Oncologic Disorders
A client is scheduled for a right lower lobectomy for lung cancer. During the admission assessment, the client asks for information about a living will and advance directive. The nurse knows that the client understands teaching about the living will and advanced directive when the client says "If I appoint a healthcare power of attorney, that person can override my wishes even if I'm still competent." "The advance directive allows me to state my healthcare wishes while I'm still able to do so." "The living will allows me to identify a person who can make healthcare decisions for me if I become too ill to make them myself." "I understand that in some states (provinces) a living will and healthcare power of attorney are the same."
"The advance directive allows me to state my healthcare wishes while I'm still able to do so."
A client who is experiencing colon cancer is scheduled to undergo a colostomy. Which interventions would be appropriate to include in a preoperative teaching plan? Select all that apply. Demonstrate turning, coughing, deep breathing, splinting, and leg ROM exercises, and provide rationales for each procedure. Instruct on dietary guidelines for healing. Arrange for an enterostomal therapist (ET) to speak with the client about colostomy care. Explain the need for early postoperative ambulation. Instruct the client on signs and symptoms of intestinal obstruction. Encourage the client to express feelings about changes in body image.
Demonstrate turning, coughing, deep breathing, splinting, and leg ROM exercises, and provide rationales for each procedure. Arrange for an enterostomal therapist (ET) to speak with the client about colostomy care. Explain the need for early postoperative ambulation. Encourage the client to express feelings about changes in body image.
A nurse is caring for a terminally ill cancer client who is being transferred to hospice care. Which information regarding hospice care would the nurse include in the teaching plan? Select all that apply. The focus of care is on controlling symptoms and relieving pain. A multidisciplinary team provides care. Services are provided on third party insurance reimbursement. Hospice care is provided only in hospice centers. Bereavement care is provided to the family. Care is provided in the home, independent of healthcare providers.
The focus of care is on controlling symptoms and relieving pain. A multidisciplinary team provides care. Bereavement care is provided to the family.
A client with a modified radical mastectomy is being discharged. The client has been very reluctant to discuss the surgery or their situation. The nurse should delegate the client's care to which person? unlicensed assistive personnel (UAP) because the client is stable and being discharged same nurse who has cared for the client the past 3 days, for continuity of care nurse in orientation who needs experience in discharge instructions nurse with the most bed baths, because this client will not need a bath
same nurse who has cared for the client the past 3 days, for continuity of care
A client has been informed of a diagnosis of cancer. Which client statement should the nurse address first? "I know I have cancer, but why me?" "I will beat this!" "I think the lab mixed up my biopsy with someone else's." "I need to end this before the cancer kills me."
"I need to end this before the cancer kills me."
A client's spouse expresses concern that the dying client keeps saying, "I have to go to the store." Which statement by the nurse will be most effective in assisting the spouse to understand the dying process? "Many dying clients are restless and can be treated with sedatives." "The client may be fighting death, and you should leave them alone." "Comments related to going somewhere or leaving on a trip are common in dying clients." "You can tell your spouse that you will take them to the store."
"Comments related to going somewhere or leaving on a trip are common in dying clients."
A client fears chemotherapy because of the side effects. What is the nurse's best response to the client's concerns? "Your health has been excellent. It's unlikely that you will experience serious side effects." "We'll give you medications to prevent the side effects, so you shouldn't be too concerned." "Each person responds differently to chemotherapy treatments. We'll monitor your responses closely." "You may choose not to take the chemotherapy, but you must understand that this will have an adverse effect on the course of your disease."
"Each person responds differently to chemotherapy treatments. We'll monitor your responses closely."
A 21-year-old client undergoes bone marrow aspiration at the clinic to establish a diagnosis of possible lymphoma. Which statement made by the client demonstrates proper understanding of discharge teaching? Select all that apply. "I will take acetaminophen for pain." "I do not need to inspect the puncture site." "I will not be able to play basketball for the next 2 days." "I will take aspirin if I have pain." "I can apply an ice pack or a cold compress to the puncture site."
"I will take acetaminophen for pain." "I will not be able to play basketball for the next 2 days." "I can apply an ice pack or a cold compress to the puncture site."
