Exam #3= Cancer

Cancer staging

-Classifying the extent and spread of cancer is termed "staging". -Clinical staging classification system determines the anatomic extent of the malignant disease process in stages. -Clinical staging may be used as a basis for staging a variety of tumor types, including cancer of cervix, Hodgkin's lymphoma

During a health promotion program, why should the nurse plan to target women in a discussion of lung cancer prevention (select all that apply)? 1= Women develop lung cancer at a younger age than men. 2= More women die of lung cancer than die from breast cancer. 3= Women have a worse prognosis from lung cancer than do men. 4= Women are more likely to develop small cell carcinoma than men. 5= Nonsmoking women are at greater risk for developing lung cancer than men.

1, 2, 4, 5 Smoking by women is taking a great toll, as reflected by the increasing incidence and deaths from lung cancer in women, who develop lung cancer at a younger age than men. Nonsmoking women are at greater risk of developing lung cancer. The incidence of small cell carcinoma is higher in women than in men. Men still have a worse prognosis than women from lung cancer.

A nurse is caring for a patient who has a benign breast tumor. What are the characteristics that differentiate a benign tumor from a malignant tumor? Select all that apply. 1= Benign tumors are encapsulated. 2= Benign tumors are metastatic. 3= Benign tumors are well differentiated. 4= Benign tumors infiltrate the neighboring areas. 5= Benign tumors have a low rate of recurrence.

1,3,5 Benign tumors of the breast are encapsulated and have a well-defined border. They have well-differentiated cells. Once treated, benign tumors have a low rate of recurrence. Unlike malignant tumors, benign tumors are not metastatic and do not infiltrate the neighboring areas. Text Reference - p. 253

A nurse is caring for a patient undergoing brachytherapy for prostate cancer. Which are appropriate nursing interventions to protect oneself from radiation hazards? Select all that apply. 1= Limit close proximity to the patient to only those care tasks that must be performed near the source. 2= Share the film badge with a colleague who forgot his or her own badge. 3= Organize care to limit the time spent in direct contact with the patient. 4= Wear the film badge at all places of work to indicate your nature of work. 5= Use shielding when providing any care to the patient.

1,3,5 When working with patients receiving radiation therapy, the nurse should exercise all precaution to prevent radiation hazards. The precautions include using as low of a dose as possible, limiting the time and distance with and around patient, and shielding oneself. The nurse should organize care to limit the time spent in direct contact with the patient. The nurse should use shielding whenever possible. A film badge indicates cumulative radiation exposure, and all the health professionals in the radiation therapy unit should wear it. The badge should not be shared and should be worn only when working in the radiation therapy unit.

The nurse assesses a 76-yr-old man with chronic myeloid leukemia receiving chemotherapy using a kinase inhibitor medication. Which question is most important for the nurse to ask? 1= "Have you had a fever?" 2= "Have you lost any weight?" 3= "Has diarrhea been a problem?" 4= "Have you noticed any hair loss?"

1= "Have you had a fever?" An adverse effect of kinase inhibitors is neutropenia. Infection is common in neutropenic patients and is the primary cause of death in cancer patients. Patients should report a temperature of 100.4° F or higher. The other options are possible while undergoing chemotherapy but do not represent the highest priority for assessment.

Previous administrations of chemotherapy agents to a cancer patient have resulted in diarrhea. Which dietary modification should the nurse recommend? 1= A bland, low-fiber diet 2= A high-protein, high-calorie diet 3= A diet high in fresh fruits and vegetables 4= A diet emphasizing whole and organic foods

1= A bland, low-fiber diet Patients experiencing diarrhea secondary to chemotherapy or radiation therapy often benefit from a diet low in seasonings and roughage before the treatment. Foods should be easy to digest and low in fat. Fresh fruits and vegetables are high in fiber and should be minimized during treatment. Whole and organic foods do not prevent diarrhea.

A client is diagnosed with cancer. The nurse realizes that which of the following are characteristics of this type of cell? (Select all that apply.) 1= Aneuploid 2= Cohesive 3= Migratory 4= Poorly differentiated 5= Specific morphology 6= Abnormal chromosomes

1= Aneuploid 3= Migratory 4= Poorly differentiated 6= Abnormal chromosomes Characteristics of malignant cells include uncontrolled cell division; large, variably shaped nuclei; anaplasia; poor differentiation; noncohesion; migration; lack of contact inhibition; aneuploidy; and abnormal chromosomes. Specific morphology and cohesiveness are characteristics of either benign or normal cells.

A client receiving chemotherapy has a platelet count of 85,000. Which of the following should the nurse do to assist this client? 1= Assess for bruising and frank bleeding. 2= Provide a razor for shaving. 3= Remind the client to floss before brushing the teeth each day. 4= Provide NSAIDs as prescribed.

1= Assess for bruising and frank bleeding. A platelet count of less than 100,000 indicates thrombocytopenia, and the client should be assessed for bruising and frank bleeding. The client should avoid the use of a razor, avoid flossing, and NSAIDs should not be provided since they promote bleeding.

The nurse is teaching a wellness class to a group of women at their workplace. Which findings represent the highest risk for developing cancer? 1= Body mass index of 35 kg/m2 and smoking cigarettes for 20 years 2= Family history of colorectal cancer and consumes a high-fiber diet 3= Limits fat consumption and has regular mammography and Pap screenings 4= Exercises five times every week and does not consume alcoholic beverages

1= Body mass index of 35 kg/m2 and smoking cigarettes for 20 years Cancer prevention and early detection are associated with the following behaviors: limited alcohol use, regular physical activity, maintaining a normal body weight, obtaining regular cancer screenings, avoiding cigarette smoking and other tobacco use, using sunscreen with SPF 15 or higher, and practicing healthy dietary habits (e.g., reduced fat and increased fruits and vegetables).

The laboratory report reveals that the cells from the patient's tumor biopsy are Grade II. What should the nurse know about this histologic grading? 1= Cells are abnormal and moderately differentiated. 2= Cells are very abnormal and poorly differentiated. 3= Cells are immature, primitive, and undifferentiated. 4= Cells differ slightly from normal cells and are well differentiated.

1= Cells are abnormal and moderately differentiated. Grade II cells are more abnormal than Grade I and moderately differentiated. Grade III cells are very abnormal and poorly differentiated. Grade IV cells are immature, primitive, and undifferentiated; the cell origin is difficult to determine. Grade I cells differ slightly from normal cells and are well differentiated. Text Reference - p. 254

The nurse is planning interventions to address the potential problem of mucositis for a client receiving chemotherapy. Which of the following assessment findings caused the nurse to identify the client as being at risk for this side effect? 1= Client prescribed chemotherapy 2= Client age 50 3= Client lives alone 4= Client is fatigued

1= Client prescribed chemotherapy High risks for developing mucositis include age younger than 20, hematologic or head and neck cancer, preexisting oral disease, and chemotherapy and radiation. Age greater than 50, living arrangements, and level of fatigue do not increase a clients risk of developing mucositis.

Thrombocytopenia develops in a patient being treated with chemotherapy for Hodgkin's disease. What is the goal of highest priority in the nursing plan of care? 1= Controlling bleeding 2= Controlling diarrhea 3= Controlling infection 4= Controlling hypotension

1= Controlling bleeding Thrombocytopenia is a low platelet count that leaves the patient at high risk for life-threatening spontaneous hemorrhage. Diarrhea and infection are not symptoms associated with thrombocytopenia. Hypotension may be seen if hemorrhagic or hypovolemic shock develops as a result of blood loss stemming from thrombocytopenia. Text Reference - p. 265

A client, prescribed to begin chemotherapy, asks the nurse "How does chemotherapy work?" Which of the following should the nurse respond to this client? 1= It prevents the process of cell growth and replication. 2= It kills only cancer cells. 3= It treats the exposed area only with high-energy rays. 4= Agents are implanted in an area to inhibit cancer growth.

1= It prevents the process of cell growth and replication. Chemotherapy is the use of drugs that prevent, kill, or block the growth and spread of cancer cells. Some noncancerous cells can be damaged during chemotherapy. External radiation treats an exposed area with high-energy rays. Internal radiation uses implanted agents.

A nurse is collecting health history information from a patient who states, "I had cancer in the cartilage of my leg." The nurse recalls that this type of malignancy found in connective tissue is known as: 1= Sarcoma 2= Osteoma 3= Adenoma 4= Myeloma

1= Sarcoma Cancer of the connective tissue is known as a sarcoma. Osteoma refers to cancer originating in bone. Adenoma refers to cancer originating in glandular tissue. Myeloma refers to cancer originating in blood-forming tissues such as bone marrow. Text Reference - p. 254

A patient is receiving an infusion of monoclonal antibodies (MoAb) for non-Hodgkin's lymphoma. The nurse finds that the patient has developed an anaphylactic reaction. Which action should the nurse perform first? 1= Stop the infusion. 2= Reduce the rate of the infusion. 3= Stabilize the airway, breathing, and circulation. 4= Inform the health care provider.

1= Stop the infusion. Monoclonal antibodies are a type of targeted therapy used for treating non-Hodgkin's lymphoma and chronic lymphocytic leukemia. Some patients may develop an anaphylactic reaction during the therapy, which can be life-threatening. If the patient develops such anaphylaxis, the infusion should immediately be stopped to prevent worsening of the anaphylactic reaction. Reducing the dose may also worsen the anaphylaxis. The airway, breathing, and circulation can be stabilized once the infusion is stopped. The primary health care provider can be informed once the infusion is stopped and the patient is stabilized. Text Reference - p. 273

To reduce the risk for most occupational lung diseases, what is the most important measure the occupational nurse should promote? 1= Maintaining smoke-free work environments for all employees. 2= Using masks and effective ventilation systems to reduce exposure to irritants. 3= Inspection and monitoring of workplaces by national occupational safety agencies. 4= Requiring periodic chest x-rays and pulmonary function tests for exposed employees.

