can be reduced with allopurinol's action of reducing the conversion of nucleic acid byproducts to uric acid, in this way preventing urate nephropathy and subsequent oliguric renal failure. Allopurinol does not stimulate the immune system, treat anemia, or prevent alopecia.

A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy induced complication? Urine output of 400 ml in 8 hours Serum potassium level of 2.6 mEq/L Blood pressure of 120/64 to 130/72 mm Hg Sodium level of 142 mEq/L

Serum potassium level of 2.6 mEq/L

The nurse knows that interferon agents are used in association with chemotherapy to produce which effects in the client? Suppression of the bone marrow Enhance action of the chemotherapy Decrease the need for addition adjuvant therapies Shorten the period of neutropenia

Shorten the period of neutropenia Interferon agents are a type of biologic response modifiers (BRMs) used in conjunction with chemotherapy to reduce the risk of infection by shortening the period of neutropenia through bone marrow stimulation

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

Stomatitis

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?

Sun safety and use of sunscreen

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 patient will be receiving radiation for 6 weeks for the treatment of breast cancer and asks the nurse why it takes so long. What is the best response by the nurse? It allows time for you to cope with the treatment It will allow time for the repair of healthy tissue It will decrease the incidence of leukopenia and thrombocytopenia it is not really understood why you have to go for 6 weeks of treatment.

it will allow time for the repair of healthy tissue the total radiation dose is delivered over several weeks in daily doses called fractions. This allows healthy tissue to repair and achieves greater cell kill by exposing more cells to the radiation as they begin active cell division.

To combat the most common adverse effects of chemotherapy, a nurse should administer an:

antiemetic

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.

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 atleast 3 months Closely monitor the client for atleast 3 days Closely monitor the client for atleast 4 weeks Closely monitor the client for atleast 5 months

Closely monitor the client for at least 3 months. - After stem cell transplantation, the nurse closely monitors the client for at least 3 months because complications related to the transplant are still possible and infections are very common.

The nurse is conducting a community education program using the American Cancer Society's colorectal screening and prevention guidelines. The nurse determines that the participants understand the teaching when they identify that people over the age of 50 should have which screening test every 10 years?

Colonoscopy

A nurse is administering a peripheral chemotherapeutic agent. What nursing actions are used for extravasation of a chemotherapeutic agent? Select all that apply. Stop the medication infusion at the first sign of extravasation Aspirate any residual drug from the IV line Administer an antidote, if indicated Apply warm compresses to the irritated site to encourage healing Schedule the client for implanted device

Stop the medication infusion at the first sign of extravasation Aspirate any residual drug from the IV line Administer an antidote, if indicated

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

Palliative

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