Med Surg Chapter 12 Oncologic Management

A young female client has received chemotherapeutic medications and asks about any effects the treatments will have related to her sexual health. The most appropriate statement by the nurse is

"You will need to practice birth control measures."

5-Fluorouracil (5FU) is classified as which type of antineoplastic agent?

Antimetabolite

A client undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: Tis, N0, M0. What does this classification mean?

Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis

Which oncologic emergency involves the accumulation of fluid in the pericardial space?

Cardiac tamponade

A nurse is performing a home visit for a client who received chemotherapy within the past 24 hours. The nurse observes a small child playing in the bathroom, where the toilet lid has been left up. Based on these observations, the nurse modifies the client's teaching plan to include:

chemotherapy exposure and risk factors.

The root cause of cancer is damage to cellular deoxyribonucleic acid (DNA) which can be caused by many factors, or carcinogens. What factors can be carcinogenic? Select all that apply.

dietary substances environmental factors viruses

The nurse is working with a client who has had an allo-hematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of

graft-versus-host disease.

According to the TNM classification system, T0 means there is

no evidence of primary tumor.

An oncology nurse is caring for a client who relates that certain tastes have changed. The client states that "meat tastes bad." What nursing intervention can be used to increase protein intake for a client with taste changes?

Encourage eating cheese, eggs, and legumes

A patient will be having an endoscopic procedure with a diagnostic biopsy. What type of biopsy does the nurse explain will remove an entire piece of suspicious tissue?

Excisional biopsy

The nurse is teaching a healthy lifestyle class to a group of adolescents. The nurse recommends

Exercising at least 60 minutes per day doing moderate to vigorous activities at least 5 days per week

A nurse is administering daunorubicin through a peripheral I.V. line when the client complains of burning at the insertion site. The nurse notes no blood return from the catheter and redness at the I.V. site. The client is most likely experiencing which complication?

Extravasation

When caring for an older client who is receiving external beam radiation, which is the key point for the nurse to incorporate into the plan of care?

Inspect the skin frequently.

For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan?

Inspecting the skin for petechiae once every shift

A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the best teaching by the nurse?

It lowers serum and uric acid levels.

What disadvantages of chemotherapy should the patient be informed about prior to starting the regimen?

It targets normal body cells as well as cancer cells.

The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest?

Malignant tumor

In which phase of the cell cycle does cell division occur?

Mitosis

Which type of surgery is used in an attempt to relieve complications of cancer?

Palliative

A client with a brain tumor is undergoing radiation and chemotherapy for treatment of cancer. The client has recently reported swelling in the gums, tongue, and lips. Which is the most likely cause of these symptoms?

Stomatitis

Which statement is true about malignant tumors?

They gain access to the blood and lymphatic channels.

The physician is attending to a client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation?

To prevent the formation of new cancer cells

Which of the following would be inconsistent as a common side effect of chemotherapy?

Weight gain

The client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse?

Tumor pressure against normal tissues

Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth?

Control

The drug interleukin-2 is an example of which type of biologic response modifier?

Cytokine

What intervention should the nurse provide to reduce the incidence of renal damage when a patient is taking a chemotherapy regimen?

Encourage fluid intake to dilute the urine.

A patient with uterine cancer is being treated with internal radiation therapy. What would the nurse's priority responsibility be for this patient?

Explain to the patient that she will continue to emit radiation while the implant is in place.

A decrease in circulating white blood cells (WBCs) is referred to as

Leukopenia

A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells?

Liver

When addressing a community group, the nurse identifies consumption of which substance(s) as a risk factor for the development of cancer? Select all that apply.

Tobacco Processed meats Alcohol

The nurse is caring for a client is scheduled for chemotherapy followed by autologous stem cell transplant. Which of the following statements by the client indicates a need for further teaching?

"I hope they find a bone marrow donor who matches."

A client with metastatic pancreatic cancer underwent surgery to remove a malignant tumor in the pancreas. Despite the tumor being removed, the physician informs the client that chemotherapy must be started. Why might the physician opt for chemotherapy?

To prevent metastasis

A male client has been unable to return to work for 10 days following chemotherapy as the result of ongoing fatigue and inability to perform usual activities. Laboratory test results are WBCs 2000/mm³, RBCs 3.2 x 10¹²/L, and platelets 85,000/mm³. The nurse notes that the client is anxious. Which of the following is the priority nursing diagnosis?

Risk for infection related to inadequate defenses

Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure?

Blood studies

A nurse is teaching a client with bone marrow suppression about the time frame when bone suppression will be noticeable after administration of floxuridine. What is the time frame the nurse should include with client teaching?

7 to 14 days

A nurse is caring for a client receiving chemotherapy. Which assessment finding places the client at the greatest risk for an infection?

Stage 3 pressure ulcer on the left heel

While doing a health history, a client tells the nurse that her mother, her grandmother, and her sister died of breast cancer. The client asks what she can do to keep from getting cancer. What is the best response by the nurse?

"Cancer prevention and detection can be done with blood analysis for tumor markers to measure your risk level."

The client has finished the first round of chemotherapy. Which statement made by the client indicates a need for further teaching by the nurse?

"I can continue taking my vitamins and herbs because they make me feel better."

