Management of Patients with Oncologic Disorders
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."
During a client's examination and consultation, the physician keeps telling the client,"You have an abdominal neoplasm." Which statements accurately paraphrase the physician's statement? Select all that apply.
"You have a new growth of abnormal tissue in your abdomen." "You have an abdominal tumor." "You have an abdominal malignancy." "You have abdominal cancer."
Which does a nurse thoroughly evaluate before a hematopoietic stem cell transplant (HSCT) procedure? Family history Drug history Blood studies Allergy history
Blood studies
Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure? Family history Drug history Blood studies Allergy history
Blood studies
An oncology nurse is caring for a client who relates that certain tastes have changed. The client states that "meat tastes bad." What nursing intervention can be used to increase protein intake for a client with taste changes? Stay away from protein beverages. Encourage maximum fluid intake. Encourage eating cheese, eggs, and legumes Suck on hard candy during treatment.
Encourage eating cheese, eggs, and legumes
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
In which phase of the cell cycle does RNA and protein synthesis occur? G1 phase S phase G2 phase Mitosis
G1 phase
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
Which is a growth-based classification of tumors? Sarcoma Carcinoma Malignancy Leukemia
Malignancy
In which phase of the cell cycle does cell division occur? Mitosis G1 phase S phase G2 phase
Mitosis
A nurse is teaching a community class about how to decrease the risk of cancer. Which food should the nurse recommend? Low-fat hot dogs Smoked ham Oranges Medium-rare steak
Oranges
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? Diagnostic Palliative Prophylactic Reconstructive
Prophylactic
A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis? White, cottage cheese-like patches on the tongue Yellow tooth discoloration Red, open sores on the oral mucosa Rust-colored sputum
Red, open sores on the oral mucosa
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 newly diagnosed cancer client is crying and states the following to the nurse: "I promised God that I will be a better person if I can just get better." What is the appropriate assessment of this comment by the nurse? The client is just trying to protect self from potential loss. Anger directed toward nursing staff is not unusual in dealing with cancer clients. The cancer is viewed as a punishment from past actions. Loss is inevitable so client is making final plans.
The cancer is viewed as a punishment from past actions.
A client with metastatic pancreatic cancer underwent surgery to remove a malignant tumor in the pancreas. Despite the tumor being removed, the physician informs the client that chemotherapy must be started. Why might the physician opt for chemotherapy? To prevent metastasis Angiogenesis Stomatitis Fatigue
To prevent metastasis
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
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
The nurse evaluates teaching as effective when a female client states that she will Use sunscreen when outdoors. Decrease tobacco smoking from one pack/day to half a pack/day. Exercise 30 minutes 3 times each week. Obtain a cancer history from her parents.
Use sunscreen when outdoors
Which of the following would be inconsistent as a common side effect of chemotherapy? Weight gain Alopecia Myelosuppression Fatigue
Weight gain
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: expected chemotherapy-related adverse effects. chemotherapy exposure and risk factors. signs and symptoms of infection. reinforcement of the client's medication regimen.
chemotherapy exposure and risk factors.
The nurse is working with a client who has had an allohematopoietic 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.
Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth? Control Cure Palliation Prevention
Control
A nurse is caring for a client receiving chemotherapy. Which assessment finding places the client at the greatest risk for an infection? White blood cell (WBC) count of 9,000 cells/mm3 Stage 3 pressure ulcer on the left heel Temperature of 98.3° F (36.8° C) Ate 75% of all meals during the day
Stage 3 pressure ulcer on the left heel
What should the nurse tell a client who is about to begin chemotherapy and is anxious about hair loss? The client should consider getting a wig or cap prior to beginning treatment. Alopecia related to chemotherapy is relatively uncommon. The hair will grow back within 2 months post therapy. The hair will grow back the same as it was before treatment.
The client should consider getting a wig or cap prior to beginning treatment.
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 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
Which oncologic emergency involves the accumulation of fluid in the pericardial space? Cardiac tamponade Disseminated intravascular coagulation (DIC) Syndrome of inappropriate antidiuretic hormone release (SIADH) Tumor lysis syndrome
Cardiac tamponade
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."
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 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.
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
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
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.
The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action? Extravasation Stomatitis Nausea and vomiting Bone pain
Extravasation
When malignant cells are killed (tumor lysis syndrome), intracellular contents are released into the bloodstream. This leads to which of the following? Select all that apply. Hypercalcemia Hyperkalemia Hyperuricemia Hyperphosphatemia
Hyperkalemia Hyperuricemia Hyperphosphatemia
The nurse is caring for a client undergoing an incisional biopsy. Which statement does the nurse understand to be true about an incisional biopsy? It is used to remove cancerous cells using a needle. It removes an entire lesion and the surrounding tissue. It removes a wedge of tissue for diagnosis. It treats cancer with lymph node involvement.
It removes a wedge of tissue for diagnosis.
The nurse is evaluating the client's risk for cancer. What lifestyle change should the nurse recommend? 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
Which oncologic emergency involves the failure in the negative feedback mechanism that normally regulates the release of antidiuretic hormone (ADH)? Syndrome of inappropriate antidiuretic hormone release (SIADH) Cardiac tamponade Disseminated intravascular coagulation (DIC) Tumor lysis syndrome
syndrome of inappropriate antidiuretic hormone release (SIADH)
Which statement by a client undergoing external radiation therapy indicates the need for further teaching? "I'll wash my skin with mild soap and water only." "I'll not use my heating pad during my treatment." "I'll wear protective clothing when outside." "I'm worried I'll expose my family members to radiation."
"I'm worried I'll expose my family members to radiation."