NU 214 PART TWO Chapter 15 cancer PRACTICE QUESTIONS

The nurse at the clinic is interviewing a 64 year old woman who is 5 feet, 3 inches tall and weighs 125 pounds (57 kgs). The patient has not seen a health care provider for 20 years. She walks 5 miles most days and has a glass of wine 2 or 3 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

A,C,D,E

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 health care provider about the symptoms D. Teach the patient how to use relaxation to reduce pain

B. Assess for sensation and strength in the legs

The nurse teaches the patient with cancer of the liver about high protein, high calorie diet choices. Which snack choice by the parent indicates that the teaching has been effective? A. Lime sorbet B. Blueberry yogurt C. Cream cheese bagel D. Fresh strawberries and bananas

B. Blueberry yogurt

A patient with cancer has a nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste sensation. Which nursing action is most appropriate? A. Add strained baby meats to food such as casserole B. Teach the patient about foods high in nutrition C. Avoid giving the patient foods that are strongly disliked D. Add extra spice to enhance the flavor of foods that are served.

C. Avoid giving the patient foods that are strongly disliked

During the teaching session for a patient who has a new diagnosis of acute Leukemia, the patient is restless and is looking away, never making eye contact. After teaching about the complications associated with chemotherapy, the patient asks the nurse to repeat all of the information. Based on this assessment, which nursing diagnosis is most 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. Risk for ineffective health maintenance related to anxiety about new Leukemia diagnosis D. Deficient knowledge: Chemotherapy related to a lack of interest in learning about treatment

C. Risk for ineffective health maintenance related to anxiety about new Leukemia diagnosis

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 32% B. Pain with deep inspiration C. Serum sodium 126 mEq/L D. Decreased breath sounds on left side

C. Serum sodium 126 mEq/L

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 ordered opioid pain medications whenever the pain is greater than a 5 (0 to 10 scale). B.The patient agrees to take the medication 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 non opioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief

C. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs

A patient with Leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). The nurse will include which information in the patients teaching plan? A. transplant of the donated cells is painful because of the nerves in the tissue lining the bone B. Donor bone marrow cells are transplanted through an incision into the sternum or hip bone C. The transplant procedure takes place in a sterile operating room to minimize the risk for infection D. Hospitalization will be required for several weeks after the stem cell transplant procedure is performed

D. Hospitalization will be required for several weeks after the stem cell transplant procedure is performed

Which action should the nurse take when caring for a patient who is receiving chemotherapy and complains of problems with concentration? A. Teach 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 health care provider D. Suggest use of daily planner and encourage adequate rest and sleep

D. Suggest use of daily planner and encourage adequate rest and sleep

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 dental work done

A,C,E

The home health nurse cares 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

A. I have frequent muscle aches and pains

The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by the UAP if observed by the nurse would require an intervention A. The UAP flushes the toilet once after emptying the patients bedpan B. The UAP stands by the patients bed for 30 minutes talking with the patient C. The UAP places the patients bedding in the laundry container in the hallway D. The UAP gives the patient an alcohol containing mouthwash to use for oral care

B. The UAP stands by the patients bed for 30 minutes talking with the patient

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 every day in the room B. The patients visitors bring in some fresh peaches from home C. The patient cleans with a warm washcloth after having a warm stool D. The patient uses soap and shampoo to shower every other day

B. The patients visitors bring in some fresh peaches from home

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

C. 24 year old patient who received neck radiation and has blood oozing from the neck Neck bleeding can indicate possible carotid artery rupture in a patient who is receiving radiation to the neck*

The nurse is caring for a patient who has been diagnosed with stage I cancer of the colon. 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 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?

C. Can you tell me what has been helpful to you in the past when coping with stressful events?

After change of shift report on the oncology unit, which patient should the nurse assess first? A. Patient with a platelet count of 82,000/L 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 (38.1) D. Patient who is worried about getting the prescribed long acting opioid on time

C. Patient who is neutropenic and has a temperature of 100.5 (38.1)

The nurse is assessing a patient who is receiving Interleukin-2. Which finding should the nurse report immediately to the provider? A. Generalized muscle aches B. Complaints of nausea and anorexia C. Oral temperature of 100.6f D. Crackles heard at lower scapular boarder

D. Crackles heard at lower scapular boarder

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 therapy with the health care provider? A. Poor oral intake B. Frequent loose stools C. Complaints of nausea and vomiting D. Increase in carcinoembryonic antigen (CEA)

D. Increase in carcinoembryonic antigen (CEA) An increase in CEA shows that chemo is not effective and may need to be modified*

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 immunologic response to tumor cells B. IL-2 stimulates malignant cells in the resting phase to enter mitosis C. IL-2 prevents the bone marrow depression caused by chemotherapy D. IL-2 protects normal cells from the harmful effects of chemotherapy

A. IL-2 enhances the immunologic response to tumor cells

The nurse assesses the patient with Non Hodgkins Lymphoma who is receiving an infusion of Rituximab (Rituxan). Which assessment finding would require the most rapid action by the nurse? A. Shortness of breath B. Temperature of 100.2 f C. Shivering and complaint of chills D. Generalized muscle aches and pains

A. Shortness of breath Assess for sensation and strength in the legs Rituximab is a monoclonal antibody. Shortness of breath should be investigated rapidly because anaphylaxis is a possible reaction. The nurse should stop the infusion, assess patient further, notify health care provider.

When caring for a patient who is pancytopenic, which action by the 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 patients saline oral rinse C. The UAP puts fluoride toothpaste on the patients toothbrush D. The UAP has the patient rinse after meals with a saline solution

A. The UAP assists the patient to use dental floss after eating

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 needs to void every hour during the day C. Patient takes only 50% of meals and refuses snacks D. Patient has audible crackles to the midline posterior chest

D. Patient has audible crackles to the midline posterior chest

The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which result is most important to report to the healthcare provider? A. Hematocrit 30% B. Platelets of 95,000/L C. Hemoglobin of 10 g/L D. White blood cell (WBC) count of 2700/L

D. White blood cell (WBC) count of 2700/L