2= Although all of the precautions identified in this question are appropriate in decreasing the risk of occupational lung diseases, using masks and effective ventilation systems to reduce exposure is the most efficient and affects the greatest number of employees.

A patient with advanced metastatic lung cancer experiences fatigue, weakness, nausea, and vomiting. The patient's blood report shows a high level of calcium in the blood. How should the nurse interpret this lab finding? 1= The patient has a metabolic emergency. 2= The patient has cardiac tamponade. 3= The patient has a spinal cord compression syndrome. 4= The patient has a third space syndrome.

1= The patient has a metabolic emergency. Advanced cancers may result in metastasis to the bones, and cause increased levels of calcium in the blood. They may manifest as apathy, depression, fatigue, muscle weakness, ECG changes, polyuria and nocturia, anorexia, nausea, and vomiting. If untreated, it may result in nephrocalcinosis and irreversible renal failure. Cardiac tamponade manifests in a heavy feeling over the chest, shortness of breath, tachycardia, cough, dysphagia, hiccups, hoarseness, nausea, vomiting, excessive perspiration, decreased level of consciousness, distant or muted heart sounds, and extreme anxiety. Spinal cord compression syndrome manifests as intense, localized, and persistent back pain. The pain may be accompanied by vertebral tenderness. Third space syndrome manifests as low blood pressure, increased heart rate, low central venous pressure, and decreased urine output. Text Reference - p. 278

A nurse is caring for a patient with lung cancer who is being treated with chemotherapy. The patient reports anorexia. The nurse understands that anorexia may be chemotherapy-induced and may cause malnutrition if not treated. How should the nurse ensure an adequate nutritional status of the patient? Select all that apply. 1= Provide large meals. 2= Weigh the patient regularly. 3= Provide nutritional supplements. 4= Provide high-calorie, high-protein food. 5= Manage nausea and vomiting if present.

2,3,4,5 Anorexia refers to a decrease in appetite and is a common side effect of chemotherapy. It increases the risk of malnutrition in the patient. The nurse should monitor the weight of the patient frequently to determine any weight loss. Nutritional supplements can be used to meet the increased demand of nutrients due to cancer and its treatment. The patient's food should be high in calories and proteins to meet the energy requirements and compensate for the protein loss due to cell lysis. Nausea and vomiting are symptoms of anorexia, and should be managed to promote food intake. Small and frequent meals are better tolerated than large meals. Text Reference - p. 269

A patient is treated with radiation therapy for lung cancer. The nurse finds that the patient has dry desquamation of the skin due to the radiation therapy. How should the nurse prevent infection and facilitate healing of the skin? Select all that apply. 1 = Apply ice packs. 2= Avoid the use of heating pads. 3= Avoid constricting garments. 4= Suggest the use of deodorants. 5= Avoid rubbing the affected area.

2,3,5 Radiation therapy may cause skin changes due to desquamation, and the skin is prone to infection. The nurse should avoid extreme temperatures on the affected area. Heating pads may cause burns and should be avoided. Constricting garments may traumatize the skin and should be avoided. Rubbing the affected area may also traumatize the skin and should be avoided. Ice packs may cause damage to the affected skin. Deodorants are chemicals and may irritate and traumatize the affected area, and should be avoided. Text Reference - p. 269

A nurse is attending a seminar on the causes of death in the United States. Which disease is considered the second most common cause of death in the United States? 1. Heart disease 2. Cancer 3. HIV infection 4. Tuberculosis

2. Cancer Cancer is the second most common cause of death in the United States. Heart disease is the primary cause of death in the United States. HIV infection, which can lead to acquired immunodeficiency syndrome, is not among the leading causes of death in the United States. Tuberculosis is an infection of the lungs, and is not among the most common causes of death.

Which statement by the nurse most facilitates patient cancer prevention during the promotion stage of cancer development? 1= "Exercise every day for 30 minutes." 2= "Follow smoking cessation recommendations." 3= "Following a vitamin regime is highly recommended." 4= "I recommend excision of the cancer as soon as possible."

2= "Follow smoking cessation recommendations." The promotion stage of cancer is characterized by the reversible proliferation of the altered cells. Changing the lifestyle to avoid promoting factors (dietary fat, obesity, cigarette smoking, and alcohol consumption) can reduce the chance of cancer development. Cigarette smoking is a promoting factor and a carcinogen. Daily exercise and vitamins alone will not prevent cancer. Surgery at this stage may not be possible without a critical mass of cells, and this advice would not be consistent with the nurse's role.

A patient who has undergone a modified radical mastectomy sees the surgical site for the first time. The patient appears shocked and exclaims, "I look horrible! Will it ever look better?" Which response by the nurse is most appropriate? 1= "Would you like to meet another patient who's had a mastectomy?" 2= "You're shocked by the change in your appearance from the surgery?" 3= "After it heals and you're dressed, you won't even know you've had surgery." 4= "Don't worry. You know that the tumor is gone, and the area will heal very soon."

2= "You're shocked by the change in your appearance from the surgery?" When a patient appears shocked by her appearance after a mastectomy, the nurse should help her express her feelings and offer supportive care. Reflecting the patient's statement will allow her to expand and discuss her feelings. "After it heals" and "Don't worry" diminish the patient's distress regarding having undergone a modified radical mastectomy. "Would you like me to?" is an appropriate statement but does not allow the patient to verbalize her fears and concerns. Text Reference - p. 280

Which patient is statistically and medically at the highest risk of developing cancer? 1= A 68-yr-old white woman who has BRCA-1 gene and is obese 2= A 56-yr-old African American man with hepatitis C who drinks alcohol daily 3= An 18-yr-old Hispanic man who eats fast food once per week and drink alcohol 4= An 80-yr-old Asian woman with coronary artery disease on blood pressure medication.

2= A 56-yr-old African American man with hepatitis C who drinks alcohol daily The combination of statistically identified risk factors in addition to current liver disease (hepatitis C that is linked to the development of liver cancer) and the added promotor of alcohol makes this patient at the highest risk. Second is the white woman with the gene for breast cancer and the added promotor of obesity. The majority of cancer cases are diagnosed in individuals older than 55 years of age. The overall incidence of cancer is higher in men than women. Cancer incidence is higher in African Americans, then whites, and then people from other cultures.

The nurse providing care for a patient with suspected cancer recalls that the only diagnostic procedure that is definitive for a diagnosis of cancer is: #242 1= MRI 2= Biopsy 3= CT scan 4= Tumor marker

2= Biopsy Only a biopsy is a definitive means of diagnosing cancer, because it actually identifies the pathological cells. Many tests, such as MRI, CT scan, and tumor markers, are indicative of cancer, but they do not confirm the presence of cancer cells as examination of a specimen obtained by biopsy does. Text Reference - p. 256

When a patient is undergoing brachytherapy, what is it important for the nurse to be aware of when caring for this patient? 1= The patient will undergo simulation to identify and mark the field of treatment. 2= The patient is a source of radiation and personnel must wear film badges during care. 3= The goal of this treatment is only palliative and the patient should be aware of the expected outcome. 4= Computerized dosimetry is used to determine the maximum dose of radiation to the tumor within an acceptable dose to normal tissue.

2= Brachytherapy is the implantation or insertion of radioactive materials directly into the tumor or in proximity to the tumor and may be curative. The patient is a source of radiation and in addition to implementing the principles of time, distance, and shielding, film badges should be worn by caregivers to monitor the amount of radiation exposure. Computerized dosimetry and simulation are used in external radiation therapy

The nurse is counseling a group of individuals over the age of 50 with average risk for cancer about screening tests for cancer. Which screening recommendation should be performed to screen for colorectal cancer? 1= Barium enema every year 2= Colonoscopy every 10 years 3= Fecal occult blood every 5 years 4= Annual prostate-specific antigen (PSA) and digital rectal exam

2= Colonoscopy every 10 years Healthy men and women should have a colonoscopy every 10 years, an annual fecal occult blood test, or a barium enema every 5 years. These frequencies may change depending on the results. Annual PSA and digital rectal exams screen for prostate problems, although the decision to test is made by the patient with his health care provider.

A client is prescribed interferon as part of treatment for cancer. Which of the following should the nurse instruct the client regarding this medication? 1= Flu-like symptoms should be reported to the physician. 2= General fatigue while receiving this medication is common. 3= Seek emergency care with a high fever. 4= Side effects are short term and will resolve in a few days.

2= General fatigue while receiving this medication is common. Side effects vary by the type of biological agent, including a flu-like illness, high fever, headache, and general fatigue. These are expected effects and do not need to be reported to the physician. Side effects of these medications are long term and can vary in intensity during the course of treatment.

The nurse is caring for a patient receiving an initial dose of chemotherapy to treat a rapidly growing metastatic colon cancer. The nurse is aware that the patient is at risk for tumor lysis syndrome (TLS) and will monitor for which abnormality associated with this oncologic emergency? 1= Hypokalemia 2= Hypocalcemia 3= Hypouricemia 4= Hypophosphatemia

2= Hypocalcemia TLS is a metabolic complication characterized by rapid release of intracellular components in response to chemotherapy. This can rapidly lead to acute renal injury. The hallmark signs of TLS are hyperuricemia, hyperphosphatemia, hyperkalemia, and hypocalcemia.

