Oncology 2014

A nurse is inspecting the stoma of a client after creation of a ureterostomy. Which of the following would the nurse expect to note?

A red and moist stoma

A nurse is reinforcing information regarding chemotherapy with a client who has been diagnosed with cancer. The nurse tells the client that an advantage of continuous intravenous (IV) chemotherapy is that it:

Uses smaller doses to kill cancer cells, so it is less toxic to normal tissues

A nurse is preparing a client for an intravesical instillation of an alkylating chemotherapeutic agent into the bladder for the treatment of bladder cancer. The nurse provides instructions to the client regarding the procedure. Which statement by the client indicates an understanding of this procedure?

"After the instillation is done, I will need to change position every 15 minutes from side to side."

A nurse is assisting in providing a session to community members about the risks associated with laryngeal cancer. Which statement by a client indicates an understanding of the risk factors?

"Exposure to airborne carcinogens can cause this type of cancer."

A nurse is providing instructions to a client receiving external radiation therapy. The nurse determines that the client needs further instructions if the client states an intention to:

Apply pressure on the radiated area to prevent bleeding.

A nurse is teaching the client who is about to begin external radiation therapy how to maintain optimal skin integrity during therapy. The nurse determines that further teaching is needed if the client states that he will do which of the following?

Apply tight dressings over the area to prevent bleeding.

A nurse is developing a plan of care for a client following a radical mastectomy and includes measures that will assist in preventing lymphedema of the affected arm. The nurse should include which of the following to prevent this complication?

Elevate the affected arm on a pillow.

A client is receiving chemotherapy that carries a risk of phototoxicity as an adverse effect. Which finding indicates that the client experienced this side effect?

Erythema

A nurse determines that a client with a history of which of the following is most at risk of endometrial cancer?

Estrogen replacement therapy

A nurse is reviewing the laboratory results of a client who has been diagnosed with multiple myeloma. Which of the following would the nurse expect to specifically note with this diagnosis?

Increased calcium level

A client is tentatively diagnosed with ovarian cancer. The nurse gathers data about which late manifestation of this disease?

Pelvic pain, anemia, and ascites

A client with cancer is at risk for experiencing vena cava syndrome. The nurse would monitor this client for which of the following as an early sign of this oncological emergency?

Periorbital edema

The nurse's teaching plan for a client with a family history of breast cancer should include which important item?

Teaching breast self-exam technique to be done every month

A nurse when inspecting the stoma of a client following an ureterostomy 6 hours ago, notes that the stoma appears pale in color. Which interpretation does the nurse make based on this finding?

The vascular supply to the stoma is insufficient.

A nurse is caring for a client who has undergone pelvic exenteration. In addressing psychosocial issues related to the surgery, which statement by the nurse would be therapeutic?

"How do you feel about your body?"

A nurse caring for a client following a radical neck dissection and creation of a tracheostomy performed for laryngeal cancer is providing discharge instructions to the client. Which statement by the client indicates the need for additional instructions regarding care to the stoma?

"I need to use an air conditioner to provide cool air to assist in breathing."

A client with lung cancer receiving chemotherapy tells the nurse that the food on the meal tray tastes "funny." Which of the following is the appropriate nursing intervention?

Provide oral hygiene care frequently

A nurse is assisting in caring for a client receiving chemotherapy. On review of the morning laboratory results, the nurse notes that the white blood cell count is extremely low, and the client is immediately placed on neutropenic precautions. The client's breakfast tray arrives, and the nurse inspects the meal and prepares to bring the tray into the client's room. Which of the following actions should the nurse take before bringing the meal to the client?

Remove the fresh orange from the breakfast tray.

A client with cancer develops white patches on the mucous membranes of the oral cavity. The nurse noting this would:

Report these symptoms, which are consistent with candidiasis.

A nurse has just confirmed that a client has been scheduled for a mammogram for the following week. The nurse reinforces that the client should: Select all that apply.

Avoid applying skin lotion on the day of the test, Remove any necklaces before presenting for the procedure.

