AH Exam 2 Chapter 15: Oncology
The client has a body surface area of 2.05 m². He is prescribed vincristine (Oncovin) 1.4 mg/m². Vincristine is available as 1 mg/1 mL. How many mL will the nurse administer? Round your answer to the nearest tenth.
2.9
Which of the following is a term used to describe the process of programmed cell death?
Apoptosis
A patient is scheduled for cryosurgery for cervical cancer and tells the nurse, "I am not exactly sure what the doctor is going to do." What is the best response by the nurse?
"The physician is going to use liquid nitrogen to freeze the area."
The lethal tumor dose is defined as the dose that will eradicate what percentage of the tumor yet preserve normal tissue?
95%
Which of the following does a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure?
Blood studies
Which of the following does a nurse thoroughly evaluate before a hematopoietic stem cell transplant (HSCT) procedure?
Blood studies
Which oncologic emergency involves the accumulation of fluid in the pericardial space?
Cardiac tamponade
A cancer client makes the following statement to the nurse: "I guess I will tell my doctor to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die."Which of the following facts supports the use of chemotherapy for this client?
Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.
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.
A client diagnosed with acute myelocytic leukemia has been receiving chemotherapy. During the last 2 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?
Closely observe the client's skin for petechiae and bruising.
Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth?
Control
Which of the following is a type of procedure that uses liquid nitrogen to freeze tissue that causes cell destruction?
Cryoablation
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 burgers every day
The nurse is caring for a client newly diagnosed with cancer. Which of the following therapies is used to treat something other than cancer?
Electroconvulsive therapy
You are an oncology nurse caring for a client who tells you that their tastes have changed. They go on to say that "meat tastes bad". What is a nursing intervention to increase protein intake for a client with taste changes?
Encourage cheese and sandwiches
A side-effect of chemotherapy is renal damage. To prevent this, the nurse should:
Encourage fluid intake, if possible, to dilute the urine.
The nurse is working with a patient who has had an allohematopoietic stem cell transplant (HSCT) and notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the patient has symptoms of which of the following?
Graft vs. host disease
Chemotherapeutic agents have which effect associated with the renal system?
Increased uric acid excretion
When caring for a client who is receiving external beam radiation, which is the key point for the nurse to incorporate into the plan of care?
Inspect skin frequently
For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan?
Inspecting the skin for petechiae once every shift
The nurse is caring for a patient undergoing an incisional biopsy. Which of the following statements does the nurse understand is true about an incisional biopsy?
It removes a wedge of tissue for diagnosis.
What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen?
It targets normal body cells as well as cancer cells.
A decrease in circulating white blood cells is
Leukopenia
A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells?
Liver
Which of the following is a growth-based classification of tumors?
Malignant
In which phase of the cell cycle does cell division occur?
Mitosis
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 bone marrow transplant?
Monitor the client closely to prevent infection.
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 closely to prevent infection.
According to the tumor-node-metastasis (TNM) classification system, T0 means there is which of the following?
No evidence of a primary tumor
A client with cancer stage T4,N3,M1 is ordered morphine sulfate 4 mg, subcutaneous every 3 to 4 hours. Two hours after the last injection, the client rings the call bell to report a pain scale of 9. Which is the appropriate action by the nurse?
Notify the physician of the breakthrough pain in an attempt to obtain additional orders.
During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior?
Progression
A nurse is caring for a client receiving chemotherapy. Which assessment finding places the client at the greatest risk for an infection?
Stage 3 pressure ulcer on the left heel
A patient with brain tumor is undergoing radiation and chemotherapy for treatment of cancer. Of late, the patient is complaining of swelling in the gums, tongue, and lips. Which of the following is the most likely cause of these symptoms?
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?
Sun safety and use of sunscreen
You are an oncology nurse caring for a client who is taking antineoplastic agents. What symptoms must you consider when monitoring this client?
Symptoms of gout
A nurse is caring for a client receiving chemotherapy. Which nursing action is most appropriate for handling chemotherapeutic agents?
Wear disposable gloves and protective clothing.
The physician recommends that you have your daughter vaccinated with HPV vaccine. What is this vaccine for?