A client with stage IV pancreatic cancer is admitted to hospice. The spouse breaks down crying, stating "I just don't know what I will do if my partner dies!" What is the best response by the nurse? "What has helped you cope with the illness so far?" "Do you want to speak with someone in the same situation?" "Your spouse has the best doctors and is receiving good care." "I see you are upset. I will come back in 10 minutes and we can talk."
"What has helped you cope with the illness so far?"
The nurse is developing a care plan for a client who has leukemia. What instruction(s) should the nurse include in the plan? Select all that apply. Monitor temperature and report elevation. Recognize signs and symptoms of infection. Avoid crowds. Maintain the integrity of skin and mucous membranes. Take a baby aspirin each day.
Monitor temperature and report elevation. Recognize signs and symptoms of infection. Avoid crowds. Maintain the integrity of skin and mucous membranes.
A client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. Which "related-to" phrase should the nurse add to complete the nursing diagnosis statement? Related to visual field deficits Related to difficulty swallowing Related to impaired balance Related to psychomotor seizures
Related to impaired balance
A client with ovarian cancer asks the nurse, "What is the cause of this cancer?" Which is the most accurate response by the nurse? Use of oral contraceptives increases the risk for ovarian cancer. Women who have had at least two live births are protected from ovarian cancer. There is less chance of developing ovarian cancer when one lives in an industrialized country. The risk for developing ovarian cancer is related to environmental, endocrine, and genetic factors.
The risk for developing ovarian cancer is related to environmental, endocrine, and genetic factors.
While changing bed linens the nurse notices a metal object on the bottom sheet of a client with radiation seeds implanted in the bladder. Which action should the nurse take? Select all that apply. Walk away from the item. Notify the radiation department. Place the object on the bedside table. Place the object on the sink in the bathroom. Scoop the item with a tissue and place in the trash.
Walk away from the item. Notify the radiation department.
The nurse is instructing a client about skin care while receiving radiation therapy to the chest. What should the nurse instruct the client to do? Apply lotion if the skin becomes dry. Shave the chest to prevent contamination from chest hair. Wash the area with tepid water and mild soap. Keep the area covered with a nonadherent dressing between treatments.
Wash the area with tepid water and mild soap.
The nurse is planning care for a client following a cervical radium implant for cervical cancer. Which is an appropriate activity for this client? out of bed as tolerated within the room bed rest with bathroom privileges bed rest in a position of comfort bed rest with the head of the bed flat
bed rest with the head of the bed flat
Interprofessional management of ovarian cancer includes which measure(s)? Select all that apply. combination chemotherapy to cure the cancer bilateral salpingo-oophorectomy to remove diseased organs radiation therapy to eliminate all cancer cells referral to social services for supportive care nutrition therapy for parenteral lipids
bilateral salpingo-oophorectomy to remove diseased organs referral to social services for supportive care
A client diagnosed with cancer is receiving chemotherapy. The nurses should assess which diagnostic value while the client is receiving chemotherapy? bone marrow cells liver tissues heart tissues pancreatic enzymes
bone marrow cells
A client is interested in making dietary changes to reduce the risk for colon cancer. What dietary selections should the nurse suggest? croissant, granola and peanut butter squares, and whole milk bran muffin, skim milk, and stir-fried broccoli granola, bagel with cream cheese, and cauliflower salad oatmeal raisin cookies, baked potato with sour cream, and a turkey sandwich
bran muffin, skim milk, and stir-fried broccoli
A client with a nagging cough makes an appointment to see the healthcare provider. For what other signs or symptoms will the nurse assess as a priority? change in appearance of moles and bowel habits swollen lymph nodes and hematuria change in voice and unexplained weight loss urinary frequency and weak urine stream
change in voice and unexplained weight loss
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 expected chemotherapy-related adverse effects. chemotherapy exposure and risk factors. signs and symptoms of infection. reinforcement of the client's medication regimen.
chemotherapy exposure and risk factors.
