Chapter 15: Cancer, Final

A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment. The patient asks the nurse what the most common side effect of chemotherapy is. What would be the best answer the nurse could give? A. Alopecia B. Nausea and vomiting C. Altered glucose metabolism D. Increased appetite

B

You are a part of a team of nurses that is developing an educational program entitled Cancer: Its Risks and What You Can Do About It. This program is an example of what? A. Primary prevention B. Risk reduction C. Secondary prevention D. Tertiary prevention

C

You are caring for a 39-year-old woman with a family history of breast cancer. She has requested a breast tumor marking test and the results are positive. The patient is requesting a bilateral mastectomy. What is this surgery an example of? A. Salvage surgery B. Palliative surgery C. Prophylactic surgery D. Reconstructive surgery

C

Malignant disease processes have the ability to spread from one organ to another throughout the body. What is one means malignant disease processes transfer cells from one place to another? A. Adhering to primary tumor cells B. Causing mutation of cells of another organ C. Phagocytizing healthy cells D. Invading host tissues

D

To prevent the debilitating cycle of fatigue-depression-fatigue in patients receiving radiation therapy, what should the nurse encourage the patient to do? A. implement walking program B. ignore the fatigue as much as possible C. do the most stressful activities when the fatigue is tolerable D. schedule rest periods throughout the day whether fatigue is present or not

A

A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that the patient is meeting the goal of improved body image and self-esteem? A. The patient requests that her family bring her makeup and wig. B. The patient begins to discuss the future with her family. C. The patient reports less disruption from pain and discomfort. D. The patient cries openly when discussing her disease.

A

A patient with a genetic mutation of BRCA1 and a family history of breast cancer is admitted to the surgical unit where she is scheduled that day for a bilateral simple mastectomy. What is the reason for this procedure? A. prevent breast cancer B. diagnose breast cancer C. cure or control breast cancer D. provide palliative care for untreated breast cancer

A

Adverse effects to chemotherapy are dealt with by patients and their caregivers every day. What would the nurse do to combat the most common adverse effects of chemotherapy? A. Administer an antiemetic B. Administer an antimetabolite C. Administer a tumor antibiotic D. Administer an anticoagulant

A

During initial chemotherapy a patient with leukemia develops hyperkalemia and hyperuricemia. The nurse recognizes these symptoms as an oncologic emergency and anticipates that the priority treatment will be to A. increase urine output with hydration therapy B. establish electrocardiogram monitoring (ECG) C. administer a bisphosphonate such as pamidronate (Aredia) D. restrict fluids and administer hypertonic sodium chloride solution

A

The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient? A. "These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and X-ray studies." B. "These symptoms are part of your disease and can't be helped." C. "Don't be concerned about these symptoms. Everybody feels this way after having radiation therapy." D. "This is a good sign. It means that only the cancer cells are dying."

A

The nurse is presenting a community education program related to cancer prevention. Based on current cancer death rates, the nurse emphasizes what as the most important preventative action for both men and women? A. Smoking cessation B. routine colonoscopies C. protection from ultraviolet light D. regular examination of reproductive organs

A

What does the presence of carcinoembryonic antigen (CEAs) and alpha-fetoprotein (AFP) on cell membranes indicate has happened to the cells? A. they have shifted to more immature metabolic pathways and functions B. they have spread from areas of original development to different body tissues C. they have produces abnormal toxins or chemicals that indicate abnormal cellular function D. they have become more differentiated as a result of repression of embryonic functions

A

Which mutated tumor suppressor gene is most likely to contribute to many types of cancer, including breast, bladder, colorectal, and lung? A. p53 B. APC C. BRCA1 D. BRCA2

A

Which word identifies a mutation of protooncogens? A. oncogenes B. retrogenes C. oncofetal antigens D. tumor angiogenesis factor

A

While a patient is receiving intravenous doxorubicin hydrochloride, the nurse observes that there is swelling and pain at the IV site. The nurse should A. stop the administration of the drug immediately. B. notify the patient's physician. C. continue to administer but decrease the rate of infusion. D. apply a warm compress to the site.

A

You are caring for a patient who is to begin receiving external radiation for a malignant tumor of the head and neck. While doing patient education, what side effects should the nurse discuss with the patient that should be assessed because of the radiation treatment? A. Impaired nutritional status B. Pink oral mucosa C. Diarrhea D. Alopecia

A

You are the clinic nurse in an oncology clinic. Your patient arrives for a 2-month follow-up appointment following chemotherapy. You note that the patient's skin appears yellow. Which blood tests should be done to further explore this clinical sign? A. Liver function test B. CBC C. Platelet count D. Electrolytes

A

Which factors will assist a patient in coping positively with having cancer (select all that apply) A. feeling in control B. strong support system C. internalizing feelings D. possibility of a cure or control E. a young person will adapt more easily F. not having had to cope with previous stressful events

A, B, D

You are giving a report in your pathophysiology class. The subject of your report is cancer cells. In differentiating between benign and malignant cells, what characteristics would you cite? (Mark all that apply.) A. Rate of growth B. Ability to cause death C. Size of cells D. Cell contents E. Ability to spread

A, B, E

You are the nurse caring for an adult patient who has developed a mild oral yeast infection following chemotherapy. What should you encourage the patient to do? (Mark all that apply.) A. Use a lip lubricant B. Scrub the tongue with a firm-bristled toothbrush C. Use dental floss every 24 hours D. Rinse the mouth with normal saline E. Eat hot foods to aid in killing the yeast

A, C, D

Cancer cells go through stages of development. What accurately describes the stage of promotion (select all that apply)? A. obesity is an example of a promoting factor B. the stage is characterized by increased growth rate and metastasis C. withdrawal of promoting factors will reduce the risk of cancer developing D. tobacco smoke is a complete carcinogen that is capable of both initiation and promotion E. promotion is the stage of cancer development in which there is an irreversible alteration in the cell's DNA

A, C, D pg. 235

A chemotherapy drug that causes alopecia is prescribed for a patient. Which action should the nurse take to support the patient's self-esteem? a. Encourage the patient to purchase a wig or hat to wear when hair loss begins. b. Suggest that the patient limit social contacts until regrowth of the hair occurs. c. Teach the patient to wash hair gently with mild shampoo to minimize hair loss. d. Inform the patient that hair usually grows back once chemotherapy is complete.

