Cancer- Chapter 15

A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention? A. The I.V. site is red and swollen. B. The client states he is nauseous. C. The laboratory reports a white blood cell (WBC) count of D. 1,000/mm3. The client begins to shiver.

A. The I.V. site is red and swollen

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

alopecia

hair loss

A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: Tis, N0, M0. What does this classification mean? A. No evidence of primary tumor, no abnormal regional lymph nodes, and no evidence of distant metastasis B. Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis C. Can't assess tumor or regional lymph nodes and no evidence of metastasis D. Carcinoma in situ, no demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis

B. Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis

A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the bestteaching by the nurse? A. It stimulates the immune system against the tumor cells. B. It treats drug-related anemia. C. It prevents alopecia. D. It lowers serum and uric acid levels.

D. It lowers serum and uric acid levels

During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior? A. Promotion B. Initiation C. Prolongation D. Progression

D. Progression

A client is receiving radiation therapy and asks the nurse about oral hygiene. What teaching specific to the client's situation should the nurse include? A. gargle after each meal B. floss before going to bed C. treat cavities immediately D. use a soft toothbrush and allow it to air dry before storing

D. use a soft toothbrush and allow it to air dry before storing

A nurse is teaching a community class about how to decrease the risk of cancer. Which food should the nurse recommend? A. low-fat hot dogs B. smoked ham C. oranges D. medium-rare steak

C. oranges

Which oncologic emergency involves the accumulation of fluid in the pericardial space?

Cardiac tamponade

What is the best way for the nurse to assess the nutritional status of a patient with cancer? A. Weigh the patient daily. B. Monitor daily caloric intake. C. Observe for proper wound healing. D. Assess BUN and creatinine levels.

A. Weigh the patient daily

Which statement is true about malignant tumors? A. They demonstrate cells that are well differentiated. B. They gain access to the blood and lymphatic channels. C. They usually grow slowly. D. They grow by expansion.

B. They gain access to the blood and lymphatic channels

aniogenesis

growth of new blood vessels that allow cancer cells to grow

malignant

having cells or processes that are characteristic of cancer

The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant?

monitor closely to prevent infection

myelosuppression

suppression of the blood cell-producing function of the bone marrow

radiation therapy

the use of ionizing radiation to kill malignant cells

After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? A. Serving small portions of bland food B. Encouraging rhythmic breathing exercises C. Administering metoclopramide and dexamethasone as ordered D. Withholding fluids for the first 4 to 6 hours after chemotherapy administration

C. Administering metoclopramide and dexamethasone as ordered

A patient is scheduled for cryoablation for cervical cancer and tells the nurse, "I am not exactly sure what the surgeon is going to do." What is the best response by the nurse?

The surgeon is going to use liquid nitrogen to freeze the area

extravasation

leakage of intravenous medication from veins into the subcutaneous tissues

nadir

lowest point of white blood cell depression after therapy that has toxic effects on the bone marrow

leading causes of cancer death in women

lung, breast, colorectal

leading causes of cancer death in men

lung, prostate, and colorectal

the incidence of cancer is higher in what gender?

men

According to the TNM classification system, T0 means there is

no evidence of primary tumor

palliation

relief of symptoms and promotion of comfort and quality of life

metastasis

spread of cancer cells from the primary tumor to distant sites

chemotherapy

the use of medications to kill tumor cells by interfering with cellular functions and reproduction

apoptosis

normal cell mechanism of programmed cell death

benign

not cancerous; may grow but unable to spread to other organs or body parts

anaplasia

pattern of growth in which cells lack normal characteristics and differ in shape and organization with respect to their cells of origin; usually, anaplastic cells are malignant

staging

process of determining the extent of disease, including tumor size and spread or metastasis to distant sites

carcinogensis

process of transforming normal cells into malignant cells

A client with a brain tumor is undergoing radiation and chemotherapy for treatment of cancer. The client has recently reported swelling in the gums, tongue, and lips. Which is the most likely cause of these symptoms?

