Week 13 Cancer

According to the TNM classification system, T0 means there is a) no distant metastasis. b) no regional lymph node metastasis. c) distant metastasis. d) no evidence of primary tumor

d) no evidence of primary tumor

What type of surgery has the goal to relieve symptoms, make the patient as comfortable as possible, and promote quality of life as defined by the patient and family? It is performed in an attempt to relieve symptoms, such as ulceration, obstruction, hemorrhage, pain, and malignant effusions a. diagnostic b. primary treatment c. prophylactic d. palliative e. reconstructive

d. palliative

The nurse is providing education to a patient with cancer radiation treatment options. The nurse determines that the patient understands when he or she states that which of the following types of radiation is aimed at protecting healthy tissue during the treatment? a) Brachytherapy b) Teletherapy c) Proton therapy d) External

a) Brachytherapy

The nurse evaluates teaching as effective when a female client states that she will a) Use sunscreen when outdoors b) Decrease tobacco smoking from one pack/day to half a pack/day. c) Exercise 30 minutes 3 times each week. d) Obtain a cancer history from her parents.

a) Use sunscreen when outdoors

What are examples of prophylactic surgeries? Select all that apply. a. colectomy b. mastectomy c. oophorectomy d. cryoablation

a, b, c

Patients with suspected cancer undergo extensive testing to diagnose. What is the purpose of these tests? Select all that apply. a. determine the presence and extent of cancer b. identify possible disease metastasis c. evaluate the function of involved and uninvolved body systems and organs d. obtain tissue and cells for analysis, including evaluation of tumor stage and grade

a, b, c, d

Your patient with cancer is at risk for impaired skin integrity, what are some nursing interventions to implement? Select all that apply. a. Avoid the use of soaps, cosmetics, perfumes, powders, lotions, and ointments; non-aluminum-based deodorant may be used on intact ski b. Use only lukewarm water to bathe the area. c. Avoid shaving the area (erythematous) with a straight-edged razor. d. If wet desquamation occurs, do not disrupt any blisters that have formed and avoid frequent washing of the area.

a, b, c, d

Your patient with cancer is at risk for infection, what are some nursing interventions to implement? Select all that apply. a. Placing patient in private room if absolute WBC count <1000/mm3 b. Avoid insertion of urinary catheters; if catheters are necessary, use aseptic technique. c. Instruct patient to never use electric razor, only blades. d. Use stool softeners to prevent constipation and straining.

a, b, d

Which statement by a client undergoing external radiation therapy indicates the need for further teaching? a) "I'll not use my heating pad during my treatment." b) "I'll wear protective clothing when outside." c) "I'll wash my skin with mild soap and water only." d) "I'm worried I'll expose my family members to radiation."

"I'm worried I'll expose my family members to radiation." Explanation:The client undergoing external radiation therapy requires further teaching when he voices a concern that he might expose his family to radiation. Internal radiation, not external radiation, poses a risk to the client's family. The client requires no further teaching if he states that he should wash his skin with mild soap and water, wear protective clothing when outside, and avoid using a heating pad.

The root cause of cancer is damage to cellular deoxyribonucleic acid (DNA) which can be caused my many factors, or carcinogens. What factors can be carcinogenic? Select all that apply. A. environmental factors B. gender C. viruses D. dietary substances E. age

A, C, D

Carcinogens are factors related to the formation of various malignancies. Which factor has the greatest impact on the development of all cancers? A. chemical agents B. environmental factors C. viruses D. defective genes

A. chemical agents (tobacco)

Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode will the nurse anticipate? a) No further treatment is indicated. b) Repeat biopsy is needed before treatment begins. c) Palliative care is likely. d) Adjuvant therapy is likely.

