Chapter 6 PrepU

A client who is diagnosed with breast cancer asks the nurse why cancer causes tumors to form. Which statement is the nurse's best response? a. "The cancer cells are much larger than normal cells, creating greater bulk in the tissues." b. "Not all cancers result in tumors. Leukemia is an example of a cancer without tumors." c. "Cancer cells differ from normal cells because they can divide an unlimited number of times." d. "All cancers behave differently. You should speak to the health care provider about your case."

"Cancer cells differ from normal cells because they can divide an unlimited number of times."

The nurse teaching a group of adolescent girls about Papanicolaou (Pap) testing determines that additional education is needed when one makes which statement? a. "It assesses for the presence of abnormal cells." b. "It is a blood test." c. "It screens for cervical cancer." d. "It can be used with nipple drainage and anal washings."

"It is a blood test."

While studying for a pathophysiology exam on cells and tissue repair, a student asks, "What happens if, in the process of going through the cell cycle, a cell is damaged?" Which is the best response? a. "I guess that is how you get skin cancer; the defect was allowed to complete the cycle and continue reproducing defective cells." b. "There are built-in checkpoints in the cell cycle to allow for defects to be edited and repaired." c. "The cell will die at that point since it will not have an accurate DNA replication." d."The cell will complete its cycle with an end result that one of the daughter cells will not be identical to that of the parent cell."

"There are built-in checkpoints in the cell cycle to allow for defects to be edited and repaired."

The nurse has provided an educational session with a 56-year-old man newly diagnosed with a benign tumor of the colon. The nurse knows that the client needs further teaching when he makes which remark? a. "Even though benign tumors can't stop growing, they aren't considered cancer." b. "This kind of tumor can't invade other organs or travel to other places in the body to start new tumors." c. "Benign tumors still produce normal cells different from other cells around them." d. "This tumor I have, will I die from it?"

"This tumor I have, will I die from it?"

Which dietary guideline should a nurse provide to a group of older adults to possibly decrease their risks of developing colon cancer? a. "Try to minimize fat and maximize fiber when you're planning your meals." b. "Eat enough fiber in your diet that you have bowel movement at least once daily." c. "Regular vitamin supplements and a low-carbohydrate diet are beneficial." d. "As much as possible, try to eat organic foods."

"Try to minimize fat and maximize fiber when you're planning your meals."

The nursing student is giving a talk on cancer to a local community group. Which clients would the student identify as being at a high risk for developing cancer? Select all that apply. a. 30-year-old client who has been diagnosed with diabetes b. 45-year-old client who has rheumatoid arthritis c. 89-year-old woman with osteoporosis d. 23 year-old client who recently had a kidney transplant e. 42-year-old male with HIV

-89-year-old woman with osteoporosis -23 year-old client who recently had a kidney transplant -42-year-old male with HIV

A nurse caring for a client with cancer notes that the client also has anemia. What might be the cause of anemia in this client? Select all that apply. a. Blood loss b. Side effect of chemotherapy c. Impaired red blood cell (RBC) production d. Hypoxia e. Liver fatigue

-Blood loss -Side effect of chemotherapy -Impaired red blood cell (RBC) production

During a lecture on stem cells, the professor mentions that the first few cells produced after fertilization are totipotent and divide into which types of cells? Select all that apply. a. Highly specialized cells b. Terminally differentiated cells c.Embryonic cells d.Permanent tissues e. Extraembryonic cells

-Embryonic cells -Extraembryonic cells

A woman diagnosed with breast cancer asks the nurse how a malignant tumor in her breast could spread to other parts of her body. The nurse answers that a malignant neoplasm is made of up less well-differentiated cells that have which abilities? Select all that apply. a. Reinvade their original site b. Enter the circulatory or lymphatic systems c. Be excreted through the alimentary canal d. Break loose e. Form secondary malignant tumors at other sites

-Enter the circulatory or lymphatic systems -Break loose -Form secondary malignant tumors at other sites

