Med Surg Chapter 15

B) Smoking cessation

1. The school health nurse is presenting a health-promotion class to a group of middle-school students. Which is the best intervention to address health-promotion strategies related to the leading cause of cancer deaths in North America? A) Monthly self-breast exams B) Smoking cessation C) Annual colonoscopies D) Monthly testicular exams

D) Discuss a referral for hospice care

16. You are caring for a patient has just been given a 6-month prognosis. The patient states that he would like to die at home. The patient's care needs are unable to be met in a home environment. What might you suggest as an alternative? A) Discuss a referral for rehabilitation hospital B) Panel the patient for a personal care home C) Discuss a referral for acute care D) Discuss a referral for hospice care

B) The cell membrane of malignant cells also contains proteins called tumor-specific antigens.

21. The nursing instructor is discussing the difference between normal cells and cancer cells with the prenursing class in pathophysiology. What would the instructor cite as a characteristic of a cancer cell? A) Malignant cells contain more fibronectin. B) The cell membrane of malignant cells also contains proteins called tumor-specific antigens. C) Chromosomes are commonly found to be strong. D) Nuclei of cancer cells are large and regularly shaped.

C) Secondary prevention

28. You are a part of a team of nurses that is developing an educational program entitled Cancer: Its Risks and What You Can Do About It. This program is an example of what? A) Primary prevention B) Risk reduction C) Secondary prevention D) Tertiary prevention

D) Dispose of the antineoplastic wastes in the hazardous waste receptacle

10. You are orienting a new nurse to the oncology unit where you work. As you prepare to administer an antineoplastic agent to a one of your patients, what should you teach the new nurse about antineoplastic agents? A) Administer only prepackaged agents from the manufacturer B) Wash hands and arms following administration C) Use gloves and a lab coat D) Dispose of the antineoplastic wastes in the hazardous waste receptacle

D) Do not visit if you've had a recent infection.

11. You are a nurse working on a bone marrow transplant unit. Your patient is scheduled to receive a bone marrow transplant. What information will you provide to the patient's visitors? A) Bring plants to improve air quality. B) Take the patient to the cafeteria for meals. C) Wear hospital scrubs when entering the patient's room. D) Do not visit if you've had a recent infection.

B) Impaired skin integrity

12. The nursing instructor is teaching a class in oncology nursing to her junior nursing students. The instructor is aware that infection is a significant consideration when providing care to an oncology patient. The leading cause of death in an oncology patient is infection caused by what? A) Malnutrition B) Impaired skin integrity C) Poor hygiene D) Broken oral mucosa

A) Use a lip lubricant C) Use dental floss every 24 hours D) Rinse the mouth with normal saline

13. You are the nurse caring for an adult patient who has developed a mild oral yeast infection following chemotherapy. What should you encourage the patient to do? (Mark all that apply.) A) Use a lip lubricant B) Scrub the tongue with a firm-bristled toothbrush C) Use dental floss every 24 hours D) Rinse the mouth with normal saline E) Eat hot foods to aid in killing the yeast

C) Risk for infection related to altered immunologic response

14. The nurse on a bone marrow transplant unit is caring for a patient with cancer who is preparing for engraphment for a bone marrow transplant. What is a priority nursing diagnosis for this patient? A) Fatigue and activity intolerance B) Altered nutrition: less than body requirements due to anorexia C) Risk for infection related to altered immunologic response D) Body image disturbance related to weight loss and anorexia

D) Avoid using soap on the area of treatment.

15. The nursing instructor is discussing the care of oncology patients with her junior nursing students. The instructor presents this scenario: An oncology patient develops erythema following radiation therapy. What should the nurse instruct the patient to do? A) Apply ice to the area. B) Keep the area cleanly shaven. C) Apply petroleum ointment to the affected area. D) Avoid using soap on the area of treatment.

A) "These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and X-ray studies."

17. The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient? A) "These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and X-ray studies." B) "These symptoms are part of your disease and can't be helped." C) "Don't be concerned about these symptoms. Everybody feels this way after having radiation therapy." D) "This is a good sign. It means that only the cancer cells are dying."

A) The patient requests that her family bring her makeup and wig.

18. A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that the patient is meeting the goal of improved body image and self-esteem? A) The patient requests that her family bring her makeup and wig. B) The patient begins to discuss the future with her family. C) The patient reports less disruption from pain and discomfort. D) The patient cries openly when discussing her disease.