ANS: A The patient is taught to anticipate hair loss and to be prepared with wigs, scarves, or hats. Limiting social contacts is not appropriate at a time when the patient is likely to need a good social support system. The damage occurs at the hair follicles and will occur regardless of gentle washing or use of a mild shampoo. The information that the hair will grow back is not immediately helpful in maintaining the patient's self-esteem. DIF: Cognitive Level: Apply (application) REF: 256 TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

A patient who is diagnosed with cervical cancer classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is accurate? a. "The cancer involves only the cervix." b. "The cancer cells look like normal cells." c. "Further testing is needed to determine the spread of the cancer." d. "It is difficult to determine the original site of the cervical cancer."

ANS: A Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time. Cell differentiation is not indicated by clinical staging. Because the cancer is in situ, the origin is the cervix. Further testing is not indicated given that the cancer has not spread. DIF: Cognitive Level: Apply (application) REF: 241 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

Interleukin-2 (IL-2) is used as adjuvant therapy for a patient with metastatic renal cell carcinoma. Which information should the nurse include when explaining the purpose of this therapy to the patient? a. IL-2 enhances the body's immunologic response to tumor cells. b. IL-2 prevents bone marrow depression caused by chemotherapy. c. IL-2 protects normal cells from harmful effects of chemotherapy. d. IL-2 stimulates malignant cells in the resting phase to enter mitosis.

ANS: A IL-2 enhances the ability of the patient's own immune response to suppress tumor cells. IL-2 does not protect normal cells from damage caused by chemotherapy, stimulate malignant cells to enter mitosis, or prevent bone marrow depression. DIF: Cognitive Level: Understand (comprehension) REF: 258 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

During a routine health examination, a 40-yr-old patient tells the nurse about a family history of colon cancer. Which action should the nurse take next? a. Obtain more information about the family history. b. Schedule a sigmoidoscopy to provide baseline data. c. Teach the patient about the need for a colonoscopy at age 50. d. Teach the patient how to do home testing for fecal occult blood.

ANS: A The patient may be at increased risk for colon cancer, but the nurse's first action should be further assessment. The other actions may be appropriate, depending on the information that is obtained from the patient with further questioning. DIF: Cognitive Level: Analyze (analysis) REF: 241 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance

When caring for a patient who is pancytopenic, which action by unlicensed assistive personnel (UAP) indicates a need for the nurse to intervene? a. The UAP assists the patient to use dental floss after eating. b. The UAP adds baking soda to the patient's saline oral rinses. c. The UAP puts fluoride toothpaste on the patient's toothbrush. d. The UAP has the patient rinse after meals with a saline solution.

ANS: A Use of dental floss is avoided in patients with pancytopenia because of the risk for infection and bleeding. The other actions are appropriate for oral care of a pancytopenic patient. DIF: Cognitive Level: Apply (application) REF: 261 OBJ: Special Questions: Delegation TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment

The nurse at the clinic is interviewing a 64-yr-old woman who is 5 feet, 3 inches tall and weighs 125 lb (57 kg). The patient has not seen a health care provider for 20 years. She walks 5 miles most days and has a glass of wine two or three times a week. Which topics will the nurse plan to include in patient teaching about cancer screening and decreasing cancer risk (select all that apply)? a. Pap testing b. Tobacco use c. Sunscreen use d. Mammography e. Colorectal screening

ANS: A, C, D, E The patient's age, gender, and history indicate a need for screening and teaching about colorectal cancer, mammography, Pap smears, and sunscreen. The patient does not use tobacco or excessive alcohol, she is physically active, and her body weight is healthy. DIF: Cognitive Level: Analyze (analysis) REF: 235 TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance

A patient develops neutropenia after receiving chemotherapy. Which information about ways to prevent infection will the nurse include in the teaching plan (select all that apply)? a. Cook food thoroughly before eating. b. Choose low fiber, low residue foods. c. Avoid public transportation such as buses. d. Use rectal suppositories if needed for constipation. e. Talk to the oncologist before having any dental work.

ANS: A, C, E Eating only cooked food and avoiding public transportation will decrease infection risk. A high-fiber diet is recommended for neutropenic patients to decrease constipation. Because bacteria may enter the circulation during dental work or oral surgery, the patient may need to postpone dental work or take antibiotics. DIF: Cognitive Level: Apply (application) REF: 253 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity

The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention? a. The UAP flushes the toilet once after emptying the patient's bedpan. b. The UAP stands by the patient's bed for 30 minutes talking with the patient. c. The UAP places the patient's bedding in the laundry container in the hallway. d. The UAP gives the patient an alcohol-containing mouthwash to use for oral care.

ANS: B Because patients with temporary implants emit radioactivity while the implants are in place, exposure to the patient is limited. Laundry and urine and feces do not have any radioactivity and do not require special precautions. Cervical radiation will not affect the oral mucosa, and alcohol-based mouthwash is not contraindicated. DIF: Cognitive Level: Apply (application) REF: 250 OBJ: Special Questions: Delegation TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment

The nurse assesses a patient who is receiving interleukin-2. Which finding should the nurse report immediately to the health care provider? a. Generalized muscle aches b. Crackles heard at the lung bases c. Complaints of nausea and anorexia d. Oral temperature of 100.6° F (38.1° C)

ANS: B Capillary leak syndrome and acute pulmonary edema are possible toxic effects of interleukin-2. The patient may need oxygen and the nurse should rapidly notify the health care provider. The other findings are common side effects of interleukin-2. DIF: Cognitive Level: Analyze (analysis) REF: 257 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity

The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient indicates a need for further assessment? a. "I have frequent muscle aches and pains." b. "I rarely have the energy to get out of bed." c. "I experience chills after I inject the interferon." d. "I take acetaminophen (Tylenol) every 4 hours."

