Oncology

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." Palliative surgeries such as bowel resection may be performed to promote comfort by relieving pain and pressure on organs within the abdominal cavity.

The client is scheduled for a breast lump excision and sentinel node biopsy. What should the nurse know in planning care for the client with a negative biopsy report?

A wide excision of lump will be performed The sentinel node is the first node in which a tumor will drain; if no malignant cells are found there, additional excision or radical removal will not be necessary.

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

Adjuvant therapy is likely.

The client has findings the first round of chemo. Which statements 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. Use of herbals should be reviewed with the oncologist.

Which of the following advice does the nurse offer clients who are undergoing unsealed radiation therapy to reduce exposure?

Avoid kissing and sexual contact Clients who are undergoing unsealed radiation therapy are advised to avoid kissing and sexual contact due to the spread of radioactivity. Encouraged to drink plenty of fluids to help flush radioactive substances. May be asked to apply mild moisturizers and are not asked not to eat after the therapy.

You are providing client teaching for a client undergoing chemotherapy. What dietary modifications should you advise?

Avoid spicy and fatty foods Encourage small meals and appropriate fluid intake.

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

I guess the doctor could not remove the entire tumor.

A client who is being treated for bladder cancer expresses his concern of passing cancer to his wife during intercourse. Which is the best response by the nurse?

Cancer is not transferred from person to person via direct contact

A cancer client makes the following statement to the nurse. I guess i will tell my doctor to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die. Which of the following facts supports the use of chemo for this client?

Chemo treatment can be adjusted to optimize effects while limiting adverse effects. With supplemental antiemetics to control the nausea and vomiting.

Which of the following can be considered carcinogens?

Dietary substances Carcinogens include chemical agents, environmental factors, dietary substances. Viruses defective genes, and medically prescribed interventions.

Based on the understanding of the effects of chemotherapy, the nurse would anticipate which of the following clinical findings in a client 2 weeks post therapy?

Ease of bruising Effects of chemotherapy can include: Myelosuppression, resulting in anemia or bleeding tendencies, as exhibited in ease of bruising.

The nurse is providing an education presentation on dietary recommendations for reducing the risk of cancer. Which of the following food selections would demonstrate a good understanding of the information provided in the presentation?

Egg white omelet with spinach and mushrooms Steamed broccoli and carrots Turkey breast on whole wheat bread

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

Extravasating

The nurse is caring for a client 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 Clients are at risk for infection and will be closely monitored for at least 3 months.

A client is scheduled for nerve sparing prostatectomy. The emotional spouse confides in the nurse that the client will not talk about the cancer and or upcoming surgery. Which nursing diagnosis will the nurse choose as primary diagnosis for this client?

Fear

The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important?

Flush the toilet twice after every use Iodine 131 is a systemic internal radiation that is excreted through body fluids, especially urine. Flushing the toilet twice after every use will avoid the exposure of others to radioactive exposure. use of separate eating utensils will be necessary for the first 8 days.

The physician recommends that you have your daughter vaccinated with HPV vaccine. What is this vaccine for?

Help prevent cervical cancer

A client diagnosed with cancer has his tumor staged and graded based on what factors?

How they tend to grow and the cell type Tumors are staged and graded based upon how they tend to grow and the cell type before a client is treated for cancer.

An elderly client has been diagnosed with metastatic cancer and has a poor prognosis of survival. The family asks the nurse for advice on whether to tell the client of the diagnosis or to keep it quiet. Which is the best response from the nurse?

In my experience, clients who know are more likely to be involved with their plan of care.

When providing care for a client with stage IV cancer, the nurse knows to include which intervention in the plan of care?

Incorporating touching and listening Psychological support can be given via therapeutic touch and through listening to the concerns and fears associated with the progressive disease.

While completing an admission assessment, the client reports a family history of ovarian cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology?

Inherited gene mutation Tumor suppressor genes assist the body in normal cell production and death.

When caring for a 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 Will allow early identification and intervention of skin problems associated with external radiation therapy. Time distance and shielding are key in the management of sealed, internal radiation therapy and not external beam radiation.

The nurse performs a breast exam on a client and finds a firm, non-movable 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 A fast growing lump is suggestive of a malignant tumor. Metastasis can only be determined by cytology, not by palpation.

Cancer has many characteristics. What is one of the most discouraging characteristics of cancer?

Metastasis Even one malignant cell can give rise to a metastatic lesion in a distant part of the body.

