Adult Oncology Saunders Q's

The nurse is preparing a client for an intravesical instillation of an alkylating chemotherapeutic agent into the bladder for the treatment of bladder cancer. The nurse provides instructions to the client regarding the procedure. Which client statement indicates an understanding of this procedure?

"After the instillation is done, I will need to change position every 15 minutes from side to side.

The nurse is assisting in preparing a teaching plan of care for a client being discharged from the hospital following surgery for testicular cancer. Which instruction would the nurse suggest to include in the plan?

"An elevation in temperature should be reported to the primary health care provider."

The nurse is reinforcing instructions to a group of high school males in a health class about how to perform a testicular self-examination (TSE). The nurse would make which statement?

"Do the examination after a warm bath or shower."

The nurse is obtaining data from a client admitted with a diagnosis of bladder cancer. Which question would the nurse ask the client to determine if the client experienced the most common symptom associated with this type of cancer?

"Do you notice any blood in the urine?"

The nurse is collecting data from a client suspected of having ovarian cancer. Which question would the nurse ask the client to elicit information specifically related to this disorder?

"Does your abdomen feel as though it is swollen?"

A client with carcinoma of the breast is admitted to the hospital for treatment with intravenous vincristine. The client tells the nurse that she has been told by her friends that she is going to lose all her hair. After offering an open-ended question in reply, the client expresses how she feels. The nurse then gives the client information. The nurse makes which appropriate response to the client?

"Hair loss may occur, and it will grow back, but it may have a different color or texture."

The nurse is collecting data from a client who is admitted to the hospital for diagnostic studies to rule out the presence of Hodgkin's disease. Which question would the nurse ask the client to elicit information specifically related to this disease?

"Have you noticed any swollen lymph nodes?"

The nurse is caring for a client who has undergone pelvic exenteration. In addressing psychosocial issues related to the surgery, which statement by the nurse would be therapeutic?

"How do you feel about this surgery?"

The nurse caring for a client following a radical neck dissection and creation of a tracheostomy performed for laryngeal cancer is reinforcing discharge instructions to the client. Which statement by the client indicates the need for further teaching regarding care of the stoma?

"I need to use an air conditioner to provide cool air to assist in breathing."

The nurse has reinforced discharge instructions regarding home care to a client following a prostatectomy for cancer of the prostate. He is being discharged with an indwelling urinary catheter. Which statement by the client indicates a need for further teaching?

"I should use the leg bag when I am in bed during the night."

A client with breast cancer has been given a prescription for cyclophosphamide. The nurse determines that the client understands the proper use of the medication if the client makes which statements? Select all that apply.

"I will increase fluid intake to 2 to 3 L/day." "I will observe my urine carefully for signs of bleeding."

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.

- Alopecia - Elevation in prostate specific antigen (PSA) levels

The nurse is collecting data from a client with a history of bladder cancer. Which signs/symptoms would the nurse expect the client to report? Select all that apply.

- Dysuria - hematuria - urgency of urination - frequency of urination

A client with endometrial cancer is receiving doxorubicin, an antineoplastic agent. The nurse would specifically collect data about which criteria? Select all that apply.

- EKG - hematological lab values

The nurse is developing a teaching plan for a client following a radical mastectomy and includes measures that will assist in preventing lymphedema of the affected arm. The nurse would include which interventions when reviewing instructions with the client to prevent this complication? Select all that apply.

- Elevate the affected arm on a pillow higher than the heart. - Instruct the client to perform simple arm exercises in the affected arm daily. - Inspect the arm daily and notify the primary health care provider of redness or swelling.

The nurse is caring for a client after a mastectomy. Which nursing interventions would assist with preventing lymphedema of the affected arm? Select all that apply.

- Elevating the affected arm on a pillow above heart level - Taking no blood pressure measurements in the affected arm

A client with ovarian cancer is scheduled to receive chemotherapy with cisplatin. The nurse assisting in caring for the client reviews the plan of care, expecting to note which interventions? Select all that apply.