A nurse reviews the laboratory results for a client diagnosed with leukemia who is receiving chemotherapy. The nurse notes that the white blood cell (WBC) count is 2000 cells/mm3. The nurse identifies the results as:

Signifying leukopenia

A nurse is caring for a client with metastatic lung cancer. The client was medicated 2 hours ago and now reports a new and sudden sharp pain in the back. The nurse appropriately interprets this finding as possibly indicating:

Spinal cord compression

A nurse is instructing a client to perform a testicular self-examination (TSE). Which instruction would the nurse provide to the client?

The best time for the examination is after a shower.

A female client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing:

The development of a vesicovaginal fistula

A client with leukemia who had a bone marrow aspiration is thrombocytopenic. The nurse gives which of the following instructions to the family as the client is discharged to home?

Watch the puncture site for bleeding for the next several days.

A nurse is reviewing the record of a client admitted to the hospital for treatment of bladder cancer. Which risk factor related to this type of cancer would the nurse likely note in the client's record?

Drinks coffee and smokes cigarettes

A nurse is assisting in caring for a client with an inoperable lung tumor and helps to develop a plan of care by addressing complications related to the disorder. The nurse includes in the plan to monitor for the early signs of vena cava syndrome. Which of the following should the nurse include in the plan of care as the early sign of this oncological emergency?

Edema of the face and eyes

A nurse is caring for a client after a radical mastectomy. Which nursing intervention would assist with preventing lymphedema of the affected arm?

Elevating the affected arm on a pillow above heart level

A client with ovarian cancer is scheduled to receive chemotherapy with cisplatin. The nurse assisting in caring for the client reviews the plan of care, expecting to note which intervention?

Encourage fluids.

A client receiving chemotherapy tells the nurse, "What will I ever do when my hair starts to fall out?" The appropriate response by the nurse should be to:

Encourage her to select a wig.

A nurse is assisting with developing a plan of care for the client with multiple myeloma. Which of the following is a priority nursing intervention for this client?

Encouraging fluids

A client is admitted to the hospital with a diagnosis of suspected Hodgkin's disease. Which of the following findings would the nurse most likely expect to find documented in the client's record?

Enlarged lymph nodes

A client has just been told by the health care provider about her diagnosis of breast cancer. The client responds, "Oh no, does this mean I'm going to die?" The nurse interprets that the client's initial reaction is one of:

Fear

A client with endometrial cancer is receiving doxorubicin (Adriamycin), an antineoplastic agent. The nurse would specifically collect data about which of the following?

Hematological laboratory values

A nurse is reviewing the record of a client with a iagnosis of cervical cancer. Which of the following should the nurse expect to note in the client's record related to a risk factor associated with this type of cancer?

History of human papillomavirus

A nurse is teaching a local women's church group about the risks of cervical cancer. The nurse determines that further teaching is necessary if a group member states that which of the following is a risk factor?

Intercourse with circumcised males

A nurse is assisting with providing a teaching session to a community group regarding the risks and causes of bladder cancer. The nurse determines that additional teaching is needed if a member of the community group states which of the following regarding this type of cancer?

It most often occurs in women.

A nurse is reviewing the laboratory results of a client who is receiving chemotherapy and notes that the platelet count is 10,000 cells/mm3. On the basis of this laboratory value, the priority action is to monitor which of the following?

Level of consciousness

A client who has just been told by the health care provider that she has breast cancer responds by stating, "Oh, no, this has to be a big mistake." The nurse interprets that the client's initial reaction is one of:

Denial

A nurse is assisting in preparing a teaching plan of care for a client being discharged from the hospital following surgery for testicular cancer. Which instruction will the nurse suggest to include in the plan?

"An elevation in temperature should be reported to the health care provider."

When reviewing the health care record of a client with ovarian cancer, the nurse recognizes which symptom as being typical of the disease?

Abdominal distention

A nurse teaching a group of adults about cancer warning signs presents to the group a list of the seven warning signs of cancer. The nurse determines that further teaching is necessary if a member of the group states that which of the following is a warning sign?

