CANCER PT. 2
A charge nurse is conducting an in-service session on ethics for a group of newly licensed nurses. Which of the following situations should the charge nurse include as an example of the ethical principle of veracity? Check Answer A. A nurse truthfully answers the client's questions about upcoming chemotherapy. B. A nurse stops inserting an NG tube when the client refuses the procedure. C. A nurse provides the same amount of time to all clients, regardless of illness. D. A nurse reports an assistive personnel who transfers a client without using a gait belt.
A
A nurse is caring for a child who has leukemia and is receiving chemotherapy. The child's parent is upset and says, "I just can't believe my child is going to lose her beautiful hair!" Which of the following responses should the nurse offer? Check Answer A. "You are feeling a sense of loss right now." B. "Sometimes the hair thins, but it will grow back." C. "This hair loss means the chemotherapy is working." D. "Kids love to wear the special baseball caps we have."
A
A nurse is caring for a client who has cancer and is experiencing pain. The nurse should implement which of the following interventions to assist the client with pain relief? A. Encourage the client to listen to soft music B. Instruct the client to practice tai chi C. Place a jasmine-scented air freshener in the client's room D. Offer the client ginger tea
A
A nurse is caring for a client who has end-stage lung cancer. Which of the following client statements should the nurse identify as an indication that the client is experiencing the bargaining stage of Kübler-Ross' stages of grief? A. "I would give anything to live to see my grandchild born." B. "Can you make sure there hasn't been a mistake with my test results?" C. "I feel so sad that I will be leaving my partner all alone." D. "What have I done to deserve this death sentence?"
A
A nurse is caring for a school-aged child who has terminal cancer and is receiving palliative care. The child's family asks about possible interventions. Which of the following statements should the nurse include in the teaching? Check Answer A. "Nonpharmacological interventions have a place in managing your child's palliative care." B. "Palliative chemotherapy is meant to lengthen your child's life and might be curative." C. "We should limit the amount of opioids your child uses to prevent addiction." D. "It is best for your child to receive medications via intramuscular injection."
A
A nurse is contributing to the plan of care for a client who has cancer and is scheduled to receive internal radiation therapy. Which of the following actions should the nurse recommend? Check Answer A. Place the client in a private room B. Secure a dosimeter badge to the client's gown C. Don a cover gown before entering the client's room D. Dispose of dislodged implants in a biohazard sharps container
A
A nurse is contributing to the plan of care for a client who has thrombocytopenia due to chemotherapy. Which of the following interventions should the nurse include? Check Answer A. Avoid IM injections B. Obtain a rectal temperature once per shift C. Do not allow the client to have visitors D. Encourage daily flossing between teeth
A
A nurse is reinforcing teaching with a client who has cancer and is receiving external radiation therapy. Which of the following statements made by the client indicates an understanding of the teaching? Check Answer A. "I need to protect the area from sunlight." B. "I'm going to apply skin lotion to the area every day." C. "I'll massage the area once per day." D. "I'll wash off the markings after each therapy treatment."
