Oncology

A client is prescribed tamoxifen, 20 mg by mouth twice per day for treatment of breast cancer. The client reports to the nurse that she has worsening bone pain. How should the nurse respond? "I'll hold the next dose and we can see if your bone pain lessens." "Acute worsening of bone pain commonly indicates that the drug will produce a good response." "I'll notify your physician immediately to see if he wants to change your treatment plan." "I'll get you something for pain immediately."

"Acute worsening of bone pain commonly indicates that the drug will produce a good response."

A young adult client received her first chemotherapy treatment for breast cancer. Which statement by the client requires further exploration by the nurse? "I want to return to school for a college degree." "I don't care about the adverse effects of the drugs." "I'm thinking about joining a dance club." "I don't think I'm going to work tomorrow."

"I don't care about the adverse effects of the drugs."

A client recently diagnosed with metastatic liver cancer is admitted for hospice care. An acquaintance of the client calls the nurse to ask how the client is doing. Which response by the nurse is best? "I will let your friend know you called, but I cannot share information without permission." "Your friend has been admitted to hospice care. I encourage you to visit." "It's important that you contact your friend's health care provider for information." "Your friend is not well. You should contact the family for more information."

"I will let your friend know you called, but I cannot share information without permission."

A client has just been diagnosed with terminal cancer and is being transferred to home hospice care. The client's child tells the nurse, "I don't know what to say to my mother if she asks me about dying." Which responses by the nurse would be appropriate? Select all that apply. "You sound like you have some questions about your mother dying. Let's talk about that." "Don't worry. Your mother still has some time left." "Tell me how you're feeling about your mother dying." "Don't worry, hospice will take care of your mother." "Let's talk about your mother's illness and how it will progress."

"Let's talk about your mother's illness and how it will progress." "You sound like you have some questions about your mother dying. Let's talk about that." "Tell me how you're feeling about your mother dying."

The nurse is caring for a client who detected a lump in her right breast. The client asks the nurse " How do I find out if it's cancer?" Which statement by the nurse would be most appropriate? "You did a good job performing your breast self exams each month." "The physician will need to perform a fine needle aspiration and biopsy to confirm the diagnosis. "We'll know more once you have a mammogram." "The physician should be able see it on a chest X-ray."

"The physician will need to perform a fine needle aspiration and biopsy to confirm the diagnosis.

As part of a primary cancer prevention program, an oncology nurse speaks to the public at a health fair. When someone asks about laryngeal cancer, which statement by the nurse would be most helpful? "Living in the city and breathing polluted air puts everyone at risk for all types of cancers." "If you develop laryngeal cancer it would most likely be an adenocarcinoma, which are easier to cure." "To reduce the risk of developing laryngeal cancer you shouldn't smoke or drink alcohol." "Men and women both develop laryngeal cancer equally."

"To reduce the risk of developing laryngeal cancer you shouldn't smoke or drink alcohol."

A client in the final stages of terminal cancer tells the nurse: "I wish I could just be allowed to die. I'm tired of fighting this illness. I have lived a good life. I continue my chemotherapy and radiation treatments only because my family wants me to." What is the nurse's best response? "Would you like to talk with your minister about the significance of death?" "I'll contact the healthcare provider to cancel your treatments." "Would you like to talk with a psychologist about your thoughts and feelings?" "Would you like to meet with your family and your healthcare provider about this matter?"

"Would you like to meet with your family and your healthcare provider about this matter?"

The nurse is teaching a group of men about prostate health. Which of the following would be most important for the nurse to tell the men? "To decrease the risk of prostate cancer, you should maintain a diet high in fat, especially animal fat." "You should discuss PSA testing with a health care provider to decide whether testing is the right choice for you." "If you have spent a significant part of your life in poverty, you are more likely to develop prostate cancer." "Black men are at less risk of developing prostate cancer than are men of other ethnicities."

"You should discuss PSA testing with a health care provider to decide whether testing is the right choice for you."

During a breast examination, which finding most strongly suggests that the client has breast cancer? Multiple firm, round, freely movable masses that change with the menstrual cycle Bloody discharge from the nipple Slight asymmetry of the breasts A fixed nodular mass with dimpling of the overlying skin

A fixed nodular mass with dimpling of the overlying skin

A client is undergoing tests for multiple myeloma. Which diagnostic finding would the nurse expect to see in multiple myeloma? low serum calcium level Bence Jones protein in the urine decreased serum protein level decreased serum creatinine level

Bence Jones protein in the urine

A client diagnosed with acute myelocytic leukemia (AML) has been receiving chemotherapy. During the last two 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? Perform a cardiovascular assessment every 4 hours. Check the client's history for a congenital link to thrombocytopenia. Monitor daily platelet counts. Closely observe the client's skin for petechiae and bruising.

