Cancer-220
A 40-year-old divorced mother of four school-age children is hospitalized with metastatic ovarian cancer. The nurse finds the patient crying, and she tells the nurse that she does not know what will happen to her children when she dies. The most appropriate response by the nurse is a. "Why don't we talk about the options you have for the care of your children?" b. "Perhaps your ex-husband will take the children when you can't care for them." c. "For now you need to concentrate on getting well, not worry about your children." d. "Many patients with cancer live for a long time, so there is time to plan for your children."
A
A chemotherapeutic agent known to cause alopecia is prescribed for a patient. To maintain the patient's self-esteem, the nurse plans to a. suggest that the patient limit social contacts until regrowth of the hair occurs. b. encourage the patient to purchase a wig or hat and wear it once hair loss begins. c. have the patient wash the hair gently with a mild shampoo to minimize hair loss. d. inform the patient that the hair will grow back once the chemotherapy is complete.
B
A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the RN caring for the patient indicates that the nurse should take action? a. The patient ambulates several times a day in the room. b. The patient's visitors bring in some fresh peaches from home. c. The patient cleans with a warm washcloth after having a stool. d. The patient uses soap and shampoo to shower every other day.
B
After the nurse has finished teaching a patient who is scheduled to receive external beam radiation for abdominal cancer about appropriate diet, which dietary selection by the patient indicates that the teaching has been effective? a. Fresh fruit salad b. Roasted chicken c. Whole wheat toast d. Cream of potato soup
B
The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient may indicate a need for a change in treatment? a. "I have frequent muscle aches and pains." b. "I rarely have the energy to get out of bed." c. "I experience chills after I inject the interferon." d. "I take acetaminophen (Tylenol) every 4 hours."
B
A patient with Hodgkin's lymphoma who is undergoing external radiation therapy tells the nurse, "I am so tired I can hardly get out of bed in the morning." An appropriate intervention for the nurse to plan with the patient is to a. minimize activity until the treatment is completed. b. exercise vigorously when fatigue is not as noticeable. c. establish a time to take a short walk almost every day. d. consult with a psychiatrist for treatment of depression.
C
A patient with ovarian cancer is distressed because her husband rarely visits and tells the nurse, "He just doesn't care." The husband indicates to the nurse that "I never know what to say to help her." An appropriate nursing diagnosis is a. compromised family coping related to disruption in lifestyle. b. impaired home maintenance related to perceived role changes. c. risk for caregiver role strain related to burdens of caregiving responsibilities. d. dysfunctional family processes related to effect of illness on family members.
D
While caring for a patient who is at the nadir of chemotherapy, the nurse establishes the highest priority for the nursing diagnosis of
Risk for Infection
When caring for a patient who is pancytopenic, which action by nursing assistive personnel (NAP) indicates a need for the RN to intervene? a. The NAP assists the patient to use dental floss after eating. b. The NAP adds baking soda to the patient's saline oral rinses. c. The NAP puts fluoride toothpaste on the patient's toothbrush. d. The NAP has the patient rinse after meals with a saline solution.
A
Which information obtained by the nurse about a patient with colon cancer who is scheduled for external radiation therapy to the abdomen indicates a need for patient teaching? a. The patient swims a mile 5 days a week. b. The patient has a history of dental caries. c. The patient eats frequently during the day. d. The patient showers with Dove soap daily.
A
A patient is receiving radiation to the head and neck and complains of mouth sores and pain. Which intervention should the nurse add to this patient's plan of care? a. Cleanse the mouth every 2 to 4 hours with hydrogen peroxide B. Apply palifermin (Kepivance) as a topical anesthetic. C. Provide high-protein and high-calorie, soft foods every 2 hours. D. Weigh the patient every month to monitor for weight loss.
C
The nurse assesses a 76-year-old man with chronic myeloid leukemia receiving nilotinib (Tasigna). It is most important for the nurse to ask which question? A. "Have you had a fever?" B. "Have you lost any weight?" C. "Has diarrhea been a problem?" D. "Have you noticed any hair loss?"