A
A nurse is reinforcing teaching with a client who has chemotherapy-induced anemia and a prescription for epoetin alfa. The nurse should instruct the client to report which of the following findings as an adverse effect of epoetin alpha? Check Answer A. Hypertension B. Leukocytosis C. Bone pain D. Neutropenia
A
A nurse is caring for a postmenopausal client who is concerned that she might have a higher-than-average risk of breast cancer. After collecting data from the client, the nurse should identify which of the following factors as increasing her breast-cancer risk? (Select all that apply.) Check Answer A. Increased breast density B. BMI 32 C. Gave birth to 5 children D. Hormonal replacement therapy for 10 years E. 1-2 alcoholic drinks per week
A, B, D
A charge nurse receives notification of the admission of a client who is coughing frequently and whose sputum is pink, frothy, and copious. The client has a history of night sweats, anorexia, and weight loss. Which of the following actions should the nurse take? (Select all that apply.) Check Answer A. Assign the client to a private room with negative-pressure airflow B. Add contact precautions to the client's plan of care C. Wear an N95 respirator when entering the client's room D. Ensure the client's environment provides 4 exchanges of fresh air per minute E. Institute protective environment precautions as soon as the client arrives on the unit
A, C
A nurse is caring for a client who recently had chemotherapy and now has myelosuppression. Which of the following interventions should the nurse initiate? (Select all that apply.) Check Answer A. Prohibit bringing fresh flowers and plants into the client's room B. Encourage frequent visits from family and friends C. Ensure thorough cleaning of the client's room and bathroom daily D. Replace wound dressings every other day E. Use dedicated equipment items such as stethoscopes
A, C, E
A nurse is contributing to the plan of care for a client who is receiving chemotherapy and has a protein deficiency. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) Check Answer A. Mix powdered skim milk into milk B. Add a raw egg to fruit smoothies C. Add a slice of cheese to hot vegetables D. Add honey to hot tea E. Mix yogurt into fresh fruit
A, C, E
A nurse in an oncology clinic is collecting data from a client who has early stage Hodgkin's lymphoma. Which of the following findings should the nurse expect? A. Bone and joint pain B. Enlarged lymph nodes C. Intermittent hematuria D. Productive cough
B
A nurse is assisting in planning care for a client who has cancer and has developed thrombocytopenia following chemotherapy. Which of the following precautions should the nurse offer to minimize the adverse effects of thrombocytopenia? Check Answer A. Monitor visitors for manifestations of infection B. Remind the client to use an electric razor C. Encourage frequent rest periods D. Instruct the client to rinse the mouth daily with normal saline
B
A nurse is assisting with the admission of a client who has tuberculosis. In addition to standard precautions, which of the following transmission-based precautions be added to the client's plan of care? Check Answer A. Protective B. Airborne C. Droplet D. Contact
B
A nurse is caring for a client who has breast cancer and is receiving a combination of chemotherapy medications. The client expresses confusion about the therapy. Which of the following explanations should the nurse provide? Check Answer A. "The risk of renal toxicity is lessened when a combination of chemotherapy medications is used." B. "The chemotherapy medications act at different stages of cell division so more tumor cells are destroyed." C. "The use of more chemotherapy medications will shorten the time you have to be in treatment." D. "The combination of chemotherapy medications will eliminate the potential for bone marrow suppression."
B
A nurse is caring for a client who has testicular cancer and is experiencing peripheral neuropathy as an adverse effect of chemotherapy. Which of the following client manifestations is an expected finding of peripheral neuropathy? Check Answer A. Thinning of the scalp hair B. Tingling of the hands and feet C. Reduced ability to concentrate D. Sores in the mucous membranes
B
A nurse is reinforcing teaching with a client who has persistent cancer pain about the adverse effects of opioids. Which of the following statements should the nurse include in the teaching? A. "Opioids do not relieve pain without causing severe adverse effects." B. "Physical dependence is not the same as addiction." C. "Tolerance typically means that the medication will no longer be effective." D. "The most common adverse effect is respiratory depression with prolonged use."
B
A nurse is reinforcing teaching with a client who has stomatitis due to chemotherapy. Which of the following statements by the client indicates a need for further instructions? Check Answer A. "I will use a soft toothbrush or foam swab for oral care." B. "I will cleanse my mouth after meals with an alcohol-based mouthwash." C. "I will use a straw when I drink liquids." D. "I will rinse my mouth frequently with a hydrogen peroxide solution."