A) Administer an antiemetic

19. Adverse effects to chemotherapy are dealt with by patients and their caregivers every day. What would the nurse do to combat the most common adverse effects of chemotherapy? A) Administer an antiemetic B) Administer an antimetabolite C) Administer a tumor antibiotic D) Administer an anticoagulant

A) Liver function test

2. You are the clinic nurse in an oncology clinic. Your patient arrives for a 2-month follow-up appointment following chemotherapy. You note that the patient's skin appears yellow. Which blood tests should be done to further explore this clinical sign? A) Liver function test B) CBC C) Platelet count D) Electrolytes

C) "You're anxious about the surgery. Do you see smoking as helping?" D) "Smoking is OK right now, b

20. A 58-year-old male patient has been hospitalized for a wedge resection of the left lower lung lobe after a routine chest x-ray shows carcinoma. The patient is anxious and asks if he can smoke. Which statement by the nurse would be most therapeutic? A) "Smoking is the reason you're here." B) "The doctor left orders for you not to smoke." C) "You're anxious about the surgery. Do you see smoking as helping?" D) "Smoking is OK right now, but after your surgery it's contraindicated."

B) Lymphatic circulation

22. The staff educator is giving a class on oncology nursing for a group of nurses new to the unit. What is the most common mechanism of metastasis of cancer cells? A) Hematologic spread B) Lymphatic circulation C) Invasion D) Angiogenisis

A) Rate of growth B) Ability to cause death E) Ability to spread

23. You are giving a report in your pathophysiology class. The subject of your report is cancer cells. In differentiating between benign and malignant cells, what characteristics would you cite? (Mark all that apply.) A) Rate of growth B) Ability to cause death C) Size of cells D) Cell contents E) Ability to spread

B) Proteins in the cell membrane

24. The nursing instructor is discussing benign versus malignant cells in the pathophysiology class. What distinguishes malignant cells from benign cells of the same tissue type? A) Slow rate of mitosis of cancer cells B) Proteins in the cell membrane C) Size of cells D) Stability of cells

D) Invading host tissues

25. Malignant disease processes have the ability to spread from one organ to another throughout the body. What is one means malignant disease processes transfer cells from one place to another? A) Adhering to primary tumor cells B) Causing mutation of cells of another organ C) Phagocytizing healthy cells D) Invading host tissues

C) Breast cancer D) Esophageal cancer E) Liver cancer

26. You are doing an initial assessment of a patient newly diagnosed with cancer. The patient tells you that he drinks about a quart of scotch every evening. What types of cancer does this put him at risk for? (Mark all that apply.) A) Pancreatic cancer B) Brain cancer C) Breast cancer D) Esophageal cancer E) Liver cancer

B) "Research has shown that taking tamoxifen can reduce your chance of breast cancer."

27. You are the clinic nurse caring for a patient whose grandmother, mother, and sister all had breast cancer. She has requested a screening test to determine her risk of developing breast cancer, and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response? A) "Research has shown that eating a healthy diet can reduce your chance of breast cancer." B) "Research has shown that taking tamoxifen can reduce your chance of breast cancer." C) "Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer." D) "Research has shown that reducing your intake of red meat can reduce your chance of breast cancer."

D) Sentinel lymph node biopsy

29. What is a minimally invasive surgical approach that is diagnostic for cancer and has, in some instances, replaced lymph node dissections? A) Lymphadenectomy B) Needle biopsy C) Open biopsy D) Sentinel lymph node biopsy

C) Baked apricot chicken and steamed broccoli

3. You are teaching a nutrition class in the local high school. One student tells you that he has heard that certain foods can increase the incidence of cancer. You respond, "Research has shown that certain foods appear to increase the risk of cancer." Which of the following menu selections would be the best choice for reducing the risks of cancer? A) Smoked salmon and green beans B) Pork chops and fried green tomatoes C) Baked apricot chicken and steamed broccoli D) Liver, onions, and steamed peas

A) Palliative

30. You are caring for a patient who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the patient the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer? A) Palliative B) Reconstructive C) Salvage D) Prophylactic

B) Superior vena cava syndrome (SVCS)

31. You are caring for a patient with an advanced stage of breast cancer. The cancer has metastasized. You enter the room and find the patient struggling to breath. You note that this patient's jugular veins are distended. What would you suspect is happening with this patient? A) Increased intracranial pressure B) Superior vena cava syndrome (SVCS) C) Spinal cord compression D) Metastatic tumor of the neck

C) Consume 2 to 4 L of fluid daily.

32. You are a hospice nurse caring for a patient with cancer in her home. You have explained to the patient and the family that the patient is at risk for hypercalcemia. You have educated them on that signs and symptoms of hypercalcemia. What else would you teach this patient and family to do to reduce the risk of hypercalcemia? A) Stool softeners are contraindicated. B) Laxatives should be taken daily. C) Consume 2 to 4 L of fluid daily. D) Restrict calcium intake.