A nurse is studying about benign cancers and recognizes which tumors are classified as benign? Select all that apply. a. Glioblastoma b. Multiple myeloma c. Fibroma d. Meningeal sarcoma e. Lymphangioma

-Fibroma -Lymphangioma

Childhood cancers are often diagnosed late in the disease process because the signs and symptoms mimic other childhood diseases. However, more children are surviving childhood cancer. Survivors may face which late-term effects of their cancer treatments? Select all that apply. a. Impaired growth and second malignancies b. Second malignancies and liver failure c. Cognitive dysfunction and hormonal dysfunction d. Cardiomyopathy and pulmonary fibrosis

-Impaired growth and second malignancies -Cognitive dysfunction and hormonal dysfunction -Cardiomyopathy and pulmonary fibrosis

An oncology nurse recognizes that the cluster of differentiation (CD) antigen is present on leukocytes and is the tumor marker used in which cancers? Select all that apply. a. Liver cancer b. Colon cancer c. Breast cancer d. Lymphoma e. Leukemia

-Lymphoma -Leukemia

A nursing student correctly identifies methods that can be utilized to perform a tissue biopsy for the purpose of diagnosing cancer types. What are these methods? Select all that apply. a. Endoscopic method b. Laparoscopic method c. Excisional biopsy d. Needle biopsy e. Blood sample

-Needle biopsy -Endoscopy method -Laparoscopic method -Excisional biopsy

Because an adolescent has revealed a history of childhood cancer, the nurse should include in the plan of care an assessment for which late-therapy sequelae? Select all that apply. a. Neurologic dysfunction b. Impaired growth c. Asthma d. Hormonal dysfunction e. Diabetes

-Neurologic dysfunction -Impaired growth -Hormonal dysfunction

The nursing instructor is teaching a class about cancer and informs the students that the difference between benign and malignant neoplasms include which distinguishing characteristics? Select all that apply. a. Potential for causing death b. Surface of tumor c. Capacity to invade and metastasize d. Manner of growth e. Rate of growth f. Cell characteristics

-Potential for causing death -Capacity to invade and metastasize -Manner of growth -Rate of growth -Cell characteristics

The professor is describing multipotent stem cells, mentioning that these hematopoietic stem cells give rise to a family of cells. Which cells are in this family? Select all that apply. a. Leukocytes b. Red blood cells c. Synovial cells d. Endothelial cells e. Collagenases

-Red blood cells -Leukocytes

Therapeutic radiation can be delivered by which methods? Select all that apply. a. Brachytherapy b. External beam c. Light therapy d. Systemic therapy

-brachytherapy -external beam -systemic therapy

A community health nurse is discussing preventative vaccines with a group of primigravida women. Which cancer-causing virus(es) should the nurse discuss that have a vaccine to prevent developing the disease? Select all that apply, a. hepatitis B b. meningitis c. human papillomavirus (HPV) d. Zika virus e. chlamydia

-hepatitis B -human papillomavirus (HPV)

A nurse doing a presentation on cancer to a local community group identifies which factors to be high-risk and associated with cancer development? Select all that apply. a. Number of siblings b. Low weight c. Immunologic mechanisms d. Hormonal factors e. Heredity f. Environmental agents

-immunologic mechanisms -hormonal factors -heredity -environmental factors

Screening for cancer can be achieved through which ways? Select all that apply. a. Procedures b. Lab tests c. Surveys d. Observation e. Palpation

-procedures -lab tets -observation -palpation

The nurse is conducting a community class on the importance of early recognition of cancer. Screening mechanisms are available for which cancers? Select all that apply. a. Lung b. Prostate c. Breast d. Cervical e. Pancreatic

-prostate -breast -cervical

When educating a client who has tested positive for human T-cell leukemia virus-1 (HTLV-1), what mode(s) of transmission should the nurse discuss to prevent the spread? Select all that apply. a. kissing a person on the forehead b. sneezing (releasing droplets) c. sexual intercourse d. infants through breast milk e. blood by sharing needles