ANS: B Fatigue can be a dose-limiting toxicity for use of immunotherapy. Flulike symptoms, such as muscle aches and chills, are common side effects with interferon use. Patients are advised to use acetaminophen every 4 hours. DIF: Cognitive Level: Apply (application) REF: 258 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse would indicate a need for further teaching? a. The patient ambulates around the room. b. The patient's visitors bring in fresh peaches. c. The patient cleans with a warm washcloth after having a stool. d. The patient uses soap and shampoo to shower every other day.

ANS: B Fresh, thinned-skin fruits are not permitted in a neutropenic diet because of the risk of bacteria being present. The patient should ambulate in the room rather than the hospital hallway to avoid exposure to other patients or visitors. Because overuse of soap can dry the skin and increase infection risk, showering every other day is acceptable. Careful cleaning after having a bowel movement will help prevent skin breakdown and infection. DIF: Cognitive Level: Apply (application) REF: 253 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity

The nurse should suggest which food choice when providing dietary teaching for a patient scheduled to receive external-beam radiation for abdominal cancer? a. Fruit salad c. Creamed broccoli b. Baked chicken d. Toasted wheat bread

ANS: B Protein is needed for wound healing. To minimize the diarrhea that is commonly associated with bowel radiation, the patient should avoid foods high in roughage, such as fruits and whole grains. Lactose intolerance may develop secondary to radiation, so dairy products should also be avoided. DIF: Cognitive Level: Apply (application) REF: 254 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

A patient who is being treated for stage IV lung cancer tells the nurse about new-onset back pain. Which action should the nurse take first? a. Give the patient the prescribed PRN opioid. b. Assess for sensation and strength in the legs. c. Notify the health care provider about the symptoms. d. Teach the patient how to use relaxation to reduce pain.

ANS: B Spinal cord compression, an oncologic emergency, can occur with invasion of tumor into the epidural space. The nurse will need to assess the patient further for symptoms such as decreased leg sensation and strength and then notify the health care provider. Administration of opioids or the use of relaxation may be appropriate but only after the nurse has assessed for possible spinal cord compression. DIF: Cognitive Level: Analyze (analysis) REF: 264 OBJ: Special Questions: Prioritization TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

The nurse administers an IV vesicant chemotherapeutic agent to a patient. Which action is most important for the nurse to take? a. Infuse the medication over a short period of time. b. Stop the infusion if swelling is observed at the site. c. Administer the chemotherapy through a small-bore catheter. d. Hold the medication unless a central venous line is available.

ANS: B Swelling at the site may indicate extravasation, and the IV should be stopped immediately. The medication generally should be given slowly to avoid irritation of the vein. The size of the catheter is not as important as administration of vesicants into a running IV line to allow dilution of the chemotherapy drug. These medications can be given through peripheral lines, although central vascular access devices are preferred. DIF: Cognitive Level: Analyze (analysis) REF: 246 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

The nurse is caring for a patient with colon cancer who is scheduled for external radiation therapy to the abdomen. Which information obtained by the nurse would indicate a need for patient teaching? a. The patient has a history of dental caries. b. The patient swims several days each week. c. The patient snacks frequently during the day. d. The patient showers each day with mild soap.

ANS: B The patient is instructed to avoid swimming in salt water or chlorinated pools during the treatment period. The patient does not need to change habits of eating frequently or showering with a mild soap. A history of dental caries will not impact the patient who is scheduled for abdominal radiation. DIF: Cognitive Level: Apply (application) REF: 255 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). The nurse will include which information in the patient's teaching plan? a. Donor bone marrow is transplanted through a sternal or hip incision. b. Hospitalization is required for several weeks after the stem cell transplant. c. The transplant procedure takes place in a sterile operating room to minimize the risk for infection. d. Transplant of the donated cells can be very painful because of the nerves in the tissue lining the bone.

ANS: B The patient requires strict protective isolation to prevent infection for 2 to 4 weeks after HSCT while waiting for the transplanted marrow to start producing cells. The transplanted cells are infused through an IV line so the transplant is not painful, nor is an operating room or incision required. DIF: Cognitive Level: Understand (comprehension) REF: 261 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity

A widowed mother of four school-age children is hospitalized with metastatic ovarian cancer. The patient is crying and tells the nurse that she does not know what will happen to her children when she dies. Which response by the nurse is most appropriate? a. "Don't you have any friends that will raise the children for you?" b. "Would you like to talk about options for the care of your children?" c. "For now you need to concentrate on getting well and not worrying about your children." d. "Many patients with cancer live for a long time, so there is time to plan for your children."

ANS: B This response expresses the nurse's willingness to listen and recognizes the patient's concern. The responses beginning "Many patients with cancer live for a long time" and "For now you need to concentrate on getting well" close off discussion of the topic and indicate that the nurse is uncomfortable with the topic. In addition, the patient with metastatic ovarian cancer may not have a long time to plan. Although it is possible that the patient's friends will raise the children, more assessment information is needed before making plans. DIF: Cognitive Level: Apply (application) REF: 265 TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

A patient with Hodgkin's lymphoma who is undergoing external radiation therapy tells the nurse, "I am so tired I can hardly get out of bed in the morning." Which intervention should the nurse add to the plan of care? a. Minimize activity until the treatment is completed. b. Establish time to take a short walk almost every day. c. Consult with a psychiatrist for treatment of depression. d. Arrange for delivery of a hospital bed to the patient's home.

