Exam 2 Cancer
A hospice nurse is well aware of how difficult it is to deal with others' pain on a daily basis. This nurse should put healthy practices into place to guard against what outcome?
Emotional exhaustion
A client is hospitalized because a large abdominal tumor was seen on the computed tomography scan. A biopsy is ordered, and the client wants to know if "this will cause a big scar." Which type of biopsy will this client likely experience?
Incisional
The organization of a client's care on the alliative care unit is based on interdisciplinary collaboration. How does interdisciplinary collaboration differ from multidisciplinary practice?
It is based on communication and cooperation between disciplines
A client with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this client's plan of care?
Limit the time that visitors spend at the client's bedside
The nurse is caring for a client who has terminal lung cancer and is unconscious. Which assessment finding would most clearly indicate to the nurse that the client's death is imminent?
Mottling of the lower limbs
The nurse on a bone marrow transplant unit is caring for a client with cancer who has just begun hematopoietic stem cell transplantation (HSCT). What is the priority nursing diagnosis for this client?
Risk for infection related to altered immunologic response
Clients who are enrolled in hospice care are often believed to suffer unnecessarily because they do not receive adequate attention for their symptoms of the underlying illness. What factor most contributes to this phenomenon?
Rules concerning completion of all cure-focused medical treatment
A 62-year-old woman diagnosed with breast cancer is scheduled for a partial mastectomy. The oncology nurse explained that the surgeon will want to take tissue samples to ensure the disease has not spread to adjacent axillary lymph nodes. The client has asked if they will have her lymph nodes dissected, like her mother did several years ago. What alternative to lymph node dissection will this client most likely undergo?
Sentinel node biopsy
The nurse is caring for a client with an advanced stage of breast cancer and the client has recently learned that the cancer has metastasized. The nurse enters the room and finds the client struggling to breathe, and the nurse's rapid assessment reveals that the client's jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
Superior vena cava syndrome (SVCS)
The nurse is admitting a 52-year-old father of four into hospice care. The client has a diagnosis of Parkinson disease, which is progressing rapidly. The client has made clear his preference to receive care at home. What intervention should the nurse prioritize in the plan of care?
Supporting the client's and family's values and choices
The hospice nurse is caring for a 45-year-old parent of three young children in the client's new home. During the most recent visit, the nurse has observed that the client has a new onset of altered mental status, likely resulting from recently diagnosed brain metastases. Which goal of nursing interventions should the nurse identify?
Teaching family members how to interact with, and ensure safety for, the client with impaired cognition
A client has just died following urosepsis that progressed to septic shock. The client's spouse says, "I knew this was coming, but I feel so numb and hollow inside." The nurse should know that these statements are characteristic of what phase?
Uncomplicated grief and mourning
The nurse is assessing a client with end-stage liver failure for the presence of hope. What should the nurse identify as a hope-fostering category?
Uplifting memories
A client with cancer has just been told that the disease is now terminal. The client tearfully states, "I can't believe I'm going to die. Why me?" What is the nurse's best response to elicit more information from the client?
"Tell me more about how you feel about this news"
The nurse is caring for a client who is having difficulty adjusting to a terminal diagnosis. The nurse notes the client's tears and sits down by the bedside. The client tells the nurse, "There are so many things I still want to accomplish." Which response would be the most therapeutic and appropriate for the nurse to make?
"Tell me what's most important to you now"
Which issue has most often presented challenging ethical issues, especially in the context of palliative care?
Ability of technology to prolong life beyond meaningful quality of life
A client newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe?
Nausea and vomiting
A nurse has made a referral to a grief support group, knowing that many individuals find these both comforting and beneficial after the death of a loved on. What is the most important positive action that can come from a grief support group?
Normalization of feelings and experiences
The nurse is caring for a client who has just been told that the client's stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the client the option of surgery to treat the progression of this disease. What type of the surgery does the oncologist offer?
Palliative
A client on the medical unit is dying and the nurse has determined that the family's psychosocial needs during the dying process need to be addressed. What is a cause of may client care dilemmas at the end of life?
Poor communication between the family and the care team
Which nursing action best demonstrates primary cancer prevention?
Promoting and providing vaccines
A woman with a family history of breast cancer received a positive result on a breast tumor marking test and is requesting a bilateral mastectomy. This surgery is an example of which type of oncologic surgery?