Absence or decreased frequency of menses

A nurse is caring for a client dying of ovarian cancer. During care, the client states, "If I can just live long enough to attend my daughter's graduation, I'll be ready to die." Which phase of coping is this client experiencing?

Bargaining

A nurse is caring for a client with cancer receiving chemotherapy who has developed stomatitis. The nurse plans to give mouth care by using oral care agents and devices:

Based on the severity of stomatitis

A nurse is providing instructions to a client scheduled for conization in 1 week for the treatment of microinvasive cervical cancer. The procedure has been explained by the health care provider, and the nurse is reviewing the complications associated with the procedure. The nurse determines that the client needs further instruction if the client states that which of the following is a complication of this procedure?

Ovarian perforation

A nurse is monitoring a client with a diagnosis of cancer for signs and symptoms related to vena cava syndrome. The nurse understands that which of the following is an early sign of this oncological emergency?

Periorbital edema

A nurse instructs the client in breast self-examination (BSE). The nurse instructs the client to lie down and examine the left breast. The nurse instructs the client that while examining the left breast, to place a pillow:

Under the left shoulder

nurse answers the call bell of a client who had insertion of an internal cervical radiation implant. The client states that the implant fell out, and the nurse sees it lying in the bed after moving back the sheet. Which of the following actions should the nurse take first?

Use a long-handled forceps to place the implant in a lead container.

A nurse reviews the care plan of a client with cancer undergoing chemotherapy. The nurse notes that the client has a concern about her appearance as a result of alopecia. The nurse plans to tell the client which of the following about hair loss and regrowth to assist the client in coping with this possible change?

Regrown hair may have a different color and texture.

A nurse is assisting with conducting a health-promotion program at a local school. The nurse determines that additional teaching is needed if a student identifies which of the following as a risk factor associated with cancer?

Low-fat and high-fiber diets

A nurse is reviewing the health record of a client with laryngeal cancer. The nurse would expect to note which most common risk factor for this type of cancer documented in the record?

Cigarette smoking

A gastrectomy is performed on a client with gastric cancer. In the immediate postoperative period the nurse notes bloody drainage from the nasogastric (NG) tube. The nurse plans to:

Continue to monitor the drainage

A nurse is assisting in the care of a client diagnosed with multiple myeloma who has been prescribed an intravenous solution. Which finding would indicate a positive response to this treatment?

Creatinine of 1 mg/dL

A nurse discusses the risk factors associated with gastric cancer as part of a health promotion program. The nurse determines that further discussion is necessary if a member attending the program states that which factor is a risk?

High meat and carbohydrate consumption

A nurse is reviewing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurs with the chemotherapy?

Increased uric acid level

A nurse is reviewing the medical history of a client admitted to the hospital with a diagnosis of colorectal cancer. The nurse understands that which information documented in the medical history is an unassociated risk factor of this type of cancer?

Regular consumption of a high-fiber diet

A nurse teaches skin care to the client who is receiving external radiation therapy. Which of the following statements, if made by the client, would indicate the need for further instruction?

"I will limit sun exposure to 1 hour daily."

A nurse informs a client that a Papanicolaou smear will be done at the next scheduled clinic visit, and the nurse provides instructions to the client regarding preparation for this test. Which statement by the client indicates an understanding of the procedure?

"If I have my period at the time of my next scheduled visit, I will not be able to have the test done."

A nurse is caring for a client after a modified radical mastectomy. Which of the following findings would indicate that the client is experiencing a complication related to the surgery?

Arm edema on the operative side

A nurse is assisting in planning care for a client with Hodgkin's disease who is neutropenic as a result of radiation and chemotherapy. Which should be included in the client's plan of care to decrease the risk of infection? Select all that apply.

Asking visitors with respiratory infection symptoms to not visit the client, Ensuring meticulous handwashing before caring for the client, Monitoring white blood cell counts daily

A nurse is teaching breast self-examination (BSE) to a client who has had a hysterectomy. The nurse tells the client to perform the BSE:

At a specific day of the month and on that same day every month thereafter

A nurse is caring for a client with cancer of the prostate after a prostatectomy. The nurse provides discharge instructions and plans to include which of the following?

