Evolve Ch 21 and 22 – Cancer – Flashcards
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The nurse is giving a group presentation on cancer prevention and recognition. Which statement by an older adult client indicates understanding of the nurse's instructions? "Cigarette smoking always causes lung cancer." "Taking multivitamins will prevent me from developing cancer." "If I have only one shot of whiskey a day, I probably will not develop cancer." "I need to report the pain going down my legs to my health care provider."
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"I need to report the pain going down my legs to my health care provider."
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The nurse is teaching a 47-year-old woman about recommended screening practices for breast cancer. Which statement by the client indicates understanding of the nurse's instructions? "My mother and grandmother had breast cancer, so I am at risk." "I get a mammogram every 2 years since I turned 30." "A clinical breast examination is performed every month since I turned 40." "A computed tomography (CT) scan will be done every year after I turn 50."
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"My mother and grandmother had breast cancer, so I am at risk."
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A 72-year-old client recovering from lung cancer surgery asks the nurse to explain how she developed cancer when she has never smoked. Which factor may explain the possible cause? A diagnosis of diabetes treated with insulin and diet An exercise regimen of jogging 3 miles four times a week A history of cardiac disease Advancing age
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Advancing age
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The nurse reviews the chart of a client admitted with a diagnosis of glioblastoma with a T1NXM0 classification. Which explanation does the nurse offer when the client asks what the terminology means? "Two lymph nodes are involved in this tumor of the glial cells, and another tumor is present." "The brain tumor measures about 1 to 2 cm and shows no regional lymph nodes and no distant metastasis." "This type of tumor in the brain is small with some lymph node involvement; another tumor is present somewhere else in your body." "Glioma means this tumor is benign, so I will have to ask your health care provider the reason for the chemotherapy and radiation."
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"The brain tumor measures about 1 to 2 cm and shows no regional lymph nodes and no distant metastasis."
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The nurse manager in a long-term care facility is developing a plan for primary and secondary prevention of colorectal cancer. Which tasks associated with the screening plan will be delegated to nursing assistants within the facility? Testing of stool specimens for occult blood Teaching about the importance of dietary fiber Referring clients for colonoscopy procedures Giving vitamin and mineral supplements
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Testing of stool specimens for occult blood
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The nurse presents a cancer prevention program to teens. Which instruction will have the greatest impact in cancer prevention? Avoid asbestos. Wear sunscreen. Get the human papilloma virus (HPV) vaccine. Do not smoke cigarettes
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Do not smoke cigarettes
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The nurse suspects metastasis from left breast cancer to the thoracic spine when the client has which symptom? Vomiting Back pain Frequent urination Cyanosis of the toes
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Back pain
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The nurse explains to a client that which risk factor of those listed most likely contributed to the client's primary liver carcinoma? Infection with hepatitis B virus Consuming a diet high in animal fat Exposure to radon Familial polyposis
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Infection with hepatitis B virus
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Which type of cancer has been associated with Down syndrome? Breast cancer Colorectal cancer Malignant melanoma Leukemia
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Leukemia
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The nurse is assessing a client with lung cancer. Which symptom does the nurse anticipate finding? Easy bruising Dyspnea Night sweats Chest wound
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Dyspnea
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Which activity performed by the community health nurse best reflects primary prevention of cancer? Assisting women to obtain free mammograms Teaching a class on cancer prevention Encouraging long-term smokers to get a chest x-ray Encouraging sexually active women to get annual Papanicolaou (Pap) smears
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Teaching a class on cancer prevention
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A 52-year-old client relates to the nurse that she has never had a mammogram because she is terrified that she will have cancer. Which response by the nurse is therapeutic? "Don't worry, most lumps are discovered by women during breast self-examination." "Does anyone in your family have breast cancer?" "Finding a cancer in the early stages increases the chance for cure." "Have you noticed a lump or thickening in your breast?"
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"Finding a cancer in the early stages increases the chance for cure."
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Which information must the organ transplant nurse emphasize before a client is discharged? "Taking immunosuppressant medications increases your risk for cancer and the need for screenings." "You are at increased risk for cancer when you reach 60 years of age." "Immunosuppressant medications will decrease your risk for developing cancers." "After 6 months, you may stop immunosuppressant medications, and your risk for cancer will be the same as that of the general population."
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"Taking immunosuppressant medications increases your risk for cancer and the need for screenings."
