prepU cancer 49/50

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 use an electric razor to shave." "I take a stool softener every morning." "I floss my teeth every morning." "I removed all the throw rugs from the house."

"I floss my teeth every morning."

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

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

A bowel resection is scheduled for a client with the diagnosis of colon cancer with metastasis to the liver and bone. Which statement by the nurse best explains the purpose of the surgery? "This surgery will prevent further tumor growth." "Tumor removal will promote comfort." "Once the tumor is removed, cell pathology can be determined." "Removing the tumor is a primary treatment for colon cancer."

"Tumor removal will promote comfort."

A patient diagnosed with colon cancer presents with the characteristic symptoms of a left-sided lesion. Which of the following symptoms are indicative of this disorder? Select all that apply. Abdominal distention Black, tarry stools Constipation Narrowing stools Dull abdominal pain

Abdominal distention Constipation Narrowing stools

The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise? Eat wholesome meals. Eat warm or hot foods. Avoid spicy and fatty foods. Avoid intake of fluids.

Avoid spicy and fatty foods.

The nurse is talking with a group of clients who are older than age 50 years about the recognition of colon cancer to access early intervention. What should the nurse inform the clients to report immediately to their primary care provider? Change in bowel habits Excess gas Daily bowel movements Abdominal cramping when having a bowel movement

Change in bowel habits

The nurse is irrigating a client's colostomy when the client begins to report cramping. What is the appropriate action by the nurse? Discontinue the irrigation immediately. Change irrigation fluid to normal saline. Clamp the tubing and allow client to rest. Increase the rate of administration.

Clamp the tubing and allow client to rest.

A nurse is assessing a patient's stoma on postoperative day 3. The nurse notes that the stoma has a shiny appearance and a bright red color. How should the nurse best respond to this assessment finding? Irrigate the ostomy to clear a possible obstruction. Document that the stoma appears healthy and well perfused. Contact the primary care provider to report this finding. Document a nursing diagnosis of Impaired Skin Integrity.

Document that the stoma appears healthy and well perfused.

The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important? Use disposable utensils for the next month. Flush the toilet twice after every use. Prepare food separately from family members. Shield your throat area when near others.

Flush the toilet twice after every use.

The nurse is assessing the diet of a female client. To decrease the risk of cancer in general, the nurse instructs the client to Decrease cigarette smoking from one pack/day to 1/2 pack/day. Include at least 6 ounces of meat in meals every day. Limit alcohol ingestion to one drink per day. Ingest two to three servings of fruits and vegetables each day.

Limit alcohol ingestion to one drink per day.

A nurse is talking with a patient who is scheduled to have a hemicolectomy with the creation of a colostomy. The patient admits to being anxious, and has many questions concerning the surgery, the care of a stoma, and necessary lifestyle changes. Which of the following nursing actions is most appropriate? Provide the patient with educational materials that match the patient's learning style. Reassure the patient that the procedure is relatively low risk and that patients are usually successful in adjusting to an ostomy. Encourage the patient to write down these concerns and questions to bring forward to the surgeon. Maintain an open dialogue with the patient and facilitate a referral to the wound-ostomy-continence (WOC) nurse.

Maintain an open dialogue with the patient and facilitate a referral to the wound-ostomy-continence (WOC) nurse.

A nurse is caring for a client receiving chemotherapy. Which assessment finding places the client at the greatest risk for an infection? Temperature of 98.3° F (36.8° C) Stage 3 pressure ulcer on the left heel Ate 75% of all meals during the day White blood cell (WBC) count of 9,000 cells/mm3

Stage 3 pressure ulcer on the left heel

The nurse is providing an educational presentation on dietary recommendations for reducing the risk of cancer. Which of the following food selections would demonstrate a good understanding of the information provided in the presentation? Select all that apply. Steamed broccoli and carrots Egg white omelet with spinach and mushrooms Smoked salmon Vegetable and cheddar quiche Turkey breast on whole wheat bread Crispy chicken Caesar Salad

Steamed broccoli and carrots Egg white omelet with spinach and mushrooms Turkey breast on whole wheat bread

The nursing instructor is talking with the junior class of nursing students about lung cancer. What would be the best rationale the instructor could give for the difficulty of early diagnosis of lung cancer? Symptoms are often minimized by clients. There are no early symptoms of lung cancer. Symptoms often mimic other infectious diseases. Symptoms often do not appear until the disease is well established.

Symptoms often mimic other infectious diseases.

The client has received chemotherapy and 1 week later is at home experiencing nausea and vomiting. The first action of the nurse is to recommend Obtaining acupressure treatments Taking prescribed ondansetron (Zofran) Using imagery techniques Practicing relaxation techniques

Taking prescribed ondansetron (Zofran)

A client is admitted to the hospital for diagnostic testing to rule out colorectal cancer. Which intervention should the nurse include on the plan of care? Test all stools for occult blood. Prepare the client for a gastrostomy tube placement. Administer topical ointment to the rectal area to decrease bleeding. Administer morphine (Duramorph PF) routinely, as ordered.

