week 3 - chapter 12: management of patients with oncologic disorders

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

"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 am so glad the doctor was able to remove the entire tumor." "I will be glad to finally be done with treatments for this thing." "Thank goodness the tumor is contained and curable."

"I guess the doctor could not remove the entire tumor."

The nurse instructs a client receiving chemotherapy on actions to prevent the development of stomatitis. Which client statement indicates to the nurse that teaching has been effective? "I will brush my teeth after every meal." "I will reduce smoking to after meals only." "I will eat spicy foods with a cool beverage." "I will limit alcoholic beverages to one a day."

"I will brush my teeth after every meal."

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 medication to inject the area." "The surgeon is going to use liquid nitrogen to freeze the area." "The surgeon is going to use a laser to remove the area." "The surgeon is going to use radiofrequency to ablate the area."

"The surgeon is going to use liquid nitrogen to freeze the area."

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 need to practice birth control measures." "You will continue having your menses every month." "You will experience menopause now." "You will be unable to have children."

"You will need to practice birth control measures."

A nurse is teaching a client with bone marrow suppression about the time frame when bone suppression will be noticeable after administration of floxuridine. What is the time frame the nurse should include with client teaching? 24 hours 2 to 4 days 7 to 14 days 21 to 28 days

7 to 14 days

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 psychiatric diagnosis everyone has at one time or another. A side effect of the neoplastic drugs. A normal reaction to the diagnosis of cancer. An aberrant psychologic reaction to the chemotherapy.

A normal reaction to the diagnosis of cancer.

The client is scheduled for a breast lump excision and sentinel node biopsy. What should the nurse know in planning care for the client with a positive biopsy? A lump excision is not necessary. A wide excision of lump will be performed. The lump and all axillary lymph nodes will be excised. The entire breast and all regional lymph nodes will be excised.

A wide excision of lump will be performed.

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.

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

Allogeneic

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 A first cousin diagnosed with cancer A second cousin diagnosed with cancer An aunt and uncle diagnosed with cancer

An aunt and uncle diagnosed with cancer

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

Avoid spicy and fatty foods.

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? No evidence of primary tumor, no abnormal regional lymph nodes, and no evidence of distant metastasis Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis Can't assess tumor or regional lymph nodes and no evidence of metastasis Carcinoma in situ, no demonstrable metastasis of the regional lymph nodes, and ascending degrees of distant metastasis

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

A nurse is planning caring for a client who has developed erythema following radiation therapy for a lesion on the left lower leg. Which intervention would the nurse include in the client's plan of care to best support skin recovery at the affected site? Periodically apply ice Keep the area cleanly shaven Wear clothing that fits snugly Cleanse with lukewarm water and pat dry Apply an emollient immediately before treatment

Cleanse with lukewarm water and pat dry

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

Control

What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen? Encourage fluid intake to dilute the urine. Take measures to acidify the urine and prevent uric acid crystallization. Withhold medication when the blood urea nitrogen level exceeds 20 mg/dL. Limit fluids to 1,000 mL daily to prevent accumulation of the drug's end products after cell lysis.

Encourage fluid intake to dilute the urine.

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? Erythema Flare Extravasation Thrombosis

Extravasation

The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action? Extravasation Stomatitis Nausea and vomiting Bone pain

Extravasation

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? Eggs and milk Fish and poultry Ham and bacon Green, leafy vegetables

Ham and bacon

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

It targets normal body cells as well as cancer cells.

A decrease in circulating white blood cells (WBCs) is referred to as Granulocytopenia Thrombocytopenia Leukopenia Neutropenia

Leukopenia

The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant? Monitor the client's toilet patterns. Monitor the client closely to prevent infection. Monitor the client's physical condition. Monitor the client's heart rate.

Monitor the client closely to prevent infection.

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's toilet patterns. Monitor the client to prevent sepsis. Monitor the client's physical condition. Monitor the client's heart rate.

Monitor the client to prevent sepsis.

According to the tumor-node-metastasis (TNM) classification system, T0 means there is No evidence of primary tumor No regional lymph node metastasis No distant metastasis Distant metastasis

No evidence of primary tumor

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

Oranges

Which type of surgery is used in an attempt to relieve complications of cancer? Palliative Prophylactic Reconstructive Salvage

Palliative

During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior? Promotion Initiation Prolongation Progression

Progression

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 Curative surgery Reduction surgery

Prophylactic surgery

A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis? White, cottage cheese-like patches on the tongue Yellow tooth discoloration Red, open sores on the oral mucosa Rust-colored sputum

Red, open sores on the oral mucosa

A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication? Urine output of 400 ml in 8 hours Serum potassium level of 2.6 mEq/L Blood pressure of 120/64 to 130/72 mm Hg Sodium level of 142 mEq/L

Serum potassium level of 2.6 mEq/L

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

Stage 3 pressure ulcer on the left heel

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? Neutropenia Extravasation Nadir Stomatitis

Stomatitis

The nurse is invited to present a teaching program to parents of school-age children. Which topic would be of greatest value for decreasing cancer risks? Pool and water safety Breast and testicular self-exams Hand washing and infection prevention Sun safety and use of sunscreen

Sun safety and use of sunscreen

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 states he is nauseous. The laboratory reports a white blood cell (WBC) count of 1,000/mm3. The client begins to shiver.

The I.V. site is red and swollen.

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. Alopecia related to chemotherapy is relatively uncommon. The hair will grow back within 2 months post therapy. The hair will grow back the same as it was before treatment.

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

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? Gargle after each meal. Floss before going to bed. Treat cavities immediately. Use a soft toothbrush and allow it to air dry before storing.

Use a soft toothbrush and allow it to air dry before storing.

Which of the following would be consistent with a benign neoplasm? Usually progressive and slow Grows by invasion Gains access to the blood and lymph channels to metastasize Cells are undifferentiated

Usually progressive and slow

The nurse understands that the client should be given human papillomavirus (HPV) vaccine per the health care provider's orders. What does this vaccine help prevent? lung cancer breast cancer cervical cancer leukemia

cervical cancer

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: expected chemotherapy-related adverse effects. chemotherapy exposure and risk factors. signs and symptoms of infection. reinforcement of the client's medication regimen

chemotherapy exposure and risk factors.

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. dietary substances environmental factors viruses gender age

dietary substances environmental factors viruses

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

eats red meat such as steaks or hamburgers every day

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 nadir. graft-versus-host disease. metastasis. acute leukopenia.

graft-versus-host disease.

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

no evidence of primary tumor.

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? lymphocyte count of 30% platelet count of 60,000/mm3 neutrophil count of 40% reticulocyte count of 1%

platelet count of 60,000/mm3