stomatitis

oncology

study of cancer

cytokines

substances produced primarily by cells of the immune system to enhance production and functioning of components of the immune system to enhance production and functioning of components of the immune system

vesicant

subtance that can cause inflammation, damage, and necrosis with extravasation from blood vessels and contact with tissues

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. Avoiding using soap on the irradiated areas B. Applying talcum powder to the irradiated areas daily after bathing C. Wearing a lead apron during direct contact with the client D. Removing thoracic skin markings after each radiation treatment

A. Avoiding using soap on the irradiated areas

A side-effect of chemotherapy is renal damage. To prevent this, the nurse should:

Encourage fluid intake, if possible, to dilute the urine.

Which oncologic emergency involves the failure in the negative feedback mechanism that normally regulates the release of antidiuretic hormone (ADH)?

syndrome of inappropriate atidiuretic hormone release (SIADH)

graft-versus-tumor effect

the donor immune cell response against the malignancy; a desirable response

neutropenia

abnormally low absolute neutrophil count

graft-versus-host disease (GVHD)

an immune response initiated by T lymphocytes of donor tissue against the recipient's tissues (skin, gastrointestinal tract, liver); an undesirable response

targeted therapies

cancer treatments that seek to minimize the negative effects on healthy tissues by disrupting specific cancer cell functions, such as malignant transformation, communication pathways, processes for growth and metastasis, and genetic coding

carcinogens

chemicals, physical factors, and other agents that cause cancer

thrombocytopenia

decrease in the number of circulating platelets; associated with the potential for bleeding

brachytherapy

delivery of radiation therapy through internal implants placed inside or adjacent to the tumor

cancer

group of disorders characterized by abnormal cell proliferation, in which cells ignore growth-regulating signals in the surrounding enviornment

neoplasia

uncontrolled cell growth that follows no physiologic demand

precision medicine

using advances in research, technology, and policies to develop individualized plans of care to prevent and treat disease

A client has been receiving chemotherapy. Upon assessing the client during morning rounds, the nurse notes the client is now bleeding from intravenous and venipuncture sites. Stool is positive for occult blood. The client is requesting to sit in a chair for a meal. The nurse implements the following interventions: (Select all that apply.) A. monitor vitals signs once a shift B. assess level of consciousness C. assist the client to a chair D. apply pressure to the bleeding sites E. check intake and output records

B. assess level of consciousness D. apply pressure to the bleeding sites E. check intake and output records

The nurse is working with a client who has had an allo-hematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of A. nadir. B. graft-versus-host disease. C. metastasis. D. acute leukopenia.

B. graft-versus-host disease

A client diagnosed with cancer makes the following statement to the nurse: "I guess I will tell my health care provider to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die." Which of the following facts supports the use of chemotherapy for this client? A. Nausea and vomiting are only a factor for the first 24 hours after treatment. B. Most clients believe the discomfort is well worth the cure for cancer. C. Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects. D. Clinical trials are opening up new cancer treatments all the time.

C. Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects

A client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer? A. Persistent nausea B. Rash C. Indigestion D. Chronic ache or pain

C. Indigestion

The nurse is caring for a client with cancer who is treating her cancer with deep-tissue massage in addition to radiation therapy. The nurse documents the use of which therapy on the client's chart? A. Alternative therapy B. Global medicine C. Integrative medicine D. Compliant medicine

C. Integrative medicine

A client diagnosed with cancer has his tumor staged and graded based on what factors?

how they tend to grow and the cell type

grading

identification of the type of tissue from which the tumor originated and the degree to which the tumor cells retain the functional and structural characteristics of the tissue of origin

mucositis

inflammation of the lining of the mouth, throat, and gastrointestinal tract often associated with cancer therapies

stomatitis

inflammation of the oral tissues, often associated with some chemotherapeutic agents and radiation therapy to the head and neck region