ANS: B Walking programs are used to keep the patient active without excessive fatigue. Having a hospital bed does not necessarily address the fatigue. The better option is to stay as active as possible while combating fatigue. Fatigue is expected during treatment and is not an indication of depression. Minimizing activity may lead to weakness and other complications of immobility. DIF: Cognitive Level: Apply (application) REF: 253 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity

The nurse teaches a patient with cancer of the liver about high-protein, high-calorie diet choices. Which snack choice by the patient indicates that the teaching has been effective? a. Lime sherbet c. Fresh strawberries b. Blueberry yogurt d. Cream cheese bagel

ANS: B Yogurt has high biologic value because of the protein and fat content. Fruit salad does not have high amounts of protein or fat. Lime sherbet is lower in fat and protein than yogurt. Cream cheese is low in protein. DIF: Cognitive Level: Apply (application) REF: 261 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity

The nurse teaches a patient who is scheduled for a prostate needle biopsy about the procedure. Which statement, if made by the patient, indicates that teaching was effective? a. "The biopsy will remove the cancer in my prostate gland." b. "The biopsy will determine how much longer I have to live." c. "The biopsy will help decide the treatment for my enlarged prostate." d. "The biopsy will indicate whether the cancer has spread to other organs."

ANS: C A biopsy is used to determine whether the prostate enlargement is benign or malignant and determines the type of treatment that will be needed. A biopsy does not give information about metastasis, life expectancy, or the impact of cancer on the patient's life. DIF: Cognitive Level: Apply (application) REF: 238 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity

External-beam radiation is planned for a patient with cervical cancer. What instructions should the nurse give to the patient to prevent complications from the effects of the radiation? a. Test all stools for the presence of blood. b. Maintain a high-residue, high-fiber diet. c. Clean the perianal area carefully after every bowel movement. d. Inspect the mouth and throat daily for the appearance of thrush.

ANS: C Radiation to the abdomen will affect organs in the radiation path, such as the bowel, and cause frequent diarrhea. Careful cleaning of this area will help decrease the risk for skin breakdown and infection. Stools are likely to have occult blood from the inflammation associated with radiation, so routine testing of stools for blood is not indicated. Radiation to the abdomen will not cause stomatitis. A low-residue diet is recommended to avoid irritation of the bowel when patients receive abdominal radiation. DIF: Cognitive Level: Apply (application) REF: 251 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

The nurse is caring for a patient with left-sided lung cancer. Which finding would be most important for the nurse to report to the health care provider? a. Hematocrit of 32% b. Pain with deep inspiration c. Serum sodium of 126 mEq/L d. Decreased breath sounds on left side

ANS: C The syndrome of inappropriate antidiuretic hormone (and the resulting hyponatremia) is an oncologic metabolic emergency and requires rapid treatment to prevent complications such as seizures and coma. The other findings also require intervention but are common in patients with lung cancer and not immediately life threatening. DIF: Cognitive Level: Analyze (analysis) REF: 263 OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

A patient with a large stomach tumor attached to the liver is scheduled for a debulking procedure. Which information should the nurse teach the patient about the outcome of this procedure? a. Pain will be relieved by cutting sensory nerves in the stomach. b. Relief of pressure in the stomach will promote better nutrition. c. Decreasing the tumor size will improve the effects of other therapy. d. Tumor growth will be controlled by the removal of malignant tissue.

ANS: C A debulking surgery reduces the size of the tumor and makes radiation and chemotherapy more effective. Debulking surgeries do not control tumor growth. The tumor is debulked because it is attached to the liver, a vital organ (not to relieve pressure on the stomach). Debulking does not sever the sensory nerves, although pain may be lessened by the reduction in pressure on the abdominal organs. DIF: Cognitive Level: Understand (comprehension) REF: 245 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. The nurse teaches the patient about the management of the skin reaction. Which statement, if made by the patient, indicates the teaching was effective? a. "I can use ice packs to relieve itching." b. "I will scrub the area with warm water." c. "I can buy aloe vera gel to use on my skin." d. "I will expose my skin to a sun lamp each day."

ANS: C Aloe vera gel and cream may be used on the radiated skin area. Ice and sunlamps may injure the skin. Treatment areas should be cleaned gently to avoid further injury. DIF: Cognitive Level: Apply (application) REF: 255 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity

The nurse receives change-of-shift report on the oncology unit. Which patient should the nurse assess first? a. A 35-yr-old patient who has wet desquamation associated with abdominal radiation b. A 42-yr-old patient who is sobbing after receiving a new diagnosis of ovarian cancer c. A 24-yr-old patient who received neck radiation and has blood oozing from the neck d. A 56-yr-old patient who developed a new pericardial friction rub after chest radiation

ANS: C Because neck bleeding may indicate possible carotid artery rupture in a patient who is receiving radiation to the neck, this patient should be seen first. The diagnoses and clinical manifestations for the other patients are not immediately life threatening. DIF: Cognitive Level: Analyze (analysis) REF: 263 OBJ: Special Questions: Multiple Patients TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment

When the patient asks about the late effects of chemotherapy and high-dose radiation, what areas of teaching should the nurse plan to include when describing these effects? A. third space syndrome B. secondary malignancies C. chronic nausea and vomiting D. persistant myelosuppression

B

A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective? a. The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale). b. The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness. c. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs. d. The patient states that nonopioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief.

