(Med-Surg I) Unit 5 Multiple Choice Questions

And caring for the patient who is being treated with internal radiation, what is the most important part of the nursing process for the nurse to prevent at self exposure?

Planning

The patient is having a radioisotope bone scan. He has had the radioactive material injected into his arm, and the nurse encourages him to drink water for the next several hours. What is the purpose of encouraging fluids?

Radioisotope that is not picked up by the bone will be flushed through the kidneys

What is the most effective regimen to manage the patient's cancer pain?

Round the clock, fixed dose

Based on the incidence of cancer and the mortality rate, which group has the greatest need for improvements and cancer prevention, detection, and treatment outcomes

African-Americans

The nurse is present when the healthcare provider tells the patient that a combination of surgery, radiation, and chemotherapy are needed to treat his cancer. Afterwards, the patient angrily says, "I'm not going to spend my last day. Getting poked by the doctor. I'm leaving the hospital!" What should the nurse say?

"I respect your decision, but is there anything I can do to help?"

Before the insertion of a radioactive cervical implant, the nurse tells the patient what to expect while it is in place. Which statement is accurate? (Select all that apply.)

1. "Nurses will always be available, but they will spend only a short time at your bedside." 3. "We will be checking your vital signs at least every 4 hours." 5. "You should make diet choices that are low in fiber."

The nurse is assisting with conducting a health-promotion program to community members regarding testicular cancer. The nurse determines that further teaching is needed if a community member states that which is a sign/symptom of testicular cancer? Select all that apply.

1. Alopecia 5. Elevation in prostate-specific antigen (PSA) levels

A 42-year-old patient has palpated a small lump in her left breast. She has scheduled an appointment with her health care provider. Which test will be used to make a definite diagnosis of a benign or malignant tumor of her breast?

1. Biopsy

A 61-year-old patient is receiving chemotherapy. The patient becomes anemic and has petechiae and ecchymoses. What side effect is the patient experiencing?

1. Bone marrow suppression

A patient has received a diagnosis of stage I breast cancer. She is receiving adjuvant chemotherapy and radiation therapy after a lumpectomy. What teaching point should be included in this patient's plan of care? (Select all that apply.)

1. Chemotherapy-related hair loss is usually temporary. 3. Hair that grows back may have a different texture and color. 4. Hair loss is most often related to radiation treatments. 5. Avoid the use of lotions on the skin at and near the site of radiation treatment, unless prescribed.

A 63-year-old patient has a diagnosis of cancer of the prostate gland with metastasis and is experiencing cachexia. How is cachexia best described?

1. Poor health, malnutrition, weakness, and emaciation

A patient is receiving chemotherapy and has a low WBC count. What patient statement indicates the need for further teaching?

2. "Fresh fruits and vegetables will help me get better."

The nurse is caring for a client after a mastectomy. Which finding would indicate that the client is experiencing a complication that may become a chronic problem related to the surgery?

2. Arm edema on the operative side.

The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?

2. Calcium level.

A 24-year-old patient has been receiving chemotherapy for acute lymphoblastic leukemia and has developed leukopenia. Which patient statement indicates that he understands discharge teaching concerning leukopenia? (Select all that apply.)

3. "I should avoid close contact with people who might give me an infection." 4. "I need to be careful not be able to stop the bleeding." 5. "I should avoid being in large crowds until my white blood cell count rises to an acceptable level."

A 58-year-old patient with colon cancer is receiving combined radiation therapy and chemotherapy. He has developed diarrhea. The patient asks the nurse why he is now having diarrhea. What nursing response is most accurate?

3. "Radiation is very irritating to the lining of your GI tract, which may have caused diarrhea."

When reinforcing teaching about signs/symptoms of ovarian cancer with a community group of women, the nurse emphasizes which as being a most typical manifestation of the disease?

3. Abdominal distention or fullness.

The patient has been diagnosed with terminal cancer. Which of the following is the most therapeutic approach by the nurse?

3. Pain is what the patient says it is.

The nurse is reviewing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory finding is indicative of the massive cell destruction that occurs with the chemotherapy?

3. increased uric acid level

The nurse is assisting with creating a plan of care for a client with pancytopenia as a result of chemotherapy. The nurse would suggest including which in the plan of care? Select all that apply.

3. restricting fresh fruits and vegetables in the diet 4. applying a face mask to the client if outside the client room

The client is receiving external radiation to the neck for cancer of the larynx. The nurse monitors the client knowing that which are side/adverse effects of the external radiation? Select all that apply.

3. sore throat 5. red and dry skin over neck

The client with small cell lung cancer is being treated with etoposide and the nurse is assisting with caring for the client during administration. The client gets up to use the bathroom and is dizzy and very weak. The nurse understands these symptoms are likely a result of which side/adverse effect that is specifically associated with this medication?

