OCN screening and early detection
BRCA1 and BRCA2 mutation's testing should be offered two family members of persons with features indicating an increased likelihood of a BRCA mutation. Which individual should be considered for testing?
A woman with multiple cases of early breast cancer in her family An individual with more than one primary cancer A man or woman diagnosed with triple negative breast cancer
Which statement best describes lead - time bias
Bias that occurs when A cancer is diagnosed early before any symptoms develop, giving the appearance of improve survival when actually there is no decrease in mortality attributed to early diagnosis
What statements are true about guaiac - based fecal occult blood test (gFOBT) and immunochemical fecal occult blood test (iFOBT) for colon rectal screening (CRC)
Both tests require three consecutive stool samples collected by the patient at home The gFOB T requires avoidance of some medications and vitamins supplements, but iFOB T is not affected by any medications. The gFOBT is the only proven CRC screening method that is consistently effective in RCTs.
The nurse is writing a grant proposal to state's department of health to provide cancer screening to uninsured individuals. What short-term variables or outcomes are important to measure to determine the program's success?
Cost per cancer detected Number of people in the target population who were offered screening and actually participated Number of preclinical cancers detected in persons with abnormal screens resulting in further testing and a definitive diagnosis
The nurse examines Ms. Y in the clinic and identifies which of the following that may be indicative of cancer?
Enlargement and darkening of a mole
How often is a screening colonoscopy recommended for colon rectal cancer prevention in individuals 50 years of age and older?
Every 10 years
A cancer-oriented physical examination should include which of the following?
Female or male genital examination Assessment of cranial nerves Rectal examination
Mrs. B is 58 years old and has been diagnosed with stage III colon rectal cancer (CRC) Her mother had a history of polyps, and her father was diagnosed with prostate cancer. She asked the nurse if she should undergo genetic testing. The nurse tells Mrs B that according to the national Cancer institute, genetic testing is recommended for individuals with one or more of the following?
Having a personal history of CRC, Adenoma or other multiple primary cancers Early age at CRC diagnosis Having a strong family history of CRC, polyps, and other cancers consistent with an inherited risk of CRC
Mrs. G, is 52 years old and has never had a screening baseline mammogram or colonoscopy. The nurse encourages her to schedule an appointment with her primary care physician for a history and physical examination, but she refuses , what should the nurse do?
Identify any cultural or religious beliefs that may influence her reluctance to seek screening Assess barriers to participation in screening programs (e.g. transportation, childcare, and cost) and work with her to overcome them Provide education about the risks and benefits of screening based on her learning style ( written ,verbal, video presentation, or combination of these)
Which of the following lung cancer screening guide lines does the American Cancer Society recommend?
Individuals between 55 and 74 years of age with at least a 30 pack year smoking history who either continue to smoke or have quit less than 15 years ago should consider screening using low dose computed tomography
The ideal screening examination for cancer will have the following characteristics?
It will be safe, precise, and valid. It will be cost-effective There should be a plan in place for managing and monitoring the screening program, ensuring quality assurance standards are met
Which of the following is true about breast cancer screening recommendations?
Mammography remains the primary screening modality There is considerable variability in how breast cancer screenings is implemented, particularly when to start and how often screening should be done Breast self-examination is no longer routinely endorsed because of its mixed efficacy results for finding early-stage tumors and its association with high rate of false positive that require biopsies
According to the NCCN guidelines, besides smoking history, what additional factors are associated with a high risk of developing lung cancer?
Occupational exposure (e.g. arsenic, asbestos, coal smoke) Exposure to radon at home Family history of lung cancer in a first degree relative
Mr. S is an 83-year-old retired chemist who went to his primary care doctor for an annual examination. He had a slightly elevated PSA and a positive digital rectal examination, and upon ultrasound guided prostatic biopsy, he was diagnosed with an early stage prostate cancer. This is an example of
Overdiagnosis
Which of the following is the only biomarker used for cancer screening?