ANS: C For chronic cancer pain, analgesics should be taken on a scheduled basis, with additional doses as needed for breakthrough pain. Taking the medications only when pain reaches a certain level does not provide effective pain control. Although nonopioid analgesics may also be used, there is no maximum dose of opioid. Opioids are given until pain control is achieved. The IV route is not more effective than the oral route, and usually the oral route is preferred. DIF: Cognitive Level: Apply (application) REF: 264 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity

The nurse is caring for a patient diagnosed with stage I colon cancer. When assessing the need for psychologic support, which question by the nurse will provide the most information? a. "How long ago were you diagnosed with this cancer?" b. "Do you have any concerns about body image changes?" c. "Can you tell me what has been helpful to you in the past when coping with stressful events?" d. "Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?"

ANS: C Information about how the patient has coped with past stressful situations helps the nurse determine usual coping mechanisms and their effectiveness. The length of time since the diagnosis will not provide much information about the patient's need for support. The patient's knowledge of typical stages in adjustment to a critical diagnosis does not provide insight into patient needs for assistance. Because surgical interventions for stage I cancer of the colon may not cause any body image changes, this question is not appropriate at this time. DIF: Cognitive Level: Apply (application) REF: 265 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

After change-of-shift report on the oncology unit, which patient should the nurse assess first? a. Patient who has a platelet count of 82,000/μL after chemotherapy b. Patient who has xerostomia after receiving head and neck radiation c. Patient who is neutropenic and has a temperature of 100.5° F (38.1° C) d. Patient who is worried about getting the prescribed long-acting opioid on time

ANS: C Temperature elevation is an emergency in neutropenic patients because of the risk for rapid progression to severe infections and sepsis. The other patients also require assessments or interventions but do not need to be assessed as urgently. Patients with thrombocytopenia do not have spontaneous bleeding until the platelets are 20,000/μL. Xerostomia does not require immediate intervention. Although breakthrough pain needs to be addressed rapidly, the patient does not appear to have breakthrough pain. DIF: Cognitive Level: Analyze (analysis) REF: 253 OBJ: Special Questions: Prioritization | Special Questions: Multiple Patients TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care Environment

The nurse is caring for a patient receiving intravesical bladder chemotherapy. The nurse should monitor for which adverse effect? a. Nausea b. Alopecia c. Hematuria d. Xerostomia

ANS: C The adverse effects of intravesical chemotherapy are confined to the bladder. The other adverse effects are associated with systemic chemotherapy. DIF: Cognitive Level: Apply (application) REF: 252 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity

A patient who is scheduled for a breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is correct? a. "Benign tumors do not cause damage to other tissues." b. "Benign tumors are likely to recur in the same location." c. "Malignant tumors may spread to other tissues or organs." d. "Malignant cells reproduce more rapidly than normal cells."

ANS: C The major difference between benign and malignant tumors is that malignant tumors invade adjacent tissues and spread to distant tissues and benign tumors do not metastasize. The other statements are inaccurate. Both types of tumors may cause damage to adjacent tissues. Malignant cells do not reproduce more rapidly than normal cells. Benign tumors do not usually recur. DIF: Cognitive Level: Understand (comprehension) REF: 240 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

A patient with cancer has a nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste sensation. Which nursing action would address the cause of the patient problem? a. Add protein powder to foods such as casseroles. b. Tell the patient to eat foods that are high in nutrition. c. Avoid giving the patient foods that are strongly disliked. d. Add spices to enhance the flavor of foods that are served.

ANS: C The patient will eat more if disliked foods are avoided and foods that the patient likes are included instead. Additional spice is not usually an effective way to enhance taste. Adding protein powder does not address the issue of taste. The patient's poor intake is not caused by a lack of information about nutrition. DIF: Cognitive Level: Apply (application) REF: 262 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

The nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. Which patient statement indicates that the teaching has been effective? a. "After cancer has not recurred for 5 years, it is considered cured." b. "The cancer will be cured if the entire tumor is surgically removed." c. "I will need follow-up examinations for many years after treatment before I can be considered cured." d. "Cancer is never cured, but the tumor can be controlled with surgery, chemotherapy, and radiation."

ANS: C The risk of recurrence varies by the type of cancer. Some cancers are considered cured after a shorter time span or after surgery, but stage III breast cancer will require additional therapies and ongoing follow-up. DIF: Cognitive Level: Apply (application) REF: 243 TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity

A patient with metastatic cancer of the colon experiences severe vomiting after each administration of chemotherapy. Which action, if taken by the nurse, is appropriate? a. Have the patient eat large meals when nausea is not present. b. Offer dry crackers and carbonated fluids during chemotherapy. c. Administer prescribed antiemetics 1 hour before the treatments. d. Give the patient a glass of a citrus fruit beverage during treatments.

ANS: C Treatment with antiemetics before chemotherapy may help prevent nausea. The patient should eat small, frequent meals. Offering food and beverages during chemotherapy is likely to cause nausea. The acidity of citrus fruits may be further irritating to the stomach. DIF: Cognitive Level: Apply (application) REF: 251 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

A patient has been assigned the nursing diagnosis of imbalanced nutrition: less than body requirements related to painful oral ulcers. Which nursing action will be most effective in improving oral intake? a. Offer the patient frequent small snacks between meals. b. Assist the patient to choose favorite foods from the menu. c. Provide teaching about the importance of nutritional intake. d. Apply prescribed anesthetic gel to oral lesions before meals.

ANS: D Because the etiology of the patient's poor nutrition is the painful oral ulcers, the best intervention is to apply anesthetic gel to the lesions before the patient eats. The other actions might be helpful for other patients with impaired nutrition but would not be as helpful for this patient. DIF: Cognitive Level: Analyze (analysis) REF: 254 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity

The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer. Which information about the patient alerts the nurse to discuss a possible change in cancer therapy with the health care provider? a. Frequent loose stools b. Nausea and vomiting c. Elevated white blood count (WBC) d. Increased carcinoembryonic antigen (CEA)

ANS: D An increase in CEA indicates that the chemotherapy is not effective for the patient's cancer and may need to be modified. Gastrointestinal adverse effects are common with chemotherapy. The nurse may need to address these, but they would not necessarily indicate a need for a change in therapy. An elevated WBC may indicate infection but does not reflect the effectiveness of the colorectal cancer therapy. DIF: Cognitive Level: Apply (application) REF: 236 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

An older adult patient who has colorectal cancer is receiving IV fluids at 175 mL/hr in conjunction with the prescribed chemotherapy. Which finding by the nurse is most important to report to the health care provider? a. Patient complains of severe fatigue. b. Patient voids every hour during the day. c. Patient takes only 50% of meals and refuses snacks. d. Patient has crackles up to the midline posterior chest.