The patient was told she has carcinoma in situ, and the student nurse wonders what that is. How should the nurse explain this to the student nurse? 1= Evasion of the immune system by cancer cells 2= Lesion with histologic features of cancer except invasion 3= Capable of causing cellular alterations associated with cancer 4= Tumor cell surface antigens that stimulate an immune response

2= Lesion with histologic features of cancer except invasion Carcinoma in situ has the histologic features except invasion. Evasion of the immune system by cancer cells by various methods is immunologic escape. Oncogenic factors are capable of causing cellular alterations associated with cancer. Tumor cell surface antigens that stimulate an immune response are tumor-associated antigens.

When teaching the patient with cancer about chemotherapy, which approach should the nurse take? 1= Avoid telling the patient about possible side effects of the drugs to prevent anticipatory anxiety. 2= Explain that antiemetics, antidiarrheals, and analgesics will be provided as needed to control side effects. 3= Assure the patient that the side effects from chemotherapy are uncomfortable but never life threatening. 4= Inform the patient that chemotherapy-related alopecia is usually permanent but can be managed with lifelong use of wigs.

2= Patients should always be taught what to expect during a course of chemotherapy, including side effects and expected outcome. Side effects of chemotherapy are serious but it is important that patients be informed about what measures can be taken to help them to cope with the side effects of therapy. Hair loss related to chemotherapy is usually reversible and wigs, scarves, or turbans can be used during and following chemotherapy until the hair grows back.

A client receiving chemotherapy tells the nurse that he is concerned that he may be developing Alzheimers disease since he is having a new onset of memory loss. Which of the following should the nurse do to help this client? 1= Discuss the clients memory issues with the physician. 2= Suggest the client use a journal to aid with short-term chemo fog problems. 3= Assess for signs of pending stroke. 4= Notify the physician and plan for transferring the client to an intensive care area.

2= Suggest the client use a journal to aid with short-term chemo fog problems. Twenty to 50% of cancer clients receiving chemotherapy describe cognitive changes such as being in a fog. To aid this client, the nurse should suggest the client keep a log or journal to document activities in order to identify when the fog is more acute. Chemo fog can last up to 2 years after treatment, but it is not permanent. The clients memory issues do not need to be discussed with a physician. The client is not experiencing a stroke. The client does not need to be transferred to an intensive care area.