Test all stools for occult blood.

Cancer is the second leading cause of death in the United States, second only to heart disease. Half of all men and one third of all women will develop cancer during their lifetimes. Which types of cancer have the highest prevalence among both men and women? colon and skin skin and brain lung and skin lung and colon

lung and colon

A client who underwent thoracic surgery to remove a lung tumor had a chest tube placed anteriorly. The surgical team places this catheter to: remove fluid from the lungs. remove air from the pleural space. administer IV medication. ventilate the client.

remove air from the pleural space.

A serum sodium concentration lower than 115 mEq/L (115 mmol/L) is associated with anorexia. weight gain. seizure. myalgia.

seizure

The nurse teaches the client whose surgery will result in a sigmoid colostomy that the feces expelled through the colostomy will be mushy. solid. fluid. semimushy.

solid

A patient with a diagnosis of renal cell carcinoma is being treated with chemotherapy. During a previous round of chemotherapy, the patient's tumor responded well to treatment but the chemotherapy caused intense nausea and vomiting. How should the patient's potential nausea and vomiting be addressed during this current round of treatment? Prioritize nonpharmacological treatments over medications. Administer antiemetics in anticipation of the patient's nausea. Provide the patient with antiemetics at his first complaint of nausea. Administer antiemetics if the patient vomits or believes he will soon vomit.

Administer antiemetics in anticipation of the patient's nausea.

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? Avoiding using soap on the irradiated areas Wearing a lead apron during direct contact with the client Applying talcum powder to the irradiated areas daily after bathing Removing thoracic skin markings after each radiation treatment

Avoiding using soap on the irradiated areas

When malignant cells are killed (tumor lysis syndrome), intracellular contents are released into the bloodstream. This leads to which of the following? Select all that apply. Hyperphosphatemia Hyperuricemia Hyperkalemia Hypercalcemia

Hyperphosphatemia Hyperuricemia Hyperkalemia

A nurse is teaching a client who is receiving radiation treatment for left lower lobe lung cancer. Which client statement indicates a need for further teaching? "I'll use hats to protect my head from the sun when my hair falls out." "If I get nauseous, I'll try to eat several small, bland meals each day." "I'll allow myself plenty of time to rest between activities." "Most of the adverse effects should go away shortly after my last radiation treatment."

"I'll use hats to protect my head from the sun when my hair falls out."

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? "New hair growth will return without any change to color or texture." "The hair loss is usually temporary." "Wigs can be used after the chemotherapy is completed." "Clients with alopecia will have delay in grey hair."

"The hair loss is usually temporary."

A client admitted with pneumonia has a history of lung cancer and heart failure. A nurse caring for this client recognizes that he should maintain adequate fluid intake to keep secretions thin for ease in expectoration. The amount of fluid intake this client should maintain is: 1.4 L. unspecified. 3 L. 2 L.

1.4

The client is to receive cyclophosphamide (Cytoxan) 50 mg/kg intravenously in divided doses over 5 days. The client weighs 176 pounds. How many mg of cyclophosphamide will the client receive each day? Enter the correct number ONLY.

800

After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? Withholding fluids for the first 4 to 6 hours after chemotherapy administration Encouraging rhythmic breathing exercises Administering metoclopramide and dexamethasone as ordered Serving small portions of bland food

Administering metoclopramide and dexamethasone as ordered

A patient, age 67 years, is admitted for diagnostic studies to rule out cancer. The patient is Caucasian, married, has been employed as a landscaper for 40 years, and has a 36-year history of smoking a pack of cigarettes daily. What significant risk factors does the nurse recognize this patient has? (Select all that apply.) Race Occupation Marital status Age Cigarette smoking

Age Cigarette smoking Occupation

Which action by the nurse is most appropriate when a client demonstrates subcutaneous emphysema along the suture line or chest dressing 2 hours after chest surgery? Report the finding to the physician immediately. Record the observation. Apply a compression dressing to the area. Measure the client's pulse oximetry.

Apply a compression dressing to the area.

A client with cancer is receiving chemotherapy and reports to the nurse that his mouth is painful and he has difficulty ingesting food. The nurse does which of the following: Rinses the client's mouth with alcohol-based mouthwash every 2 hours Teaches the client to floss his teeth once every 24 hours Asks the client to open his mouth to facilitate inspection of the oral mucosa Consults with the healthcare provider about use of nystatin (Mycostatin) Instructs the client to brush the teeth with a soft toothbrush

Asks the client to open his mouth to facilitate inspection of the oral mucosa Consults with the healthcare provider about use of nystatin (Mycostatin) Instructs the client to brush the teeth with a soft toothbrush

The nurse should teach the patient who is being radiated about protecting his skin and oral mucosa. An important teaching point would be to tell the patient to: Cleanse the skin with a mild soap, using his fingertips, not a rough wash cloth. Apply a small ice compress to the treated area afterward to decrease localized redness, post-radiation. Use an approved emollient 2 hours before the radiation to give the skin time to absorb the medication and provide a shield for damage. Use an ointment, after treatment, to decrease the feeling of burning, which may last for several hours.

