ch 18

The nurse recognizes which of the following alternative therapies as appropriate in the care of cancer clients? Select all that apply. A) Reminiscing B) Patient-controlled analgesia C) Hot and cold therapy D) Epidural stimulators E) Alternating analgesics F) Nonopioid use

A,C

The nurse is caring for a client is scheduled for chemotherapy followed by autologous stem cell transplant. Which of the following statements by the client indicates a need for further teaching? A) "I hope they find a bone marrow donor who matches." B) "The doctor will remove cells from my bone marrow before beginning chemotherapy." C) "I will receive chemotherapy until most of the cancer is gone, and then I will get my own stem cells back." D) "I will need to be in protective isolation for up to 3 months after treatment."

A

The nurse knows that interferon agents are used in association with chemotherapy to produce which effects in the client? A) Suppression of the bone marrow B) Enhance action of the chemotherapy C) Decrease the need for additional adjuvant therapies D) Shorten the period of neutropenia

D

Which of the following advice does the nurse offer clients who are undergoing unsealed radiation therapy to reduce exposure? A) Avoid drinking plenty of fluids. B) Avoid eating for 3 hours after therapy. C) Avoid applying skin moisturizers. D) Avoid kissing and sexual contact.

D

When providing care for a client with stage IV cancer, the nurse knows to include which intervention in the plan of care? A) Incorporating touching and listening B) Encouraging the expression of life regrets C) Assessing signs and symptoms of impending death D) Discussing ways for the client to handle the dying process

A

You are an oncology nurse caring for a client who is taking antineoplastic agents. What adverse symptoms must you monitor for in this client? A)Symptoms of gout B)Symptoms of hypertension C)Symptoms of diarrhea D)Symptoms of anemia

A

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

B

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? A) Monitor the client's toilet patterns. B) Monitor the client closely to prevent infection. C) Monitor the client's physical condition. D) Monitor the client's heart rate.

B

The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest? A) Normal finding B) Benign fibrocystic disease C) Malignant tumor D) Malignant tumor with metastasis to surrounding tissue

C

The physician recommends that you have your daughter vaccinated with HPV vaccine. What is this vaccine for? A) Help prevent lung cancer B) Help prevent breast cancer C) Help prevent cervical cancer D) Help prevent leukemia

C

Which of the following can be considered carcinogens? A) Parasites B) Medical procedures C) Dietary substances D) Infective genes

C

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? A) "Removing the tumor is a primary treatment for colon cancer." B) "This surgery will prevent further tumor growth." C) "Once the tumor is removed, cell pathology can be determined." D) "Tumor removal will promote comfort."

D

A client diagnosed with cancer has his tumor staged and graded based on what factors? A) How they tend to grow and the cell type B) How they spread and tend to grow C) How they differentiate the cell type D) How they spread and differentiate

A

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? A) "I guess the doctor could not remove the entire tumor." B) "I am so glad the doctor was able to remove the entire tumor." C) "I will be glad to finally be done with treatments for this thing." D) "Thank goodness the tumor is contained and curable."

A

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

A

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

A

While completing an admission assessment, the client reports a family history of ovarian cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology? A) Inherited gene mutation B) Smoking and tobacco use C) Exposure to chemicals and spermicides D) Increased tumor suppressor genes

A

You are a public health nurse giving a talk on the warning signals of cancer to a local community group. Which of the following are the warning signals of cancer? Select all that apply. A) Sores that don't heal B) Unusual bleeding or discharge C) Yellow discoloration of body area D) Tenderness or pain E) Persistent indigestion

A,B,E

Which nursing interventions are most important when implementing care for a client receiving temporary internal sealed radiation therapy? Select all that apply. A) Time, distance, and shielding B) Count wires, threads, or needles every shift C) Maintain indelible skin markings. D) Provide rest periods between treatments. E) Administer treatment through IV access port. F) Avoid standing in direct path of implants.

A,B,F

A client is scheduled for a nerve-sparing prostatectomy. The emotional spouse confides in the nurse that the client will not talk about the cancer and/or upcoming surgery. Which nursing diagnosis will the nurse choose as primary diagnosis for this client? A) Sexual Dysfunction B) Fear C) Knowledge Deficit D) Ineffective Coping

B

A client who is being treated for bladder cancer expresses his concern of passing cancer to his wife during intercourse. Which is the best response by the nurse? A) "You should avoid intercourse until your cancer is cured." B) "Cancer is not transferred from person to person via direct contact." C) "I understand you are concerned about your wife, but don't worry." D) "Perhaps you should have your sperm tested for presence of cancer cells."

B

You are providing client teaching for a client undergoing chemotherapy. What dietary modifications should you advise? A) Eat wholesome meals. B) Avoid spicy and fatty foods. C) Avoid intake of fluids. D) Eat warm or hot foods.

B

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? A) Nausea and vomiting are only a factor for the first 24 hours after treatment. B) Most clients believe the discomfort is well worth the cure for cancer. C) Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects. D) Clinical trials are opening up new cancer treatments all the time.