Avoid lifting objects heavier than 20 pounds for at least 6 weeks

A cervical radiation implant is placed in the client for treatment of cervical cancer. What activity order would the nurse most likely expect to note in the health care provider's prescriptions?

Bedrest

A client with liver cancer who is receiving chemotherapy tells the nurse that some foods on the meal tray taste bitter. The nurse would try to limit which of the following foods that is most likely to have this taste for the client?

Beef

A client is diagnosed as having a bowel tumor, and several diagnostic tests are prescribed. The nurse understands that which test will confirm the diagnosis of malignancy?

Biopsy of the tumor

A client with cancer has undergone a total abdominal hysterectomy and has a Foley catheter in place during the immediate postoperative period. The nurse would expect to note which of the following types of urinary drainage immediately following this surgery?

Blood tinged

A nurse is caring for a client with a suspected diagnosis of aplastic anemia. Which of the following tests would the nurse anticipate to be performed to confirm the diagnosis?

Bone marrow aspiration

A client who has been diagnosed with multiple myeloma asks the nurse about the diagnosis. The nurse bases the response on which characteristic of the disorder?

Malignant proliferation of plasma cells and tumors within the bone

A nursing student is assisting in caring for a client with a lung tumor; the client will be having a pneumonectomy. The nursing instructor reviews the postoperative plan of care developed by the student and suggests deleting which of the following from the plan?

Monitoring the closed chest tube drainage system

A client is receiving radiation therapy to the brain because of a diagnosis of a brain tumor. Which side effect does the nurse expect the client to likely experience?

Nausea and vomiting

A nurse is reviewing the laboratory results of a client with bladder cancer and bone metastasis and notes that the calcium level is 15 mg/dL. The nurse should take which appropriate action?

Notify the health care provider.

A nurse is assisting in caring for a client with a diagnosis of bladder cancer who recently received chemotherapy. The nurse receives a telephone call from the laboratory who reports that the client's platelet count is 20,000/mm3. Based on this laboratory value, the nurse revises the plan of care and suggests including which intervention?

Monitor skin for the presence of petechiae.

A client with cancer is receiving chemotherapy and develops thrombocytopenia. Which intervention is a priority in the nursing plan of care?

Monitor the client for bleeding.

A nurse is preparing a list of home care instructions regarding stoma and laryngectomy care to a client who had a laryngectomy. Choose the instructions that would be included in the list. Select all that apply.

Obtain a Medic-Alert bracelet, Prevent debris from entering the stoma, Avoid exposure to people with infections, Avoid swimming and use care when showering

A nursing instructor asks a nursing student about the characteristics of Hodgkin's disease. The instructor determines that the student needs to read about the characteristics of this disease if the student states that which of the following is an associated characteristic?

Occurrence most often in older adults

A nurse is instructing a group of female clients about breast self-examination (BSE). The nurse would instruct the clients to perform the examination:

One week after menstruation begins

A nurse working in an obstetrical-gynecological health care provider's office is instructing a small group of female clients about breast self-examination (BSE). The nurse teaches the clients to perform the exam:

One week after menstruation begins

A client is hospitalized for the insertion of an internal cervical radiation implant. While giving care, the nurse finds the radiation implant in the bed. The nurse would immediately:

Pick up the implant with long-handled forceps and place into a lead container.

A nurse is assisting in developing a postoperative plan of care for a client following a mastectomy. Choose the interventions that will be included in the plan of care. Select all that apply

Place the affected arm on a pillow, Assess the incision for signs of infection, Monitor and measure drainage in the collection device.

A nurse should monitor for which of the following laboratory results as indicating an adverse reaction in the client with endometrial cancer who is receiving chemotherapy?

Platelet count 20,000/mm3

A nurse is reviewing the laboratory results of a client receiving chemotherapy for cancer. The nurse reports which abnormal result to the health care provider?

Platelet count, 40,000 cells/mm3

A bone marrow aspiration is scheduled for a client suspected of having leukemia. The nurse prepares supplies for the procedure and plans to bring which of the following skin cleansing agents to the bedside before this procedure?