ANS: D Rapid fluid infusions may cause heart failure, especially in older patients. The other findings are common in patients who have cancer or are receiving chemotherapy. DIF: Cognitive Level: Analyze (analysis) REF: 266 OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

The nurse is caring for a patient who smokes two packs/day. Which action by the nurse could help reduce the patient's risk of lung cancer? a. Teach the patient about the seven warning signs of cancer. b. Plan to monitor the patient's carcinoembryonic antigen (CEA) level. c. Teach the patient about annual chest x-rays for lung cancer screening. d. Discuss risks associated with cigarette smoking during each patient encounter.

ANS: D Teaching about the risks associated with cigarette smoking is recommended at every patient encounter because cigarette smoking is associated with multiple health problems. The other options may detect lung cancer that is already present but do not reduce the risk. DIF: Cognitive Level: Apply (application) REF: 237 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance

A patient who has ovarian cancer is crying and tells the nurse, "My husband rarely visits. He just doesn't care." The husband indicates to the nurse that he does not know what to say to his wife. Which nursing diagnosis is appropriate for the nurse to add to the plan of care? a. Compromised family coping related to disruption in lifestyle b. Impaired home maintenance related to perceived role changes c. Risk for caregiver role strain related to burdens of caregiving responsibilities d. Dysfunctional family processes related to effect of illness on family members

ANS: D The data indicate that this diagnosis is most appropriate because poor communication among the family members is affecting family processes. No data suggest a change in lifestyle or its role as an etiology. The data do not support impairment in home maintenance or a burden caused by caregiving responsibilities. DIF: Cognitive Level: Apply (application) REF: 265 TOP: Nursing Process: Diagnosis MSC: NCLEX: Psychosocial Integrity

The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which laboratory result is most important to report to the health care provider? a. Hematocrit 30% b. Platelets 95,000/μL c. Hemoglobin 10 g/L d. White blood cells (WBC) 2700/μL

ANS: D The low WBC count places the patient at risk for severe infection and is an indication that the chemotherapy dose may need to be lower or that WBC growth factors such as filgrastim (Neupogen) are needed. Although the other laboratory data indicate decreased levels, they do not indicate any immediate life-threatening adverse effects of the chemotherapy. DIF: Cognitive Level: Apply (application) REF: 235 OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient? a. Remove food debris from the teeth and oral mucosa with a stiff toothbrush. b. Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth. c. Gargle and rinse the mouth several times a day with an antiseptic mouthwash. d. Rinse the mouth before and after each meal and at bedtime with a saline solution.

ANS: D The patient should rinse the mouth with a saline solution frequently. A soft toothbrush is used for oral care. Hydrogen peroxide may damage tissues. Antiseptic mouthwashes may irritate the oral mucosa and are not recommended. DIF: Cognitive Level: Apply (application) REF: 251 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

During the teaching session for a patient who has a new diagnosis of acute leukemia, the patient is restless and looks away without making eye contact. The patient asks the nurse to repeat the information about the complications associated with chemotherapy. Based on this assessment, which nursing diagnosis is appropriate for the patient? a. Risk for ineffective adherence to treatment related to denial of need for chemotherapy b. Acute confusion related to infiltration of leukemia cells into the central nervous system c. Deficient knowledge: chemotherapy related to a lack of interest in learning about treatment d. Risk for ineffective health maintenance related to possible anxiety about leukemia diagnosis

ANS: D The patient who has a new cancer diagnosis is likely to have high anxiety, which may impact learning and require that the nurse repeat and reinforce information. The patient's history of a recent diagnosis suggests that infiltration of the leukemia is not a likely cause of the confusion. The patient asks for the information to be repeated, indicating that lack of interest in learning and denial are not etiologic factors. DIF: Cognitive Level: Apply (application) REF: 265 TOP: Nursing Process: Diagnosis MSC: NCLEX: Psychosocial Integrity

Which action should the nurse take when caring for a patient who is receiving chemotherapy and complains of problems with concentration? a. Teach the patient to rest the brain by avoiding new activities. b. Teach that "chemo-brain" is a short-term effect of chemotherapy. c. Report patient symptoms immediately to the health care provider. d. Suggest use of a daily planner and encourage adequate rest and sleep.

ANS: D Use of tools to enhance memory and concentration such as a daily planner and adequate rest are helpful for patients who develop "chemo-brain" while receiving chemotherapy. Patients should be encouraged to exercise the brain through new activities. Chemo-brain may be short or long term. There is no urgent need to report common chemotherapy side effects to the provider. DIF: Cognitive Level: Apply (application) REF: 252 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

The nurse uses many precautions during IV administration of vesicant chemotherapeutic agents, primarily to prevent, A. septicemia B. extravasation C. catheter occlusion D. anaphylactic shock

B

The nursing instructor is discussing benign versus malignant cells in the pathophysiology class. What distinguishes malignant cells from benign cells of the same tissue type? A. Slow rate of mitosis of cancer cells B. Proteins in the cell membrane C. Size of cells D. Stability of cells

B

The nursing instructor is discussing the difference between normal cells and cancer cells with the prenursing class in pathophysiology. What would the instructor cite as a characteristic of a cancer cell? A. Malignant cells contain more fibronectin. B. The cell membrane of malignant cells also contains proteins called tumor-specific antigens. C. Chromosomes are commonly found to be strong. D. Nuclei of cancer cells are large and regularly shaped.