-sexual intercourse -infants through breast milk -blood by sharing needles

Four clients come to the clinic for a yearly wellness check. Which client likely faces the lowest risk of cancer? a. A 48-year-old man who takes immunosuppressant drugs following a kidney transplant b. A 38-year-old female with Down syndrome and congenital scoliosis c. A 51-year-old woman whose grandmother died of breast cancer d. A 50-year-old man who is obese and has a low-fiber, high-fat diet

A 38-year-old female with Down syndrome and congenital scoliosis

The nurse is orienting a student to the oncology setting. Which characteristic does the student identify as one that is representative of a benign tumor? a. Undifferentiated cells b. A fibrous capsule c. Distant infiltration d. Rapid replication

A fibrous capsule

A biopsy of a client's liver has been taken because there is suspicion that his lung cancer may have metastasized. The results confirm that there are cancerous cells in the client's liver and the oncologist has estimated a high growth fraction in the sample. The nurse should draw what implication from this finding? a. The doubling time of the mass is increasing. b. The neoplastic cells in the tissue sample have achieved their maximum size. c. A large proportion of the cells in the sample are actively dividing. d. Embryonic stem cells are present in the sample and represent a high risk for tumor growth.

A large proportion of the cells in the sample are actively dividing.

Based solely on the inheritable condition, a child with Down syndrome is susceptible for developing which type of cancer? a. Brain cancer b. Non-Hodgkin lymphoma c. Kidney cancer d. Acute lymphocytic leukemia (ALL)

Acute lymphocytic leukemia (ALL)

Tumor markers are used for screening, establishing prognosis, monitoring treatment, and detecting recurrent disease. Which serum tumor markers have been proven to be among the most useful in clinical practice?

Alpha-fetoprotein and human chorionic gonadotropin

A client whose mother and grandmother both have had cancer is at a higher risk for also developing the disease. Which tumor suppressor genes are associated with genetic susceptibility to breast cancer? Select all that apply. 1. BRCA2 2. TGF-B 3. BRCA1 4. TGF-A

BRCA2 + BRCA1

A nurse interpreting a pathology report that indicates a client has an adenoma determines that the client's tumor is considered: a. Malignant b. Benign c. Differentiated d. Apoptotic

Benign

A nursing student identifies which statement about tumors to be true? a. Malignant tumors are usually surrounded by a capsule. b. Benign tumors usually grow by expansion. c. Malignant tumors usually grow by utilization of the lymph channels. d. Benign tumors usually spread through the lymph and blood pathways.

Benign tumors usually grow by expansion.

A 51-year-old client has been diagnosed with stage IV breast cancer with lung metastases. The oncologist sits down with the client/family to explain treatment options. The nurse knows that which treatment option will be discussed for her cancers? a. Chemotherapy b. Radiation therapy c. Hormone therapy d. Surgery

Chemotherapy

A nurse reading a client's chart notes that the client's cancer is documented as carcinoma in situ of the cervix. Which term most accurately interprets what this means in terms of survival? a. Curable b. Inoperable c. Metastasizing d. Benign

Curable

A client diagnosed with breast cancer will undergo a surgical procedure that includes biopsy of the sentinel node. What can be accomplished by this biopsy? a. Facilitate lymph drainage b. Identify if the node is infected c. Determine the cause of the cancer d. Determine the extent of the disease

Determine the extent of the disease

A client has undergone a screening colonoscopy. The doctor removed several polyps that were sent to pathology and identified as benign. Select the best explanation of a polyp. a. Benign microscopic or macroscopic fingerlike projections b. Benign tumor arising in fibrous tissue c. Benign epithelial neoplasm of glandular tissue d. Growth that projects from a mucosal surface