Help prevent cervical cancer
The nurse is caring for a patient with cancer who is treating her cancer with deep tissue massage in addition to radiation therapy. The nurse documents the use of which of the following on the patient's chart?
Integrative medicine
A decrease in circulating white blood cells (WBC) is referred to as which of the following?
Leukopenia
Which type of surgery is utilized in an attempt to relieve complications of cancer?
Palliative
Which of the following are true statements about effective radiation therapy? Select all that apply.
• Slower-growing tissues at rest (muscle) are more radioresistant. • Tumors that are well oxygenated are more sensitive to radiation. • Tumors that are small in size and dividing rapidly are more sensitive
A nurse is developing a care plan for bone marrow suppression, the major dose-limiting adverse reaction to floxuridine (FUDR). How long after drug administration does bone marrow suppression become noticeable?
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 normal reaction to the diagnosis of cancer.
What should the nurse tell a female client who is about to begin chemotherapy and anxious about losing her hair?
She should consider getting a wig or cap before she loses her hair.
Following a BMT the patient should be monitored for at least
3 months
Which type of vaccine uses the patient's own cancer cells that are prepared for injection back into the patient?
Autologous
The nurse is conducting a screening for familial predisposition of cancer. Which of the following should the nurse note as a possible indication of hereditary cancer syndrome?
An aunt and uncle diagnosed with cancer
What are considered carcinogens?
Dietary substances
While administering cisplatin (Platinol-AQ) to a client, the nurse assesses swelling at the insertion site. The first action of the nurse is to
Discontinue the intravenous medication.
During chemotherapy, an oncology client has a nursing diagnosis of Impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis?
Providing a solution of viscous lidocaine for use as a mouth rinse
A patient is undergoing chemotherapy treatment for prostate cancer and has lost considerable weight due to nausea and vomiting. Which of the following nursing interventions is appropriate for the patient?
Adjusting meal plan before/after chemotherapy
After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention?
Administering metoclopramide and dexamethasone as ordered
Which type of hematopoietic stem cell transplantation (HSCT) is characterized by cells from a donor other than the patient?
Allogenic
Which of the following is a sign or symptoms of septic shock?
Altered mental status
The client is receiving a vesicant anti neo plastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action?
Extra vasation
A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis?
Red, open sores on the oral mucosa
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?
Risk for infection
The client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse?
Tumor pressure against normal tissues
Which statement by a client undergoing external radiation therapy indicates the need for further teaching?
"I'm worried I'll expose my family members to radiation."
The nurse at the clinic explains to the patient that the surgeon will be removing a mole on the patient's back that has the potential to develop into cancer. The nurse informs the patient that this is what type of procedure?
Prophylactic
Which of the following is a characteristic of a malignant tumor?
It gains access to the blood and lymphatic channels.
What does the nurse understand is the rationale for administering allopurinol for a patient receiving chemotherapy?
It lowers serum and uric acid levels.
A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication?
Serum potassium level of 2.6 mEq/L
A nurse is administering a chemotherapeutic medication to a client, who reports generalized itching and then chest tightness and shortness of breath. The nurse immediately
Stops the chemotherapeutic infusion
Which of the following is a term used to describe the process by which a new blood supply is formed?
Angiogenesis
A client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis is appropriate for this client?
Anticipatory grieving
You are an oncology nurse caring for a client who tells you that their tastes have changed. They go on to say that "meat tastes bad". What is a nursing intervention to increase protein intake for a client with taste changes?
Encourage cheese and sandwiches.
Your client is receiving radiation therapy. The client asks you about oral hygiene. What advice regarding oral hygiene should you offer?
Use a soft toothbrush and avoid an electronic toothbrush.
The nurse is evaluating bloodwork results of a patient with cancer who is receiving chemotherapy. The patient's platelet count is 60,000/mm3. Which of the following is an appropriate nursing action?
Avoiding use of products containing aspirin
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
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?
Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis
A patient with metastatic pancreatic cancer underwent surgery for removal of a malignant tumor in his pancreas. Despite the tumor being removed, the physician informs the patient that he needs to start chemotherapy. Which of the following may be a reason for the physician to opt for chemotherapy?
Metastasis