B
A charge nurse is observing a newly licensed nurse provide care for a client. This client is receiving internal radiation therapy for the treatment of cervical cancer. Which of the following actions by the newly licensed nurse should prompt the charge nurse to intervene? Check Answer A. Leaving soiled linens in a container in the room B. Instructing visitors to remain 1 m (3 ft) away from the client C. Borrowing a dosimeter film badge from another nurse before entering the client's room D. Removing an extra IV pole from the client's room to be used for another client
C
A nurse in an oncology clinic is collecting data for a client who is undergoing treatment for ovarian cancer. Which of the following statements by the client indicates she is experiencing psychological distress? Check Answer A. "My parents are retired, and they have come to help with our children." B. "I am going to ask my husband to go to counseling with me." C. "I keep having nightmares about my upcoming surgery." D. "My girlfriends bought me a nice wig."
C
A nurse in the outpatient setting is planning to administer the varicella vaccine to a toddler. Which of the following findings is a contraindication to the child receiving this vaccination? Check Answer A. The child is displaying manifestations of a cold B. The child has a sibling with autism C. The child is receiving chemotherapy D. The child has a documented allergy to eggs
C
A nurse is caring for a client who has a new diagnosis of pernicious anemia. The nurse should expect the client's provider to prescribe which of the following medications for this client? Check Answer A. Ferrous sulfate B. Epoetin alfa C. Vitamin B12 D. Folic acid
C
A nurse is caring for a client who has breast cancer. The client has been receiving radiation therapy for several months and now refuses to undergo further treatment. Which of the following actions should the nurse take? Check Answer A. Suggest the client talk with someone who has survived breast cancer B. Encourage the client not to give up C. Support the client's decision D. Refer the client to a counselor
C
A nurse is caring for a client who is experiencing severe cancer pain. Which of the following medications should the nurse expect the provider to prescribe? Check Answer A. Buprenorphine B. Tramadol C. Hydromorphone D. Oxycodone
C
A nurse is caring for a client who is receiving brachytherapy. Which of the following measures should the nurse contribute to the client's plan of care? Check Answer A. Plan to spend extra time with the client to provide emotional support B. Ensure that chemotherapy medications do not extravasate into the client's tissues C. Keep the door to the client's room closed D. Encourage family and friends to visit for at least 1 hr per day
C
A nurse is caring for a client who is receiving chemotherapy to treat cancer. Which of the following adverse effects should the nurse anticipate from the chemotherapy? Check Answer A. Gingival hyperplasia B. Hirsutism C. Pancytopenia D. Weight gain
C
A nurse is collecting data from a client who has cancer and is receiving chemotherapy by peripheral IV infusion. The client reports pain at the insertion site, and the nurse notes fluid leaking around the catheter. Which of the following actions should the nurse take first? A. Take a photograph of the peripheral IV site B. Obtain and record the client's vital signs C. Stop the infusion D. Identify all medications administered through the IV site for the past 24 hours
C
A nurse is collecting data from a client who has cancer and is receiving chemotherapy by peripheral IV infusion. The client reports pain at the insertion site, and the nurse notes fluid leaking around the catheter. Which of the following actions should the nurse take first? Check Answer A. Take a photograph of the peripheral IV site B. Obtain and record the client's vital signs C. Stop the infusion D. Identify all medications administered through the IV site for the past 24 hours
C
A nurse is reinforcing preoperative teaching with a client who has colorectal cancer and is scheduled to undergo placement of a colostomy with a perineal wound. Which of the following statements by the client indicates an understanding of the teaching? A. "It will be a relief to not have any further rectal pain." B. "I will need to sit on a rubber donut when I am out of bed and sitting in a chair." C. "I can have only liquids for 2 days before the surgery." D. "The colostomy will start working about 7 days after the surgery."
C
A nurse is reinforcing preoperative teaching with a client who has colorectal cancer and is scheduled to undergo placement of a colostomy with a perineal wound. Which of the following statements by the client indicates an understanding of the teaching? Check Answer A. "It will be a relief to not have any further rectal pain." B. "I will need to sit on a rubber donut when I am out of bed and sitting in a chair." C. "I can have only liquids for 2 days before the surgery." D. "The colostomy will start working about 7 days after the surgery."