C

A client with advanced cancer makes the following comment to the nurse: "Why are you bathing me? I am going to die no matter what." What is the most appropriate response of the nurse? A) "A bath will make you feel better." B) "Do you want to skip the bath today?" C) "Would you like to talk about what you are feeling?" D) "I can give you some medicine to make you feel better."

C

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

D

Chemotherapy has been used for the past 3 months to treat a client with pancreatic cancer. The CA 19-9 levels are rising. Which explanation would the nurse attribute as the most likely cause? A) It is normal for this antigen to rise for up to 6 months. B) The client is having an adverse response to the chemotherapy. C) The chemotherapy is effectively destroying the cancer cells. D) The cancer is growing despite the chemotherapy treatment.

D

The client has finished the first round of chemotherapy. Which statement made by the client indicates a need for further teaching by the nurse? A) "I will eat clear liquids for the next 24 hours." B) "Hair loss may not occur until after the second round of therapy." C) "I will use birth control measures until after all treatment is completed." D) "I can continue taking my vitamins and herbs because they make me feel better."

D

While doing a health history, a client tells you that her mother, grandmother, and sister died of cancer. The client wants to know what she can do to keep from getting cancer. What would be your best response? A) "You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is." B) "If you eat right, exercise, and get enough rest, you can prevent breast cancer." C) "With your family history, there is nothing you can do to prevent getting cancer." D) "Cancer often skips a generation, so don't worry about it."

A

Following surgery for adenocarcinoma, the client learns the tumor stage is T3, N1, M0. What treatment mode will the nurse anticipate? A) No further treatment is indicated. B) Adjuvant therapy is likely. C) Palliative care is likely. D) Repeat biopsy is needed before treatment begins.

B

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 negative biopsy report? A) A lump excision is not necessary. B) A wide excision of lump will be performed. C) The lump and all axillary lymph nodes will be excised. D) The entire breast and all regional lymph nodes will be excised.

B

An elderly client has been diagnosed with metastatic cancer and has a poor prognosis of survival. The family asks the nurse for advice on whether to tell the client of the diagnosis or to keep it quiet. Which is the best response from the nurse? A) "I wouldn't tell, if I were you." B) "In my experience, clients who know are more likely to be involved with their plan of care." C) "The shock of learning the diagnosis may be too much stress for an elderly person." D) "This is a private concern that should include the physician, not me."

B

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. A) Egg white omelet with spinach and mushrooms B) Crispy chicken Caesar Salad C) Steamed broccoli and carrots D) Turkey breast on whole wheat bread E) Smoked salmon F) Vegetable and cheddar quiche

A,C,D

A client with a 4-cm breast mass is scheduled for biopsy with frozen section followed by lumpectomy and possible mastectomy. The client asks the nurse, "Why can't the doctor tell me specifically whether I will need to have my entire breast removed"? Which is the best response from the nurse? A) "The doctor will know which surgery is required, once the tumor is exposed." B) "The frozen section will determine presence of cancer and type of surgery required." C) "You need to trust your doctor to provide you with the best of care." D) "You seem anxious about your upcoming surgery."

B

A newly diagnosed cancer client is crying and states the following to the nurse: "I promised God that I will be a better person if I can just get better." What is the appropriate assessment of this comment by the nurse? A) The client is just trying to protect self from potential loss. B) Anger directed toward nursing staff is not unusual in dealing with cancer clients. C) The cancer is viewed as a punishment from past actions. D) Loss is inevitable so client is making final plans.

C

Cancer has many characteristics. What is one of the most discouraging characteristics of cancer? A) Large size B) Carcinogenesis C) Metastasis D) Slow growth

C

The nurse is caring for a client with the diagnosis of colon cancer with metastasis to the liver. Which statement made by the client indicates an understanding of the diagnosis? A) "Once the colon tumor is removed, I will be fine." B) "I will be happy once all the cancer is cut out." C) "How could I be so unlucky to get cancer twice?" D) "My cancer has now spread to my liver."

D

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? A) Pool and water safety B) Breast and testicular self-exams C) Handwashing and infection prevention D) Sun safety and use of sunscreen

D

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? A) Explain to the client that the medication can only be given every 3 to 4 hours. B) Ignore the call bell and stall until it is time to administer the next dose. C) Notify the physician of the breakthrough pain in an attempt to obtain additional orders. D) Ask the family to attempt diversion activities until the next dose can be given.

C

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? A) Random, rapid growth of the tumor B) Cells colonizing to distant body parts C) Tumor pressure against normal tissues D) Emission of abnormal proteins

C

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? A) Time, distance, and shielding B) The use of disposable utensils and wash cloths C) Avoid showering or washing over skin markings. D) Inspect the skin frequently.

D

When the client complains of increased fatigue following radiotherapy, the nurse knows this is most likely to be related to which factor? A) The cancer is spreading. B) The cancer cells are dying in large numbers. C) Fighting off infection is an exhausting venture. D) Radiation can result in myelosuppression.

D

Which of the following laboratory findings, would be identified by the nurse as the greatest risk for a cancer client scheduled for implantable port? A) White blood cell count 10,800/mm3 B) Hemoglobin 10 g/dL C) Hematocrit 36.0% D) Platelet count 98,000/mm3

D