- Encourage fluids - monitor serum BUN and creatinine levels

The nurse is reviewing the medical history of a client admitted to the hospital with a diagnosis of colorectal cancer. The nurse understands that which information documented in the medical history are risk factors of this type of cancer? Select all that apply.

- Family history of colon cancer - A history of inflammatory bowel disease - Regular consumption of red or processed meats - Regular consumption of a diet high in fats and carbohydrates

The nurse is assisting in planning care for a client with Hodgkin's disease who is neutropenic as a result of radiation and chemotherapy. Which actions would be included in the client's plan of care? Select all that apply.

- Monitor white blood cell counts daily - Ensure meticulous hand washing before caring for the client - Ask visitors with respiratory infection symptoms to not visit the client.

The nurse is assisting in developing a postoperative plan of care for a client following a right mastectomy. Which interventions will be included in the plan of care? Select all that apply.

- Place the right arm on a pillow. - Monitor the right arm for edema. - Check the incision for approximation. - Monitor and measure drainage in the Jackson-Pratt drain. - Place a notation: "No intravenous (IVs), blood draws, or blood pressure readings in right arm."

The nurse is caring for a client with an internal radiation implant. The nurse would observe which principles? Select all that apply.

- Pregnant women are not allowed into the client's room - Wear a lead apron while delivering bedside care to the client.

The nurse is performing oral care for a newly admitted client who is undergoing chemotherapy for thyroid cancer. The nurse would take which actions while performing oral care? Select all that apply.

- Provide a soft toothbrush. - Check oral mucous membranes. - check for missing teeth and cavities

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.

- Restricting fresh fruits and vegetables in the diet - Applying a face mask to the client if outside the client room

A client who has terminal cancer has been experiencing a significant increase in pain. However, today the client is no longer complaining of pain but is quiet and isolative. Which types of therapeutic communication would the nurse employ? Select all that apply.

- Sit by client's bed holding his or her hand. - Reminisce with the client and share a humorous story that the client enjoys. - The nurse asks: "What can I do that might make you feel more comfortable today?" - The nurse asks: "I noticed you grimacing earlier when I walked in your room. Are you in pain?" - The nurse states: "It must be very frustrating to be in pain and not be able to get complete relief from your pain."

The nurse is assisting in providing a session to community members about the risks associated with laryngeal cancer. A client indicates an understanding of the risks by listing which factors? Select all that apply.

- Smoking cigarettes or cigars - Drinking alcohol, especially daily - working in a dusty environment - persistent exposure to chemicals in the air - following a diet low in protein and vitamins

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? Select all that apply.

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

The nurse is reinforcing instructions to a client on performing a testicular self-examination (TSE). Which instructions would the nurse provide to the client? Select all that apply.

- The best time for the examination is after a shower. - Set up a schedule of performing TSE on the same day each month.

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.

- apply pressure on the radiated area to prevent bleeding - avoid standing within six feet of the persons under the age of 18

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

- encouraging fluids - monitoring serum Ca and uric acid levels

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

- institute safety measures - monitor sodium blood levels - gather neuro status data - administer antagonistic to ADH

The nurse is assisting with conducting a health-promotion program at a local school. The nurse determines that there is a need for further teaching if a student identifies which risk factors associated with cancer? Select all that apply.

- low fat and high fiber diets - maintaining a normal weight

The nurse is reviewing the laboratory results of a client who is receiving chemotherapy and notes that the platelet count is 10,000 mm3 (10 × 109/L). On the basis of this laboratory value, the nurse would perform which interventions? Select all that apply.

- monitor stools for occult blood - instruct the client not to bend over at the waist or lift - instruct the client to blow nose very gently without blocking either nostril

A client with cancer has undergone a total abdominal hysterectomy and has an indwelling Foley catheter in place. The nurse would expect to note which types of urinary drainage immediately following this surgery? Select all that apply.

- pale - light amber

The nurse is caring for a client who will have insertion of an internal cervical radiation implant. Which interventions would the nurse review with the client to prepare her for this procedure? Select all that apply.