Adjuvant therapy is likely. Explanation:T3 indicates a large tumor size with N1 indicating regional lymph node involvement. Although M0 suggest no metastasis, following with adjuvant (chemotherapy or radiation therapy) treatment is indicated to prevent the spread of cancer outside the lymph to other organs. The tumor staging of stage IV is indicative of palliative care

Following bone marrow aspiration of a 19-year-old client, analysis reveals more than 20% immature blast cells. Platelet counts are 9000/mm³. What nursing interventions should the nurse employ for the care of this client? Select all answers that apply. a. Administer prescribed docusate (Colace) daily. b. Recommend taking ibuprofen for mild aches and pains. c.Apply pressure to venipuncture sites for 1 to 2 minutes. d. Assess for mental state changes. e. Discuss the withholding of oral contraceptives.

a, d he client has leukemia with immature blast cells and an extremely low platelet count. The client is at increased risk for bleeding. Interventions that would address bleeding include assessing for mental status changes (because bleeding could occur in the brain) and administering stool softeners to prevent constipation (which would increase the risk of bleeding from the rectum). Oral contraceptives would be administered to induce amenorrhea. Ibuprofen would be avoided because this medication inhibits platelet function. The nurse is to apply pressure to venipuncture sites for 5 minutes.

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process in a client with leukemia? a. Apply prolonged pressure to needle sites or other sources of external bleeding. b. Monitor temperature at least once per shift. c. Eliminate direct contact with others who are infectious. d. Implement neutropenic precautions

a. Apply prolonged pressure to needle sites or other sources of external bleeding.

What type of surgery is performed to obtain a tissue sample for histologic analysis of cells suspected to be malignant? a. diagnostic b. primary treatment c. prophylactic d. palliative e. reconstructive

a. diagnostic

What type of radiotherapy is the most commonly used form? a. external radiation (proton beam) b. internal radiation c. brachytherapy d. toxicity

a. external radiation (proton beam)

What type of prevention are HPV vaccinations and smoking cessation for cervical cancer? a. primary b. secondary c. tertiary

a. primary

What type of prevention is breast feeding for breast cancer? a. primary b. secondary c. tertiary

a. primary

What type of prevention is smoking cessation, exercise, and high-fiber diet for cervical cancer? a. primary b. secondary c. tertiary

a. primary

Which level of prevention is about reducing the risks of disease through health promotion and risk reduction strategies, such as nutrition and physical activity? a. primary b. secondary c. tertiary

a. primary

Which level of prevention is the use of immunization to reduce the risk of cancer through prevention of infections associated with cancer? Such as the HPV vaccine to prevent cervical and head and neck cancers. a. primary b. secondary c. tertiary

a. primary

What management for cancer remains the ideal and most frequently used treatment method? a. surgery b. radiotherapy c. chemotherapy

a. surgery

What diagnostic test for cancer is the analysis of substances found in tumor tissue, blood, or other body fluids that are indicative of cancer cells or specific characteristics of cancer cells? These substances may also be found in some normal body tissues. a. tumor marker identification b. genetic tumor markers c. mammography d. MRI e. CT scan

a. tumor marker identification

Which of these are carcinogenic agents and factors? Select all that apply. a. Viruses, bacteria b. Physical agents: sunlight, radiation, chronic irritation c. Chemical agents: tobacco, asbestos d. Genetic, familial factors e. Life style factors f. Hormonal agents

all of the above

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? a) Wearing a lead apron during direct contact with the client b) Avoiding using soap on the irradiated areas c) Removing thoracic skin markings after each radiation treatment d) Applying talcum powder to the irradiated areas daily after bathing

b) Avoiding using soap on the irradiated areas

Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth? a) Palliation b) Control c) Cured d) Prevention

b) Control

Your patient with cancer is at risk for impaired oral mucous membrane: stomatitis, what are some nursing interventions to implement? Select all that apply. a. Leave dentures in at night to help the mouth adjust. b. Advise patient to avoid irritants such as commercial mouthwashes, alcoholic beverages, and tobacco c. Use normal saline mouth rinses every 1-4 hours (mild stomatitis) d. Assess ability to chew and swallow; assess gag reflex (severe stomatitis) e. Administer systemic analgesics as prescribed.