4. Orthostatic, hypertension

The nurse educator is discussing the importance of the reduction of carcinogens in primary prevention of cancer. Which risk factor is considered significant in many types of cancer?

4. Smoking

Which person is most likely candidate for low-dose helical CT for lung cancer screening

55-year-old male quit smoking 5 years ago and is in fairly good health with a 30 pack year history

The patient has a positive guaiac test, but he tells the nurse that he may have not followed the dietary instructions correctly. Which food substance is most likely to cause a false positive

A rare steak

A prostate specific antigen (PSA) test is usually recommended at age 50. Beginning at age 40, members of which ethnic group need to be advised to get the test.

African-American

The healthcare provider inform the nurse that the patient may have metastasis to the bone. The provider request that the nurse notify her immediately with the relevant results. Which test will the nurse be watching for?

Alkaline phosphatase

What is a clinical manifestation of testicular cancer

An enlargement in either testicles

Which observation would be consistent with a platelet count of fewer than 20,000/mm^3

Bleeding gums

The patient is placed on a neutropenic precautions for a neutrophil count of fewer than 1000/mm^3 . Which prescription will the nurse question

Catheterize for urine specimen

Which lunch tray contains the best selection of foods to reduce cancer risks?

Cottage cheese with tomato tomatoes and melon ball salad

The unlicensed assistive personnel is assigned to assist with hygiene for a patient who is currently undergoing external radiation over large portion of the trunk. What instructions will the nurse give?

Do not put lotion, cream, or body powder over the marked areas

The nurse is reviewing the patient's medication list and sees that the patient is taking ondansetron. What additional intervention will the nurse plan to use?

Minimize food odors or noxious smells

What is an early sign/symptom of tumor lysis syndrome

Muscle weakness

Which person has the greatest risk for developing cancer

Older white male who started smoking at age 14

The nurse is talking to a 23 year old woman about breast examination. What does the nurse tell the patient about timing and frequency of doing BSE

Perform the examination 2 to 3 days after your period ends

The UAP is assigned to assisted patient who is being treated with radioactive material and the vagina. What instruction should the nurse give?

Spend a maximum of 10 minutes to help with a bed from the waist up

According to the TNM classification system, which set of parameters, suggest the best prognosis

T0; N0; M0

While caring for a 23-year-old patient undergoing chemotherapy, the patient voices concerns about her hair loss. What information with the nurse gave to the patient

The loss of her hair will not be permanent

malignant

abnormal cell growth with a loss of normal role and function, and ability to spread to other body sites

sarcoma

malignant tumors of connective tissues

carcinoma

malignant tumors of epithelial cells

benign

not recurrent or progressive; nonmalignant

metastasis

process by which tumor cells spread

differentiated

recognizable as being the same in size or shape as normal cells

According to clinical stage in classification, which stage indicates the most extensive cancer with the poorest prognosis

stage IV

neoplasm

uncontrolled or abnormal growth of cells

What instructions should be given to boys and men about self examination of the testes? Select all that apply.

- Should be done once a month - Feel for lumps or thickening - Check after a warm bath or shower - Self examination should begin at puberty.

Which factors are shown to have an impact on how a patient will cope with a diagnosis of cancer? Select all that apply.

- age at the time of the diagnosis - availability of significant others - presence of symptoms - ability to express feelings

During meal planning for a cancer, patient, the patient reports that things have a "strange" taste, which is affecting her appetite. Which responses accurately pertain to her concern? Select all that apply.

- this is a common occurrence and will get better after the treatment ends - onion and ham may help to improve the taste of vegetables - lemon juice is successfully used to mask strange taste sensations

The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic studies will be prescribed? Select all that apply.

1. Chest x-ray 5. Pulmonary function studies

The nurse is assisting with creating a plan of care for the client with multiple myeloma. Which nursing intervention needs to be included to assess for and prevent renal failure for this client? Select all that apply.

1. Encouraging fluids 5. Monitoring serum calcium and uric acid levels

The client is admitted to the hospital with a diagnosis of suspected Hodgkin's disease. Which sign(s)/(symptom(s) of the client are associated with Hodgkin's disease? Select all that apply.

1. Fatigue 3. Weakness 5. Night sweats 6. Enlarged lymph nodes

The nurse is reviewing the laboratory results of a client who is receiving chemotherapy and notes that the platelet count is 10,000 mm3. On the basis of this laboratory value, the nurse would perform which intervention(s)? Select all that apply.

1. Monitor for occult blood. 3. Instruct the client not to bend over at the waist or lift. 5. Instruct the client to blow nose very gently without blocking either nostril.

The nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling. The nurse needs to take which appropriate action?

1. Notify the registered nurse immediately

The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase, an antineoplastic agent. The nurse consults with the registered nurse regarding the administration of the medication if which is documented in the client's history?

1. Pancreatitis

The nurse is assisting with caring for a client with cancer who is receiving cisplatin. Which adverse effects are associated with this medication? Select all that apply.

1. Tinnitus. 2. Ototoxicity. 5. Nephrotoxicity. 6. Hypomagnesemia

The licensed practical nurse (LPN) is assisting the registered nurse (RN) to create a teaching plan for the client receiving an antineoplastic medication. The LPN expects which information to be included? Select all that apply.

1. Rinse mouth after meals and use a soft toothbrush. 3. Maintain oral hygiene and inspect the mouth for sores daily. 5. Consult with the primary healthcare provider before receiving immunizations.

The nurse is caring for a client with an internal radiation implant. The nurse needs to observe which principle(s)? Select all that apply.

1. pregnant woman are not allowed into the client's room 3. wear a lead apron while delivery bedside care to the client

A patient has a history of oat cell carcinoma of the lung and is being treated with chemotherapy. His WBC count is 2.5/mm3. What is the nurse's primary concern?

2. Prevention of infection

The patient is receiving chemotherapy and has the patient problem of insufficient nutrition. What are likely reasons for this lack of nutrition related to side effects of this type of treatment? (Select all that apply.)

2. The patient complains that she has developed small sores in her mouth. 3. The patient has developed diarrhea. 4. The patient complains that she has been nauseated.

The client with acute myelocytic leukemia is being treated with busulfan. Which laboratory value would the nurse specifically monitor during treatment with this medication?

2. Uric acid level

The client with carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH) as a complication of the cancer. Besides treatment of the lung cancer, the nurse anticipates that which intervention(s) may be prescribed to treat the SIADH? Select all that apply.

3. Institute safety measures 4. Frequent monitoring of sodium blood levels 5. Gather data about the neurological status frequently 6. Medication that is antigonistic to anti-diuretic hormone (ADH)

The nurse is reinforcing discharge instructions to a client with cancer of the prostate after a suprapubic prostatectomy. The nurse would reinforce which discharge instruction(s)? Select all that apply.

3. Take the prescribed stool softener every day. 4. Avoid lifting objects heavier than 20 pounds for 6 weeks

Which is true regarding cancer prevention and health care promotion behaviors for patients with a diagnosis of cancer?

3. They are increasingly important with the growing population of cancer survivors.

The nurse provides skin care instructions to the client who is receiving external radiation therapy. Which statement(s) by the client indicates the need for further teaching? Select all that apply

4. "I will limit sun exposure to 1 hour daily" 5. "I will apply moisturizer with a cotton tipped applicator for itching"

Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that which is the primary action of this medication?

4. Compete with estradiol for binding to estrogen and tissues, containing high concentrations of receptors.

The client with ovarian cancer is being treated with vincristine. The nurse monitors the client, knowing that which adverse effect is specific to this medication?

4. Extremity numbness

The nurse is reinforcing instructions to a client receiving external radiation therapy. The nurse determines that the client needs further teaching if the client states an intention to take which action? Select all that apply.

4. apply pressure on the radiated area to prevent bleeding 5. avoid standing within 6 feet of persons younger than the age of 18

The client is hospitalized for the insertion of an internal cervical radiation implant. While giving care, the nurse finds the radiation implant in the bed. Which is the immediate nursing action?

4. pick up the implant with long-handled forceps and place into lead container

Which dietary recommendation to decrease risk for cancer comes from the National Cancer Institute

Eat at least five servings of fruit and vegetables each day

The patient states that she knows vitamin C is an important nutrient in the prevention of cancer, but she really dislikes citrus fruits. What is the best alternative source that the nurse could suggest?

Eating strawberries or tomatoes

Which intervention is the nurse most likely to use for a patient who has "chemo brain"?

Help patient to establish routine and avoid multitasking

The healthcare provider is considering magnetic residence imaging for a patient might have a spinal tumor. Prior to the MRI, the nurse would notify the provider if the patient disclosed which information.

History of hip fracture

The nurse is volunteering at a local health fair and is talking with people about cancer prevention and screening recommendations. Which person should be referred for cancer risk assessment and genetic counseling.

History of multiple primary cancers in one family member

The patient is receiving epoetin alfa. Which laboratory finding indicates that the therapy is helping.

Improvement of the red cell count

What is the clinical significance for persons who have the BRCA1 and BRCA2 genes?

Increased incident of breast cancer

Patient has stomatitis secondary to chemotherapy. Which intervention will the nurse use?

Use a sponge tipped applicator to perform frequent mouth care