- the clients activity will be bed rest - the client will have an indwelling catheter placed - caregivers will wear lead shields while caring for the client

A client with liver cancer who is receiving chemotherapy tells the nurse that some foods on the meal tray taste bitter, especially meats. The nurse would instruct the client to eat which foods instead of meat? Select all that apply.

- yogurt - custard

The nurse is reinforcing client education regarding symptoms of testicular cancer. The nurse encourages the client to report which symptoms as being associated with testicular cancer? Select all that apply.

A grainy mass palpated in a testicle An enlargement of one of the testes

The nurse is reviewing the laboratory results of a client receiving chemotherapy for cancer. The nurse reports which abnormal result to the primary health care provider?

A platelet count of 40,000/mm3

When reinforcing teaching about signs and symptoms of ovarian cancer with a community group of women, the nurse emphasizes which sign/symptom as being a typical manifestation of the disease recognized by persons diagnosed with the condition?

Abdominal distention or fullness

The nurse is reinforcing instructions to a group of adults about the seven warning signs of cancer. The nurse determines that a member of the group needs further teaching if the member states which sign/symptom is a warning sign?

Absence or decreased frequency of menses

The nurse is orienting a new nurse to the care of a client who has an internal radiation implant. Which statement by the new nurse demonstrates the need for further teaching?

After visiting hours, the client may be put in a wheel chair and taken out of the room.

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?

Arm edema on the operative side

The nurse is caring for a client with metastatic lung cancer. The client was medicated 2 hours ago and now reports a new and sudden sharp pain in the back. The nurse appropriately interprets this finding as possible spinal cord compression. Which would the nurse do next?

Ask the client about numbness and tingling in all the extremities.

A client receiving chemotherapy asks the nurse, "What will I do when my hair starts to fall out?" Which action by the nurse is therapeutic?

Assist her to express feelings.

The nurse reviews the care plan of a client with cancer and notes that the client has a problem with adequate food intake related to side effects of therapy. In order to enhance appetite and nutrition, the nurse would offer which advice to the client?

Avoid strong smelling foods

The nurse working in an obstetrical-gynecological primary health care provider's office is instructing a small group of premenopausal female clients about breast self-examination (BSE). Which instruction would the nurse reinforce as the first step to begin the BSE?

BSE begins with inspection of the breast standing before a mirror.

A client is diagnosed as having a bowel tumor, and several diagnostic tests are prescribed. The nurse reinforces instructions to the client and includes information that which test will confirm the diagnosis of malignancy?

Biopsy of the tumor

Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse assists in planning care, knowing that which is the primary action of this medication?

Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.

A gastrectomy is performed on a client with gastric cancer. In the immediate postoperative period, the nurse notes bloody drainage from the nasogastric (NG) tube. Which action would the nurse take?

Continue to monitor the drainage

The nurse is assisting in the care of a client diagnosed with multiple myeloma who has been prescribed an intravenous solution of 0.9% normal saline at 125 mL per hour. Which finding would indicate a positive response to this treatment?

Creatinine of 1 mg/dL

The nurse is reviewing the record of a client admitted to the hospital for treatment of bladder cancer. Which risk factor related to this type of cancer would the nurse likely note in the client's record?

Drinks coffee and smokes cigarettes

The nurse is assisting in caring for a client with an inoperable lung tumor and helps develop a plan of care by addressing complications related to the disorder. The nurse includes monitoring for the early signs of vena cava syndrome in the plan. Which early sign of this oncological emergency would the nurse include monitoring for in the plan of care?

Edema of the face and eyes

The nurse is monitoring a client on chemotherapy for signs and symptoms related to tumor lysis syndrome. The nurse understands that which is an early sign of this oncological emergency?

Elevated potassium

The nurse discusses the risk factors associated with gastric cancer as part of a health promotion program. The nurse determines that there is a need for further teaching if a member attending the program states that which factor is a risk?