A female client is currently receiving radiation therapy to the chest wall for recurrent breast cancer. They have pain while swallowing and burning and tightness in their chest. The nurse should further assess the client for indications of which health problem? hiatal hernia stomatitis radiation enteritis esophagitis
esophagitis
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? erythema flare extravasation thrombosis
extravasation
A client had a right pneumonectomy for lung cancer yesterday and now has dyspnea. What position in bed will be best for this client? lying on the left side positioned for postural drainage head of the bed elevated flat in bed on full bed rest
head of the bed elevated
The nurse is conducting a wellness program for adults about cancer. The nurse should teach clients about which potential risk factor for the development of colon cancer? chronic constipation long-term use of laxatives history of smoking history of inflammatory bowel disease
history of inflammatory bowel disease
For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan? administering aspirin if the temperature exceeds 102° F (38.8° C) inspecting the skin for petechiae once every shift providing for frequent rest periods placing the client in strict isolation
inspecting the skin for petechiae once every shift
As part of a primary cancer prevention program, an oncology nurse answers questions from the public at a health fair. When someone asks about laryngeal cancer, the nurse should explain that laryngeal cancer is one of the most preventable types of cancer. inhaling polluted air isn't a risk factor for laryngeal cancer. laryngeal cancer occurs primarily in women. adenocarcinoma accounts for most cases of laryngeal cancer.
laryngeal cancer is one of the most preventable types of cancer.
Which finding is an early indicator of bladder cancer? painless hematuria occasional polyuria nocturia dysuria
painless hematuria
Which action is most important when the nurse is planning pain management for a client after a lobectomy for lung cancer? repositioning the client immediately after administering pain medication reassessing the client after administering pain medication reassuring the client after administering pain medication readjusting the pain medication dosage as needed
reassessing the client after administering pain medication
A client undergoing chemotherapy has a white blood cell count of 2300/mm3 (2.3 X 109/L); a hemoglobin level of 9.8 g/dL (98 g/L); a platelet count of 80,000/mm3 (80 X 109/L); and a potassium level of 3.8 mEq/L (3.8 mmol/L). Which finding should take priority? blood pressure 136/88 mm Hg emesis of 90 mL temperature 101° F (38.3° C). urine output 40 mL per hour
temperature 101° F (38.3° C).
When reporting to the outpatient cancer center for their first chemotherapy treatment, a client appears anxious and apprehensive. Which statement by the nurse may help allay the client's anxiety? "You may have a seat right over here." "We wear gowns and gloves to administer chemotherapy drugs because they're very dangerous." "You look anxious, don't worry you will get used to this place." "As a precaution, we wear gowns, goggles, and gloves to administer the medication."
"As a precaution, we wear gowns, goggles, and gloves to administer the medication."
A client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis is appropriate for this client? Anticipatory grieving Impaired swallowing Disturbed body image Chronic low self-esteem
Anticipatory grieving
Several days before admission, a client reports finding a small lump in the left breast near the nipple. What should the nurse tell the client to do? Inform the physician immediately. Squeeze the nipple to check for drainage. Check the area after the next menses. Put a heating pad on the area to reduce inflammation.
Inform the physician immediately.
After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? serving small portions of bland food encouraging rhythmic breathing exercises administering metoclopramide and dexamethasone as ordered withholding fluids for the first 4 to 6 hours after chemotherapy administration
administering metoclopramide and dexamethasone as ordered
The nurse is teaching the family of a client diagnosed with leukemia about ways to prevent infection. Which instruction has the most impact? bathing the client daily covering the client's mouth when coughing maintaining an intact skin integrity ingesting a plant-based diet
maintaining an intact skin integrity
A right orchiectomy is performed on a client with a testicular malignancy. The client expresses concerns regarding their sexuality. What information should the nurse give the client to address their concerns? The client: is not a candidate for sperm banking. should retain normal sexual drive and function. will be impotent. will have a change in secondary sexual characteristics.
should retain normal sexual drive and function.
Which nursing goal is appropriate for the nurse to make with a client who has multiple myeloma? Achieve effective management of bone pain. Recover from the disease with minimal disabilities. Decrease episodes of nausea and vomiting. Avoid hyperkalemia.
Achieve effective management of bone pain.
A nurse is assessing a client with multiple myeloma. The nurse should keep in mind that clients with multiple myeloma are at risk for chronic liver failure. acute heart failure. pathologic bone fractures. hypoxemia.
pathologic bone fractures.
After a transsphenoidal adenohypophysectomy, a client is likely to undergo hormone replacement therapy. A transsphenoidal adenohypophysectomy is performed to treat which type of cancer? esophageal carcinoma pituitary carcinoma laryngeal carcinoma colorectal carcinoma
pituitary carcinoma
A client at risk for lung cancer asks about the reason for having a computed tomography (CT) scan as part of the initial examination. What is the nurse's best response? "A CT scan is: far superior to magnetic resonance imaging for evaluating lymph node metastasis." noninvasive and readily available." useful for distinguishing small differences in tissue density and detecting nodal involvement." used to distinguish a malignant from a nonmalignant adenopathy."
useful for distinguishing small differences in tissue density and detecting nodal involvement."
