NUR 112 exam 2

extravasation

: leakage of intravenous medication from the veins into the subcutaneous tissues grading: identification of the type of tissue from which the tumor originated and the degree to which the tumor cells retain the functional and structural characteristics of the tissue of origin

The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. What response by the nurse would best reassure this patient? A. "Don't be concerned about these symptoms. Everybody feels this way after having radiation therapy." B. "These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and X-ray studies." C. "These symptoms are part of your disease and can't be helped." D. "This is a good sign. It means that only the cancer cells are dying."

B

You are caring for a client who has just been told that they have stage IV colon cancer. The client asks you what "stage IV" means. What would be your best response? A. "It means the cancer cells are well-differentiated." B. "It means the cancer cells are undifferentiated cells." C. "Stage IV means that the cancer can be easily cured." D. "Stage IV means that the cancer has spread to other organs of the body."

D

A client who will have his last chemotherapy cycle in 11 days becomes neutropenic. The client demonstrates an understanding of his condition when he makes which statement? A "I'll monitor my temperature frequently and go to the nearest emergency department if my temperature rises above 100.4° F for more than one hour." B. "I've found that shaving with my straight razor works better for me." C. "Going out for a quiet dinner and a movie relieves the stress and anxiety of my cancer treatment." D. "I love going to my yoga class; it gives me a lot of inner peace and tranquility."

a

The nurse is caring for a thin, elderly client who was diagnosed with cancer and is receiving aggressive chemotherapy. The client is experiencing acute side effects and has lost 10 pounds in the past week. What teaching should the nurse include? (Select all that apply.) A. Drink liquid supplements between meals to increase intake of nutrients. B. Eat more warm foods and avoid cold foods. C. Eat small frequent meals high in calories and protein. D. Purchase fast foods and prepared foods. E. Encourage spicy foods related to decreased taste sensation.

a c

Cancer

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

benign

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

anaplasia

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

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

A

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

A

The clinic nurse is caring for a client who has just been diagnosed with a tumor. The client says to the nurse "The doctor says my tumor is benign. What does that mean?" What is the nurse's best response? A. "Benign tumors don't usually cause death." B. "Benign tumors grow very rapidly." C. "Benign tumors invade surrounding tissue." D. "Benign tumors can spread from one place to another."

A

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

A

A client received chemotherapy 24 hours ago. Which precautions are necessary when caring for the client? A. Provide a urinal or bedpan to decrease the likelihood of soiling linens. B.Wear personal protective equipment when handling blood, body fluids, and feces. C. Wear sterile gloves. D. Place incontinence pads in the regular trash container.

B

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

B

Which of the following would be inconsistent as a common side effect of chemotherapy? A. Fatigue B. Weight gain C. Myelosuppression D. Alopecia

B

A 16-year-old female client experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. The nurse should determine that the client is meeting the goal of improved body image and self-esteem when the client: A. begins to discuss the future with her family. B. reports less disruption from pain and discomfort. C. requests that her family bring her makeup and wig. D. cries openly when discussing her disease.

C

A client calls the oncology office nurse and reports nausea and vomiting one week after receiving chemotherapy. What action should the nurse recommend? A. Using imagery techniques B. Practicing relaxation techniques C. Taking prescribed ondansetron D. Obtaining acupressure treatments

C

A nurse is caring for a client with prostate cancer and assesses bleeding gums and hematuria. What serum indicator should the nurse relate the bleeding? A. reticulocyte count of 1% B. lymphocyte count of 30% C. platelet count of 60,000/mm3 D. neutrophil count of 40%

C

According to the TNM classification system, T0 means there is A. no distant metastasis. B. distant metastasis. C. no evidence of primary tumor. D. no regional lymph node metastasis.

C

An oncology client has begun to experience skin reactions to radiation therapy, prompting the nurse to make the diagnosis Impaired Skin Integrity: erythematous reaction to radiation therapy. What intervention best addresses this nursing diagnosis? A. Apply an ice pack or heating pad PRN to relieve pain and pruritis B. Apply phototherapy PRN C. Avoid rubbing or scratching the affected area D. Avoid skin contact with water whenever possible

C

Palliation refers to A. hair loss. B. the spread of cancer cells from the primary tumor to distant sites. C. relief of symptoms of disease and promotion of comfort and quality of life. D. the lowest point of white blood cell depression after therapy that has toxic effects on bone marrow.