High meat and carbohydrate consumption

The nurse is reviewing the record of a client with a diagnosis of cervical cancer. Which would the nurse expect to note in the client's record related to a risk factor associated with this type of cancer?

Hx of HPV infection

The nurse is reviewing the laboratory results of a client who has been diagnosed with multiple myeloma. Which finding would the nurse expect to note with this diagnosis?

Increased calcium level

The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse note as a result of the massive cell destruction that occurred from the chemotherapy?

Increased uric acid level

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?

Increased uric acid levels

The nurse is teaching a local women's church group about the risks of cervical cancer. The nurse determines that there is a need for further teaching if a group member states that which is a risk factor?

Intercourse with circumcised males

The nurse is reinforcing instructions to a community group regarding the risks and causes of bladder cancer. The nurse determines that there is a need for further teaching if a member of the community group makes which statement regarding this type of cancer?

It most often occurs in women

The nurse is reinforcing information regarding chemotherapy with a client who has been diagnosed with cancer. The nurse tells the client that which is an advantage of continuous intravenous (IV) chemotherapy?

It uses smaller doses to kill cancer cells, so it is less toxic to normal tissues.

The nurse is reinforcing instructions to the client on how to maintain optimal skin integrity during external radiation therapy. The nurse determines that there is a need for further teaching if the client states plans to do which action?

Keep at least 6 feet away from pregnant women especially in the first 3 months.

A client is receiving radiation therapy to the brain because of a diagnosis of a brain tumor. Which sign/symptom of the client is noted to be a positive outcome of the radiation therapy?

Less severe headache

A client who has been diagnosed with multiple myeloma asks the nurse about the diagnosis. The nurse bases the response on which characteristic of the disorder?

Malignant proliferation of plasma cells and tumors within the bone

The nurse reinforces the teaching plan for a client with a family history of breast cancer. Which teaching point would be included?

Measures to prevent and screen for cancer

The nurse is assisting in caring for a client with a diagnosis of bladder cancer who recently received chemotherapy. The nurse receives a telephone call from the laboratory, which reports that the client's platelet count is 20,000 mm3. Based on this laboratory value, the nurse revises the plan of care and suggests including which interventions? Select all that apply.

Monitor skin for the presence of petechiae.

A client with cancer is receiving chemotherapy and develops thrombocytopenia. Which intervention is a priority in the nursing plan of care?

Monitor the client for bleeding

A nursing student is assisting in caring for a client with a lung tumor; the client will be having a pneumonectomy. The nursing instructor reviews the postoperative plan of care developed by the student and suggests deleting which item from the plan?

Monitoring the closed chest tube drainage system

The nurse is reviewing the laboratory results of a client with bladder cancer and bone metastasis and notes that the calcium level is 15 mg/dL. The nurse would take which appropriate action?

Notify the PHCP

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 would take which appropriate action?

Notify the RN immediately

A nursing instructor asks a nursing student about the characteristics of Hodgkin's disease. The instructor determines that the student needs additional study if the student states that which is an associated characteristic?

Occurs most often in older adults

The nurse is reinforcing instructions to a group of female clients about breast self-examination (BSE). When would the nurse instruct the pre-menopausal client to perform this examination?

One week after menstruation begins

The nurse is reinforcing instructions to a client scheduled for conization in 1 week for the treatment of microinvasive cervical cancer. The procedure has been explained by the primary health care provider, and the nurse is reviewing the complications associated with the procedure. The nurse determines that the client needs further teaching if the client states that which is a complication of this procedure?

Ovarian perforation

A client is tentatively diagnosed with ovarian cancer. The nurse gathers data about which late symptom of this disease?

Pelvic pain, anemia, and ascites

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?

Pick up the implant with long-handled forceps and place into a lead container.

A cervical radiation implant is placed in the client for treatment of cervical cancer. Which intervention would the nurse most likely expect to note in the primary health care provider's prescriptions?

Place an indwelling urinary catheter

The nurse would monitor for which laboratory result as indicating an adverse reaction in the client who is receiving chemotherapy?