Povidone-iodine (Betadine)

A nurse is orienting a new nurse to the care of a client who has an internal radiation implant. The nurse includes which of the following instructions in discussions with the new nurse?

Pregnant women are not allowed in the client's room.

A nurse is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which principle?

Pregnant women are not allowed into the client's room.

A client with carcinoma of the lung develops the syndrome of inappropriate antidiuretic hormone (SIADH) as a complication of the cancer. The nurse anticipates that which of the following may be prescribed? Select all that apply.

Radiation, Chemotherapy, Serum sodium blood levels, Medication that is antagonistic to antidiuretic hormone (ADH)

A clinic nurse has given a client the materials needed to test the stool for occult blood as part of a routine screening for colorectal cancer. When the client asks the nurse whether there are any special precautions that must be followed in doing this test, the nurse tells the client to avoid eating which of the following for at least a day before performing the test?

Red meat

A nurse is preparing a client with a bowel tumor for surgery. The health care provider has informed the client that the surgery is palliative in the treatment of the tumor. The nurse understands that this type of surgery is performed to:

Reduce pain

A nurse is assisting with developing a plan of care for a client who is experiencing hematological toxicity as a result of chemotherapy. The nurse suggests including which of the following in the plan of care?

Restricting fresh fruits and vegetables in the diet

A nurse reviews the care plan of a client with cancer and notes that the client has a problem with adequate food intake related to side effects of therapy. In order to enhance appetite and nutrition, the nurse advises the client to avoid:

Strong-smelling foods

A nurse has provided instructions to a client scheduled for a mammography regarding the procedure. Which statement by the client indicates an understanding of the procedure?

"I should not wear deodorant on the day of the test."

A nurse has reinforced discharge instructions regarding home care to a client following a prostatectomy for cancer of the prostate. Which statement by the client indicates an understanding of the instructions?

"I should not lift anything over 20 pounds."

A client is receiving external radiation to the neck for cancer of the larynx. The nurse plans the client's care knowing that the most likely side effect to be expected is:

Sore throat

A nurse is teaching a group of high school males in a health class about how to perform a testicular self-examination (TSE). The nurse would make which of the following statements during the class?

"Do the examination after a warm bath or shower."

A nurse is obtaining data from a client admitted with a diagnosis of bladder cancer. Which question should the nurse ask the client to determine if the client experienced the common symptom associated with this type of cancer?

"Do you notice any blood in the urine?"

A nurse is collecting data from a client suspected of having ovarian cancer. Which question should the nurse ask the client to elicit information specifically related to this disorder?

"Does your abdomen feel as though it is swollen?"

A nurse is collecting data from a client who is admitted to the hospital for diagnostic studies to rule out the presence of Hodgkin's disease. Which question should the nurse ask the client to elicit information specifically related to this disease?

"Have you noticed any swollen lymph nodes?"

A nurse is assisting with conducting a health-promotion program to community members regarding testicular cancer. The nurse determines that further teaching is needed if a community member states that which of the following is a sign of testicular cancer?

Alopecia

A nurse inspects the skin of a client receiving external radiation therapy and documents a finding noted as moist desquamation. The nurse understands that moist desquamation is best described as which of the following?

Weeping of the skin

A nurse is providing client education regarding symptoms of testicular cancer. The nurse encourages the client to report which symptoms as being associated with testicular cancer? Select all that apply.

A grainy mass palpated in a testicle, An enlargement of one of the testes

A client undergoing diagnostic testing for cancer is scheduled for magnetic resonance imaging (MRI). The nurse reinforces to the client which of the following about the procedure?

Expect the MRI machine to make loud noises.

A nurse is reviewing the history of a client with bladder cancer. The nurse would expect to note which most common symptom of this type of cancer as being documented in the client's record?

Hematuria

A client suspected of having an abdominal tumor is scheduled for a computed tomography (CT) scan with dye injection. The nurse tells the client which of the following about the test?

The dye injected may cause a warm, flushing sensation.