Growth that projects from a mucosal surface

It is well known that cancer is not a single disease. It follows then that cancer does not have a single cause. It seems more likely that the occurrence of cancer is triggered by the interactions of multiple risk factors. What are some identified risk factors for cancer? a. Immunologic mechanisms, cancer-causing viruses, and color of skin b. Radiation, cancer-causing viruses, and color of skin c. Hormonal factors, chemicals, and immunologic mechanisms d. Body type, age, and heredity

Hormonal factors, chemicals, and immunologic mechanisms

A client who is being screened for cancer due to a family history asks the nurse what is meant by "tumor suppressor genes"? Which statement would be the nurse's best response? a. "It is a category associated with gene underactivity, which by being less active creates an environment in which cancer is promoted." b. "These genes play no role in the development of cancer." c. "It is a category associated with gene normal activity, which increases the risk of cancer." d. "It is a category associated with gene overactivity, which leads to decreased risk of cancer."

It is a category associated with gene underactivity, which by being less active creates an environment in which cancer is promoted."

A newly diagnosed lung cancer client asks how his tumor spread (metastasized) so fast without displaying many signs/symptoms. The nurse responds that malignant tumors affect area tissues by: a. Increasing tissue blood flow b. Liberating enzymes and toxins c. Forming fibrous membranes d. Providing essential nutrients

Liberating enzymes and toxins

In some cancers, the presenting factor is an effusion, or fluid, in the pleural, pericardial, or peritoneal spaces. Research has found that almost 50% of undiagnosed effusions in people not known to have cancer turn out to be malignant. Which cancers are often found because of effusions? a. Ovarian and rectal cancers b. Breast and colon cancers c. Lung and ovarian cancers d. Colon and rectal cancers

Lung and ovarian cancers

The nursing student who is studying about cancer correctly identifies which type to be the leading cause of cancer death in both men and women? a. Skin cancer b. Breast cancer c. Lung cancer d. Prostate cancer

Lung cancer

A client has developed a large wound as a result of trauma sustained during an auto accident. The cells will undergo which process to regenerate tissue? a. Cytogenetics b. Meiosis c. Mitosis d. Cloning

Mitosis

An oncology class is reviewing the cell cycle as it pertains to tumor growth. When talking about the M phase, which process is occurring at this time? a.Nuclear division occurs. b. Two separate sets of chromosomes arise, one for each daughter cell. c.DNA synthesis ceases. d. Cell growth takes place.

Nuclear division occurs

A public health nurse has cited a reduction in cancer risk among the many benefits of maintaining a healthy body mass index. Which fact underlies the relationship between obesity and cancer? a. Increased cardiac workload and tissue hypoxia can interfere with normal cell differentiation. b. Obesity can cause inflammation and hormonal changes that are associated with cancer. c. Increased numbers of body cells increase the statistical chances of neoplastic cell changes. d. Adipose tissue is more susceptible to malignancy than other types of connective tissue.

Obesity can cause inflammation and hormonal changes that are associated with cancer.

A big difference in the treatment of childhood cancer as opposed to adult cancer is that chemotherapy is the most widely used treatment therapy for childhood cancer. What is the reason for this? a. Children do not tolerate other forms of therapy as well as adults do. b. Children do not complain about the nausea and vomiting caused by chemotherapy like adults do. c. Pediatric tumors are more responsive to chemotherapy than adult cancers. d. Children think losing their hair is "cool."

Pediatric tumors are more responsive to chemotherapy than adult cancers.

One group of chemical carcinogens is called indirect-reacting agents. Another term for these agents is procarcinogens, which become active only after metabolic conversion. One of the most potent procarcinogens is a group of dietary carcinogens called: a. Aflatoxins b. Initiators c. Diethylstilbestrol d. Polycyclic aromatic hydrocarbons

Polycyclic aromatic hydrocarbons

The nurse is educating a client who is about to undergo a stem cell transplant, mentioning that a single stem cell can give rise to many cells needed for normal tissue repair. With stem cell division, one daughter cell retains the stem cell characteristics while the other daughter cell becomes which type of cell leading to terminal differentiation? a. Embryonic b. Asymmetric c.Progenitor d. Totipotent