B

The nursing instructor is teaching a class in oncology nursing to her junior nursing students. The instructor is aware that infection is a significant consideration when providing care to an oncology patient. The leading cause of death in an oncology patient is infection caused by what? A. Malnutrition B. Impaired skin integrity C. Poor hygiene D. Broken oral mucosa

B

The patient was told she has carcinoma in situ, and the student nurse wonders what that is. How should the nurse explain this to the student nurse? A. evasion of the immune system by cancer cells B. lesion with histologic features of cancer except invasion C. capable of causing cellular alterations associated with cancer D. tumor cell surface antigens that stimulate immune response

B

The school health nurse is presenting a health-promotion class to a group of middle-school students. Which is the best intervention to address health-promotion strategies related to the leading cause of cancer deaths in North America? A. Monthly self-breast exams B. Smoking cessation C. Annual colonoscopies D. Monthly testicular exams

B

The staff educator is giving a class on oncology nursing for a group of nurses new to the unit. What is the most common mechanism of metastasis of cancer cells? A. Hematologic spread B. Lymphatic circulation C. Invasion D. Angiogenisis

B

When a patient is undergoing brachytherapy, what is it important for the nurse to be aware of when caring for this patient? A. the patient will undergo simulation to identify and mark the field of treatment B. the patient is a source of radiation and personnel must wear film badges during care C. the goal of this treatment is only palliative and the patient should be aware of the expected outcomes D. computerized dosimetry is used to determine the maximum dose of radiation to the timor within an acceptable dose to normal tissue

B

When teaching a patient with cancer about chemotherapy, which approach should the nurse take? A. avoid telling the patient about possible side effects of the drugs to prevent anticipatory anxiety B. explain that antiemetics, antidiarrheals, and analgesics will be provided as needed to control side effects C. assure the patient that the side effects from chemotherapy are uncomfortable but never life threatening D. inform the patient that chemotherapy-related alopecia is permanent but can be managed with lifelong use of wigs

B

Which patient would be most likely to be cured with chemotherapy as a treatment measure? A. small cell lung cancer B. new neuroblastoma C. small tumor in the bone D. large hepatocellular carcinoma

B

You are the clinic nurse caring for a patient whose grandmother, mother, and sister all had breast cancer. She has requested a screening test to determine her risk of developing breast cancer, and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response? A. "Research has shown that eating a healthy diet can reduce your chance of breast cancer." B. "Research has shown that taking tamoxifen can reduce your chance of breast cancer." C. "Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer." D. "Research has shown that reducing your intake of red meat can reduce your chance of breast cancer."

B

A small lesion is discovered in a patient's lung when an x-ray is performed for cervical spine pain. What is the definitive method of determining if the lesion is malignant? A. lung scan B. tissue biopsy C. oncofetal antigens in the blood D. CT or position emisson tomography (PET) scan

B Although other tests may be used in diagnosing the presence and extent of cancer, biopsy is the only method bywhich cells can be definitely determined to be malignant.

The nurse in counseling a group of individuals over the age of 50 with average risk for cancer about screening tests for cancer. Which screening recommendation should be preformed to screen for colorectal cancer? A. barium enema every year B. colonoscopy every 10 years C. fecal occult blood every 5 years D. annual prostate-specific antigen (PSA. and digital rectal exam

B ? can't find in book

Which normal tissue manifest early, acute response to radiation therapy? A. spleen and liver B. kidney and nervous tissue C. bone marrow and gastrointestinal mucosa D. hollow organs such as the stomach and bladder

C

A 58-year-old male patient has been hospitalized for a wedge resection of the left lower lung lobe after a routine chest x-ray shows carcinoma. The patient is anxious and asks if he can smoke. Which statement by the nurse would be most therapeutic? A. "Smoking is the reason you're here." B. "The doctor left orders for you not to smoke." C. "You're anxious about the surgery. Do you see smoking as helping?" D. "Smoking is OK right now, but after your surgery it's contraindicated."

C

An allogenic hematopoetic stem cell transplant is considered as treatment for a patient with acute myelogenous leukemia. What information should the nurse include when teaching the patient about this procedure? A. there is no risk for graft-versus-host disease because the donated marrow is treated to remove cancer cells B. the patient's bone marrow will be removed, treated, stored, and then reinfused after intensive chemotherapy C. peripheral stem cells are obtained from a donor who has a human leukocyte antigen (HLA. match with the patient D. there is no need for posttrasplant protective isolation because the stem cells are infused directly into the blood.

C

PRIORITY DECISION: While caring for a patient who is at the nadir of chemotherapy, the nurse establishes the highest priority for nursing actions related to: A. diarrhea B. grieving C. risk for infection D. inadequate nutritional intake

C

The nurse on a bone marrow transplant unit is caring for a patient with cancer who is preparing for engraphment for a bone marrow transplant. What is a priority nursing diagnosis for this patient? A. Fatigue and activity intolerance B. Altered nutrition: less than body requirements due to anorexia C. Risk for infection related to altered immunologic response D. Body image disturbance related to weight loss and anorexia

C

Traditionally, nurses have been involved with tertiary prevention with their cancer patients. However, emphasis is also placed on both primary and secondary prevention. What would be an example of primary prevention? A. Yearly Papanicolaou tests B. Testicular self-examination C. Teaching patients to wear sunscreen D. Screening mammogram

C

What describes a primary use of therapy in cancer treatment? A. protect normal, rapaidly producing cells of the gastrointestinal system from damage during chemotherapy B. prevent the fatigue associated with chemotherapy and high-dose radiation as seen with bone marrow suppression C. enhance or supplement the effects of the host's immune response to tumor cells that produce flu-like symptoms D. depress the immune system and circulating lymphocytes as well as increase a sense of well-being by replacing central nervous system deficits