C

The nurse is evaluating bloodwork results of a client with cancer who is receiving chemotherapy. The client's platelet count is 60,000/mm3. Which is an appropriate nursing action? A. Providing a razor so the client can shave B. Taking the client's temperature rectally C. Avoiding the use of products containing aspirin D. Providing commercial mouthwash to the client

C

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

C

Which of the following is the single largest preventable cause of cancer? A Pesticides B Arsenic C Tobacco D Asbestos

C

A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe? A Pruritis (itching) B Altered glucose metabolism C Confusion D Nausea and vomiting

D

After being seen in the oncology clinic, a client with severe bone marrow suppression is admitted to the hospital. The client's cancer therapy consisted of radiation and chemotherapy. When developing the care plan for this client, which nursing diagnosis takes priority? A. Anxiety B. Risk for injury C. Imbalanced nutrition: Less than body requirements D. Risk for infection

D

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? A. Green, leafy vegetables B. Eggs and milk C. Fish and poultry D. Ham and bacon

D

Apoptosis

a normal cell mechanism of programmed cell death

graft-versus-host disease (GVHD)

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

The nurse is helping the client with iron-deficiency anemia to select appropriate menu choices. Which diet choices indicate that teaching has been effective? A Tofu with mixed vegetables in curry, milk, whole-grain bun. B. Roast beef, steamed spinach, tomato soup, and orange juice. C. Pork chop, mashed potatoes and gravy, cauliflower, and tea. D. Broiled fish, lettuce salad, grapefruit half, carrot sticks.

b

When providing patient teaching regarding taking iron pills, the nurse would include which instructions? (Select all that apply.) A. Take this medication with milk to avoid Gl problems. B. Teaching about potential constipation. C. Keep this potentially toxic medication away from children. D. Take the medication with antacids to alleviate Gl upset. E. Your stools may be green colored.

b c e

The client is diagnosed with cancer and receives a series of chemotherapy treatments. Following this treatment, the nurse reads the client's medical record and learns the tumor has been designated a Stage IV, T4, N3, M1. Which interpretation of this finding is correct? A. No metastasis. B. Metastasis but no lymph node involvement. C. Metastasis, with lymph node involvement. D. No cancer evident.

c

targeted therapies

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

Carcinogens

chemicals, physical factors, and other agents that cause cancer

For a client diagnosed with pernicious anemia, the nurse emphasizes the importance of lifelong administration of which vitamin supplement? A. Vitamin A B. Vitamin C. C. Folic acid. D. Vitamin B 12.

d

The nurse prepares to administer synthetic erythropoietin to a client with renal failure. The nurse expects the therapeutic effect of this treatment to be the stimulation of the production of which cell or substance? A Platelets. B. White blood cells. C. Lymph fluid. D. Red blood cells.

d

Your client is receiving radiation therapy. The client asks you about oral hygiene. What advice regarding oral hygiene should you offer? A Gargle with alcohol based mouthwash after each meal. B. Floss vigorously before going to bed. C. Keep dentures in all day to prevent friction and discomfort. D. Use a soft toothbrush and avoid an electronic toothbrush.

d

thrombocytopenia

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

brachytherapy

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

oncology

field or study of cancer

Angiogenesis

growth of new blood vessels that allow cancer cells to grow

alopecia

hair loss

malignant

having cells or processes that are characteristic of cancer

mucositis

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

stomatitis

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

nadir

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

palliation

relief of symptoms and promotion of comfort and quality of life regardless of the disease stage

metastasis

spread of cancer cells from the primary tumor to distant sites

vesicant

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

cytokines

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

myelosuppression

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

graft-versus-tumor effect

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

radiation therapy:

the use of ionizing radiation to kill malignant cells

chemotherapy

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

neoplasia

uncontrolled cell growth that follows no physiologic demand; cancer

precision medicine:

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

staging

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

Carcinogenesis

process of transforming normal cells into malignant cells

neutropenia

abnormally low absolute neutrophil count

A client on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in clients at risk for thrombocytopenia? A. Interrupted sleep pattern B. Hot flashes C. Epistaxis D. Increased weight

C

The nurse is caring for a client who has just been given a 6-month prognosis following a diagnosis of extensive stage small-cell lung cancer. The client states that he would like to die at home, but the team believes that the client's care needs are unable to be met in a home environment. What might the nurse suggest as an alternative? A. Discuss a referral for rehabilitation hospital. B. Panel the client for a personal care home. C. Discuss a referral for acute care. D. Discuss a referral for hospice care.

D