C
A nurse is reviewing the laboratory results for a client who has a non-healing wound. Wound cultures have identified vancomycin-resistant enterococci (VRE). Which of the following types of precautions should the nurse initiate? Check Answer A. Airborne B. Droplet C. Contact D. Protective
C
A home health nurse is contributing to the plan of care for a client who is receiving chemotherapy and has neutropenia. Which of the following foods should the nurse include in the client's plan of care? Check Answer A. Soft-boiled eggs B. Brie cheese made with unpasteurized milk C. Cold sandwiches made with deli meat D. Baked chicken
D
A nurse is caring for a client who has cancer involving the lumbar vertebrae and has been prescribed gabapentin. Which of the following therapeutic effects should the nurse identify for the client when taking this medication? A. Reduced cancer-related bone pain B. Decreased anxiety and insomnia C. Decreased inflammatory response to cancer tumors D. Reduced cramping, aching, and burning neuropathic pain
D
A nurse is caring for a client who is receiving radiation therapy for breast cancer and reports a metallic taste in the mouth. Which of the following dietary recommendations should the nurse relay? Check Answer A. Eat with metal utensils B. Limit coffee C. Avoid citrus fruits D. Offer mints
D
A nurse is caring for a client who is receiving radiation therapy for mouth cancer and reports a dry mouth. Which of the following dietary recommendations should the nurse provide? Check Answer A. Offer graham crackers as a snack B. Avoid foods containing citrus C. Rinse the mouth with an alcohol- based mouthwash before eating D. Use gravies or sauces to soften food
D
A nurse is caring for a client who takes scheduled morphine for cancer pain. The client reports experiencing breakthrough pain. The nurse should anticipate a prescription from the provider for which of the following medications to treat breakthrough pain? A. Meperidine B. Buprenorphine C. Methadone D. Fentanyl
D
A nurse is caring for a client who will receive brachytherapy to treat uterine cancer. The nurse should ensure the client understands that she will receive which of the following interventions? Check Answer A. Chemotherapy via a central venous access device B. Radiation to the tumor from an external source C. Precise delivery of high-dose radiation after tumor imaging D. Radioactive infusions or insertions into or near the tumor
D
A nurse is caring for a female adult client who is experiencing menopause and has a prescription for estrogen along with progestin. The nurse should identify that the provider has prescribed these medications for which of the following reasons? Check Answer A. Long-term use to reduce the risk of breast cancer B. Short-term use to stimulate the endometrium C. Long-term use to prevent osteoporosis D. Short-term use to control urogenital atrophy
D
A nurse is collecting data from a client who has Kaposi sarcoma. Which of the following findings should the nurse expect with this condition? Check Answer A. Nonproductive cough with a fever and shortness of breath B. Lesions on the retina that produce blurred vision C. Onset of progressive dementia D. Reddish-purple skin lesions
D
A nurse is collecting data from a client who has cancer of the cervix. Which of the following manifestations should the nurse expect? A. Weight gain B. Oliguria C. Back pain D. Vaginal bleeding
D
A nurse is collecting data from a client who has chronic pancreatitis. Which of the following findings should the nurse identify as a likely cause of the client's condition? Check Answer A. High-calorie diet B. Prior gastrointestinal illnesses C. Tobacco use D. Alcohol use
D
A nurse is contributing to the plan of care for a client who has been admitted for the treatment of a malignant melanoma of the upper leg without metastasis. The nurse should expect the provider to perform which of the following procedures? Check Answer A. Curettage B. External radiation therapy C. Regional chemotherapy D. Surgical excision
D
A nurse is reinforcing teaching with a school-aged child who has a new diagnosis of acute lymphoblastic leukemia (ALL). Which of the following statements from the child indicates an understanding of the teaching? Check Answer A. "Once treatment starts, I won't feel so tired." B. "This started because of that terrible illness I had last month." C. "My parents will do things for me so I don't get tired." D. "I have a good chance of surviving this cancer."
D