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. Until transplanted stem cells begin to produce blood cells, these clients have no physiological means to fight infection, which makes them very prone to infection.

The nurse is caring for a client with the diagnosis of colon cancer with metastasis to the liver. Which statement made by the client indicates an understanding of the diagnosis?

My cancer has now spread to my liver

A client with cancer stage T4, N3, M1 is ordered morphine sulfate 4 mg, subcutaneous every 3 to 4 hours. Two hours after the last injection, the client rings the call bell to report a pain scale of 9. Which is the appropriate action by the nurse?

Notify the physician of the breakthrough pain in an attempt to obtain additional orders

Which of the following lab findings, would be identified by the nurse as the greatest risk for a cancer client schedule for implantable port?

Platelet count 98,000 Platelet count is very low and places the client at risk for bleeding

When the client complains of increased fatigue following radiotherapy, the nurse knows that is most likely related to which factor?

Radiation can result in myelosuppression Fatigue results from anemia associated with myelosuppression and decreased RBC production. The spreading of cancer can cause many symptoms dependent on location and type of cancer but not a significant factor to support fatigue w radiotherapy.

A client with advanced cancer makes the following comment to the nurse: Why are you bathing me? I am going to die no matter what. What is the appropriate response?

Would you like to talk about what you are feeling?

The nurse recognizes which of the following alternative therapies as appropriate in the care of cancer clients? SATA

Reminiscing Hot and cold therapy

The nurse knows that interferon agents are used in association with chemotherapy to produce which effects in the client?

Shorten the period of neutropenia

You are a public health nurse giving a talk on the warning signals of cancer to a local community group. Which of the following are the warning signals of cancer? SATA

Sores that don't heal Unusual bleeding or discharge Persistent indigestion Seven warning signals of cancer should be familiar to all: 1. A change in bowel habits or bladder function 2. Sores that do not heal 3. Unusual bleeding or discharge 4. Thickening or lump in breast or other body parts 5. Persistent indigestion or difficulty swallowing 6. A change in a wart or mole 7. A persistent nagging cough or hoarseness

The nurse is invited to present a teaching program to parents of school age children. Which topic would be of greatest value for decreasing cancer risks?

Sun safety and use of sunscreen

You are an oncology nurse caring for a client who is taking antineoplastic agents. What adverse symptoms must you monitor for this client?

Symptoms of gout The nurse monitors this client for gout because the antineoplastic drugs increase uric acid levels, joint pain, and edema.

Chemotherapy has been used for the past three months to treat a client with pancreatic cancer. The CA 19-9 levels are rising. Which explanation would the nurse attribute as the most likely cause?

The cancer is growing despite the chemotherapy treatment. Elevation of specific tumor markers, such as CA 19-9, is indicative of progression and proliferation of the cancer cells. If the chemotherapy was successful in the treating of the pancreatic cells, the tumor markers would be decreased.

A newly diagnosed cancer client is crying and states the following to the nurse I promised God that i will be a better person if i can just get better. What is the appropriate assessment of this comment by the nurse?

The cancer is viewed as a punishment from past actions

A client with a 4cm breast mass is scheduled for biopsy with frozen section followed by lumpectomy and possible mastectomy. The client asks the nurse, "Why cant the doctor tell me specifically whether i will need to have my entire breast removed?" Which is the best response from the nurse?

The frozen section will determine presence of cancer and type of surgery required. A frozen section during surgery allows the pathologist to quickly examine the tissue under the microscope allowing the surgeon to make a decision for best surgical approach.

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 temporary

Which nursing interventions are most important when implementing care for a client receiving temporary internal sealed radiation therapy? SATA

Time distance and shielding Count wires threads or needles every shift Avoid standing in direct path of implants Internal sealed radiation implants are in the form of needles, seeds, pellets, wires, etc. these forms contain radioactive material and must be counted each shift to ensure accidental exposure does not occur to staff or others who may come in contact with the material. Indelible skin markings are only used with external beam radiation. Chemotherapy is the treatment given through the IV access.

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 pressing against normal tissues Benign tumors grow more slowly than malignant tumors and do not emit tumor-specific antigens or proteins. Benign tumors do not metastasize to distant sites. Benign tumors can compress tissues as it grows, which can result in impaired organ functioning.

While doing a health history, a client tells you that her mother, grandmother, and sister died of cancer. The clients wants to know what she can do to keep from getting cancer. What would be your best response?

You cant prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is. Specialized tests have been developed for tumor markers, specific proteins, antigens, hormones, genes, or enzymes that cancer cells release.