Prophylactic surgery
A hospice nurse is caring for a young adult client with a terminal diagnosis of leukemia. When updating this client's plan of nursing care, what should the nurse prioritize?
Providing realistic emotional preparation for death
A client was diagnosed with cancer several weeks ago and family members describe the client as "utterly distraught." The client has fully withdrawn from social and family contact. What is the nurse's best action?
Refer the client to the appropriate mental health provider
The nurse is assessing a client whose spouse died 16 months ago. The client tells the nurse about joining a hiking group, volunteering as a college mentor, and thinking about dating again. The nurse determines that the client is in which stage of Rando's processes of mourning?
Reinvestment
A medical nurse is providing end-of-life care for a client with metastatic bone cancer. The nurse notes that the client has been receiving oral analgesics for pain with adequate effect, but is now having difficulty swallowing the medication. What should the nurse do?
Request the health care provider to prescribe analgesics by an alternative route
A 16-year-old female client has post-chemotherapy aloplecia. This prompts the nursing diagnosis of Disturbed Body Image and Situational Low Self-Esteem. Which response by the client would best indicate improved coping related to these diagnoses?
Requests that her family bring her makeup and a wig
As the American population ages, nurses expect to see more clients admitted to long-term care facilities in need of palliative care. Regulation now in place that govern how the care in these facilities is both organized and reimbursed emphasize what aspect of care?
Restorative measures
The public health nurse is presenting a health promotion class o a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?
Smoking cessation
An adult oncology client has a diagnosis of bladder cancer with metastasis and the client has asked the nurse about the possibility of hospice care. Which principle is central to a hospice setting?
The client and family should be viewed as a single unit of care
A client's rapid cancer metastases have prompted a shift from active treatment to palliative care. When planning this client's care, the nurse should identify what primary aim?
To prevent and relieve suffering
The home health nurse is performing a home visit for an oncology client discharged three days ago after completing chemotherapy treatment for non-Hodgkin lymphoma. The nurse's priority assessment should include examination for the signs and symptoms of which complication?
Tumor lysis syndrome (TLS)
A client with cancer, who has just learned that the cancer has spread to distant organs, tells the nurse, "I am not sure how many more treatments I can put up with." The nurse responds by saying, "You have been through so many treatments for your cancer." Using the NURSE framework for responding to emotions, which empathetic response did the nurse use?
UNDERSTAND the emotion
The hospice nurse has just admitted a new client to the program. What principle guides hospice care?
Care addresses the needs of the client as well as the needs of the family
Which intervention should the nurse teach a client who is at risk for hypercalcemia?
Consume 2-4 L of fluid daily
In recent decades, nursing has moved into the forefront in providing care for the dying. Which phenomenon has most contributed to this increased focus of care of the dying?
Demographic changes in the population
A nurse provides care on a bone marrow transplant unit and is preparing a client for a hematopoietic stem cell transplantation (HSCT) the following day. Which information should the nurse emphasize to the client's family and friends?
"Do not visit if you've had a recent infection"
The nurse is admitting a client with a diagnosis of ovarian cancer. The client has just been told that her ovarian cancer is terminal. What question should the nurse include in a spiritual assessment of the client?
"Do you have a sense of peace of mind and a purpose to your life?"
An adult client with leukemia will soon begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy?
Administer an antiemetic
A client is in a hospice receiving palliative care for lung cancer which has metastasized to the client's liver and bones. For the past several hours, the client has been experiencing dyspnea. What nursing action is most appropriate?
Administer bronchodilators and corticosteroids, as prescribed
The nurse is conducing a health education about cancer prevention to a group of adults. What menu best demonstrates dietary choices for potentially reducing the risks of cancer?
Baked apricot chicken and steamed broccoli
The nurse is assessing a 72-year-old client who was diagnosed with metastatic prostate cancer. The nurse notes that the client is exhibiting signs of loss, grief, and intense sadness. Based on this assessment data, the nurse will document that the client is most likely in what stage of death and dying?
Depression
When discussing with a client factors that distinguish malignant cells from benign cells of the same tissue type, which characteristic should the nurse mention?
Different proteins in the cell membrane
A client with terminal small-cell lung cancer has been given a six-month prognosis and wants to die at home. The health care team believes the condition warrants inpatient care. The nurse might suggest which compromise?