Progenitor

The nurse is explaining to a client the adverse side effects of cancer therapies. Which target of both chemotherapy and radiation treatment accounts for the adverse as well as therapeutic effects of these treatments? a. Blood vessels b. Rapidly proliferating cells c. Cell-surface receptors d. Circulating hormone levels

Rapidly proliferating cells

The hand-off report to the nurse of a client with cancer includes that the client is scheduled for palliative surgery. The nurse interprets this to mean that the goal of the client's surgery is to do which of the following? a. Relieve the client's symptoms b. Determine the extent of metastasis c. Diagnose the cancer d. Stage the cancer

Relieve the client's symptoms

A client is diagnosed with metastatic lung cancer. The client begins treatment imminently but is experiencing nausea, vomiting, and abnormal ECG findings on admission. When assessing the client for possible paraneoplastic syndromes, the nurse should prioritize what laboratory assessment? a. Serum calcium level b. AST, ALT, and GGT levels c. Blood urea nitrogen and creatinine levels d. Erythrocyte sedimentation rate and C-reactive protein

Serum calcium level

The nurse explains to her client that clinical manifestations vary with the type of cancer and organs involved. Which systemic clinical manifestation is a result of abnormal tumor growth? a. Involuntary weight gain b. Sleep disturbances c. Hypocalcemia d. Copious lymph flow

Sleep disturbances

A client is scheduled for a bronchoscopy related to a history of "bronchitis" for the last 3 months that has been unresponsive to antibiotics. The nurse shares with the client that a primary purpose for this bronchoscopy is to help diagnose which complication? a. Visualizing airways looking for adhesions b. Flushing out the airway to remove debris and sputum c. Opening airways looking for any aspirated food d. Taking tissue biopsy and looking for abnormal cells

Taking tissue biopsy and looking for abnormal cells

A client diagnosed with liver cancer has been admitted to a palliative care unit for bone metastases. His family shares with the nurse that he is usually a "big eater," but now he just isn't interested in food, which has resulted in muscle loss. Which factors may underlie the client's change in nutritional status? a. The action of cytokines and persistent inflammation b. Production of onconeural antigens by cancerous cells c. Changes in peptide hormone levels d. Loss of appetite due to fatigue and pain

The action of cytokines and persistent inflammation

A client has undergone extensive diagnostic testing and has been diagnosed with breast cancer staged as T3, N0, M0. What conclusion can the nurse draw from the staging of the client's breast cancer? 1. The client has a tumor that does not have the potential for metastasis. 2. The client has a sizable tumor but there is no lymphatic involvement. 3. The client has a tumor that is estimated to be 3 mm in diameter. 4. The client's tumor is not considered to be neoplastic and it has not metastasized.

The client has a sizable tumor but there is no lymphatic involvement.

Select the option that best describes metastasis. a. Cancer cells are deposited into body cavities. b. Crablike projections of cancer cells invade the surrounding tissue. c. The development of a secondary tumor. d. Hyperplastic cellular changes.

The development of a secondary tumor.

The oncologist is reviewing data to determine if a client diagnosed with a malignant tumor is at risk for developing metastasis. Select the option that places the client at greatest risk. a. Aggressiveness of the cancer cells b. The establishment of a dedicated vascular system c. Early detection of the primary site d. The general health status of the individual

The establishment of a dedicated vascular system

A lung biopsy and magnetic resonance imaging have confirmed the presence of a benign lung tumor in a client. Which characteristic is associated with this client's neoplasm? a. The tumor is likely to infiltrate the lung tissue that presently surrounds it. b. The cells that constitute the tumor are undifferentiated, with atypical structure. c. The tumor will grow by expansion and is likely encapsulated. d. If left untreated, the client's tumor is likely to metastasize.

The tumor will grow by expansion and is likely encapsulated.

