Med Surg: Chapter 15

A young female client has received chemotherapeutic medications and asks about any effects the treatments will have related to her sexual health. The most appropriate statement by the nurse is "You will be unable to have children." "You will need to practice birth control measures." "You will continue having your menses every month." "You will experience menopause now."

"You will need to practice birth control measures."

A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: Tis, N0, M0. What does this classification mean?

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

A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication?

Serum potassium level of 2.6 mEq/L

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

Stomatitis

Which statement is true about malignant tumors?

They gain access to the blood and lymphatic channels.

A client with metastatic pancreatic cancer underwent surgery to remove a malignant tumor in the pancreas. Despite the tumor being removed, the physician informs the client that chemotherapy must be started. Why might the physician opt for chemotherapy?

To prevent metastasis

The physician is attending to a 72-year-old client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation?

To prevent the formation of new cancer cells

What is the best way for the nurse to assess the nutritional status of a patient with cancer?

Weigh the patient daily.

Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure?

blood studies

A nurse is performing a home visit for a client who received chemotherapy within the past 24 hours. The nurse observes a small child playing in the bathroom, where the toilet lid has been left up. Based on these observations, the nurse modifies the client's teaching plan to include: -signs and symptoms of infection. -expected chemotherapy-related adverse effects. -reinforcement of the client's medication regimen. -chemotherapy exposure and risk factors.

chemotherapy exposure and risk factors.

A serum sodium concentration lower than 115 mEq/L (115 mmol/L) is associated with

seizure

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

"The surgeon is going to use liquid nitrogen to freeze the area." Cryoablation is the use of liquid nitrogen or a very cold probe to freeze tissue and cause cell destruction. It is used for cervical, prostate, and rectal cancers. Chemosurgery is the use of medication. Laser surgery is the use of a laser. Radiofrequency ablation is the use of thermal energy.

The drug interleukin-2 is an example of which type of biologic response modifier?

Cytokine

What foods should the nurse suggest that the patient consume less of in order to reduce nitrate intake because of the possibility of carcinogenic action? Green, leafy vegetables Ham and bacon Fish and poultry Eggs and milk

Ham and bacon

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

How they tend to grow and the cell type

A client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer?

Indigestion

The nurse is caring for a client undergoing an incisional biopsy. Which statement does the nurse understand to be true about an incisional biopsy?

It removes a wedge of tissue for diagnosis.

A decrease in circulating white blood cells (WBCs) is referred to as

Leukopenia

A patient with uterine cancer is being treated with intracavitary radiation. The patient will emit radiation while the implant is in place. The nurse is aware of the precautions necessary for the provider of care and visitors. Which of the following are appropriate guidelines to follow? Select all that apply. -The nurse can provide direct care for up to 60 minutes per 8-hour shift. -Family members should stand about 6 feet from the patient. -Lead aprons should be worn to buffer the exposure. -Visitors may stay for 30 minutes or less.

Family members should stand about 6 feet from the patient. Lead aprons should be worn to buffer the exposure. Visitors may stay for 30 minutes or less.

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

The I.V. site is red and swollen.

What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen? It functions against disseminated disease. It causes a systemic reaction. It targets normal body cells as well as cancer cells. It attacks cancer cells during their vulnerable phase.

It targets normal body cells as well as cancer cells.

Which statement by a client undergoing external radiation therapy indicates the need for further teaching? "I'll wear protective clothing when outside." "I'll wash my skin with mild soap and water only." "I'm worried I'll expose my family members to radiation." "I'll not use my heating pad during my treatment."

"I'm worried I'll expose my family members to radiation."

A nurse is caring for a client who is receiving chemotherapy and has a platelet count of 30,000/mm3. Which statement by the client indicates a need for additional teaching? "I take a stool softener every morning." "I removed all the throw rugs from the house." "I use an electric razor to shave." "I floss my teeth every morning."

"I floss my teeth every morning."

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? "I guess the doctor could not remove the entire tumor." "I will be glad to finally be done with treatments for this thing." "I am so glad the doctor was able to remove the entire tumor." "Thank goodness the tumor is contained and curable."

"I guess the doctor couldn't 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?

"The hair loss is usually temporary."

The root cause of cancer is damage to cellular deoxyribonucleic acid (DNA) which can be caused by many factors, or carcinogens. What factors can be carcinogenic? Select all that apply. age viruses gender environmental factors dietary substances

-viruses -environmental factors -dietary substances

The oncology nurse is giving chemotherapy to a client in a short stay area. The client confides that they are very depressed. The nurse recognizes depression as which of the following?

A normal reaction to the diagnosis of cancer.

The nurse is conducting a screening for familial predisposition to cancer. Which element should the nurse note as a possible indication of hereditary cancer syndrome? Onset of cancer after age 50 in family member An aunt and uncle diagnosed with cancer A first cousin diagnosed with cancer A second cousin diagnosed with cancer

An aunt and uncle diagnosed with cancer

5-Fluorouracil (5FU) is classified as which type of antineoplastic agent?

Antimetabolite

Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client?

Autologous

A client diagnosed with cancer makes the following statement to the nurse: "I guess I will tell my health care provider to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die." Which of the following facts supports the use of chemotherapy for this client?