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

The nurse is preparing to discharge a client with advanced multiple myeloma from the oncology unit. When the nurse provides the client with the follow-up appointment date for the oncology clinic, the nurse learns the client has no reliable means of transportation. Which action should the nurse take? Assist the client in looking up available bus routes from home to the clinic. Inquire with the client's family about possible help in transporting the client. Provide information about transportation companies for people with disabilities. Consult the social worker about available transportation solutions for the client.

Consult the social worker about available transportation solutions for the client.

How can breast cancer prevention programs best serve women who are at risk and come from lower socioeconomic backgrounds? Increase access to health care. Provide access to health insurance. Develop screening and educational programs. Increase support services.

Develop screening and educational programs.

A client has been receiving chemotherapy for cancer treatment. The client is competent and has been actively involved in decisions regarding care; however, the client has now decided to refuse treatment. What should the nurse do when the client refuses the next dose of chemotherapy? Ensure that the client understands the rationale for taking the medication. Document the client's choice and offer to discuss feelings about the chemotherapy. Persuade the client to take the medication as ordered. Ask the client's spouse to encourage the client to take the chemotherapy.

Document the client's choice and offer to discuss feelings about the chemotherapy.

A client with a diagnosis of ovarian cancer is receiving chemotherapy with cisplatin and reports nausea and loss of appetite resulting in decreased food intake. What should the nurse recommend to improve nutrition? Consume only a liquid diet until nausea subsides. Eat small meals high in protein and calories throughout the day. Recommend large meals but less frequently throughout the day. Offer the client her favorite foods to increase the appetite.

Eat small meals high in protein and calories throughout the day.

Which of the following actions displayed by a grieving husband over his dying wife would cause the nurse to suggest counseling? He refuses to acknowledge his wife's family and blames them for her current health problems. He is planning to give away his wife's treasured items to family members. He has already planned his wife's funeral. He takes out wedding pictures and memorabilia to show to the staff.

He refuses to acknowledge his wife's family and blames them for her current health problems.

The nurse is caring for a client recently diagnosed with gastric cancer. Which bacteria does the nurse anticipate may be present? Helicobacter pylori Lactobacillus acidophilus Clostridium difficile Bacillus anthracis

Helicobacter pylori

A child hospitalized with complications related to chemotherapy is placed on protective isolation precautions. What is the best action for the nurse related to the client's visitors? Allow only visitors who are older than 16 years. Identify the visitors the child and family wish to see. Post a sign at the door requiring visitors to see the nurse. Obtain a health care provider's order to prohibit all visitors.

Identify the visitors the child and family wish to see.

Several days before admission, a client reports finding a small lump in the left breast near the nipple. What should the nurse tell the client to do? Inform the physician immediately. Put a heating pad on the area to reduce inflammation. Squeeze the nipple to check for drainage. Check the area after her next menses.

Inform the physician immediately.

For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the plan of care? Inspecting the skin for petechiae once every shift Providing frequent rest periods Placing the client in strict isolation Administering aspirin if the temperature exceeds 102° F (38.8° C)

Inspecting the skin for petechiae once every shift

The nurse is caring for a client diagnosed with cancer of the cervix. When reinforcing education on intracavitary radiation, which explanation best explains the importance of emptying the bowel?

Pressure changes in the pelvis associated with bowel movements can alter the position of the applicator and the radiation source.

A client in the terminal stage of cancer is receiving a continuous infusion of morphine for pain management. Which data collection finding suggests that the client is experiencing an adverse effect of this drug? Pupils constricted and equal Respiratory rate of 8 breaths/minute Irregular heart rate of 82 beats/minute Voiding of 350 ml of concentrated urine in 8 hours

Respiratory rate of 8 breaths/minute

A client with stage II ovarian cancer undergoes a total abdominal hysterectomy and bilateral salpingo-oophorectomy with tumor resection, omentectomy, appendectomy, and lymphadenectomy. During the second postoperative day, which data collection finding would raise concern in the nurse? Serous drainage from the incision Shallow breathing and increasing lethargy Hypoactive bowel sounds Abdominal pain

Shallow breathing and increasing lethargy

A client is receiving chemotherapy and radiation for stage III breast cancer and has an ANC (absolute neutrophil count) of 800/mm3 (0.8 × 109/L) a hemoglobin of 10g/dL (100 g/L), and a platelet count of 108,000/mm3 (108 × 109/L) Based on these results, the nurse should be most concerned with which finding? Temperature of 100.8 °F (38.2 °C), fatigue, and shortness of breath Rhinitis and throat pain when swallowing Tenderness at the site of radiation, headache, and constipation Fatigue, nausea, and skin redness at the site of radiation

Temperature of 100.8 °F (38.2 °C), fatigue, and shortness of breath

The nurse is teaching a session on cancer prevention to a group of young adults. Which nutrition information will the nurse share? Charbroil meats to reduce intake of fats. Increase intake of red meat for protein. Strive to maintain a healthy weight. Use creamy sauces to enhance food flavor.