Review Questions - Chapter 15 Assessment Performance OVERVIEW INCORRECT CORRECT Question 1 of 26 Previous administrations of chemotherapy agents to a cancer patient have resulted in diarrhea. Which dietary modification should the nurse recommend? CORRECT A bland, low-fiber diet Patients experiencing diarrhea secondary to chemotherapy or radiation therapy often benefit from a diet low in seasonings and roughage before the treatment. Foods should be easy to digest and low in fat. Fresh fruits and vegetables are high in fiber and should be minimized during treatment. Whole and organic foods do not prevent diarrhea. A high-protein, high-calorie diet Patients experiencing diarrhea secondary to chemotherapy or radiation therapy often benefit from a diet low in seasonings and roughage before the treatment. Foods should be easy to digest and low in fat. Fresh fruits and vegetables are high in fiber and should be minimized during treatment. Whole and organic foods do not prevent diarrhea. A diet high in fresh fruits and vegetables Patients experiencing diarrhea secondary to chemotherapy or radiation therapy often benefit from a diet low in seasonings and roughage before the treatment. Foods should be easy to digest and low in fat. Fresh fruits and vegetables are high in fiber and should be minimized during treatment. Whole and organic foods do not prevent diarrhea. A diet emphasizing whole and organic foods Patients experiencing diarrhea secondary to chemotherapy or radiation therapy often benefit from a diet low in seasonings and roughage before the treatment. Foods should be easy to digest and low in fat. Fresh fruits and vegetables are high in fiber and should be minimized during treatment. Whole and organic foods do not prevent diarrhea. Question 2 of 26 The nurse assesses a 76-yr-old man with chronic myeloid leukemia receiving chemotherapy using a kinase inhibitor medication. Which question is most important for the nurse to ask? CORRECT "Have you had a fever?" An adverse effect of kinase inhibitors is neutropenia. Infection is common in neutropenic patients and is the primary cause of death in cancer patients. Patients should report a temperature of 100.4° F or higher. The other options are possible while undergoing chemotherapy but do not represent the highest priority for assessment. "Have you lost any weight?" An adverse effect of kinase inhibitors is neutropenia. Infection is common in neutropenic patients and is the primary cause of death in cancer patients. Patients should report a temperature of 100.4° F or higher. The other options are possible while undergoing chemotherapy but do not represent the highest priority for assessment. "Has diarrhea been a problem?" An adverse effect of kinase inhibitors is neutropenia. Infection is common in neutropenic patients and is the primary cause of death in cancer patients. Patients should report a temperature of 100.4° F or higher. The other options are possible while undergoing chemotherapy but do not represent the highest priority for assessment. "Have you noticed any hair loss?" An adverse effect of kinase inhibitors is neutropenia. Infection is common in neutropenic patients and is the primary cause of death in cancer patients. Patients should report a temperature of 100.4° F or higher. The other options are possible while undergoing chemotherapy but do not represent the highest priority for assessment. Question 3 of 26 Which nursing diagnosis is most appropriate for a patient experiencing myelosuppression secondary to chemotherapy for cancer treatment? Acute pain Myelosuppression is accompanied by a high risk of infection and sepsis. Hypothermia, powerlessness, and acute pain are also possible nursing diagnoses for patients undergoing chemotherapy, but the threat of infection is paramount. Hypothermia Myelosuppression is accompanied by a high risk of infection and sepsis. Hypothermia, powerlessness, and acute pain are also possible nursing diagnoses for patients undergoing chemotherapy, but the threat of infection is paramount. Powerlessness Myelosuppression is accompanied by a high risk of infection and sepsis. Hypothermia, powerlessness, and acute pain are also possible nursing diagnoses for patients undergoing chemotherapy, but the threat of infection is paramount. CORRECT Risk for infection Myelosuppression is accompanied by a high risk of infection and sepsis. Hypothermia, powerlessness, and acute pain are also possible nursing diagnoses for patients undergoing chemotherapy, but the threat of infection is paramount. Question 4 of 26 A 33-yr-old patient has recently been diagnosed with stage II cervical cancer. Which statement by the nurse best explains the diagnosis? "The cancer is found at the point of origin only." Stage II cancer is associated with limited local spread. Stage 0 denotes cancer in situ or at the point of origin only; stage I denotes tumor limited to the tissue of origin with localized tumor growth. Stage III denotes extensive local and regional spread. Stage IV denotes metastasis such as to the liver. "Tumor cells have been identified in the cervical region." Stage II cancer is associated with limited local spread. Stage 0 denotes cancer in situ or at the point of origin only; stage I denotes tumor limited to the tissue of origin with localized tumor growth. Stage III denotes extensive local and regional spread. Stage IV denotes metastasis such as to the liver. "The cancer has been identified in the cervix and the liver." Stage II cancer is associated with limited local spread. Stage 0 denotes cancer in situ or at the point of origin only; stage I denotes tumor limited to the tissue of origin with localized tumor growth. Stage III denotes extensive local and regional spread. Stage IV denotes metastasis such as to the liver. CORRECT "Your cancer was identified in the cervix and has limited local spread." Stage II cancer is associated with limited local spread. Stage 0 denotes cancer in situ or at the point of origin only; stage I denotes tumor limited to the tissue of origin with localized tumor growth. Stage III denotes extensive local and regional spread. Stage IV denotes metastasis such as to the liver. Question 5 of 26 The nurse is caring for an 18-yr-old female patient with acute lymphocytic leukemia that is scheduled for hematopoietic stem cell transplantation (HSCT). Which patient statement indicates a correct understanding of the procedure? "I understand the transplant procedure has no dangerous side effects." Hematopoietic stem cell transplantation (HSCT) requires eradication of diseased or cancer cells. This is accomplished by administering higher-than-usual dosages of chemotherapy with or without radiation therapy. A relative such as a brother would not be a perfect match with human leukocyte antigens; only identical twins are an exact match. HSCT is an intensive procedure with adverse effects and possible death. HSCT recipients can expect a 2- to 4-week hospitalization after the transplant. "After the transplant, I will feel better and can go home in 5 to 7 days." Hematopoietic stem cell transplantation (HSCT) requires eradication of diseased or cancer cells. This is accomplished by administering higher-than-usual dosages of chemotherapy with or without radiation therapy. A relative such as a brother would not be a perfect match with human leukocyte antigens; only identical twins are an exact match. HSCT is an intensive procedure with adverse effects and possible death. HSCT recipients can expect a 2- to 4-week hospitalization after the transplant. "My brother will be a 100% match for the cells used during the transplant." Hematopoietic stem cell transplantation (HSCT) requires eradication of diseased or cancer cells. This is accomplished by administering higher-than-usual dosages of chemotherapy with or without radiation therapy. A relative such as a brother would not be a perfect match with human leukocyte antigens; only identical twins are an exact match. HSCT is an intensive procedure with adverse effects and possible death. HSCT recipients can expect a 2- to 4-week hospitalization after the transplant. CORRECT "Before the transplant, I will have chemotherapy and possibly full-body radiation." Hematopoietic stem cell transplantation (HSCT) requires eradication of diseased or cancer cells. This is accomplished by administering higher-than-usual dosages of chemotherapy with or without radiation therapy. A relative such as a brother would not be a perfect match with human leukocyte antigens; only identical twins are an exact match. HSCT is an intensive procedure with adverse effects and possible death. HSCT recipients can expect a 2- to 4-week hospitalization after the transplant. Question 6 of 26 A 70-yr-old man who has end-stage lung cancer is admitted to the hospital with confusion and oliguria for 2 days. Which finding would the nurse report immediately to the health care provider? Weight gain of 6 lb Lung cancer cells are able to manufacture and release antidiuretic hormone (ADH) with resultant water retention and hyponatremia. Hyponatremia (serum sodium levels less than 135 mEq/L) may lead to central nervous system symptoms such as confusion, seizures, coma, and death. The other options listed are also symptoms of hyponatremia but are not as critical to report to the health care provider. Nausea and vomiting Lung cancer cells are able to manufacture and release antidiuretic hormone (ADH) with resultant water retention and hyponatremia. Hyponatremia (serum sodium levels less than 135 mEq/L) may lead to central nervous system symptoms such as confusion, seizures, coma, and death. The other options listed are also symptoms of hyponatremia but are not as critical to report to the health care provider. Urine specific gravity of 1.004 Lung cancer cells are able to manufacture and release antidiuretic hormone (ADH) with resultant water retention and hyponatremia. Hyponatremia (serum sodium levels less than 135 mEq/L) may lead to central nervous system symptoms such as confusion, seizures, coma, and death. The other options listed are also symptoms of hyponatremia but are not as critical to report to the health care provider. CORRECT Serum sodium level of 118 mEq/L Lung cancer cells are able to manufacture and release antidiuretic hormone (ADH) with resultant water retention and hyponatremia. Hyponatremia (serum sodium levels less than 135 mEq/L) may lead to central nervous system symptoms such as confusion, seizures, coma, and death. The other options listed are also symptoms of hyponatremia but are not as critical to report to the health care provider. Question 7 of 26 The nurse is teaching a wellness class to a group of women at their workplace. Which findings represent the highest risk for developing cancer? CORRECT Body mass index of 35 kg/m2 and smoking cigarettes for 20 years Cancer prevention and early detection are associated with the following behaviors: limited alcohol use, regular physical activity, maintaining a normal body weight, obtaining regular cancer screenings, avoiding cigarette smoking and other tobacco use, using sunscreen with SPF 15 or higher, and practicing healthy dietary habits (e.g., reduced fat and increased fruits and vegetables). Family history of colorectal cancer and consumes a high-fiber diet Cancer prevention and early detection are associated with the following behaviors: limited alcohol use, regular physical activity, maintaining a normal body weight, obtaining regular cancer screenings, avoiding cigarette smoking and other tobacco use, using sunscreen with SPF 15 or higher, and practicing healthy dietary habits (e.g., reduced fat and increased fruits and vegetables). Limits fat consumption and has regular mammography and Pap screenings Cancer prevention and early detection are associated with the following behaviors: limited alcohol use, regular physical activity, maintaining a normal body weight, obtaining regular cancer screenings, avoiding cigarette smoking and other tobacco use, using sunscreen with SPF 15 or higher, and practicing healthy dietary habits (e.g., reduced fat and increased fruits and vegetables). Exercises five times every week and does not consume alcoholic beverages Cancer prevention and early detection are associated with the following behaviors: limited alcohol use, regular physical activity, maintaining a normal body weight, obtaining regular cancer screenings, avoiding cigarette smoking and other tobacco use, using sunscreen with SPF 15 or higher, and practicing healthy dietary habits (e.g., reduced fat and increased fruits and vegetables). Question 8 of 26 The patient is told that her adenoma tumor is not encapsulated but has normally differentiated cells and surgery will be needed. The patient asks the nurse what this means. What should the nurse tell the patient? It will recur. Benign tumors are usually encapsulated, have normally differentiated cells, and do not metastasize. Malignant tumors are rarely encapsulated, have poorly differentiated cells, and are capable of metastasis. It has metastasized. Benign tumors are usually encapsulated, have normally differentiated cells, and do not metastasize. Malignant tumors are rarely encapsulated, have poorly differentiated cells, and are capable of metastasis. CORRECT It is probably benign. Benign tumors are usually encapsulated, have normally differentiated cells, and do not metastasize. Malignant tumors are rarely encapsulated, have poorly differentiated cells, and are capable of metastasis. It is probably malignant. Benign tumors are usually encapsulated, have normally differentiated cells, and do not metastasize. Malignant tumors are rarely encapsulated, have poorly differentiated cells, and are capable of metastasis. Question 9 of 26 Which statement by the nurse most facilitates patient cancer prevention during the promotion stage of cancer development? "Exercise every day for 30 minutes." The promotion stage of cancer is characterized by the reversible proliferation of the altered cells. Changing the lifestyle to avoid promoting factors (dietary fat, obesity, cigarette smoking, and alcohol consumption) can reduce the chance of cancer development. Cigarette smoking is a promoting factor and a carcinogen. Daily exercise and vitamins alone will not prevent cancer. Surgery at this stage may not be possible without a critical mass of cells, and this advice would not be consistent with the nurse's role. CORRECT "Follow smoking cessation recommendations." The promotion stage of cancer is characterized by the reversible proliferation of the altered cells. Changing the lifestyle to avoid promoting factors (dietary fat, obesity, cigarette smoking, and alcohol consumption) can reduce the chance of cancer development. Cigarette smoking is a promoting factor and a carcinogen. Daily exercise and vitamins alone will not prevent cancer. Surgery at this stage may not be possible without a critical mass of cells, and this advice would not be consistent with the nurse's role. "Following a vitamin regime is highly recommended." The promotion stage of cancer is characterized by the reversible proliferation of the altered cells. Changing the lifestyle to avoid promoting factors (dietary fat, obesity, cigarette smoking, and alcohol consumption) can reduce the chance of cancer development. Cigarette smoking is a promoting factor and a carcinogen. Daily exercise and vitamins alone will not prevent cancer. Surgery at this stage may not be possible without a critical mass of cells, and this advice would not be consistent with the nurse's role. "I recommend excision of the cancer as soon as possible." The promotion stage of cancer is characterized by the reversible proliferation of the altered cells. Changing the lifestyle to avoid promoting factors (dietary fat, obesity, cigarette smoking, and alcohol consumption) can reduce the chance of cancer development. Cigarette smoking is a promoting factor and a carcinogen. Daily exercise and vitamins alone will not prevent cancer. Surgery at this stage may not be possible without a critical mass of cells, and this advice would not be consistent with the nurse's role. Question 10 of 26 A 64-yr-old male patient who is receiving radiation to the head and neck as treatment for an invasive malignant tumor complains of mouth sores and pain. Which intervention should the nurse add to the plan of care? Provide ice chips to soothe the irritation. A patient with stomatitis should have soft, nonirritating foods offered frequently. The diet should be high in protein and high in calories to aid healing. Extremes of temperature are to be avoided. Saline or water should be used to cleanse the mouth (not hydrogen peroxide). Patients should be weighed at least twice each week to monitor for weight loss. Weigh the patient every month to monitor for weight loss. A patient with stomatitis should have soft, nonirritating foods offered frequently. The diet should be high in protein and high in calories to aid healing. Extremes of temperature are to be avoided. Saline or water should be used to cleanse the mouth (not hydrogen peroxide). Patients should be weighed at least twice each week to monitor for weight loss. Cleanse the mouth every 2 to 4 hours with hydrogen peroxide. A patient with stomatitis should have soft, nonirritating foods offered frequently. The diet should be high in protein and high in calories to aid healing. Extremes of temperature are to be avoided. Saline or water should be used to cleanse the mouth (not hydrogen peroxide). Patients should be weighed at least twice each week to monitor for weight loss. CORRECT Provide high-protein and high-calorie, soft foods every 2 hours. A patient with stomatitis should have soft, nonirritating foods offered frequently. The diet should be high in protein and high in calories to aid healing. Extremes of temperature are to be avoided. Saline or water should be used to cleanse the mouth (not hydrogen peroxide). Patients should be weighed at least twice each week to monitor for weight loss. Question 11 of 26 The laboratory reports that the cells from the patient's tumor biopsy are grade II. What should the nurse know about this histologic grading? CORRECT Cells are abnormal and moderately differentiated. Grade II cells are more abnormal than grade I and moderately differentiated. Grade I cells differ slightly from normal cells and are well-differentiated. Grade III cells are very abnormal and poorly differentiated. Grade IV cells are immature, primitive, and undifferentiated; the cell origin is difficult to determine. Cells are very abnormal and poorly differentiated. Grade II cells are more abnormal than grade I and moderately differentiated. Grade I cells differ slightly from normal cells and are well-differentiated. Grade III cells are very abnormal and poorly differentiated. Grade IV cells are immature, primitive, and undifferentiated; the cell origin is difficult to determine. Cells are immature, primitive, and undifferentiated. Grade II cells are more abnormal than grade I and moderately differentiated. Grade I cells differ slightly from normal cells and are well-differentiated. Grade III cells are very abnormal and poorly differentiated. Grade IV cells are immature, primitive, and undifferentiated; the cell origin is difficult to determine. Cells differ slightly from normal cells and are well-differentiated. Grade II cells are more abnormal than grade I and moderately differentiated. Grade I cells differ slightly from normal cells and are well-differentiated. Grade III cells are very abnormal and poorly differentiated. Grade IV cells are immature, primitive, and undifferentiated; the cell origin is difficult to determine. Question 12 of 26 The patient was told that he would have intraperitoneal chemotherapy. He asks the nurse when the IV will be started for the chemotherapy. What should the nurse teach the patient about this type of chemotherapy delivery? It is delivered via an Ommaya reservoir and extension catheter. Intraperitoneal chemotherapy is delivered to the peritoneal cavity via a temporary percutaneously inserted Silastic catheter and drained from this catheter after the dwell time in the peritoneum. The Ommaya reservoir is used for intraventricular chemotherapy. Intravesical bladder chemotherapy is delivered via a urinary catheter. Intraarterial chemotherapy is delivered via a surgically placed catheter that delivers chemotherapy via an external or internal infusion pump. It is instilled in the bladder via a urinary catheter and retained for 1 to 3 hours. Intraperitoneal chemotherapy is delivered to the peritoneal cavity via a temporary percutaneously inserted Silastic catheter and drained from this catheter after the dwell time in the peritoneum. The Ommaya reservoir is used for intraventricular chemotherapy. Intravesical bladder chemotherapy is delivered via a urinary catheter. Intraarterial chemotherapy is delivered via a surgically placed catheter that delivers chemotherapy via an external or internal infusion pump. CORRECT A Silastic catheter will be percutaneously placed in the abdomen for chemotherapy administration. Intraperitoneal chemotherapy is delivered to the peritoneal cavity via a temporary percutaneously inserted Silastic catheter and drained from this catheter after the dwell time in the peritoneum. The Ommaya reservoir is used for intraventricular chemotherapy. Intravesical bladder chemotherapy is delivered via a urinary catheter. Intraarterial chemotherapy is delivered via a surgically placed catheter that delivers chemotherapy via an external or internal infusion pump. The arteries supplying the tumor are accessed with surgical placement of a catheter connected to an infusion pump. Intraperitoneal chemotherapy is delivered to the peritoneal cavity via a temporary percutaneously inserted Silastic catheter and drained from this catheter after the dwell time in the peritoneum. The Ommaya reservoir is used for intraventricular chemotherapy. Intravesical bladder chemotherapy is delivered via a urinary catheter. Intraarterial chemotherapy is delivered via a surgically placed catheter that delivers chemotherapy via an external or internal infusion pump. Question 14 of 26 A female patient is having chemotherapy for brain metastasis. She is concerned about how she will look when she loses her hair. What is the best response by the nurse to this patient? "When your hair grows back, it will be patchy." The best response by the nurse is to suggest getting a wig before she loses her hair so she will not look or feel so different. Although hair loss with chemotherapy is usually reversible, hair loss with radiation is usually permanent in the areas radiation was administered. When hair grows back it could be a different color or texture. Avoiding use of electric hair dryers, curlers, and curling irons may slow the hair loss but will not answer the patient's concern. The American Cancer Society's "Look Good, Feel Better" program will be helpful, but this response is avoiding the patient's immediate concern. "Don't use your curling iron, and that will slow down the loss." The best response by the nurse is to suggest getting a wig before she loses her hair so she will not look or feel so different. Although hair loss with chemotherapy is usually reversible, hair loss with radiation is usually permanent in the areas radiation was administered. When hair grows back it could be a different color or texture. Avoiding use of electric hair dryers, curlers, and curling irons may slow the hair loss but will not answer the patient's concern. The American Cancer Society's "Look Good, Feel Better" program will be helpful, but this response is avoiding the patient's immediate concern. CORRECT "You can get a wig now to match your hair so you will not look different." The best response by the nurse is to suggest getting a wig before she loses her hair so she will not look or feel so different. Although hair loss with chemotherapy is usually reversible, hair loss with radiation is usually permanent in the areas radiation was administered. When hair grows back it could be a different color or texture. Avoiding use of electric hair dryers, curlers, and curling irons may slow the hair loss but will not answer the patient's concern. The American Cancer Society's "Look Good, Feel Better" program will be helpful, but this response is avoiding the patient's immediate concern. "You should contact "Look Good, Feel Better" to figure out what to do about this." The best response by the nurse is to suggest getting a wig before she loses her hair so she will not look or feel so different. Although hair loss with chemotherapy is usually reversible, hair loss with radiation is usually permanent in the areas radiation was administered. When hair grows back it could be a different color or texture. Avoiding use of electric hair dryers, curlers, and curling irons may slow the hair loss but will not answer the patient's concern. The American Cancer Society's "Look Good, Feel Better" program will be helpful, but this response is avoiding the patient's immediate concern. Question 15 of 26 A patient has been diagnosed with Burkitt's lymphoma. In the initiation stage of cancer, the cells genetic structure is mutated. Exposure to what may have functioned as a carcinogen for this patient? Bacteria Burkitt's lymphoma consistently shows evidence of the presence of Epstein-Barr virus in vitro. Bacteria do not initiate cancer. Sun exposure causes cell alterations leading to melanoma and squamous and basal cell skin carcinoma. Long-term exposure to certain chemicals (e.g., ethylene oxide, chloroform, benzene) is known to initiate cancer. Sun exposure Burkitt's lymphoma consistently shows evidence of the presence of Epstein-Barr virus in vitro. Bacteria do not initiate cancer. Sun exposure causes cell alterations leading to melanoma and squamous and basal cell skin carcinoma. Long-term exposure to certain chemicals (e.g., ethylene oxide, chloroform, benzene) is known to initiate cancer. Most chemicals Burkitt's lymphoma consistently shows evidence of the presence of Epstein-Barr virus in vitro. Bacteria do not initiate cancer. Sun exposure causes cell alterations leading to melanoma and squamous and basal cell skin carcinoma. Long-term exposure to certain chemicals (e.g., ethylene oxide, chloroform, benzene) is known to initiate cancer. CORRECT Epstein-Barr virus Burkitt's lymphoma consistently shows evidence of the presence of Epstein-Barr virus in vitro. Bacteria do not initiate cancer. Sun exposure causes cell alterations leading to melanoma and squamous and basal cell skin carcinoma. Long-term exposure to certain chemicals (e.g., ethylene oxide, chloroform, benzene) is known to initiate cancer. Question 18 of 26 A patient with breast cancer is having teletherapy radiation treatments after her surgery. What should the nurse teach the patient about the care of her skin? Use Dial soap to feel clean and fresh. Avoiding heat and cold in the treatment area will protect it. Only mild soap and unscented, nonmedicated lotions may be used to prevent skin damage. The patient will want to avoid wearing tight-fitting clothing such as a bra over the treatment field and will want to expose the area to air as often as possible. Scented lotion can be used on the area. Avoiding heat and cold in the treatment area will protect it. Only mild soap and unscented, nonmedicated lotions may be used to prevent skin damage. The patient will want to avoid wearing tight-fitting clothing such as a bra over the treatment field and will want to expose the area to air as often as possible. CORRECT Avoid heat and cold to the treatment area. Avoiding heat and cold in the treatment area will protect it. Only mild soap and unscented, nonmedicated lotions may be used to prevent skin damage. The patient will want to avoid wearing tight-fitting clothing such as a bra over the treatment field and will want to expose the area to air as often as possible. Wear the new bra to comfort and support the area. Avoiding heat and cold in the treatment area will protect it. Only mild soap and unscented, nonmedicated lotions may be used to prevent skin damage. The patient will want to avoid wearing tight-fitting clothing such as a bra over the treatment field and will want to expose the area to air as often as possible. Question 19 of 26 The patient is receiving an IV vesicant chemotherapy drug. The nurse notices swelling and redness at the site. What should the nurse do first? 1= Ask the patient if the site hurts. 2= Turn off the chemotherapy infusion. 3= Call the ordering health care provider. 4= Administer sterile saline to the reddened area.

