chapter 18

While completing an admission assessment, the client reports a family history of ovarian cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology? A) Inherited gene mutation B) Smoking and tobacco use C) Exposure to chemicals and spermicides D) Increased tumor suppressor genes

A) Inherited gene mutation

You are a public health nurse giving a talk on the warning signals of cancer to a local community group. Which of the following are the warning signals of cancer? Select all that apply. A) Sores that don't heal B) Unusual bleeding or discharge C) Yellow discoloration of body area D) Tenderness or pain E) Persistent indigestion

A) Sores that don't heal B) Unusual bleeding or discharge D) Tenderness or pain

You are an oncology nurse caring for a client who is taking antineoplastic agents. What adverse symptoms must you monitor for in this client? A) Symptoms of gout B) Symptoms of hypertension C) Symptoms of diarrhea D) Symptoms of anemia

A) Symptoms of gout

Which nursing interventions are most important when implementing care for a client receiving temporary internal sealed radiation therapy? Select all that apply. A) Time, distance, and shielding B) Count wires, threads, or needles every shift C) Maintain indelible skin markings. D) Provide rest periods between treatments. E) Administer treatment through IV access port. F) Avoid standing in direct path of implants.

A) Time, distance, and shielding B) Count wires, threads, or needles every shift F) Avoid standing in direct path of implants.

A client who is being treated for bladder cancer expresses his concern of passing cancer to his wife during intercourse. Which is the best response by the nurse? A) "You should avoid intercourse until your cancer is cured." B) "Cancer is not transferred from person to person via direct contact." C) "I understand you are concerned about your wife, but don't worry." D) "Perhaps you should have your sperm tested for presence of cancer cells."

B) "Cancer is not transferred from person to person via direct contact."

An elderly client has been diagnosed with metastatic cancer and has a poor prognosis of survival. The family asks the nurse for advice on whether to tell the client of the diagnosis or to keep it quiet. Which is the best response from the nurse? A) "I wouldn't tell, if I were you." B) "In my experience, clients who know are more likely to be involved with their plan of care." C) "The shock of learning the diagnosis may be too much stress for an elderly person." D) "This is a private concern that should include the physician, not me."

B) "In my experience, clients who know are more likely to be involved with their

A client with a 4-cm breast mass is scheduled for biopsy with frozen section followed by lumpectomy and possible mastectomy. The client asks the nurse, "Why can't the doctor tell me specifically whether I will need to have my entire breast removed"? Which is the best response from the nurse? A) "The doctor will know which surgery is required, once the tumor is exposed." B) "The frozen section will determine presence of cancer and type of surgery required." C) "You need to trust your doctor to provide you with the best of care." D) "You seem anxious about your upcoming surgery."

B) "The frozen section will determine presence of cancer and type of surgery required."

The client is scheduled for a breast lump excision and sentinel node biopsy. What should the nurse know in planning care for the client with a negative biopsy report? A) A lump excision is not necessary. B) A wide excision of lump will be performed. C) The lump and all axillary lymph nodes will be excised. D) The entire breast and all regional lymph nodes will be excised.

B) A wide excision of lump will be performed.

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) Adjuvant therapy is likely. C) Palliative care is likely. D) Repeat biopsy is needed before treatment begins.

B) Adjuvant therapy is likely.

You are providing client teaching for a client undergoing chemotherapy. What dietary modifications should you advise? A) Eat wholesome meals. B) Avoid spicy and fatty foods. C) Avoid intake of fluids. D) Eat warm or hot foods.

B) Avoid spicy and fatty foods.

The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important? A) Shield your throat area when near others. B) Flush the toilet twice after every use. C) Prepare food separately from family members. D) Use disposable utensils for the next month.

B) Flush the toilet twice after every use.

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? A) Monitor the client's toilet patterns. B) Monitor the client closely to prevent infection. C) Monitor the client's physical condition. D) Monitor the client's heart rate.

B) Monitor the client closely to prevent infection.

While doing a health history, a client tells you that her mother, grandmother, and sister died of cancer. The client wants to know what she can do to keep from getting cancer. What would be your best response? A) "You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is." B) "If you eat right, exercise, and get enough rest, you can prevent breast cancer." C) "With your family history, there is nothing you can do to prevent getting cancer." D) "Cancer often skips a generation, so don't worry about it."

C) "With your family history, there is nothing you can do to prevent getting cancer."

A client with advanced cancer makes the following comment to the nurse: "Why are you bathing me? I am going to die no matter what." What is the most appropriate response of the nurse? A) "A bath will make you feel better." B) "Do you want to skip the bath today?" C) "Would you like to talk about what you are feeling?" D) "I can give you some medicine to make you feel better."

C) "Would you like to talk about what you are feeling?"

7. Which of the following can be considered carcinogens? A) Parasites B) Medical procedures C) Dietary substances D) Infective genes

C) Dietary substances

The physician recommends that you have your daughter vaccinated with HPV vaccine. What is this vaccine for? A) Help prevent lung cancer B) Help prevent breast cancer C) Help prevent cervical cancer D) Help prevent leukemia

C) Help prevent cervical cancer

The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest? A) Normal finding B) Benign fibrocystic disease C) Malignant tumor D) Malignant tumor with metastasis to surrounding tissue

C) Malignant tumor

Cancer has many characteristics. What is one of the most discouraging characteristics of cancer? A) Large size B) Carcinogenesis C) Metastasis D) Slow growth

C) Metastasis

A client with cancer stage T4, N3, M1 is ordered morphine sulfate 4 mg, subcutaneous every 3 to 4 hours. Two hours after the last injection, the client rings the call bell to report a pain scale of 9. Which is the appropriate action by the nurse? A) Explain to the client that the medication can only be given every 3 to 4 hours. B) Ignore the call bell and stall until it is time to administer the next dose. C) Notify the physician of the breakthrough pain in an attempt to obtain additional orders. D) Ask the family to attempt diversion activities until the next dose can be given.