After lobectomy for lung cancer, a client receives a chest tube connected to a disposable chest drainage system. The nurse observes that the drainage system is functioning correctly when the nurse notes tidal movements or fluctuations in which compartment of the system as the client breathes? water-seal chamber air-leak chamber collection chamber suction control chamber
water-seal chamber
The nurse is assessing a client who is suspected of being in the early symptomatic stages of human immunodeficiency virus (HIV) infection. Which indication of infection should the nurse detect during this stage? whitish-yellow patches in the mouth dyspnea bloody diarrhea raised, hyperpigmented lesions on the legs
whitish-yellow patches in the mouth
An oncology clinic nurse is reinforcing prevention measures for oropharyngeal infections to a client receiving chemotherapy. Which statement by the client indicates that teaching was successful? "I clean my teeth gently several times per day." "I replace my toothbrush every month." "I lubricate my lips with petroleum jelly." "I use an alcohol-based mouthwash every morning."
"I clean my teeth gently several times per day."
A registered nurse(RN) on the oncology floor is busy with another client, so the RN delegates care of a client to a coworker, a licensed practical nurse (LPN). The client that the LPN begins caring for requires a three-hour chemotherapy infusion. Which statement is in accordance with the Nurse Practice Act? The LPN may administer the chemotherapy drug if the LPN passed the hospital's chemotherapy administration course. The chemotherapy will need to be held until another RN can care for the client. A chemotherapy certified RN must begin the chemotherapy, then the LPN may monitor the client. The physician must administer the drug.
A chemotherapy certified RN must begin the chemotherapy, then the LPN may monitor the client.
A client with malignant pleural effusions has dyspnea and chest pain. In which order of priority from first to last should the nurse manage the client's care? All options must be used. Apply oxygen at 2 L via nasal cannula. Administer morphine sulfate 2 mg IV. Coach the client on deep-breathing exercises. Educate the client in anticipation of a thoracentesis.
Administer morphine sulfate 2 mg IV. Apply oxygen at 2 L via nasal cannula. Educate the client in anticipation of a thoracentesis. Coach the client on deep-breathing exercises.
A client receiving 5-fluorouracil is experiencing nausea and vomiting. What is the nurse's best course of action? Hold the medication, as this is a dose-limiting side effect. Assess for dry mucous membranes and poor skin turgor. Administer ondansetron prior to administering the 5-fluorouracil. Assess for elevated temperature.
Administer ondansetron prior to administering the 5-fluorouracil.
A client receiving radiation therapy for lung cancer is having difficulty sleeping. What should the nurse do first when teaching the client about promoting sleep? Tell the client to stop watching television before bed. Ask the client about usual sleep patterns. Instruct the client to sleep in a darkened room. Suggest the client stop drinking coffee until the therapy is completed.
Ask the client about usual sleep patterns.
he client who is in the end stages of cancer is requesting spiritual support. What should the nurse do next? Review the client's medical record to determine the client's religion. Call a chaplain, and set up an appointment for spiritual guidance. Request that the family notify the client's spiritual advisor. Ask the client what spiritual activities would be most helpful.
Ask the client what spiritual activities would be most helpful.
A client with a history of pancreatic cancer is revived following cardiac arrest but is determined to have suffered brain death. The family tells the nurse they want to donate any usable body organs so their loved one can live on in others. Which action by the nurse is appropriate? Tell the family that the client is not a candidate for organ donation. Call the local organ procurement representative to meet with them. Have the physician pronounce the client dead before taking the organs. Check the driver's license for a donor sticker to authorize organ donation.
Call the local organ procurement representative to meet with them.
A nurse is caring for a client with a long-term central venous catheter. Which steps should the nurse include in teaching how to care for the catheter at home? Use clean technique when accessing the port with a needle. If the needle becomes contaminated before accessing the port, clean the needle with povidone-iodine solution. Clean the port with an alcohol pad before administering I.V. fluid through the catheter. Flush each port using a 10ml NSS syringe, giving each port 5ml from the syringe.