Cleanse the skin with a mild soap, using his fingertips, not a rough wash cloth.

A nurse is providing care for a patient whose recent colostomy has contributed to a nursing diagnosis of Disturbed Body Image Related to Colostomy. What intervention best addresses this diagnosis? Encourage the patient to conduct online research into colostomies. Emphasize the fact that the colostomy was needed to alleviate a much more serious health problem. Emphasize the fact that the colostomy is temporary measure and is not permanent. Engage the patient in the care of the ostomy to the extent that the patient is willing.

Engage the patient in the care of the ostomy to the extent that the patient is willing.

When caring for an older client who is receiving external beam radiation, which is the key point for the nurse to incorporate into the plan of care? Time, distance, and shielding Avoid showering or washing over skin markings. The use of disposable utensils and wash cloths Inspect the skin frequently.

Inspect the skin frequently.

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

Inspecting the skin for petechiae once every shift

The nurse is caring for a client with cancer who is treating her cancer with deep-tissue massage in addition to radiation therapy. The nurse documents the use of which therapy on the client's chart? Alternative therapy Integrative medicine Global medicine Compliant medicine

Integrative medicine

What does the nurse understand is the rationale for administering allopurinol for a patient receiving chemotherapy? It treats drug-related anemia. It stimulates the immune system against the tumor cells. It lowers serum and uric acid levels. It prevents alopecia.

It lowers serum and uric acid levels.

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

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

The root cause of cancer is damage to cellular deoxyribonucleic acid (DNA). Such damage results from multiple factors. Which of the following is a carcinogen? Medically prescribed interventions Chemical agents Viruses Environmental factors Defective genes Dietary substances

Medically prescribed interventions Chemical agents Viruses Environmental factors Defective genes Dietary substances

A nurse is interviewing a client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer? Hemorrhoids Weight gain Duodenal ulcers Polyps

Polyps

A male client has been unable to return to work for 10 days following chemotherapy as the result of ongoing fatigue and inability to perform usual activities. Laboratory test results are WBCs 2000/mm³, RBCs 3.2 x 10¹²/L, and platelets 85,000/mm³. The nurse notes that the client is anxious. Which of the following is the priority nursing diagnosis? Fatigue related to deficient blood cells Anxiety related to change in role function Risk for infection related to inadequate defenses Activity intolerance related to side effects of chemotherapy

Risk for infection related to inadequate defenses

The nurse is to administer a vesicant chemotherapeutic drug to a client who had a right mastectomy and inserts the intravenous line With a butterfly needle With a soft, plastic catheter In the client's right forearm In the client's left hand

With a soft, plastic catheter

The nurse is evaluating the client's risk for cancer and recommends changes when the client states she eats red meat such as steaks or hamburgers every day works as a secretary at a medical radiation treatment center drinks 1 glass of wine at dinner each night uses the treadmill for 30 minutes on 5 days each week

eats red meat such as steaks or hamburgers every day

Based on the understanding of the effects of chemotherapy, the nurse would anticipate which of the following clinical findings in a client 2 weeks post therapy? Elevated temperature Ease of bruising Change in hair color Elevated white blood cells count

Ease of bruising

The nurse is performing a community screening for colorectal cancer. Which characteristic should the nurse include in the screening? Low-fat, low-protein, high-fiber diet Age younger than 40 years Familial polyposis History of skin cancer

Familial polyposis

The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient? Impaired nutritional status Cognitive changes Alopecia Diarrhea

Impaired nutritional status

Nursing action for extravasation of a chemotherapeutic agent would include which of the following nursing actions? Select all that apply. Stop the medication infusion at the first sign of extravasation. Administer an antidote, if indicated. Aspirate any residual drug from the IV line. Apply warm compresses to the irritated site to encourage healing.

Stop the medication infusion at the first sign of extravasation. Administer an antidote, if indicated. Aspirate any residual drug from the IV line.

A client has been receiving chemotherapy. Upon assessing the client during morning rounds, the nurse notes the client is now bleeding from intravenous and venipuncture sites. Stool is positive for occult blood. The client is requesting to sit in a chair for a meal. The nurse implements the following interventions: (Select all that apply.) Check intake and output records. Assist the client to a chair. Apply pressure to the bleeding sites. Assess level of consciousness. Monitor vital signs once a shift.

Apply pressure to the bleeding sites. Assess level of consciousness. Check intake and output records.

A client suspected of having colorectal cancer requires which diagnostic study to confirm the diagnosis? Sigmoidoscopy Stool Hematest Abdominal computed tomography (CT) scan Carcinoembryonic antigen (CEA)

Sigmoidoscopy

A client reports dyspnea, fatigue, and having had a persistent productive cough for the last few months, which the client attributes to a bout with the flu. The nurse suspects that this client may have: lung cancer. lung abscess. pleural effusion. pleurisy.

lung cancer.