b, c, d, e

What diagnostic test for cancer is the analysis for the presence of mutations (alterations) in genes found in tumors or body tissues? Assists in diagnosis, selection of treatment, prediction of response to therapy, and risk of progression or recurrence. a. tumor marker identification b. genetic tumor markers c. mammography d. MRI e. CT scan

b. genetic tumor markers

What type of radiotherapy includes localized implantation or systemic radionuclide administration. Brachytherapy delivers the dose of radiation to a localized area while systemic radiotherapy relies on strategies for getting the radionuclides closer to the tumor. a. external radiation (proton beam) b. internal radiation c. radiation reactions d. toxicity

b. internal radiation

What type of surgery has the goal is to remove the entire tumor or as much as is feasible (a procedure sometimes called debulking) as well as any involved surrounding tissue, including regional lymph nodes? a. diagnostic b. primary treatment c. prophylactic d. palliative e. reconstructive

b. primary treatment

What management for cancer irradiates the diseased parts? a. surgery b. radiation therapy c. chemotherapy

b. radiation therapy

Which level of prevention is occurring when survivors are assessed for the development of second malignancies such as lymphoma and leukemia, which have been associated with certain chemotherapy agents and the use of radiation therapy? a. primary b. secondary c. tertiary

c. tertiary

What may be used to cure cancer, as in thyroid carcinomas, localized cancers of the head and neck, and cancers of the cervix? It may also be used to control cancer when a tumor cannot be removed surgically or when local nodal metastasis is present. It can be used as palliative therapy to relieve the symptoms of locally advanced or metastatic disease, especially when the cancer has spread to the brain, bone, or soft tissue, or to treat oncologic emergencies, such as superior vena cava syndrome, bronchial airway obstruction, or spinal cord compression. a. surgery b. radiation therapy c. chemotherapy

b. radiation therapy

What type of prevention is screening colonoscopy and villous adenoma excision for cervical cancer? a. primary b. secondary c. tertiary

b. secondary

What type of prevention is screening cytology, HPV testing, and HSIL treatment for cervical cancer? a. primary b. secondary c. tertiary

b. secondary

What type of prevention is screening mammography, DCIS treatment for breast cancer? a. primary b. secondary c. tertiary

b. secondary

Which level of prevention involves screening and early detection activities that seek to identify precancerous lesions and early-stage cancer in individuals who lack signs and symptoms of cancer? a. primary b. secondary c. tertiary

b. secondary

Which level of prevention is occurring when women undergo regular screening mammography starting at age 45 year? a. primary b. secondary c. tertiary

b. secondary

A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis? a) White, cottage cheese-like patches on the tongue b) Rust-colored sputum c) Red, open sores on the oral mucosa d) Yellow tooth discoloration

c) Red, open sores on the oral mucosa

A patient with brain tumor is undergoing radiation and chemotherapy for treatment of cancer. Of late, the patient is complaining of swelling in the gums, tongue, and lips. Which of the following is the most likely cause of these symptoms? a) Neutropenia b) Extravasation c) Stomatitis d) Nadir

c) Stomatitis

Which precautions should a nurse include in the care plan for a client with leukemia and neutropenia? a. Provide a clear liquid, low-sodium diet. b. Put on a mask, gown, and gloves when entering the client's room. c. Eliminate fresh fruits and vegetables, avoid using enemas, and practice frequent hand washing. d. Have the client use a soft toothbrush and electric razor, avoid using enemas, and watch for signs of bleeding.

c. Eliminate fresh fruits and vegetables, avoid using enemas, and practice frequent hand washing. Neutropenia occurs when the absolute neutrophil count falls below 1,000/mm3, reflecting a severe risk of infection. The nurse should provide a low-bacterial diet, which means eliminating fresh fruits and vegetables, avoiding invasive procedures such as enemas, and practicing frequent hand washing. Using a soft toothbrush, avoiding straight-edged razors and enemas, and monitoring for bleeding are precautions for clients with thrombocytopenia. Putting on a mask, gown, and gloves when entering the client's room are reverse isolation measures. A neutropenic client doesn't need a clear liquid diet or sodium restrictions.

A client with leukemia has developed a cough and increased fatigue. What is the primary nursing intervention? a. Medicate the client to relieve pain. b. Place a cooling blanket on the client. c. Evaluate the client for potential infection. d. Administer an antitussive.

c. Evaluate the client for potential infection.