A
A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. Which patient statement indicates that the nurse's teaching about management of the skin reaction has been effective? a. "I can buy some aloe vera gel to use on the area." b. "I will expose the treatment area to a sun lamp daily." c. "I can use ice packs to relieve itching in the treatment area." d. "I will scrub the area with warm water to remove the scales."
A
Interleukin-2 (IL-2) is used as adjuvant therapy for a patient with metastatic renal cell carcinoma. The nurse teaches the patient that the purpose of therapy with this agent is to a. enhance the patient's immunologic response to tumor cells. b. stimulate malignant cells in the resting phase to enter mitosis. c. prevent the bone marrow depression caused by chemotherapy. d. protect normal cells from the harmful effects of chemotherapy.
A
When reviewing the chart for a patient with cervical cancer, the nurse notes that the cancer is staged as Tis, N0, M0. The nurse will teach the patient that a. the cancer is localized to the cervix. b. the cancer cells are well-differentiated. c. further testing is needed to determine the spread of the cancer. d. it is difficult to determine the original site of the cervical cancer.
A
The nurse at the clinic is interviewing a 64-year-old woman who is 5 feet, 3 inches tall and weighs 125 pounds (57 kg). The patient has not seen a health care provider for 20 years. She walks 5 miles most days and has a glass of wine 2 or 3 times a week. Which topics will the nurse plan to include in patient teaching about cancer screening and decreasing cancer risk (select all that apply)? a. Pap testing b. Tobacco use c. Sunscreen use d. Mammography e. Colorectal screening
A, C, D, E
When caring for a patient with a temporary radioactive cervical implant, which action by nursing assistive personnel (NAP) indicates that the RN should intervene? a. The NAP flushes the toilet once after emptying the patient's bedpan. b. The NAP stands by the patient's bed for 30 minutes talking with the patient. c. The NAP places the patient's bedding in the laundry container in the hallway. d. The NAP gives the patient an alcohol-containing mouthwash to use for oral care.
B
The nurse in the outpatient clinic is caring for a 50-year-old who smokes heavily. To reduce the patient's risk of dying from lung cancer, which action will be best for the nurse to take? a. Educate the patient about the seven warning signs of cancer. b. Plan to monitor the patient's carcinoembryonic antigen (CEA) level. c. Discuss the risks associated with cigarettes during every patient encounter. d. Teach the patient about the use of annual chest x-rays for lung cancer screening.
C
The nurse teaches a patient with cancer of the liver about high-protein, high-calorie diet choices. Which snack choice by the patient indicates that the teaching has been effective? a. Orange sherbet b. Fresh fruit salad c. Strawberry yogurt d. Cream cheese bagel
C
The nurse is caring for a patient receiving intravesical bladder chemotherapy. The nurse should monitor for which adverse effect? a. Nausea b. Alopecia c. Mucositis d. Hematuria
D
The nurse is teaching a postmenopausal patient with stage III breast cancer about the expected outcomes of her cancer treatment. Which patient statement indicates that the teaching has been effective? a. "After cancer has not recurred for 5 years, it is considered cured." b. "The cancer will be cured if the entire tumor is surgically removed." c. "Cancer is never considered cured, but the tumor can be controlled with surgery, chemotherapy, and radiation." d. "I will need to have follow-up examinations for many years after I have treatment before I can be considered cured."
D
Which finding in a patient who is receiving interleukin-2 indicates a need for rapid action by the nurse? a. Generalized muscle aches b. Complaints of nausea and anorexia c. Oral temperature of 100.6° F (38.1° C) d. Crackles heard at the lower scapular border
D
Which nursing action will be most effective in improving oral intake for a patient with the nursing diagnosis of imbalanced nutrition: less than body requirements related to painful oral ulcers? a. Offer the patient frequent small snacks between meals. b. Assist the patient to choose favorite foods from the menu. c. Provide education about the importance of nutritional intake. d. Apply the ordered anesthetic gel to oral lesions before meals.
D
during initial chemotherapy, a patient with leukemia develops hyperkalemia and hyperuricemia. The nurse recognizes these symptoms as an oncologic emergency and anticipates that the priority treatment will be:
Increasing urine output with hydration therapy
A side effect common to biologic therapies is
flu-like symptoms