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

A client diagnosed with acute myelocytic leukemia has been receiving chemotherapy. During the last 2 cycles of chemotherapy, the client developed severe thrombocytopenia requiring multiple platelet transfusions. The client is now scheduled to receive a third cycle. How can the nurse best detect early signs and symptoms of thrombocytopenia?

Closely observe the client's skin for petechiae and bruising.

Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth? Prevention Cure Palliation Control

Control The range of possible treatment goals may include complete eradication of malignant disease (cure), prolonged survival and containment of cancer cell growth (control), or relief of symptoms associated with the disease (palliation). Prevention is not a treatment goal when the patient has already been diagnosed with cancer. Prevention of metastasis to a secondary site may be a goal

An oncology nurse is caring for a client who relates that certain tastes have changed. The client states that "meat tastes bad." What nursing intervention can be used to increase protein intake for a client with taste changes? Encourage maximum fluid intake. Encourage eating cheese, eggs, and legumes Suck on hard candy during treatment. Stay away from protein beverages

Encourage cheese, eggs, and legumes. The nurse encourages the clients with taste changes to eat cheese, eggs, and legumes.. Encouraging the client to take in the maximum amount of fluids does not increase protein intake. The nurse advises the client to drink protein beverages. Sucking on hard candies during treatment does not increase protein intake.

A patient will be having an endoscopic procedure with a diagnostic biopsy. What type of biopsy does the nurse explain will remove an entire piece of suspicious tissue?

Excisional biopsy

A nurse is administering daunorubicin through a peripheral I.V. line when the client complains of burning at the insertion site. The nurse notes no blood return from the catheter and redness at the I.V. site. The client is most likely experiencing which complication?

Extravasation

A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the best teaching by the nurse?

It lowers serum and uric acid levels.

A nurse is caring for a client after a bone marrow transplant. What is the nurse's priority in caring for the client?

Monitor the client to prevent sepsis.

A nurse is teaching a community class about how to decrease the risk of cancer. Which food should the nurse recommend? Medium-rare steak Smoked ham Oranges Low-fat hot dogs

Oranges

Which type of surgery is used in an attempt to relieve complications of cancer?

Palliative

You are a clinic nurse. One of your clients has found she is at high risk for breast cancer. She asks you what can be done to reduce her risk. What is a means of reducing the risk for breast cancer? Palliative surgery Prophylactic surgery Reduction surgery Curative surgery

Prophylactic surgery

A patient is admitted for an excisional biopsy of a breast lesion. What intervention should the nurse provide for the care of this patient?

Provide time for the patient to discuss her concerns.

What should the nurse tell a client who is about to begin chemotherapy and is anxious about hair loss?

The client should consider getting a wig or cap prior to beginning treatment.

Which of the following would be inconsistent as a common side effect of chemotherapy?

Weight gain

A nurse is caring for a client newly diagnosed with cancer. Which therapies are used to treat cancer? Select all that apply. electroconvulsive therapy surgery radiation therapy chemotherapy hyperthermia

surgery hyperthermia radiation therapy chemotherapy

Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode should the nurse anticipate? No further treatment is indicated. Adjuvant therapy is likely. Palliative care is likely. Repeat biopsy is needed before treatment begins.

Adjuvant therapy is likely.

The patient diagnosed with thrombocytopenia is at risk for which of the following adverse effects: Diminished reflexes Stomatitis Headache Bleeding

Bleeding

The nurse is working with a client who has had an allo-hematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of

Graft-versus-host disease

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? Emission of abnormal proteins Cells colonizing to distant body parts Tumor pressure against normal tissues Random, rapid growth of the tumor

Tumor pressure against normal tissues Benign tumors grow more slowly than malignant tumors and do not emit tumor-specific antigens or proteins. Benign tumors do not metastasize to distant sites. Benign tumors can compress tissues as it grows, which can result in impaired organ functioning.

A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of Risk for impaired skin integrity. Which intervention should be part of this client's care plan? -Applying talcum powder to the irradiated areas daily after bathing -Wearing a lead apron during direct contact with the client -Avoiding using soap on the irradiated areas -Removing thoracic skin markings after each radiation treatment

Avoiding using soap on the irradiated areas

A nurse is caring for a client receiving chemotherapy. Which nursing action is most appropriate for handling chemotherapeutic agents?

Wear disposable gloves and protective clothing.Explanation:A nurse must wear disposable gloves and protective clothing to prevent skin contact with chemotherapeutic agents. The nurse shouldn't recap or break needles. The nurse should use a sterile gauze pad when priming I.V. tubing, connecting and disconnecting tubing, inserting syringes into vials, breaking glass ampules, or other procedures in which chemotherapeutic agents are being handled. Contaminated needles, syringes, I.V. tubes, and other equipment must be disposed of in a leak-proof, puncture-resistant container

The nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice? -drinks one glass of wine at dinner each night -works as a secretary at a medical radiation treatment center -uses the treadmill for 30 minutes on 5 days each week -eats red meat such as steaks or hamburgers every day

eats red meat such as steaks or hamburgers every day