Platelet count 20,000 mm3

A client with lung cancer receiving chemotherapy tells the nurse that the food on the meal tray tastes "funny." Which is the appropriate nursing intervention?

Provide oral hygiene care frequently.

The nurse reviews the care plan of a client with cancer undergoing chemotherapy. The nurse notes that the client has a concern about her appearance as a result of alopecia. The nurse plans to tell the client which information about hair loss and regrowth to assist the client in coping with this possible change?

Regrown hair may have a different color and texture.

The nurse is assisting in caring for a client receiving chemotherapy. On review of the morning laboratory results, the nurse notes that the white blood cell count is extremely low, and the client is immediately placed on neutropenic precautions. The client's breakfast tray arrives, and the nurse inspects the meal and prepares to bring the tray into the client's room. Which action would the nurse take before bringing the meal to the client?

Remove the fresh orange from the breakfast tray.

A client with cancer develops white, dough-like patches on the mucous membranes of the oral cavity. Which action would the nurse take when noting this?

Report these symptoms, which are consistent with candidiasis

The nurse is caring for a client in the oncology unit who has developed stomatitis during chemotherapy. The nurse would plan which measure to treat this complication?

Rinse the mouth with dilute baking soda or saline solution

The nurse reviews the laboratory results for a client diagnosed with leukemia who is receiving chemotherapy. The nurse notes that the white blood cell (WBC) count is 2000 mm3. The nurse identifies the finding as indicative of which?

Signifying leukopenia

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.

Sore throat Red and dry skin over the neck

A client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing which?

The development of a vesicovaginal fistula

When inspecting the stoma of a client following an ureterostomy 6 hours ago, the nurse notes that the stoma appears pale in color. Which interpretation does the nurse make based on this finding?

The vascular supply to the stoma is insufficient.

The nurse reinforces instructions to the client about breast self-examination (BSE). The nurse instructs the client to lie down and examine the left breast. Which is the correct area for placing a pillow when examining the left breast?

Under the left shoulder

The nurse is caring for a client dying of cancer. During care, the client states, "If I can just live long enough to attend my daughter's graduation, I'll be ready to die." Which phase of coping is this client experiencing?

bargaining

The nurse is reviewing the health record of a client with laryngeal cancer. The nurse would expect to note which most common risk factor for this type of cancer documented in the record?

cigarette smoking

A client who has just been told by the primary health care provider that she has breast cancer responds by stating, "Oh, no, this has to be a big mistake." The nurse interprets the client's initial response as which type of reaction?

denial

A client is receiving chemotherapy that carries a risk of phototoxicity as an adverse effect. Which finding indicates that the client experienced this side effect?

erythema

The nurse determines that a client with which history is most at risk for endometrial cancer?

estrogen replacement therapy

The client is admitted to the hospital with a diagnosis of suspected Hodgkin's disease. Which signs and symptoms of the client are associated with Hodgkin's disease? Select all that apply.

fatigue weakness night sweats enlarged lymph nodes

A client has just been told by the primary health care provider about her diagnosis of breast cancer. The client responds, "Oh no, does this mean I'm going to die?" The nurse interprets which response as the client's initial reaction?

fear

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

i will limit sun exposure to 1 hour daily i will apply moisturizer with a cotton tipped applicator for itching

A client with which type of cancer is at greatest risk for experiencing the complication vena cava syndrome?

lung cancer

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.

rinse the mouth after meals and use a soft toothbrush maintain oral hygiene and inspect mouth for sores daily consult with HCP before receiving immunizations

The nurse is caring for a client with cancer receiving chemotherapy who has developed stomatitis. The nurse plans to give mouth care by using oral care agents and devices that meet which additional criterion?

the severity of stomatitis

The nurse is preparing a client with a bowel tumor for surgery. The primary health care provider has informed the client that the surgery is palliative in the treatment of the tumor. Which rationale is the reason to perform this type of surgery?

to reduce pain