2= Turn off the chemotherapy infusion. Because extravasation of vesicants may cause severe local tissue breakdown and necrosis, with any sign of extravasation, the infusion should first be stopped. Then the protocol for the drug-specific extravasation procedures should be followed to minimize further tissue damage. The site of extravasation usually hurts, but it may not. It is more important to stop the infusion immediately. The health care provider may be notified by another nurse while the patient's nurse starts the drug-specific extravasation procedures, which may or may not include sterile saline.

The nurse is administering a vesicant chemotherapy agent to a patient who has colon cancer. During rounds, the nurse notes that the intravenous site is reddened and swollen, and the patient complains that it is painful. What is the first action the nurse will take? 1= Slow the infusion rate. 2= Turn off the infusion. 3= Check the patient's vital signs. 4= Notify the primary health care provider.

2= Turn off the infusion. EXTRAVASATION= Infiltration of drugs into tissues surrounding the infusion site causing local tissue damage VESICANT= Severe, local tissue breakdown and necrosis #246 It is extremely important to monitor for and promptly recognize symptoms associated with extravasation of a vesicant and to take immediate action if it occurs. Immediately turn off the infusion and follow protocols for drug-specific extravasation procedures to minimize further tissue damage. It is not appropriate to slow the infusion rate. The health care provider should be notified, and vital signs checked, but they are not the first action that should be taken. Text Reference - p. 259

A nurse finds that the patient undergoing radiotherapy has developed erythema and desquamation. Which measure should the nurse include when teaching the patient about skin care in the radiation treatment area? 1= Wear fabrics such as wool and corduroy to prevent exposure to cold. 2= Use perfumes and cosmetics on the treatment area as desired. 3= Gently cleanse the skin using a mild soap, tepid water, and a soft cloth. 4= Allow brief periods of direct exposure to sunlight for good bone health.

3 Gently cleanse the skin using a mild soap, tepid water, and a soft cloth. The skin should be gently cleansed using a mild soap, tepid water, and a soft cloth. Fabrics such as wool and corduroy should not be worn, as they can traumatize the skin. Chemicals like perfumes, cosmetics, and powders should not be used on the treatment area, as they are harsh on skin and can increase the irritation of the skin. The skin should not be exposed to direct sunlight. Protective clothing should be worn, if exposure to sun is expected. Text Reference - p. 270

The oncologist has told the patient that he or she has a benign tumor in the liver. The patient asks the nurse, "What is the main difference between benign and malignant tumors?" Which answer by the nurse is correct? 1= "Malignant tumors usually are encapsulated." 2= "Malignant tumors have a rare recurrence rate." 3= "Benign tumors do not invade and spread to other organs." 4= "Malignant tumors require less nutrients for their cells than benign tumors."