Discuss a referral for hospice care
The nursing is caring for a client to begin receiving external radiation for a malignant tumor of the neck. While providing client education, what potential adverse effects should the nurse discuss with the client?
Impaired nutritional status
The nurse is admitting an oncology client to the unit prior to surgery. The nurse reads in the electronic health record that the client has just finished radiation therapy. With knowledge of the consequent health risks, the nurse should prioritize assessments related to what health problem?
Impaired would healing
The family of a client receiving palliative care for end-stage congestive heart failure is upset that the client is not eating. Which intervention should the nurse recommend to the family?
Remove unpleasant odors and sights during meals
After caring for several clients who died in the hospital, the nurse has identified some lapses in care that many of these clients received toward the end of their lives. What have research studies identifies as a potential deficiency in the care of the dying in hospital settings?
The perception that palliative care constitutes "giving up"
A medical nurse is providing palliative care to a client with a diagnosis of end-stage chronic obstructive pulmonary disease (COPD). What is the primary goal of this nurse's care?
To improve the client's and family's quality of life
The nurse has observed that an older adult client with a diagnosis of end-stage kidney disease seems to prefer to have the client's eldest child make all of the health care decisions. While the family is visiting, the client explains that this is a cultural practice and very important that it occurs. How should the nurse best handle this situation?
Work with the team to negotiate informed consent
A nurse who sits on the hospital's ethics committee is reviewing a complex case that has many of the characteristics of assisted suicide?. Which of the following would be an example of assisted suicide?
Administering a lethal dose of medication to a client whose death is imminent
A pediatric nurse is emotionally distraught by the death of a 9-year-old client who received care on the unit over the course of many admissions spanning several years. What action is the most appropriate response to the nurse's own grief?
Attend the client's memorial service
A client with a terminal diagnosis has asked the nurse about "helping me and my suffering." What is the nurse's responsibility in the domain of assisted suicide?
Discussing concerns and fears with the client
The nurse manager is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, which action should the nurse manager emphasize?
Dispose of antineoplastic wastes in the hazardous waste receptacle
The clinic nurse is caring for an adult oncology client who reports extreme fatigue and weakness after the first week of radiation therapy. Which response by the nurse would best reassure this client?
"These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory studies and test results"
The nurse learns that a computed tomography scan a client underwent to investigate new seizure activity revealed a brain tumor. When the client later asks about the results of the scan, which therapeutic response should the nurse give the client?
"What is your understanding of your condition?"
A client has been hospitalized for a wedge resection of the left lower lung lobe after a routine chest x-ray showed carcinoma. The client reports feeling anxious and asks to smoke. Which statement by the nurse would be the most therapeutic?
"You are anxious about the surgery. Do you see smoking as helping?"
A nurse who works in an oncology clinic is assessing a client who has arrived for a 2-month follow-up appointment following chemotherapy. The nurse notes that the client's skin appears yellow. Which blood tests should be done to further explore this clinical sign?
Liver function tests (LFTs)
During a routine mammogram, a client asks the nurse whether breast cancer causes the most deaths. Which type of cancer is the leading cause of death in the United States?
Lung cancer
A client's most recent diagnostic imaging has revealed that lung cancer has metastasized to the bones and liver. What is the most likely mechanism by which the client's cancer cells spread?
Lymphatic circulation
The nurse is describing palliative care and the hospice services to a client with end-stage congestive heart failure. The client and family have many questions about the differences between palliative care and hospice. Which statement should the nurse provide the family?
"Hospice is the application of palliative care at the end of life"
While on spring break, a 22-year-old client was taken to the hospital for heat stroke and alcohol poisoning. The client is worried and states that a biopsy was taken and showed "some kind of benign condition." Which response by the nurse would be best?
"I understand that you are worries. Benign conditions are noncancerous, but let's take a look at your chart to see your results"
An oncology nurse educator is providing health education to a client who has been diagnosed with skin cancer. The client's wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?
Malignant cells contain proteins called tumor-associated antigens
A client on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in clients at risk for thrombocytopenia?
Epistaxis (nosebleeds)
A public health nurse has formed an interdisciplinary team that is developing an educational program entitled Cancer: The Risks and What You Can Do About Them. Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity?
Secondary prevention
While a client is receiving intravenous (IV) doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize which action?
Stopping the administration of the drug immediately
