HURST QUESTIONS [ONCOLOGY]

A client with a severe cough is suspected of having lung cancer. When preparing the client for testing to confirm a diagnosis of cancer, which tests should a nurse anticipate? Select all that apply. 1. Chest x-ray 2. Arterial blood gas 3. Bronchoscopy 4. Pulmonary arteriogram 5. Pulmonary function test

1. & 3. Correct: Chest x-ray and bronchoscopy are evidenced-based tests used in the diagnosis of lung cancer due to the efficacy of the tests. 2. Incorrect: Arterial blood gas measures the quantity of oxygen in the blood and acid-base status. 4. Incorrect: Pulmonary arteriogram is used to diagnose pulmonary embolus. 5. Incorrect: Pulmonary function test is used to diagnose obstructive lung diseases, such as emphysema.

A client, scheduled for a total hysterectomy for advanced cervical cancer, is crying and states, "I want to have more children! I do not know if I should have this procedure." Which responses by the nurse are best? Select all that apply. 1. Allow the client to discuss her fears. 2. Tell client good things that she will be able to do without more children. 3. Explain to the client that her ovaries can be frozen for egg harvesting at a later time. 4. Advise the client to put off having the surgery until she is sure. 5. Encourage client to talk to primary healthcare provider again.

1. & 5. Correct: This may be anticipatory grieving and being scared. Let the person talk and encourage them to talk again to the primary healthcare provider. They need reassurance that they are making the right decision. 2. Incorrect: This is not her fear and not helpful in this situation. 3. Incorrect: Not an appropriate answer and we don't freeze ovaries. 4. Incorrect: The cancer is already advanced stages. Will the waiting help her survive?

Which discharge referral would be a priority for the nurse to make in order to promote continuity of care for a client following a colectomy and colostomy formation due to colon cancer? 1. Home health 2. Meals on Wheels 3. Hospice care 4. Registered dietitian

1. Correct: Clients often go home quickly and do not completely understand discharge instructions. The first priority would be for colostomy care, which can be provided by home health. 2. Incorrect: Meals on Wheels will be important later during rehabilitation but is not the priority. 3. Incorrect: Hospice care is premature. The question does not reveal if surgery was successful or not to remove the colon cancer. 4. Incorrect: A dietary consult may be necessary later, but is not the priority at present.

A client has been receiving 5-FU treatments for colon cancer and is admitted with weakness, fatigue, thrombocytopenia and low grade fever. Which actions would be contraindicated for this client? Select all that apply. 1. Keep dedicated supplies in room. 2. Semi-private room. 3. Rectal temperatures every 4 hours. 4. Limit visitors. 5. Encourage a diet of fresh fruits.

1. Keep dedicated supplies in room. 4. Limit visitors.

What should the nurse include in the teaching plan for a client receiving external beam radiation? Select all that apply. 1. Small marks will be placed on the skin to mark the treatment area. 2. Lotion may be used around the treatment area to decrease dryness. 3. The radiation therapist can see, hear, and talk with you at all times during treatment. 4. Stay away from babies for 24 hours. 5. You will have to hold your breath during radiation treatment.

1., & 3. Correct: Small ink marks or small tattoos will be placed on the skin to mark the treatment area. Do not remove the marks. The radiation therapist can see, hear, and talk to the client at all times during treatment. Relieve anxiety by letting client know he/she is not alone. 2. Incorrect: Do not put lotion, powder or deodorant near or on treatment area. 4. Incorrect: Client is not radioactive and will not radiate others. The client can safely be around other people, babies, and children. 5. Incorrect: The client will need to stay very still so radiation goes to the exact same place each time, but can breathe as always and does not have to hold breath.

Which interventions should a nurse discuss with a client for primary prevention of skin cancer from exposure to ultraviolet light? Select all that apply. 1. Use sunscreen when outdoors 2. Stay in the shade when outdoors 3. Wear wide brimmed hats when outdoors 4. Plan to be outdoors between 10 am to 2 pm 5. Have an annual skin assessment by a dermatologist

1., 2. & 3. Correct: According to the Task Force on Community Preventive Services, using sunscreen, staying in shaded areas, and wearing wide brimmed hats are effective interventions to prevent skin cancer. 4. Incorrect: Spending time in the sun between 10 am to 2 pm, when ultraviolet rays are most intense, increases the risk for skin cancer. 5. Incorrect: Assessment by a dermatologist is not a prevention strategy.

What signs and symptoms of ovarian cancer should a nurse include when educating women? Select all that apply. 1. Urinary frequency. 2. Menorrhagia with breast tenderness. 3. Watery vaginal discharge. 4. Increasing abdominal girth. 5. Fullness after a heavy meal.

1., 2., & 4. Correct: Signs and symptoms of ovarian cancer include irregular menses, increasing premenstrual tension, menorrhagia with breast tenderness, early menopause, abdominal discomfort, dyspepsia, pelvic pressure and urinary frequency. Flatulence, fullness after a light meal, and increasing abdominal girth are significant symptoms. 3. Incorrect: Watery, vaginal discharge is a sign of advanced cervical cancer. 5. Incorrect: A sense of fullness occurs after ingesting a light meal.

The nurse is caring for a client who is receiving a chemotherapy drug that is a vesicant. While assessing the IV site the nurse notes swelling, pain, and no blood return. What should be the nurse's first action? 1. Apply a cold compress. 2. Stop the infusion. 3. Call the PCP. 4. Continue the infusion.

2. Stop the infusion.

A client with bladder cancer is 2 days post ileal conduit. The nurse's assessment of the urinary output verifies the urine has flecks of mucous and the hourly output has gone from 200 mL at 8:00 am to 140 mL at 10:00 am. What is the nurse's priority action? 1. Irrigate the ileal conduit. 2. Increase PO fluids. 3. Notify PCP. 4. Scan the bladder/ileal conduit.

2. Increase PO fluids.

A client's absolute neutrophil count (ANC) is 750/mm3. Which measure should the nurse take to protect the client? Select all that apply. 1. Prohibit the client from shaving. 2. Instruct the client to wear a mask when leaving the hospital room. 3. Remove fresh flowers and plants from the client's room. 4. Ask visitors to perform hand hygiene before entering the client's room. 5. Instruct client to avoid vigorous flossing of teeth.

2., 3. & 4. Correct: Normal ANC is 1500-8000/mm3. If a client's ANC is less than 1000/mm3, the client is at risk for infection. Instructing the client to wear a mask outside of the hospital room protects the client from infection. The soil in fresh flowers and plants can carry bacteria and fungi, which can cause infection. Performing hand hygiene is the best way to prevent the spread of infection. 1. Incorrect: Not allowing the client to shave or vigorous flossing of teeth would be an appropriate intervention for someone with a low platelet count. This client has a low white cell count. 5. Incorrect: Not allowing the client to shave or vigorous flossing of teeth would be an appropriate intervention for someone with a low platelet count.