Clean the port with an alcohol pad before administering I.V. fluid through the catheter.
A client is struggling with the decision of whether or not to continue chemotherapy. The client tells the nurse, "It's making me so sick and ruining whatever time I have with my family." What is the nurse's role when caring for this client? Share stories about how others made this decision. Listen to the client's concerns. Advocate for the client with the health care provider. Teach the client how to logically approach the situation.
Listen to the client's concerns.
A nurse is assessing an adult who has been receiving chemotherapy. The client has a platelet count of 22,000 cells/mm3 (22 × 109/L) and has petechiae on their lower extremities. What should the nurse should instruct their client to do? Increase the amount of iron in their diet. Apply lotion to their lower extremities. Elevate their legs. Consult the health care provider.
Consult the health care provider.
The nurse is planning with a client who has cancer to improve the client's independence in activities of daily living after radiation therapy. What should the nurse do? Refer the client to a community support group after discharge from the rehabilitation unit. Make certain that a family member is present for the rehabilitation sessions. Provide positive reinforcement for skills achieved. Inform the client of rehabilitation plans made by the rehabilitation team.
Provide positive reinforcement for skills achieved.
Before surgery for a modified radical mastectomy, a client is extremely anxious and asks many questions. Which approach offers the best guide for the nurse to answer these questions? Tell the client as much as they want to know and can understand. Postpone discussing the client's questions until they are convalescing. Delay discussing the client's questions until their apprehension subsides. Explain to the client that they should discuss their questions first with the health care provider.
Tell the client as much as they want to know and can understand.
A nurse is preparing a client for magnetic resonance imaging (MRI) scan to confirm or rule out a spinal cord lesion. Which action would pose a threat to the client during the procedure? The client is positioned supine. The client receives lorazepam 1 mg by mouth prior to the procedure. The client eats breakfast prior to the procedure. The client wears a watch and wedding band.
The client wears a watch and wedding band.
At a public health fair, a nurse teaches a group of women about breast cancer awareness. What is most important for the nurse to include in teaching about the warning signs of breast cancer? breast discomfort and multiple movable nodules breast changes during menstruation nipple discharge and a breast nodule fever and erythema of the breast
nipple discharge and a breast nodule
Which statement by a client undergoing external radiation therapy indicates the need for further teaching? "I'll wash my skin with mild soap and water only." "I'll not use my heating pad during my treatment." "I'll wear protective clothing when outside." "I'm worried I'll expose my family members to radiation."
"I'm worried I'll expose my family members to radiation."
On the night before a 58-year-old female client is to have a lobectomy for lung cancer, the client remarks to the nurse, "I'm so scared of this cancer. I should've quit smoking years ago. Now I've brought all this fear and sadness on myself and now my family." How should the nurse respond to the client? "It's normal to be scared. I would be, too. We'll help you through it." "Do you feel guilty because you smoked?" "Don't be so hard on yourself. You don't know if your smoking caused the cancer." "It's okay to be scared. What is it about cancer that you are afraid of?"
"It's okay to be scared. What is it about cancer that you are afraid of?"
On the third postoperative day after a radical mastectomy, a client's drainage tube is removed, and the dressings are changed. The client appears shocked when they see the operative area and exclaims, "I look horrible! Will it ever look better?" Which response by the nurse would be most appropriate? "After it heals and you're dressed, you won't even know you had surgery." "Don't worry. You know the tumor is gone, and the area will heal very soon." "Would you like to meet Ms. Paul? She looks just great, and she had a mastectomy, too." "You're shocked by the sudden change in your appearance as a result of this surgery, aren't you?"
"You're shocked by the sudden change in your appearance as a result of this surgery, aren't you?"
A client is ordered a dose of epoetin alfa to treat anemia related to chemotherapy. The recommended dose is 150 units/kg. The client weighs 60 kg. The vial is labeled 10,000 units/ml. How many milliliters of epoetin alfa would the nurse administer? Record your answer using one decimal place.
