The Client with Cancer (in progress - not complete)
A 21-year-old client undergoes bone marrow aspiration at the clinic to establish a diagnosis of possible lymphoma. Which statement made by the client demonstrates proper understanding of discharge teaching? Select all that apply
"I will take Tylenol for pain." "I will not be able to play basketball for the next 2 days." "I can apply an ice pack or a cold compress to the puncture site."
A 62-year-old female is taking long-acting morphine 120 mg every 12 hours for pain from metastatic breast cancer. She can have 20 mg of immediate-release morphine every 3 to 4 hours as needed for breakthrough pain. The physician should be notified if the client uses more than how many breakthrough doses of morphine in 24 hours?
Seven.
A 48-year-old client with cancer has been receiving 10 mg of IV morphine while hospitalized. Which of the following is an equivalent dose of oral morphine?
30 mg.
Lifestyle influences that are considered risk factors for colorectal cancer include:
A high-fat, low-fiber diet.
Assessment of a client taking a nonsteroidal anti-inflammatory drug (NSAID) for pain management should include specific questions regarding which of the following systems?
Gastrointestinal
A 52-year-old male was discharged from the hospital for cancer-related pain. His pain appeared to be well controlled on the IV morphine. He was switched to oral morphine when discharged 2 days ago. He now reports his pain as an 8 on a 10-point scale and wants the IV morphine. Which of the following represents the most likely explanation for the client's reports of inadequate pain control?
He is undermedicated on the oral opioid.
The nurse is assessing a 60-year-old who has hoarseness. The nurse should conduct a focused assessment to determine:
History of tobacco use and alcohol consumption.
A 29-year-old woman is concerned about her personal risk factors for malignant melanoma. She is upset because her 49-year-old sister was recently diagnosed with the disease. After gathering information about the client's history of sun exposure, the nurse's best response would be to explain that:
Some melanomas have a familial component, and she should seek medical advice.
Which of the following clients is at highest risk for colorectal cancer?
The client who has been treated for Crohn's disease for 20 years.
The nurse is teaching a 17-year-old, sexually active female client about the importance of regular Papanicolaou (Pap) smears. The nurse should instruct the client that:
The initial Pap smear should be done when at age 21.
Cancer prevalence is defined as:
The number of persons with cancer at a given point in time.
A nurse is palpating a female client's breast while assessing for breast disease. Which area of the breast is where tumors are most commonly found?
Upper outer
A client at risk for lung cancer asks about the reason for having a computed tomography (CT) scan as part of the initial exam. The nurse's best response is which of the following? "A CT scan:
is useful for distinguishing small differences in tissue density and detecting nodal involvement."
A 42-year-old is interested in making dietary changes to reduce the risk of colon cancer. What dietary selections should the nurse suggest?
Bran muffin, skim milk, stir-fried broccoli.
The nurse is preparing an educational program on breast cancer for women at a Black community center. What information is important for the nurse to consider for the discussion?
Breast cancer concerns vary between socioeconomic levels of Black women.
The nurse is assessing a client with chronic pain. Which of the following is an expected response of a client in chronic pain?
Normal vital signs, physical inactivity, and normal facial expressions.
Which of the following is an environmental factor that increases the risk of cancer?
Nutrition.
Which of the following groups would benefit most from education regarding potential risk factors for melanoma?
Parents with children.
A client diagnosed with testicular cancer expresses concerns about fertility. The couple desires to eventually have a family and the nurse discusses the option of sperm banking. The nurse should inform the couple that sperm banking would need to be performed:
Before treatment is started.
A nurse is conducting a cancer risk screening program. Which of the following clients is at greatest risk for skin cancer?
60-year-old mountain biker.
A client with lung cancer is being cared for by his wife at home. His pain is increasing in severity. The nurse recognizes that teaching has been effective when the wife does which of the following? Select all that apply.
Administers long-acting or sustained-release oral pain medication (OxyContin) regularly around the clock. Administers immediate-release medication (oxycodone) for breakthrough pain. Uses music for distraction as well as heat or cold in combination with medications. Has her husband use a pain-rating scale to measure the effectiveness at reaching his individual pain goal.
A client with a family history of cancer asks the nurse what the single most important risk factor is for cancer. Which of the following risk factors should the nurse discuss?
Age.
A client with advanced ovarian cancer takes 150 mg of long-acting morphine orally every 12 hours for abdominal pain. When the client develops a small bowel obstruction, the physician discontinues the oral morphine and begins morphine 6 mg/h IV. After calculating the equianalgesic conversion from oral to intravenous morphine, the nurse should:
Clarify the prescription to recommend the initial morphine dose of 4 mg/h.
Experimental and epidemiologic evidence suggests that a high-fat diet increases the risk of several cancers. Which of the following cancers is linked to a high-fat diet?
Colon.
A client with pancreatic cancer has been receiving morphine via a subcutaneous pump for 2 weeks. The client is requiring an increased dose of the morphine to manage the pain. The nurse should document that the client is:
Developing a tolerance for the medication.
Which of the following terms describes the condition of a client who requires an increase in dosage to maintain adequate analgesia?
Drug tolerance.
The incidence and risk of cancer increase when smoking is combined with:
Asbestos exposure and alcohol consumption.
A 42-year-old female highway construction worker is concerned about her cancer risks. She has been married for 18 years, has two children, smokes one pack of cigarettes per day, and occasionally drinks one to two beers. She is 30 lb (13.6 kg) overweight, eats fast food often, and rarely eats fresh fruits and vegetables. Her mother was diagnosed with breast cancer 2 years ago. Her father and an aunt both died of lung cancer. She had a basal cell carcinoma removed from her cheek 3 years earlier. What behavioral changes should the nurse instruct this client to make to decrease her risk of cancer? Select all that apply.
Improve nutrition. Use sunscreen. Stop smoking. Lose weight.
When planning a culturally sensitive health education program the nurse should:
Integrate folk beliefs and traditions of the target population into the content.
A client in a hospice program has increasing pain. The nurse and client collaborate to schedule analgesics to provide which of the following?
Around-the-clock routine administration of analgesics for continuous pain relief.
A client had a craniotomy for removal of a malignant brain tumor in the occipital region. The nurse should question a prescription for which of these drugs?
Morphine sulfate.
A nurse is providing education in a community setting about general measures to avoid excessive sun exposure. Which of the following recommendations is appropriate?
Apply sunscreen with a sun protection factor (SPF) of 15 or more before sun exposure.
A nurse is assessing a client with bone cancer pain. Which of the following components of a thorough pain assessment is most significant for this client?
Intensity.
Which of the following reasons explains why meperidine (Demerol) is not recommended for chronic cancer-related pain?
It contains a metabolite that causes seizures.