3= "Benign tumors do not invade and spread to other organs." The ability of malignant tumor cells to invade and metastasize is the major difference between benign and malignant neoplasms. Benign tumors usually are encapsulated; metastasis is absent, and recurrence is rare. Malignant tumors rarely are encapsulated, are capable of metastasis, and are capable of recurring. Text Reference - p. 253

The nurse is discussing the effects of chemotherapy with a patient who has a new diagnosis of cancer. Which statement by the patient reflects an adequate understanding of the teaching? 1= "I will need to use effective birth control methods for the rest of my life." 2= "My doctor will stop the chemotherapy if nausea and vomiting occur during treatment." 3= "I will join a support group after my therapy is finished to help me get back on my feet." 4= "I probably won't be able to do anything I used to do anymore now that I have cancer."

3= "I will join a support group after my therapy is finished to help me get back on my feet." The impact of a cancer diagnosis can affect many aspects of a patient's life, with cancer survivors commonly reporting financial, vocational, marital, and emotional concerns even long after treatment is over. These psychosocial effects can play a profound role in a patient's life after cancer, with issues related to living in uncertainty being encountered frequently. Participation in appropriate supportive care and community resources would benefit the patient in recovery or ongoing care. It will not be necessary for the patient to use birth control for the rest of the patient's life; nausea and vomiting are expected effects of chemotherapy and treatment will continue unless the vomiting becomes severe. Text Reference - p. 61

The patient has osteosarcoma of the right leg. The unlicensed assistive personnel (UAP) reports that the patient's vital signs are normal, but the patient says he still has pain in his leg and it is getting worse. Which question would best determine treatment measures for the patient's pain? 1= "Where is the pain?" 2= "Is the pain getting worse?" 3= "What does the pain feel like?" 4= "Do you use medications to relieve the pain?"

3= "What does the pain feel like?" The UAP told the nurse the location of the patient's pain and the patient reports worsening of pain (pattern). Asking about the quality of the pain will help in planning further treatment. The nurse should already know if the patient is using medication to relieve the pain or can check the patient's medication administration record to see if analgesics have been administered. The intensity of pain using a pain scale should also be assessed.

The female patient is having whole brain radiation for brain metastasis. She is concerned about how she will look when she loses her hair. What is the best response by the nurse to this patient? 1= "When your hair grows back it will be patchy." 2= "Don't use your curling iron and that will slow down the loss." 3= "You can get a wig now to match your hair so you will not look different." 4= "You should contact 'Look Good, Feel Better' to figure out what to do about this."

3= "You can get a wig now to match your hair so you will not look different." Hair loss with radiation usually is permanent. The best response by the nurse is to suggest getting a wig before the patient loses her hair so she will not look or feel so different. When hair grows back after chemotherapy it is frequently a different color or texture. Avoiding use of electric hair dryers, curlers, and curling irons may slow the hair loss, but will not answer the patient's concern. The American Cancer Society's "Look Good, Feel Better" program will be helpful, but this response is avoiding the patient's immediate concern. Text Reference - p. 266

The nurse is caring for an 18-yr-old female patient with acute lymphocytic leukemia that is scheduled for hematopoietic stem cell transplantation (HSCT). Which patient statement indicates a correct understanding of the procedure? 1= "I understand the transplant procedure has no dangerous side effects." 2= After the transplant, I will feel better and can go home in 5 to 7 days." 3= "My brother will be a 100% match for the cells used during the transplant." 4= "Before the transplant, I will have chemotherapy and possibly full-body radiation."

4= "Before the transplant, I will have chemotherapy and possibly full-body radiation." Hematopoietic stem cell transplantation (HSCT) requires eradication of diseased or cancer cells. This is accomplished by administering higher-than-usual dosages of chemotherapy with or without radiation therapy. A relative such as a brother would not be a perfect match with human leukocyte antigens; only identical twins are an exact match. HSCT is an intensive procedure with adverse effects and possible death. HSCT recipients can expect a 2- to 4-week hospitalization after the transplant.

The patient was told that he would have intraperitoneal chemotherapy. He asks the nurse when the IV will be started for the chemotherapy. What should the nurse teach the patient about this type of chemotherapy delivery? 1= It is delivered via an Ommaya reservoir and extension catheter. 2= It is instilled in the bladder via a urinary catheter and retained for 1 to 3 hours. 3= A Silastic catheter will be percutaneously placed in the abdomen for chemotherapy administration. 4= The arteries supplying the tumor are accessed with surgical placement of a catheter connected to an infusion pump.

3= A Silastic catheter will be percutaneously placed in the abdomen for chemotherapy administration. Intraperitoneal chemotherapy is delivered to the peritoneal cavity via a temporary percutaneously inserted Silastic catheter and drained from this catheter after the dwell time in the peritoneum. The Ommaya reservoir is used for intraventricular chemotherapy. Intravesical bladder chemotherapy is delivered via a urinary catheter. Intraarterial chemotherapy is delivered via a surgically placed catheter that delivers chemotherapy via an external or internal infusion pump.

A client receiving chemotherapy for cancer has a hemoglobin level of 9.7 g/dL. Which of the following should the nurse anticipate as treatment for this client? 1= Place client in reverse isolation. 2= Administer antibiotics as prescribed. 3= Administer epoetin alfa as prescribed. 4= Administer filgrastim as prescribed.

3= Administer epoetin alfa as prescribed. Treatment for moderate anemia in the client receiving chemotherapy for cancer would include the administration of epoetin alfa as prescribed. This medication elevates hemoglobin levels and improves the quality of life for clients. The other choices would be appropriate for the client diagnosed with neutropenia and not anemia.

A patient with breast cancer is having teletherapy radiation treatments after her surgery. What should the nurse teach the patient about the care of her skin? 1= Use Dial soap to feel clean and fresh. 2= Scented lotion can be used on the area. 3= Avoid heat and cold to the treatment area. 4= Wear the new bra to comfort and support the area.

3= Avoid heat and cold to the treatment area. Avoiding heat and cold in the treatment area will protect it. Only mild soap and unscented, nonmedicated lotions may be used to prevent skin damage. The patient will want to avoid wearing tight-fitting clothing such as a bra over the treatment field and will want to expose the area to air as often as possible.

A 33-year-old patient recently has been diagnosed with stage II cervical cancer. The nurse should understand what about the patient's cancer? 1= It is in situ 2= It has metastasized 3= It has spread locally 4= It has spread extensively

3= It has spread locally Stage II cancer is associated with limited local spread. Stage 0 denotes cancer in situ. Stage I denotes tumor limited to the tissue of origin with localized tumor growth. Stage III denotes extensive local and regional spread and stage IV denotes metastasis. Text Reference - p. 254

The patient is told that her adenoma tumor is not encapsulated but has normally differentiated cells and surgery will be needed. The patient asks the nurse what this means. What should the nurse tell the patient? 1= It will recur. 2= It has metastasized. 3= It is probably benign. 4= It is probably malignant.

3= It is probably benign.

The patient is told that the adenoma tumor is not encapsulated, but has normally differentiated cells and that surgery will be needed. The patient asks the nurse what this means. What should the nurse tell the patient? 1= It will recur. 2= It has metastasized. 3= It is probably benign. 4= It is probably malignant.

3= It is probably benign. Benign tumors usually are encapsulated and have normally differentiated cells. They do not metastasize and rarely recur as malignant tumors do. Surgery is necessary because the tumor may become malignant and has the potential to cause health complications over time. Text Reference - p. 258

A nurse is learning about the different types of cancers. Which cancer has the highest incidence among men? 1= Lung cancer 2= Colon cancer 3= Prostate cancer 4= Thyroid cancer

3= Prostate cancer Among all the cancers in men, prostate cancer has the highest incidence (29%). Lung cancer has the highest death rate among men (29%). The incidence of colon cancer in males is 9%. Thyroid cancer is more common in women than men. Text Reference - p. 248

The nurse is performing an assessment on a patient who has been receiving chemotherapy and radiation for breast cancer. The patient's most recent complete blood count (CBC) results are shown in the chart. Considering the patient's CBC results, which of these additional assessment findings is of most concern? Refer to chart. 1= Nausea 2= Fatigue 3= Temperature of 101.8° F 4= Skin redness at site of radiation

3= Temperature of 101.8° F Neutropenia is most common in patients receiving chemotherapy and can place them at serious risk for life-threatening infection and sepsis. Any sign of infection should be treated promptly, because fever in the setting of neutropenia is a medical emergency. Nausea, fatigue, and skin redness at the site of radiation are expected effects of chemotherapy and radiation therapy. Text Reference - p. 33

A client is experiencing nausea and vomiting 1 day after chemotherapy has begun for cancer treatment. The nurse realizes this clients nausea and vomiting would be considered: 1= anticipatory. 2= acute. 3= delayed. 4= chronic.

3= delayed Delayed nausea and vomiting occurs more than 24 hours after chemotherapy. Anticipatory nausea and vomiting occur before, during, or after chemotherapy, and they appear earlier than expected. Acute nausea and vomiting occur within 24 hours after starting chemotherapy. Chronic nausea and vomiting affect people with advanced cancer and is not well understood.

A clients most recent prostate-specific antigen level has decreased since starting treatment for prostate cancer. The nurse realizes this level would indicate that the client: 1= no longer has the disease. 2= has an increase in the severity of the disease process. 3= is responding to treatment. 4= should be retested.