0.9 ml
A nurse is developing a care plan for bone marrow suppression, the major dose-limiting adverse reaction to floxuridine (FUDR). How long after drug administration does bone marrow suppression become noticeable? 24 hours 2 to 4 days 7 to 14 days 21 to 28 days
7 to 14 days
A client has been receiving radiation therapy for 3 weeks to treat cancer and has fatigue. The nurse should consider which factor when planning to help the client cope with the fatigue? Fatigue is a temporary problem that requires no active intervention. The cause of the fatigue should be determined. Fatigue indicates that the client's cancer is not under control. A balance of activity and rest will help manage the fatigue.
A balance of activity and rest will help manage the fatigue.
Following a simple mastectomy, the nurse is totaling the amount of drainage in 24 hours from a suction drain in the incision. The nurse notes there is 200 mL of serosanguineous drainage for the first 24 hours. What should the nurse do? Document the findings. Notify the surgeon. Remove the drain. Place the client's arm in a dependent position.
Document the findings.
A client with suspected lung cancer is scheduled for thoracentesis as part of the diagnostic workup. The nurse reviews the client's history for conditions that might contraindicate this procedure. Which condition is a contraindication for thoracentesis? seizure disorder chronic obstructive pulmonary disease (COPD) anemia bleeding disorder
bleeding disorder
In providing care to the client with leukemia who has developed thrombocytopenia, the nurse assesses the most common sites for bleeding. Which is not a common site? biliary system gastrointestinal tract brain and meninges pulmonary system
biliary system
A client who is receiving chemotherapy is not eating well but otherwise feels healthy. What should the nurse suggest the client eat? cereal with milk and strawberries milkshake made with blueberries, bananas, and ice cream broiled chicken, green beans, and cottage cheese steak and French fries
broiled chicken, green beans, and cottage cheese
A client with pancreatic cancer who has been bedbound for 3 weeks has just returned from having a left subclavian, long-term, tunneled catheter inserted for the administration of analgesic medication. The nurse has not yet received the radiographic results for confirmation of placement. The client becomes restless and dyspneic and has chest pain radiating to the middle of the back. A physical assessment reveals tachycardia and absent breath sounds in the left lung. What complication should the nurse further assess for? air embolus pneumothorax pulmonary embolus myocardial infarction
pneumothorax
A nurse is interviewing a client about their past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer? duodenal ulcers hemorrhoids weight gain polyps
polyps
A client with a diagnosis of cancer is frequently disruptive and challenges the nurse. This behavior may be caused by which factor? uncertainty and an underlying fear of recurrence the usual trajectory of a short-term illness a history of a behavioral illness the one-time crisis from learning of the diagnosis
uncertainty and an underlying fear of recurrence
The nurse is preparing a community presentation on oral cancer. Which is a primary risk factor for oral cancer that the nurse should emphasize in the presentation? use of alcohol frequent use of mouthwash lack of vitamin B12 lack of regular teeth cleaning by a dentist
use of alcohol
A client with lung cancer is being cared for by their spouse at home. The client's pain is increasing in severity. The nurse recognizes that teaching has been effective when the spouse uses which pain relief strategy? Select all that apply. gives the client a long-acting or sustained-release oral pain medication regularly around the clock uses an immediate-release medication (oxycodone) for breakthrough pain avoids long-acting opioids because of the client's concern about addiction uses music for distraction as well as heat or cold in combination with medications substitutes acetaminophen to avoid tolerance to the medications has the client use a pain rating scale to measure the effectiveness of reaching their individual pain goal
gives the client a long-acting or sustained-release oral pain medication regularly around the clock uses an immediate-release medication (oxycodone) for breakthrough pain uses music for distraction as well as heat or cold in combination with medications has the client use a pain rating scale to measure the effectiveness of reaching their individual pain goal
The nurse is teaching a client who had a mastectomy for breast cancer how to prevent lymphedema. What should the nurse teach the client to do? Apply an elastic bandage to the affected extremity. Limit range-of-motion exercises in the shoulder and elbow. Elevate the affected arm on a pillow. Use diuretics as necessary to decrease swelling.
Elevate the affected arm on a pillow.
When the nurse is developing a plan of care to manage a client's pain from cancer, what should the nurse plan to do? Individualize the pain medication regimen for the client. Select medications that are least likely to lead to addiction. Administer pain medication as soon as the client requests it. Change pain medications periodically to avoid drug tolerance.
Individualize the pain medication regimen for the client.