What type of radiotherapy is the placement of radioactive sources within or immediately next to the cancer site in order to provide a highly targeted, intense dose of radiation beyond a dose that is usually provided by EBRT? In addition, this form of radiation delivery helps to spare exposure to normal surrounding tissue. a. external radiation (proton beam) b. internal radiation c. brachytherapy d. toxicity

c. brachytherapy

What involves the use of antineoplastic drugs in an attempt to destroy cancer cells by interfering with cellular functions, including replication and DNA repair? It is used primarily to treat systemic disease rather than localized lesions that are amenable to surgery or radiation. It may be combined with surgery, radiation therapy, or both to reduce tumor size preoperatively (neoadjuvant), to destroy any remaining tumor cells postoperatively (adjuvant), or to treat some forms of leukemia or lymphoma (primary). The goals are to (cure, control, or palliation) and must be realistic because they will determine the medications that are used and the aggressiveness of the treatment plan. a. surgery b. radiation therapy c. chemotherapy

c. chemotherapy

What management for cancer treats with medication? a. surgery b. radiation therapy c. chemotherapy

c. chemotherapy

What diagnostic test for cancer is the use of x-rays that identify contrasts in body tissue densities; may involve the use of contrast agents? a. tumor marker identification b. genetic tumor markers c. fluoroscopy d. ultrasonography e. endoscopy

c. fluoroscopy

What diagnostic test for cancer is the use of x-ray images of the breasts? a. tumor marker identification b. genetic tumor markers c. mammography d. MRI e. CT scan

c. mammography

What type of surgery involves removing non-vital tissues or organs that are at increased risk of developing cancer? a. diagnostic b. primary treatment c. prophylactic d. palliative e. reconstructive

c. prophylactic

What type of prevention are interventions to prevent breast cancer progression or recurrence? a. primary b. secondary c. tertiary

c. tertiary

What type of prevention is the early detection of cancer progression or recurrence for cervical cancer? a. primary b. secondary c. tertiary

c. tertiary

Which level of prevention efforts focus on monitoring for and preventing recurrence of the primary cancer as well as screening for the development of second malignancies in cancer survivors? a. primary b. secondary c. tertiary

c. tertiary

What is associated with radiation therapy are most often localized in the region being irradiated and may be increased if concomitant chemotherapy is given? Acute or early most often begin within 2 weeks of the initiation of treatment occur when normal cells within the treatment area are damaged and cellular death exceeds regeneration. Body tissues most affected are those that normally proliferate rapidly, such as the skin, the epithelial lining of the gastrointestinal tract, and the bone marrow (alopecia). a. external radiation (proton beam) b. internal radiation c. brachytherapy d. toxicity

d. toxicity

What diagnostic test for cancer are high-frequency sound waves echoing off body tissues are converted electronically into images; used to assess tissues deep within the body? a. tumor marker identification b. genetic tumor markers c. fluoroscopy d. ultrasonography e. endoscopy

d. ultrasonography

What diagnostic test for cancer is the use of narrow-beam x-ray to scan successive layers of tissue for a cross-sectional view? a. tumor marker identification b. genetic tumor markers c. mammography d. MRI e. CT scan

e. CT scan

What diagnostic test for cancer is the direct visualization of a body cavity or passageway by insertion of an endoscope into a body cavity or opening; allows tissue biopsy, fluid aspiration, and excision of small tumors? Used for diagnostic and therapeutic purposes. a. tumor marker identification b. genetic tumor markers c. fluoroscopy d. ultrasonography e. endoscopy

e. endoscopy

What diagnostic test for cancer uses IV injection or ingestion of radioisotope substances followed by imaging of tissues that have concentrated the radioisotopes? a. tumor marker identification b. genetic tumor markers c. fluoroscopy d. ultrasonography e. nuclear medicine imaging

e. nuclear medicine imaging

What type of surgery may follow curative or extensive surgery in an attempt to improve function or obtain a more desirable cosmetic effect? It may be performed in one operation or in stages. It may be indicated for breast, head and neck, and skin cancers. a. diagnostic b. primary treatment c. prophylactic d. palliative e. reconstructive

e. reconstructive