3= is responding to treatment. A decrease in a tumor marker is important in the assessment of cancer, monitoring tumor response during treatment strategies, and diagnosis of recurrence of disease. A decrease in the prostate-specific antigen level once treatment has begun for prostate cancer would indicate that the client is responding to treatment. A drop in the level does not mean that the client no longer has the disease, that the disease is progressing, or that the client needs to be retested.

A patient has been advised to undergo an autologous bone marrow transplant. A nurse explains the procedure to the patient. Which patient statement indicates that the teaching has been understood? 1= "It involves transfusing stem cells from an identical twin." 2= "It involves transfusing stem cells from a family member." 3= "It involves transfusing stem cells from a donor from a bone marrow registry." 4= "It involves transfusing stem cells harvested from myself."

4= "It involves transfusing stem cells harvested from myself." Bone marrow transplants are very effective in treating malignancies of the bone marrow. There are three types of bone marrow transplantation. An autologous stem cell transplant requires harvesting the stem cells from the patient, and transfusing it back to the patient after myeloablative therapy. Syngeneic transplantation involves obtaining stem cells from one identical twin and infusing them into the other. An allogeneic transplantation involves obtaining stem cells from a donor who is human leukocyte antigen (HLA) matched to the patient. It can be a family member or a donor from a bone marrow registry. Text Reference - p. 274

A patient with lung cancer tells the nurse, "I know I am going to die pretty soon, perhaps in the next month." What is the best response by the nurse? 1= "Would you like for me to call your spiritual advisor so you can talk about your feelings?" 2= "Perhaps you are depressed about your illness; I will speak to the health care provider about getting some medications for you." 3= "None of us knows when we are going to die. Is this a particularly difficult day?" 4= "What are your feelings about being so sick and thinking you may die soon?"

4= "What are your feelings about being so sick and thinking you may die soon?" The best response to psychosocial questions is to acknowledge the patient's feelings and explore his or her concerns. "What are your feelings about being so sick and thinking you may die soon?" does both and is a helpful response that encourages further communication between patient and nurse. Calling the spiritual advisor is permissible; however, this does not increase communication and rapport between the patient and the nurse. The patient is expressing feelings; medication is not indicated for this. Ignoring the patient's feelings is not therapeutic communication. Text Reference - p. 280

Which item would be most beneficial when providing oral care to a patient with metastatic cancer who is at risk for oral tissue injury secondary to chemotherapy? 1= Firm-bristle toothbrush 2= Hydrogen peroxide rinse 3= Alcohol-based mouthwash 4= 1 tsp salt in 1 L water mouth rinse

4= 1 tsp salt in 1 L water mouth rinse A salt-water mouth rinse will not cause further irritation to oral tissue that is fragile because of mucositis, which is a side effect of chemotherapy. A soft-bristle toothbrush will be used. One teaspoon of sodium bicarbonate may be added to the salt-water solution to decrease odor, alleviate pain, and dissolve mucin. Hydrogen peroxide and alcohol-based mouthwash are not used because they would damage the oral tissue.

The patient is receiving immunotherapy and targeted therapy for ovarian cancer. What medication should the nurse expect to administer before therapy to combat the most common side effects of these medications? 1= Morphine sulfate 2= Ibuprofen (Advil) 3= Ondansetron (Zofran) 4= Acetaminophen (Tylenol)

4= Acetaminophen (Tylenol) Acetaminophen is administered before therapy and every 4 hours to prevent or decrease the intensity of the severe flu-like symptoms, especially with interferon which is frequently used for ovarian cancer. Morphine sulfate and ibuprofen will not decrease flu-like symptoms. Ondansetron is an antiemetic but is not used first to combat flu-like symptoms of headache, fever, chills, myalgias, and so on.

The nurse is caring for a patient suffering from anorexia secondary to chemotherapy. Which strategy would be most appropriate to increase the patient's nutritional intake? 1= Increase intake of liquids at mealtime to stimulate the appetite. 2= Serve three large meals per day plus snacks between each meal. 3= Avoid the use of liquid protein supplements to encourage eating at mealtimes. 4= Add items such as skim milk powder, cheese, honey, or peanut butter to selected foods.

4= Add items such as skim milk powder, cheese, honey, or peanut butter to selected foods. The nurse can increase the nutritional density of foods by adding items high in protein and/or calories (e.g., peanut butter, skim milk powder, cheese, honey, brown sugar) to foods the patient will eat. Increasing fluid intake at mealtime fills the stomach with fluid and decreases the desire to eat. Small frequent meals are best tolerated. Supplements can be helpful.

A patient has been diagnosed with Burkitt's lymphoma. In the initiation stage of cancer, the cells genetic structure is mutated. Exposure to what may have functioned as a carcinogen for this patient? 1= Bacteria 2= Sun exposure 3= Most chemicals 4= Epstein-Barr virus

4= Epstein-Barr virus

A patient has been diagnosed with Burkitt's lymphoma. In the initiation stage of cancer, the cells' genetic structure is mutated. Exposure to what may have had the greatest impact as a carcinogen for this patient? 1= Bacteria 2= Sun exposure 3= Most chemicals 4= Epstein-Barr virus

4= Epstein-Barr virus Burkitt's lymphoma consistently shows evidence of the presence of Epstein-Barr virus in vitro. Bacteria do not initiate cancer. Sun exposure causes cell alterations leading to melanoma and squamous and basal cell skin carcinoma. Long-term exposure to certain chemicals (e.g., ethylene oxide, chloroform, benzene) is known to initiate cancer. Text Reference - p. 251

A client recovering from bone marrow transplantation is experiencing vomiting, fatigue, and skin reactions. Which of the following should the nurse do to help this client? 1= Prepare to administer platelets as prescribed. 2= Prepare to administer red blood cells as prescribed. 3= Limit fluids. 4= Explain that the client is experiencing expected short-term side effects.

4= Explain that the client is experiencing expected short-term side effects. Clients who undergo bone marrow transplantation may experience short-term side effects, including nausea, vomiting, fatigue, loss of appetite, mouth sores, hair loss, and skin reactions. These side effects are not treated with platelets or red blood cells. Limiting fluids can make the side effects worse.

Even though a client has completed a course of chemotherapy and has been found to be cancer free at this time, she continues to experience fatigue. Which of the following should the nurse instruct this client? 1= Fatigue is the first warning sign of cancer and should be reported to the physician. 2= Fatigue indicates a poor diet. 3= Fatigue is caused by poor fluid intake. 4= Fatigue can persist after treatment ends, but it will eventually improve.

4= Fatigue can persist after treatment ends, but it will eventually improve. Fatigue is the most common symptom associated with cancer and cancer treatment. Fatigue is more often a result of the treatment than the cancer itself. The client should be informed that fatigue may persist after cancer therapy is completed, but it will eventually improve.

When caring for the patient with cancer, what does the nurse understand as the response of the immune system to antigens of the malignant cells? 1= Metastasis 2= Tumor angiogenesis 3= Immunologic escape 4= Immunologic surveillance

4= Immunologic surveillance Immunologic surveillance is the process in which lymphocytes check cell surface antigens and detect and destroy cells with abnormal or altered antigenic determinants to prevent these cells from developing into clinically detectable tumors. Metastasis is increased growth rate of the tumor, increased invasiveness, and spread of the cancer to a distant site in the progression stage of cancer development. Tumor angiogenesis is the process of blood vessels forming within the tumor itself. Immunologic escape is the cancer cells' evasion of immunologic surveillance that allows the cancer cells to reproduce.

A 64-yr-old male patient who is receiving radiation to the head and neck as treatment for an invasive malignant tumor complains of mouth sores and pain. Which intervention should the nurse add to the plan of care? 1= Provide ice chips to soothe the irritation. 2= Weigh the patient every month to monitor for weight loss. 3= Cleanse the mouth every 2 to 4 hours with hydrogen peroxide. 4= Provide high-protein and high-calorie, soft foods every 2 hours.

4= Provide high-protein and high-calorie, soft foods every 2 hours. A patient with stomatitis should have soft, nonirritating foods offered frequently. The diet should be high in protein and high in calories to aid healing. Extremes of temperature are to be avoided. Saline or water should be used to cleanse the mouth (not hydrogen peroxide). Patients should be weighed at least twice each week to monitor for weight loss.

Which nursing diagnosis is most appropriate for a patient experiencing myelosuppression secondary to chemotherapy for cancer treatment? 1= Acute pain 2= Hypothermia 3= Powerlessness 4= Risk for infection

4= Risk for infection Myelosuppression is accompanied by a high risk of infection and sepsis. Hypothermia, powerlessness, and acute pain are also possible nursing diagnoses for patients undergoing chemotherapy, but the threat of infection is paramount.

A 70-yr-old man who has end-stage lung cancer is admitted to the hospital with confusion and oliguria for 2 days. Which finding would the nurse report immediately to the health care provider? 1= Weight gain of 6 lb 2= Nausea and vomiting 3= Urine specific gravity of 1.004 4= Serum sodium level of 118 mEq/L

4= Serum sodium level of 118 mEq/L Lung cancer cells are able to manufacture and release antidiuretic hormone (ADH) with resultant water retention and hyponatremia. Hyponatremia (serum sodium levels less than 135 mEq/L) may lead to central nervous system symptoms such as confusion, seizures, coma, and death. The other options listed are also symptoms of hyponatremia but are not as critical to report to the health care provider.

The nurse realizes that for a cell to become cancer, it needs to progress through four stages. Which of the following is not a stage of this process? 1= Initiation 2= Metastasis 3= Progression 4= Stimulation

4= Stimulation The four stages of oncogenesis or carcinogenesis are: 1) initiation, 2) promotion, 3) progression, and 4) metastasis. Stimulation is not a stage of carcinogenesis.