C) Notify the physician of the breakthrough pain in an attempt to obtain additional

A newly diagnosed cancer client is crying and states the following to the nurse: "I promised God that I will be a better person if I can just get better." What is the appropriate assessment of this comment by the nurse? A) The client is just trying to protect self from potential loss. B) Anger directed toward nursing staff is not unusual in dealing with cancer clients. C) The cancer is viewed as a punishment from past actions. D) Loss is inevitable so client is making final plans.

C) The cancer is viewed as a punishment from past actions.

The client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse? A) Random, rapid growth of the tumor B) Cells colonizing to distant body parts C) Tumor pressure against normal tissues D) Emission of abnormal proteins

C) Tumor pressure against normal tissues

The nurse is caring for a client with the diagnosis of colon cancer with metastasis to the liver. Which statement made by the client indicates an understanding of the diagnosis? A) "Once the colon tumor is removed, I will be fine." B) "I will be happy once all the cancer is cut out." C) "How could I be so unlucky to get cancer twice?" D) "My cancer has now spread to my liver."

D) "My cancer has now spread to my liver."

A bowel resection is scheduled for a client with the diagnosis of colon cancer with metastasis to the liver and bone. Which statement by the nurse best explains the purpose of the surgery? A) "Removing the tumor is a primary treatment for colon cancer." B) "This surgery will prevent further tumor growth." C) "Once the tumor is removed, cell pathology can be determined." D) "Tumor removal will promote comfort."

D) "Tumor removal will promote comfort."

Which of the following advice does the nurse offer clients who are undergoing unsealed radiation therapy to reduce exposure? A) Avoid drinking plenty of fluids. B) Avoid eating for 3 hours after therapy. C) Avoid applying skin moisturizers. D) Avoid kissing and sexual contact.

D) Avoid kissing and sexual contact.

Based on the understanding of the effects of chemotherapy, the nurse would anticipate which of the following clinical findings in a client 2 weeks posttherapy? A) Change in hair color B) Elevated temperature C) Elevated white blood cells count D) Ease of bruising

D) Ease of bruising

When caring for a client who is receiving external beam radiation, which is the key point for the nurse to incorporate into the plan of care? A) Time, distance, and shielding B) The use of disposable utensils and wash cloths C) Avoid showering or washing over skin markings. D) Inspect the skin frequently.

D) Inspect the skin frequently.

Which of the following laboratory findings, would be identified by the nurse as the greatest risk for a cancer client scheduled for implantable port? A) White blood cell count 10,800/mm3 B) Hemoglobin 10 g/dL C) Hematocrit 36.0% D) Platelet count 98,000/mm3

D) Platelet count 98,000/mm3

When the client complains of increased fatigue following radiotherapy, the nurse knows this is most likely to be related to which factor? A) The cancer is spreading. B) The cancer cells are dying in large numbers. C) Fighting off infection is an exhausting venture. D) Radiation can result in myelosuppression.

D) Radiation can result in myelosuppression.

The nurse is invited to present a teaching program to parents of school-age children. Which topic would be of greatest value for decreasing cancer risks? A) Pool and water safety B) Breast and testicular self-exams C) Handwashing and infection prevention D) Sun safety and use of sunscreen

D) Sun safety and use of sunscreen

Chemotherapy has been used for the past 3 months to treat a client with pancreatic cancer. The CA 19-9 levels are rising. Which explanation would the nurse attribute as the most likely cause? A) It is normal for this antigen to rise for up to 6 months. B) The client is having an adverse response to the chemotherapy. C) The chemotherapy is effectively destroying the cancer cells. D) The cancer is growing despite the chemotherapy treatment.

D) The cancer is growing despite the chemotherapy treatment.

A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed? A) "I guess the doctor could not remove the entire tumor." B) "I am so glad the doctor was able to remove the entire tumor." C) "I will be glad to finally be done with treatments for this thing." D) "Thank goodness the tumor is contained and curable."

A) "I guess the doctor could not remove the entire tumor."

The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia? A) "The hair loss is temporary." B) "New hair growth will return without any change to color or texture." C) "Clients with alopecia will have delay in grey hair." D) "Wigs can be used after the chemotherapy is completed.

A) "The hair loss is temporary."

The nurse is providing an educational presentation on dietary recommendations for reducing the risk of cancer. Which of the following food selections would demonstrate a good understanding of the information provided in the presentation? Select all that apply. A) Egg white omelet with spinach and mushrooms B) Crispy chicken Caesar Salad C) Steamed broccoli and carrots D) Turkey breast on whole wheat bread E) Smoked salmon F) Vegetable and cheddar quiche

A) Egg white omelet with spinach and mushrooms,C) Steamed broccoli and carrots,E) Smoked salmon

A client diagnosed with cancer has his tumor staged and graded based on what factors? A) How they tend to grow and the cell type B) How they spread and tend to grow C) How they differentiate the cell type D) How they spread and differentiate

A) How they tend to grow and the cell type

When providing care for a client with stage IV cancer, the nurse knows to include which intervention in the plan of care? A) Incorporating touching and listening B) Encouraging the expression of life regrets C) Assessing signs and symptoms of impending death D) Discussing ways for the client to handle the dying process

A) Incorporating touching and listening