Oncology Prepu
A benign tumor of the blood vessels is a(n)
Hemangioma Explanation: A hemangioma is a benign tumor of the blood vessels. An osteoma is a tumor of the connective tissue. A neuroma is a tumor of the nerve cells. A chondroma is a tumor of the cartilage.
During unplanned, spontaneous moments, dying clients usually discuss fears or concerns that nurses should not ignore or rush. What is the nurse's best response in such situations?
Communicate interest and a willingness to listen by sitting down, leaning forward in the client's direction, and making direct eye contact. Explanation: The nurse can communicate interest and a willingness to listen by sitting down, leaning forward in the client's direction, and making direct eye contact. Nodding, responsive comments such as "Yes" or brief periods of silence encourage the client to continue verbalizing. Calling out to the client's family members and asking them to sit next to the client may not be the best intervention. It is important for nurses to be flexible and to interrupt physical care if and when the client indicates a need for companionship, support, and communication. This client is seeking companionship and communication, not rest.
A client is diagnosed with a terminal illness and has been given less than 6 months to live. What type of referral should the nurse make to assist this patient and family at home?
Hospice Explanation: Hospice is palliative care provided to terminally ill persons and their families in the last 6 months of the client's life. None of the other interventions would be as appropriate or effective for this patient.
The nurse is caring for a client undergoing an incisional biopsy. Which statement does the nurse understand to be true about an incisional biopsy?
It removes a wedge of tissue for diagnosis. Explanation: The three most common biopsy methods are excisional, incisional, and needle. In an incisional biopsy, a wedge of tissue is removed from the tumor and analyzed. In an excisional biopsy, the surgeon removes the tumor and the surrounding marginal tissues. Needle aspiration biopsy involves aspirating tissue fragments through a needle guided into the cancer cells.
A client with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this client's plan of care?
Limit the time that visitors spend at the client's bedside. Explanation: To limit radiation exposure, visitors should generally not spend more than 30 minutes with the client. Pregnant nurses or visitors should not be near the client, but there is no reason to limit care to nurses who are male. All necessary care should be provided to the client and a single room should be used.
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. Explanation: Safety precautions are used for the client with a radioactive implant. They include assigning the client to a private room, seeing that visitors maintain a 6-foot distance from the radiation source, prohibiting visits by children, and preventing exposure to those who may be or are pregnant. Staff needs to wear dosimeters. Family may visit for up to 30 minutes per day.
Palliation refers to
Relief of symptoms of disease and promotion of comfort and quality of life. Explanation: Palliation is the goal for care of clients with terminal cancer. Alopecia is the term that refers to hair loss. Metastasis is the term that refers to the spread of cancer cells from the primary tumor to distant sites. Nadir is the term that refers to the lowest point of white blood cell depression after therapy that has toxic effects on bone marrow.
The nurse is admitting a 52-year-old father of four into hospice care. The client has a diagnosis of Parkinson disease, which is progressing rapidly. The client has made clear his preference to receive care at home. What interventions should the nurse prioritize in the plan of care?
Supporting the client's and family's values and choices Explanation: Nurses need to develop skill and comfort in assessing clients' and families' responses to serious illness and planning interventions that support their values and choices throughout the continuum of care. To be admitted to hospice care, the client must have come to terms with the fact that he is dying. The scenario states that the client wants to be cared for at home, not in a long-term setting. The children may be able to participate in their father's care, but they should not be assigned responsibility for planning it.
The nurse is evaluating bloodwork results of a client with cancer who is receiving chemotherapy. The client's platelet count is 60,000/mm3. Which is an appropriate nursing action?
Correct response: Avoiding the use of products containing aspirin Explanation: Clients with a platelet count of 60,000/mm3 are at mild risk for bleeding. Appropriate nursing interventions include avoiding the use of products such as aspirin that may interfere with the client's clotting systems; avoiding taking temperature rectally and administering suppositories; providing the client with an electric shaver for shaving; and avoiding commercial mouthwashes because of their potential to dry out oral mucosa, which can lead to cracking and bleeding.
Which of the following nursing interventions is appropriate with regard to pain control in the dying client?
Give pain medications on a routine schedule. Explanation: The nurse usually gives pain medication on a routine schedule around the clock to avoid causing intense discomfort followed by a period of heavy sedation. Morphine may be used. Oxygen eventually may be used.
A nurse is caring for a terminally ill client who is receiving chemotherapy and radiation for an aggressive lung cancer. The treatment success is limited in shrinking the tumor, and the treatments are making the client very ill. The client states, "I feel that I would like to stop treatments. I would like to enjoy the time that I have remaining with my family." Which emotional reaction does the nurse recognize that the client is experiencing?
Acceptance Explanation: In the final stage, dying clients accept their fate and makes peace spiritually and with those to whom they are close. Clients begin to detach themselves socially and wish to be with only a small group of close friends and family. The other options are stages that occur earlier in the process.
The nurse assesses that extravasation of a chemotherapy agent has occurred. What is the nurse's initial action?
Discontinue the infusion. Explanation: If extravasation is suspected, the medication administration is stopped immediately, and depending on the drug, the nurse may attempt to aspirate any remaining drug from the extravasation site. The other actions listed may be appropriate to perform, but should occur after discontinuing the infusion.
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 Explanation: A stage 3 pressure ulcer is a break in the skin's protective barrier, which could lead to infection in a client who is receiving chemotherapy. The WBC count and temperature are within normal limits. Eating 75% of meals is normal and doesn't increase the client's risk for infection. A client who is malnourished is at a greater risk for infection.