Which of the following statements made by a client after receiving instruction regarding internal radiation would indicate that teaching has been successful? 1= My children can come visit me after school. 2= Individuals will need to keep at least 3 feet away when possible. 3= I will be sharing a room near the nursing station. 4= The hospital staff will limit the amount of time in my room.

4= The hospital staff will limit the amount of time in my room. General guidelines include assigning the patient to a private room; postradiation precaution signage; limiting the amount of time in the room; observing a distance of at least 6 feet from the source when possible; and prohibiting pregnant staff, family, visitors, and children from interacting or visiting with the patient. The other choices would indicate the need for additional instruction and are incorrect

The patient with advanced cancer is having difficulty controlling her pain. She says she is afraid she will become addicted to the opioids. What is the first thing the nurse should do for this patient? 1= Administer a nonsteroidal antiinflammatory drug. 2= Assess the patient's vital signs and behavior to determine the medication to use. 3= Have the patient keep a pain diary to better assess the patient's potential addiction. 4= Obtain a detailed pain history including quality, location, intensity, duration, and type of pain.

4= The priority in pain management is to obtain a comprehensive history of the patient's pain. This will determine the medications most useful for this patient's pain to enable giving the dose that relieves the pain with the fewest side effects. Teaching the patient about the lack of tolerance and addiction associated with effective cancer pain management will also be important for this patient's pain management.

The patient is being treated with brachytherapy for cervical cancer. What factors must the nurse be aware of to protect herself when caring for this patient? 1= The medications the patient is taking 2= The nutritional supplements that will help the patient 3= How much time is needed to provide the patient's care 4= The time the nurse spends at what distance from the patient

4= The time the nurse spends at what distance from the patient The principles of ALARA (as low as reasonably achievable) and time, distance, and shielding are essential to maintain the nurse's safety when the patient is a source of internal radiation. The patient's medications, nutritional supplements, and time needed to complete care will not protect the nurse caring for a patient with brachytherapy for cervical cancer.

A clients tumor was staged using the TNM system. The tumor was staged as T4,N1,Mx. The nurse realizes that this staging means: 1= tumor in situ, minimal node involvement, no presence of metastasis. 2= large tumor, no node involvement, presence of metastasis. 3= medium tumor, multiple nodes involvement, no presence of metastasis. 4= large tumor, single node involvement, unable to assess metastasis.

4= large tumor, single node involvement, unable to assess metastasis. The larger the number in the TNM staging system, the increasing involvement or larger size of the tumor, node, and metastasis. T4 reflects the size of the tumor. N1 describes the regional node involvement. Mx signals the inability to assess the presence or absence of distant metastasis.

The nurse provides instructions regarding markings on the skin to a patient who is undergoing radiation therapy. What explanation should the nurse provide regarding the markings? 1= They are permanent effects of radiation therapy. 2= They indicate that previous treatments have been unsuccessful. 3=They are a warning of potentially serious side effects of radiation. 4=They should be protected, because they are landmarks for the radiation therapy.

4=They should be protected, because they are landmarks for the radiation therapy. Markings should be protected from being washed or removed because they are landmarks for the radiation therapy treatment field. They are not permanent; nor are they an indication that previous treatment has been unsuccessful or a warning about the side effects of radiation. Text Reference - p. 262

Patients may reduce the risk of developing cancer using health promotion strategies.Identify strategies which can reduce the risk of developing cancer (select all that apply.). 1= Control weight 2= Genetic testing 3= Immunizations 4= Use sunscreen 5= Stop smoking 6= Limit alcohol intake

ALL of the above

A client is experiencing nausea and vomiting related to chemotherapy. Which of the following strategies can the nurse use to improve nutrition in this client? (Select all that apply.) 1= Adding peppermint to foods 2= Administering ondansetron 3= Drinking adequate fluids 4= Drinking hot beverages 5= Eating food at room temperature 6= Sipping ice water

ANS: 1, 2, 3, 5 Strategies to improve nutrition in the client experiencing nausea and vomiting from chemotherapy include using herbs such as peppermint, administering prescribed anti-emetics, ensuring an adequate intake of fluids, and ingesting foods at room temperature. Foods and fluids of extreme temperatures such as hot beverages and ice water should be avoided by the patient with nausea and vomiting.

A client asks the nurse what he can do to prevent the onset of cancer. The nurse realizes that which of the following contribute to the development of cancer? (Select all that apply.) 1= Heredity 2= Environment 3= Lifestyle 4= Stress 5= Age 6= Blood pressure

ANS: 1, 2, 3, 5 The factors known to contribute to the development of cancer include heredity, environment, and lifestyle. Aging has a direct effect on ones risk of developing cancer. The longer one lives, the greater the risk for developing cancer. Stress and blood pressure are not factors known to contribute to the development of cancer.

A client is prescribed a selective estrogen receptor modulator as treatment for ovarian cancer. Which of the following should the nurse instruct the client regarding side effects of this medication? (Select all that apply.) 1= Hot flashes 2= Blood clots 3= Drop in blood pressure 4= Reduce libido 5= Increased risk of developing other cancer 6= Weight gain

ANS: 1, 2, 4, 5 Side effects of selective estrogen modulator medications include hot flashes, blood clots, loss of interest in sex, and a higher risk of other cancers. Drop in blood pressure and weight gain are not side effects associated with this classification of medication.

A nurse is teaching at a health fair about the early warning signs of cancer. Which of the following would the nurse include as early warning signs? (Select all that apply.) 1= A sore that does not heal 2= Change in bladder or bowel habits 3= Family history 4= Unusual discharge 5= Obvious change in nevus 6= Nagging cough

ANS: 1, 2, 4, 5, 6 Early warning signs can be easily remember using the acronym CAUTION: C, change in bladder or bowel habits; A, a sore that does not heal; U, unusual bleeding or discharge; T, presence of a lump or thickening; I, indigestion; O, obvious change in a wart or mole; and N, a nagging cough or hoarseness.

The nurse is planning to instruct a client on strategies to lessen the impact of lifestyle on the development of cancer. Which of the following should the nurse include in these instructions? (Select all that apply.) 1= Follow a low-fat diet. 2= Avoid prescribed medications. 3= Exercise regularly. 4= Limit sun exposure. 5= Sleep less than 7 hours each night. 6= Do not smoke or use any tobacco products.

ANS: 1, 3, 4, 6 Strategies to lessen the impact of lifestyle on the development of cancer include following a low-fat diet, exercising regularly, limiting sun exposure, and avoiding all use of tobacco products. Prescribed medications will not lessen the impact of lifestyle on the development of cancer. Sleeping less than 7 hours each night will not lessen the impact of lifestyle on the development of cancer.

A patient is undergoing brachytherapy of the cervix and tells the nurse, "I feel like I'll be alone in this room forever!" What is the best response by the nurse? 1. "The staff is trying to provide privacy for you as much as possible." 2. Is there a family member we can call to stay with you during the treatment?" 3. "Let me call your primary health care provider to see if the therapy can be removed early." 4. "During the treatment, we have to limit how much time we are in the room, but the treatment will be finished soon."

Answer: 4. "During the treatment, we have to limit how much time we are in the room, but the treatment will be finished soon." Brachytherapy consists of the implantation or insertion of radioactive materials directly into the tumor or adjacent to the tumor. Caring for the person undergoing brachytherapy or receiving radiopharmaceuticals requires the nurse to take special precautions. The principles of ALARA (as low as reasonably achievable) and of time, distance, and shielding are vital to health care professional safety when caring for the person with an internal radiation source. To minimize anxiety and confusion, tell the patient the reason for time and distance limitations before the procedure. The reason the patient is in isolation is not to provide privacy. It is not appropriate for a family member to put themselves at risk by staying with the patient. Therapy cannot be ceased early.

Cancer staging: 0

Cancer in situ

Histologic classification: Grade 4

Cells are immature and primitive (anaplasia) and is difficult to determine (high grade)

Histologic classification: Grade 2

Cells are more abnormal (moderate dysplasia) and moderately intermediate grade

Histologic classification: Grade 3

Cells are very abnormal (severe dysplasia) and poorly grade

Histologic classification: Grade 1

Cells differ slightly from normal cells (mild dysplasia) and are low grade

Cancer staging: 3

Extensive local and regional spread

Histologic classification: Grade 5

Grade cannot be assessed

Histologic classification

Histological grading takes into account the appearance of cells and degree of differentiation are evaluated pathologically. Four grades are used to evaluate abnormal cells based on the degree to which the cells resemble the tissue of the organ. Tumors that are poorly differentiated (undifferentiated) have a poorer prognosis than those that are close in appearance to the normal tissue (well differentiated)

Cancer staging: 2

Limited local spread

Tumor classification: Carcinoma

Originate from embryonal ectoderm (skin and glands) and endoderm (mucous membrane linings of the respiratory, GI and genitourinary tract)

Tumor classification: Sarcoma

Originate from embryonal mesoderm (connective tissue, muscle, bone and fat)

Tumor classification: Lymphoma and leukemia

Originate from the hematopoietic system

Cancer staging: 1

Tumor limited to the tissue of origin: localized tumor growth

REFERENCES

https://quizlet.com/106741301/flashcards https://quizlet.com/106760941/eaq-care-of-patients-w-cancer-flash-cards/ https://quizlet.com/129750696/lewis-study-guide-questions-flash-cards/ https://quizlet.com/129750696/lewis-study-guide-questions-flash-cards/ http://testbankgo.eu/chapter-15-cancer-management/