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The home health nurse is caring for a client who has a history of a kidney transplant and takes cyclosporine (Sandimmune) and prednisone (Deltasone) to prevent rejection. Which assessment finding is most important to communicate to the transplant team? Temperature of 96.6° F Reports of joint pain Pink and dry oral mucosa Palpable lump in the client's axilla
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Palpable lump in the client's axilla
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A client who is scheduled to undergo radiation for prostate cancer is admitted to the hospital by the nurse. Which statement by the client is most important to communicate to the health care provider? "I am allergic to iodine." "My urinary stream is very weak." "My legs are numb and weak." "I am incontinent when I cough."
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"My legs are numb and weak."
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When the nurse is counseling a 60-year-old African-American male client with all of these risk factors for lung cancer, teaching should focus most on which risk factor? Tobacco use Ethnicity Gender Increased age
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Tobacco use
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Which statement about the process of malignant transformation is correct? Mutation of genes is an irreversible event that always leads to cancer development in the initiation phase. Insulin and estrogen enhance the division of an initiated cell during the promotion phase. Tumors form when carcinogens invade the gene structure of the cell in the latency phase. Nutrition of cancer cells is provided by tumor angiogenesis factor (TAF) in the promotion stage.
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Nutrition of cancer cells is provided by tumor angiogenesis factor (TAF) in the promotion stage. The promotion phase consists of progression when the blood supply changes from diffusion to TAF.Insulin and estrogen increase cell division. If cell division is halted, mutation of genes does not lead to cancer development in the initiation phase. In the initiation phase, carcinogens invade the DNA of the nucleus of a single cell. A 1-cm tumor consists of 1 billion cells. The latency phase occurs between initiation and tumor formation.
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A client has a glioblastoma. The nurse begins to plan care for this client with which type of cancer? Liver (hepato) Smooth muscle (leiomyo) Fatty tissue (lipo) Brain
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Brain
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A client has a diagnosis of lung cancer. To which areas does the nurse anticipate that this client's tumor may metastasize? (Select all that apply.) Brain Bone Lymph nodes Kidneys Liver
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Brain, Bone, Lymph Nodes, Liver
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The nurse is conducting a community health education class on diet and cancer risk reduction. What should be included in the discussion? (Select all that apply.) Limit sodium intake. Avoid beef and processed meats. Increase consumption of whole grains. Eat "colorful fruits and vegetables," including greens. Avoid gas-producing vegetables such as cabbage.
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Avoid beef and processed meats. Increase consumption of whole grains. Eat "colorful fruits and vegetables," including greens.
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What are the common cancers related to tobacco use? (Select all that apply.) Cardiac cancer Lung cancer Cancer of the tongue Skin cancer Cancer of the larynx
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Lung cancer Cancer of the tongue Cancer of the larynx
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The nurse includes which factors in teaching regarding the typical warning signs of cancer? (Select all that apply.) Persistent constipation Scab present for 6 months Curdlike vaginal discharge Axillary swelling Headache
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Persistent constipation Scab present for 6 months Axillary swelling
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The nurse is caring for a client with end-stage ovarian cancer who needs clarification on the purpose of palliative surgery. Which outcome should the nurse teach the client is the goal of palliative surgery? Cure of the cancer Relief of symptoms or improved quality of life Allowing other therapies to be more effective Prolonging the client's survival time
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Relief of symptoms or improved quality of life
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Which statement made by a client allows the nurse to recognize whether the client receiving brachytherapy for ovarian cancer understands the treatment plan? "I may lose my hair during this treatment." "I must be positioned in the same way during each treatment." "I will have a radioactive device in my body for a short time." "I will be placed in a semiprivate room for company."
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"I will have a radioactive device in my body for a short time."
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When caring for a client receiving chemotherapy, the nurse plans care during the nadir of bone marrow activity to prevent which complication? Drug toxicity Polycythemia Infection Dose-limiting side effects
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Infection
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The nurse teaches a client that intraperitoneal chemotherapy will be delivered to which part of the body? Veins of the legs Lung Heart Abdominal cavity
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Abdominal cavity
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The oncology nurse is caring for a group of clients receiving chemotherapy. The client with which sign/symptom is displaying bone marrow suppression? Hemoglobin of 7.4 and hematocrit of 21.8 Potassium level of 2.9 mEq/L and diarrhea 250,000 platelets/mm3 5000 white blood cells/mm3
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Hemoglobin of 7.4 and hematocrit of 21.8
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The nurse corrects the nursing student when caring for a client with neutropenia secondary to chemotherapy in which circumstance? The student scrubs the hub of IV tubing before administering an antibiotic. The nurse overhears the student explaining to the client the importance of handwashing. The student teaches the client that symptoms of neutropenia include fatigue and weakness. The nurse observes the student providing oral hygiene and perineal care.