A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed?

"I guess the doctor could not remove the entire tumor."

A client receiving chemotherapy has a nursing diagnosis of Deficient diversional activity related to decreased energy. Which client statement indicates an accurate understanding of appropriate ways to deal with this deficit?

"I'll play card games with my friends."

The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia?

"The hair loss is usually temporary."

A bowel resection is scheduled for a client with the diagnosis of colon cancer with metastasis to the liver and bone. Which statement by the nurse best explains the purpose of the surgery?

"Tumor removal will promote comfort."

A nurse is assessing a 75-year-old woman who had a total hysterectomy when she was 30 years old and normal Pap test results for the past 10 years. The client asks about continuing the Pap test. What is the best response by the nurse?

"You may choose to discontinue this test."

After a bone marrow transplant (BMT), the client should be monitored for at least

100 days

After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention?

Administering metoclopramide and dexamethasone as ordered

Which type of hematopoietic stem cell transplantation (HSCT) is characterized by cells from a donor other than the patient?

Allogeneic

Which is a sign or symptom of septic shock?

Altered mental status

The nurse is conducting a screening for familial predisposition to cancer. Which element should the nurse note as a possible indication of hereditary cancer syndrome?

An aunt and uncle diagnosed with cancer

The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise?

Avoid spicy and fatty foods.

A client is receiving external radiation to the left thorax to treat lung cancer. Which intervention should be part of this client's care plan?

Avoiding using soap on the irradiated areas

A nurse is planning caring for a client who has developed erythema following radiation therapy for a lesion on the left lower leg. Which intervention would the nurse include in the client's plan of care to best support skin recovery at the affected site? Select all that apply.

Cleanse with lukewarm water and pat dry

A client diagnosed with acute myelocytic leukemia has been receiving chemotherapy. During the last 2 cycles of chemotherapy, the client developed severe thrombocytopenia requiring multiple platelet transfusions. The client is now scheduled to receive a third cycle. How can the nurse best detect early signs and symptoms of thrombocytopenia?

Closely observe the client's skin for petechiae and bruising.

What foods should the nurse suggest that the patient consume less of in order to reduce nitrate intake because of the possibility of carcinogenic action?

Ham and bacon

During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior?

Progression

The nurse at the clinic explains to the patient that the surgeon will be removing a mole on the patient's back that has the potential to develop into cancer. The nurse informs the patient that this is what type of procedure?

Prophylactic

A patient is admitted for an excisional biopsy of a breast lesion. What intervention should the nurse provide for the care of this patient?

Provide time for the patient to discuss her concerns.

A client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a chemotherapy-induced complication?

Serum potassium level of 2.6 mEq/L

The nurse is preparing to assess a client whose chart documents that the client experienced extravasation when receiving the vesicant vincristine during the previous shift. The documentation also notes that an antidote was administered immediately. The nurse prepares to assess for which conditions? Select all that apply.

Sloughing tissue Tissue necrosis Effectiveness of the antidote

A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention?

The I.V. site is red and swollen.

What should the nurse tell a client who is about to begin chemotherapy and is anxious about hair loss?

The client should consider getting a wig or cap prior to beginning treatment.

The nurse understands that the client should be given human papillomavirus (HPV) vaccine per the health care provider's orders. What does this vaccine help prevent?

cervical cancer

Palliation refers to

relief of symptoms associated with disease and promotion of comfort and quality of life.

A serum sodium concentration lower than 115 mEq/L (115 mmol/L) is associated with

seizure.

A client with a recent history of GI disturbance has been scheduled for a barium study. The physician ordered this particular test for this client because it will:

show movement of the GI tract.

A nurse is caring for a client who is receiving chemotherapy and has a platelet count of 30,000/mm3. Which statement by the client indicates a need for additional teaching?

"I floss my teeth every morning."

Which statement by a client undergoing external radiation therapy indicates the need for further teaching?

"I'm worried I'll expose my family members to radiation."

A client is receiving radiation therapy and asks the nurse about oral hygiene. What teaching specific to the client's situation should the nurse include?

Use a soft toothbrush and allow it to air dry before storing.

The oncology nurse is giving chemotherapy to a client in a short stay area. The client confides that they are very depressed. The nurse recognizes depression as which of the following?

A normal reaction to the diagnosis of cancer.

Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode should the nurse anticipate?

Adjuvant therapy is likely.

The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant?

Monitor the client closely to prevent infection

The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action?

Extravasation

An oncology client has presented with the signs of possible cardiac tamponade with pericardial effusion. What diagnostic and medical procedures should the nurse prepare the client for? Select all that apply.

Chest x-ray Pericardiocentesis Computed tomography (CT) scan Echocardiogram

Which is a growth-based classification of tumors?

Malignancy

A nurse is receiving a client with a radioactive implant for the treatment of cervical cancer. What is the nurse's best action?

Place the client in a private room.

Carcinogens are factors related to the formation of various malignancies. Which factor has the greatest impact on the development of all cancers?

chemical agents

The nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice?

eats red meat such as steaks or hamburgers every day

An oncologist advises a client with an extensive family history of breast cancer to consider a mastectomy. What type of surgery would the nurse include in teaching?

prophylactic