The nurse is providing discharge instructions about preventing infection to a client who had a modified radical mastectomy and will be pruning flowers when they return to work. To prevent infection, what should the nurse instruct the client to do? Wear protective gloves when gardening. Avoid crowded areas. Keep cuticles cut. Remove underarm hair with a sharp razor.
Wear protective gloves when gardening.
A few minutes after beginning a blood transfusion, a nurse notes that a client has chills, dyspnea, and urticaria. The nurse reports this to the physician immediately because the client probably is experiencing which problem? a hemolytic reaction to mismatched blood a hemolytic reaction to Rh-incompatible blood a hemolytic allergic reaction caused by an antigen reaction a hemolytic reaction caused by bacterial contamination of donor blood
a hemolytic allergic reaction caused by an antigen reaction
The nurse is performing a breast examination on a client. Which findings most strongly suggest that a client has breast cancer? asymmetry of breasts, clear discharge from nipple fixed nodular mass, breast pain, dimpling of the skin bloody discharge from nipple, multiple movable masses, pain swollen axilla lymph nodes, fever, and fatigue
fixed nodular mass, breast pain, dimpling of the skin
A client has just begun treatment with busulfan, 4 mg by mouth daily, for chronic myelogenous leukemia. The client receives busulfan until their white blood cell (WBC) count falls to between 10,000/mm3 and 25,000/mm3. Then the drug is stopped. When should treatment resume? when the WBC falls to 5,000/mm3 when lost hair begins to grow back when the WBC count rises to 50,000/mm3 when the client displays anemia
when the WBC count rises to 50,000/mm3
A client receiving chemotherapy for cervical cancer indicates that she has an advance directive. She tells the nurse that she worries her children will not honor her wishes if her condition should worsen. In order to facilitate the honoring of the client's wishes, what should the nurse encourage the client to do? Recommend that the client contact her attorney. Obtain additional legal documents. Discuss her end-of-life wishes with her family. Appoint a proxy who is not a family member.
Discuss her end-of-life wishes with her family.
A client with metastatic brain cancer is admitted to the oncology floor. What action will the admitting nurse take regarding an advanced directive for this client? Decide on a treatment plan if the client cannot. Inform the client or legal guardian of the right to execute an advance directive. Respect the individuals' moral rights. Advise the client to refuse medical treatment if unable to make health care decisions.
Inform the client or legal guardian of the right to execute an advance directive.
The nurse is planning future care with a middle-age client who has undergone surgical resection for lung cancer. Which plan will best promote adaptation and rehabilitation? arranging a visit from a client who has recovered from a similar surgery planning a progressive activity regimen teaching about dressing care requesting house-cleaning services for 3 months
planning a progressive activity regimen
The nurse at the gynecologic clinic is teaching the client about the results of her Papanicolaou test, which demonstrated dysplasia. Which represents the nurse's best intervention? Ask the client about any family history of cervical cancer. Encourage the client to express feelings about cervical cancer. Assist the client to schedule a treatment plan for cervical cancer. Explain that the results show cervical changes that require follow up.
Explain that the results show cervical changes that require follow up.
A client is to have radiation therapy after a modified radical mastectomy. What instruction should the nurse give the client about caring for the skin at the site of the radiation therapy? Wash the area with water. Expose the area to dry heat. Apply an ointment to the area. Use talcum powder on the area.
Wash the area with water.
Which nursing intervention is most appropriate for a client with multiple myeloma? monitoring respiratory status balancing rest and activity restricting fluid intake preventing bone injury
preventing bone injury
A client was discharged from the hospital for cancer-related pain. While the client was in the hospital, the pain was well controlled on patient-controlled administration (PCA) of intravenous (IV) morphine, and on discharge 2 days ago, the client was taking oral morphine. The client now reports pain as an 8 on a 10-point scale and is asking the nurse about using PCA for the morphine at home. Which explanation is the most likely for the client's reports of inadequate pain control? The client is: addicted to the IV morphine. going through withdrawal from the IV opioid. physically dependent on the IV morphine. undermedicated on the oral opioid.
undermedicated on the oral opioid.
A middle-age female client with a history of breast-conserving surgery, axillary node dissection, and radiation therapy reports that their arm is red, warm to touch, and slightly swollen. Which action should the nurse suggest? Apply warm compresses to the affected arm. Elevate the arm on two pillows. Contact the health care provider immediately. Apply an ice pack to the area of the swelling.
Contact the health care provider immediately.