PSA
Which of the following screening test for cervical cancer is recommended in women between the ages of 30 and 65 years?
Pap test every five years with human papilloma virus (HPV) testing or Pap test every three years without HPV testing
Which screening test has the strongest evidence (randomized clinical trial )to decrease mortality in a defined population
Pap test for cervical cancer
A nurse in a public health setting is asked to perform a comprehensive cancer risk assessment on each new patient seen. A key component of the client history to be obtained during the cancer-oriented screening examination is
Personal and family history of cancer
The percentage of persons who screen positive for a particular cancer and actually have that disease is the...
Positive predictive value
Which of the following factors may affect the sensitivity and Specificity of PSA levels?
Presence of benign prosthetic hypertrophy(BPH) Inflammation Recent ejaculation, (within 48 hours)
A nurse volunteers at a community health fair, providing education about cancer screening to the public. An individual asked why the general population is not screened annually for all types of cancer because many cancers can be detected earlier with proper screening techniques. Which of the following rationales for cancer screenings my the nurse provide?
Regular Pap test have decreased incidence and death rates from cervical cancer. However annual testing is not appropriate in certain age ranges because of the slow growth rate of this cancer. Routine annual PSA screening's has not been associated with decreases in prostate cancer mortality. Early diagnosis have prompted the use of therapies, causing side effects in many men who might never have required treatment either because of age or tumor growth pattern The cost associated with routine lung cancer screenings (radiographs, CT scans or both )are very high. False positives have occurred, which result in patients in during unnecessary test. Screenings have achieved only a small number of prevented death. Therefore, annual lung cancer screenings is not used
The nurse suggest to woman at high risk for developing breast cancer that she begin annual mammograms at age 30 years. This is a example of
Secondary prevention
Which of the following is true about a screening tests' sensitivity
Sensitivity is a measure of the tests' ability to correctly identify persons with the disease among the population screened Sensitivity is dependent on the experience level of the person performing the procedure A screening test that has 100% sensitivity has no false positives
The nurse completes an assessment of the patient's history for each new patient who comes to the cancer clinic. Which of the following elements should be included?
The chief complaint Social history Occupational exposure
Cancer incidence is defined as
The number of new cancer cases identified in a specific population during a defined period of time
Which of the following is true about genetic testing for BRCA1 and BRCA2 mutation's?
These mutations are responsible for approximately 5% to 10% of all breast cancer's in women
What are the facts about CT colonography (also known as virtual colonoscopy)?
This test is a good alternative to colonoscopy for elderly or frail patients If a lesion is detected, a lower endoscopy is needed for biopsy, requiring a bowel prep. The test is recommended every 5 years as a screening option in individuals 50 years of age or older with an average risk of colon rectal cancer
When conducting a clinical examination, which of the following findings would be considered suspicious for brain tumor or brain metastasis?
Visual disturbances, cognitive deficits, headache
The American Cancer Society, the national comprehensive Cancer network (NCCN) and the American College of obstetrics and gynecologist support the discontinuation of cervical cancer screening in which situation?
Women older than age 65 years who have undergone regular cervical cancer testing with normal results
Which of the following are breast cancer screening recommendations using mammography?
Women who have received the thoacic (mantle) irradiation between the ages of 10 and 30 years should receive an annual mammogram or magnetic resonance imaging ( MRI )starting at age 25 years High risk women (those with a greater than 15% to 20% lifetime risk or family history ) should begin annual mammography at age 30 years All women age 40 years and older should have an annual mammogram
A 64-year-old African-American patient was recently diagnosed with prostate cancer. He asked if his 45-year-old son should be screened for prostate cancer. What should the nurse tell him?
Your son has a few risk factors for developing prostate cancer. He is African-American, he has a family history of prostate cancer, and you were diagnosed before age 65. He should receive a PSA and digital rectal exam now. The frequency of the continued testing will depend on his PSA level. I would have him consult with his physician to gather more information