Strive to maintain a healthy weight.

A client with metastatic cancer is experiencing neuropathic pain. Which alternative therapy is most beneficial in treating this type of pain? Cryotherapy Herbal therapy Transcutaneous electrical nerve stimulation (TENS) Biofeedback

Transcutaneous electrical nerve stimulation (TENS)

A client received treatment with cytotoxic medications 24 hours ago. Which precautions are necessary when caring for the client? Use a bleach solution to clean bedpans or urinals after use. Provide a urinal or bedpan to decrease the likelihood of soiling linens. Wear sterile gloves when emptying bedpans or urinals. Wear personal protective equipment when handling blood, body fluids, and feces.

Wear personal protective equipment when handling blood, body fluids, and feces.

A nurse is participating in a cancer-screening program for colorectal cancer. Which client presents the fewest risk factors for colon cancer? a 72-year-old client with a history of breast cancer a 50-year-old client with a father who died of colon cancer a 60-year-old client who follows a diet low in fat and high in fiber a 45-year-old client with a 25-year history of ulcerative colitis

a 60-year-old client who follows a diet low in fat and high in fiber

To combat the most common adverse effects of chemotherapy, the nurse would administer an: antiemetic. anticoagulant. antimetabolite. antibiotic.

antiemetic.

The nurse is caring for a client who was admitted with rectal bleeding. The client is at high risk for having colorectal cancer. The nurse anticipates preparing the client for which diagnostic test to confirm this suspicion? stool Hematest colonoscopy abdominal computed tomography (CT) scan carcinoembryonic antigen (CEA)

colonoscopy

A multidisciplinary oncology team notes that a client who has been undergoing chemotherapy is now experiencing pancytopenia. When reviewing the laboratory data, which values support this diagnosis? Select all that apply. decreased white blood cells Increased RBCs increased white blood cells decreased red blood cells decreased platelets increased platelets

decreased white blood cells decreased platelets decreased red blood cells

Which nurse should be assigned to a client receiving brachytherapy for the treatment of cervical cancer? female nurse with 3 years' experience working in oncology male nurse who is also assigned to another client receiving brachytherapy female nurse with 10 years' experience who suspects she may be pregnant male nurse who has floated to this unit from the operating room

female nurse with 3 years' experience working in oncology

A client receives a sealed radiation implant to treat cervical cancer. When caring for this client, the nurse should: maintain the client on complete bed rest with bathroom privileges only. consider the client's urine, feces, and vomitus to be highly radioactive. consider the client to be radioactive for 10 days after implant removal. allow soiled linens to remain in the room until after the client is discharged.

maintain the client on complete bed rest with bathroom privileges only.

The nurse is assessing a client with multiple myeloma. The nurse should keep in mind that clients with multiple myeloma are at risk for: hypoxemia. acute heart failure. chronic liver failure. pathologic bone fractures.

pathologic bone fractures.

The nurse is assessing a client with multiple myeloma. The nurse should keep in mind that clients with multiple myeloma are at risk for: pathologic bone fractures. chronic liver failure. hypoxemia. acute heart failure.

pathologic bone fractures.

The nurse on the oncology unit is caring for a client with a total white blood cell (WBC) count equal to 2000/µL (2.0 ×109/L). Which intervention is most important to include in the plan of care? Monitor temperature every 4 hours perform proper hand hygiene avoid rectal thermometers and suppositories restrict visitors and provide a private room

perform proper hand hygiene

The nurse is caring for a male client who reports difficulty urinating. Which laboratory test does the nurse anticipate may be administered? prostate-specific antigen (PSA) carcinoembryonic antigen (CEA) alpha-fetoprotein (AFP) CA125

prostate-specific antigen (PSA)

On discharge, a client who underwent a left mastectomy expresses relief that "the cancer" has been treated. When discussing this issue with the client, the nurse should stress that she: may expect her menstrual periods to be irregular. is lucky that the cancer was caught in time. should continue to perform breast self-examination on her right breast. should schedule a follow-up appointment in 6 months.

should continue to perform breast self-examination on her right breast.

The nurse has instructed a group of adolescents about the importance of skin care and protection from the sun. Which type of cancer is the nurse hoping to prevent in this population? squamous cell carcinoma osteosarcoma meningeal sarcoma lymphoma

squamous cell carcinoma