C

You are teaching a nutrition class in the local high school. One student tells you that he has heard that certain foods can increase the incidence of cancer. You respond, "Research has shown that certain foods appear to increase the risk of cancer." Which of the following menu selections would be the best choice for reducing the risks of cancer? A. Smoked salmon and green beans B. Pork chops and fried green tomatoes C. Baked apricot chicken and steamed broccoli D. Liver, onions, and steamed peas

C

Your patient is receiving carmustine, a chemotherapy agent. A significant side effect of this medication is thrombocytopenia. Which symptom would the nurse assess for in patients at risk for thrombocytopenia? A. Interrupted sleep pattern B. Hot flashes C. Nose bleed D. Increased weight

C

A patient's breast tumor originates from embryonal ectoderm. It has moderate dysplasia and moderately differentiated cells. It is a small tumor with minimal lymph node involvement and no metastasis. What is the best description of this tumor? A. Sarcoma, grade II, T3, N4, M0 B. Leukemia, grade I, T1, N2, M1 C. Carcinoma, grade II, T1, N1, M0 D. Lymphoma, grade III, T1, N0, M1

C , pg. 238

You are doing an initial assessment of a patient newly diagnosed with cancer. The patient tells you that he drinks about a quart of scotch every evening. What types of cancer does this put him at risk for? (Mark all that apply.) A. Pancreatic cancer B. Brain cancer C. Breast cancer D. Esophageal cancer E. Liver cancer

C, D, E

A patient is admitted with acute myelogenous leukemia and a history of Hodgkin's lymphoma. What is the nurse likely to find in the patient's history? A. work as a radiation chemist B. Esptein-Barr virus diagnosed in vitro C. intesnse tanning throughout lifetime D. alkylating agents for treating the Hodgkin's lymphoma

D

PRIORITY DECISION: The patient with advanced cancer is having difficulty controlling her pain. She says she is afraid she will become addicted to the opioids. What is the first thing the nurse should do for this patient? A. administer a non steroidal anti-inflammatory drug B. assess the patient's vital signs and behavior to determine the medication to use C. have the patient keep a pain diary to better assess the patient's potential addiction D. obtain a detailed pain history including quality, location, intensity, duration, and type of pain

D

The nursing instructor is discussing the care of oncology patients with her junior nursing students. The instructor presents this scenario: An oncology patient develops erythema following radiation therapy. What should the nurse instruct the patient to do? A. Apply ice to the area. B. Keep the area cleanly shaven. C. Apply petroleum ointment to the affected area. D. Avoid using soap on the area of treatment.

D

The patient is learning about skin care related to the external radiation that he is receiving. Which instruction should the nurse include in this teaching? A. moisturize skin with lotion B. keep the area covered if it is sore C. dry the skin thoroughly after cleaning it D. avoid extreme temperatures to the area

D

What defect in cellular proliferation is in involved in the development of cancer? A. a rate of cell proliferation that is more rapid than that of normal body cells B. shortened phases of cell life cycles with occasional skipping of GI or S phases C. Rearrangement of stem cell RNA that causes abdominal cellular protein synthesis D. Indiscriminate and continuous proliferation of cells with loss of contact inhibition

D

What factor differentiates a malignant tumor from a benign tumor? A. it causes death B. it grows at a faster rate C. it is often encapsulated D. it invades and metastasizes

D

You are a nurse working on a bone marrow transplant unit. Your patient is scheduled to receive a bone marrow transplant. What information will you provide to the patient's visitors? A. Bring plants to improve air quality. B. Take the patient to the cafeteria for meals. C. Wear hospital scrubs when entering the patient's room. D. Do not visit if you've had a recent infection.

D

You are caring for a patient has just been given a 6-month prognosis. The patient states that he would like to die at home. The patient's care needs are unable to be met in a home environment. What might you suggest as an alternative? A. Discuss a referral for rehabilitation hospital B. Panel the patient for a personal care home C. Discuss a referral for acute care D. Discuss a referral for hospice care

D

You are orienting a new nurse to the oncology unit where you work. As you prepare to administer an antineoplastic agent to a one of your patients, what should you teach the new nurse about antineoplastic agents? A. Administer only prepackaged agents from the manufacturer B. Wash hands and arms following administration C. Use gloves and a lab coat D. Dispose of the antineoplastic wastes in the hazardous waste receptacle

D

What is the name of a tumor from the embryonal mesoderm tissue of origin located in the anatomic site of the meninges that has malignant behavior? A. meningitis B. meningioma C. meningocele D. meningeal sarcoma

D pg. 238

Which delivery system would be used to deliver regional chemotherapy for metastasis from primary colorectal cancer? A. intrathecal B. intraarterial C. intravenous D. intraperitoneal

D. pg. 245. Intraperitoneal = colorectal, ovarian, malignant ascites. Chemo is flushed in then, dwells for 1-4 hours, then sucked out. Intrathecal or intraventricular = for cancers in the CNS (difficult to treat cuz of blood brain barrier). so they'll put chemo in via a lumbar puncture Intraarterial = chemo is delivered through the arteries that supply blood to the tumor, treats osteogenic sarcoma, cancers of head and neck...

For which type of malignancy should the nurse expect the use for intravesicular route of regional chemotherapy delivery? A. bladder B. leukemia C. osteogenic sarcoma D. metastasis to the brain

a. Bladder Intravesical regional chemotherapy is administered into the bladder via a urinary catheter. Leukemia is treated with IV chemotherapy. Osteogenic sarcoma is treated with intraarterial chemotherapy via vessels supplying the tumor. Metastasis to the brain is treated with intraventricular orintrathecal chemotherapy via an Ommaya reservoir or lumbar punctures.