A) Assist patient to turn, cough, and deep breathe B) Accurate I & O C) Prevent bleeding

33. You are caring for an oncology patient at risk for disseminated intravascular coagulation (DIC). What would be the appropriate care for this patient? (Mark all that apply.) A) Assist patient to turn, cough, and deep breathe B) Accurate I & O C) Prevent bleeding D) Assess hearing disturbances E) Maximize physical activity

A) Tumor lysis syndrome

34. You are a home health nurse caring for an oncology patient discharged home 3 days ago after completing therapy. What would you assess the patient for? A) Tumor lysis syndrome B) Syndrome of inappropriate antiduretic hormone C) Disseminated intravascular coagulation D) Hypercalcemia

B) Impaired wound healing

35. You are admitting an oncology patient to your unit prior to surgery. The patient has just finished radiation therapy. What does this put your patient at increased risk for? A) Nutritional deficit B) Impaired wound healing C) Cardiac tamponade D) Tumor lysis syndrome

C) Wound dehiscence

36. Your patient has just returned from the PACU after salvage surgery for renal carcinoma. What would you assess this patient for? A) Vasoconstriction B) Anorexia C) Wound dehiscence D) Metastasis to the brain

D) Strive to facilitate communication among family members.

37. You have just admitted a new patient to the hospice program you work for. While you are doing the initial assessment, a family member states, "my sister just won't talk to any of us about what is happening to her." What should you do? A) Strive to facilitate communication between the family and health care providers. B) Strive to facilitate communication between the patient and health care providers. C) Strive to facilitate communication between family members and yourself. D) Strive to facilitate communication among family members.

A) Focus of care is on the family as well as the patient.

38. What is the most important focus of hospice care? A) Focus of care is on the family as well as the patient. B) Focus of care is on the patient centrally and the family peripherally. C) Focus of care is solely on the patient. D) Focus of care emotionally is totally on the family.

B) Interacts and socializes with others

39. You are caring for a 14-year-old female patient with leukemia. She has developed alopecia due to treatment for the leukemia. What would be an expected outcome found on her plan of care? A) Maintains adequate hydration B) Interacts and socializes with others C) Verbalizes positive self-awareness D) Maintains academic standing in school

C) Teaching patients to wear sunscreen

4. Traditionally, nurses have been involved with tertiary prevention with their cancer patients. However, emphasis is also placed on both primary and secondary prevention. What would be an example of primary prevention? A) Yearly Pap tests B) Testicular self-examination C) Teaching patients to wear sunscreen D) Screening mammogram

C) A phase of cancer care that comes after primary treatment and lasts until cancer recurrence or the end of life

40. You are the clinic nurse caring for a patient who was just told he was cancer free at 5 years after diagnosis. The patient has been told he is a cancer survivor. What is cancer survivorship? A) The period just after being pronounced cancer-free 5 years after being diagnosed B) The time during which the patient lives with an active diagnosis of cancer C) A phase of cancer care that comes after primary treatment and lasts until cancer recurrence or the end of life D) The end of cancer care

C) Prophylactic surgery

5. You are caring for a 39-year-old woman with a family history of breast cancer. She has requested a breast tumor marking test and the results are positive. The patient is requesting a bilateral mastectomy. What is this surgery an example of? A) Salvage surgery B) Palliative surgery C) Prophylactic surgery D) Reconstructive surgery

A) Impaired nutritional status

6. You are caring for a patient who is to begin receiving external radiation for a malignant tumor of the head and neck. While doing patient education, what side effects should the nurse discuss with the patient that should be assessed because of the radiation treatment? A) Impaired nutritional status B) Pink oral mucosa C) Diarrhea D) Alopecia

A) stop the administration of the drug immediately.

7. While a patient is receiving intravenous doxorubicin hydrochloride, the nurse observes that there is swelling and pain at the IV site. The nurse should A) stop the administration of the drug immediately. B) notify the patient's physician. C) continue to administer but decrease the rate of infusion. D) apply a warm compress to the site.

B) Nausea and vomiting

8. A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment. The patient asks the nurse what the most common side effect of chemotherapy is. What would be the best answer the nurse could give? A) Alopecia B) Nausea and vomiting C) Altered glucose metabolism D) Increased appetite

C) Nose bleed

9. Your patient is receiving carmustine, a chemotherapy agent. A significant side effect of this medication is thrombocytopenia. Which symptom would the nurse assess for in patients at risk for thrombocytopenia? A) Interrupted sleep pattern B) Hot flashes C) Nose bleed D) Increased weight