A 5-year-old girl's diagnosis of bone cancer required an aggressive treatment regimen. Which consideration forms the most significant threat to her future health? a. Retention of chemotherapeutic drugs in the healthy bone matrix b. Unwanted effects of chemotherapy and radiation therapy c. Resistance to chemotherapy and radiation if required later in life d. Risk for recurrence of the primary neoplasm after puberty

Unwanted effects of chemotherapy and radiation therapy

A young client who received radiation treatment to decrease the size of his tonsils is at high risk for developing thyroid cancer. Which time frame is considered the latency period for this cancer? a. Up to 35 years b. Up to 7 years c. 2 to 3 years d. 5 to 10 years

Up to 35 years

A client has been diagnosed with cancer and will begin aggressive treatment. The client's course of treatment includes drug therapies that affect cyclins and cyclin-dependent kinases (CDKs). This drug will achieve a therapeutic effect by: a. affecting the progression of cells through the process of cell division. b. hastening the differentiation of stem cells into healthy cells. c. reversing the process of uncontrolled cell growth by causing cell atrophy. d. aiding stem cells in the identification of neoplasms.

affecting the progression of cells through the process of cell division.

A nurse is teaching a group of clients about causes/risk factors for cancer, which include which factors? Select all that apply. a. Age b. Genetics c. Financial status d. Environment e. Heredity

age, genetics, environment, heredity

Select the option that best identifies how adult cancers differ in origin from childhood cancers. Adult cancers originate from: a. the hematopoietic system. b. epithelial cells. c. neuronal tissues. d. embryonic cells.

epithelial cells

A client has stage IV cancer but further testing is needed to determine the site of origin of this metastatic tumor. Which form of testing will the health care provider be discussing with this client? a. Papanicolaou test b. microarray technology c. sentinel node recovery d. immunohistochemistry

immunohistochemistry

The nurse is educating a client who is undergoing gamma knife radiosurgery for a brain metastasis. What advantage to this procedure should the nurse share when comparing it to other conventional treatments? a. less chance of developing focal seizures b. less explosive vomiting c. lessen the number of migraine headaches per day d. less cognitive dysfunction

less cognitive dysfunction

A client had a positive Pap smear. The surgeon diagnosed "cancer in situ of the cervix." The client asks, "What does this mean?" From the following statements, which is most appropriate in response to this question? The tumor has: a. been walled off within a strong fibrous capsule. b. grown undifferentiated cells that no longer look like the tissue from which it arose. c. developed a distant infiltration. d. not crossed the basement membrane, so it can be surgically removed with little chance of growing back.

not crossed the basement membrane, so it can be surgically removed with little chance of growing back.

The oncologist has assessed a client diagnosed with cancer and determined that radiation therapy is the best course of treatment. The therapy will be most effective for: a. radiosensitive tumors that are slow growing. b. radiosensitive tumors that have extensive metastasis. c. radiosensitive tumors that have hypoxic cells. d. radiosensitive tumors that are fast growing.

radiosensitive tumors that are fast growing.

An oncology nurse is caring for a client with newly diagnosed B-cell lymphoma. Extensive blood work has been drawn and sent to the lab. Results reveal an elevated antiapoptotic protein BCL-2 level. The client/family asks, "What does this mean?" The health care provider bases his or her response on the fact that: a. this means the cancer cells have found a way to survive and grow even with damaged DNA. b. this is a good result. Normal cells undergo apoptosis if DNA is damaged in any way. c. the client's body is trying to limit the blood supply to the cancer cells by producing high levels of this protein. d. the client's immune system is trying to kill the cancer cell by sending this protein to engulf it.

this means the cancer cells have found a way to survive and grow even with damaged DNA.

During the synthesis phase of the cell cycle, the cell is: a. undergoing a period of DNA synthesis and replication of the chromosomes. b. forming a mitotic spindle and dividing the cells into 2 daughter cells. c. starting to prepare for DNA replication and mitosis. d. synthesizing enzymes and other proteins needed for cellular division.

undergoing a period of DNA synthesis and replication of the chromosomes.