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The student teaches the client that symptoms of neutropenia include fatigue and weakness. Symptoms of neutropenia include low neutrophil count, fever, and signs and symptoms of infection
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When caring for the client with chemotherapy-induced mucositis, which intervention will be most helpful? Administering a biological response modifier Encouraging oral care with commercial mouthwash Providing oral care with a disposable mouth swab Maintaining NPO until the lesions have resolved
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Providing oral care with a disposable mouth swab
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A client who is undergoing chemotherapy for breast cancer reports problems with concentration and memory. Which nursing intervention is indicated at this time? Explain that this occurs in some clients and is usually permanent. Inform the client that a small glass of wine may help her relax. Protect the client from infection. Allow the client an opportunity to express her feelings.
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Allow the client an opportunity to express her feelings.
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Which client problem does the nurse set as the priority for the client experiencing chemotherapy-induced peripheral neuropathy? Potential for lack of understanding related to side effects of chemotherapy Potential for injury related to sensory and motor deficits Potential for ineffective coping strategies related to loss of motor control Altered sexual function related to erectile dysfunction
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Potential for injury related to sensory and motor deficits
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The nurse is caring for a client who is receiving rituximab (Rituxan) for treatment of lymphoma. During the infusion, it is essential for the nurse to observe for which side effect? Alopecia Allergy Fever Chills
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Allergy
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The oncology nurse should use which intervention to prevent disseminated intravascular coagulation (DIC)? Monitoring platelets Administering packed red blood cells Using strict aseptic technique to prevent infection Administering low-dose heparin therapy for clients on bedrest
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Using strict aseptic technique to prevent infection
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When caring for the client with hyperuricemia associated with tumor lysis syndrome (TLS), for which medication does the nurse anticipate an order? Recombinant erythropoietin (Procrit) Allopurinol (Zyloprim) Potassium chloride Radioactive iodine-131 (131I)
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Allopurinol (Zyloprim)
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The nurse is caring for a client receiving chemotherapy who reports anorexia. Which measure does the nurse use to best monitor for cachexia? Monitor weight Trend red blood cells and hemoglobin and hematocrit Monitor platelets Observe for motor deficits
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Monitor weight
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Which finding alarms the nurse when caring for a client receiving chemotherapy who has a platelet count of 17,000/mm3? Increasing shortness of breath Diminished bilateral breath sounds Change in mental status Weight gain of 4 pounds in 1 day
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Change in mental status
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Which instruction is most appropriate for the nurse to convey to the client with chemotherapy-induced neuropathy? Bathe in cold water. Wear cotton gloves when cooking. Consume a diet high in fiber. Make sure shoes are snug.
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Consume a diet high in fiber. A high-fiber diet will assist with constipation due to neuropathy
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Which medication does the nurse plan to administer to a client before chemotherapy to decrease the incidence of nausea and vomiting? Morphine Ondansetron (Zofran) Naloxone (Narcan) Diazepam (Valium)
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Ondansetron (Zofran)
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A newly graduated RN has just finished a 6-week orientation to the oncology unit. Which client is most appropriate to assign to the new graduate? A 30-year-old with acute lymphocytic leukemia who will receive combination chemotherapy today A 40-year-old with chemotherapy-induced nausea and vomiting who has had no urine output for 16 hours A 45-year-old with pancytopenia who will require IV administration of erythropoietin (Procrit) A 72-year-old with tumor lysis syndrome who is receiving normal saline IV at a rate of 250 mL/hr
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A 45-year-old with pancytopenia who will require IV administration of erythropoietin (Procrit)
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The RN working on an oncology unit has just received report on these clients. Which client should be assessed first? Client with chemotherapy-induced neutropenia who has just been admitted with an elevated temperature Client with lymphoma who will need administration of an antiemetic before receiving chemotherapy Client with metastatic breast cancer who is scheduled for external beam radiation in 1 hour Client with xerostomia associated with laryngeal cancer who needs oral care before breakfast
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Client with chemotherapy-induced neutropenia who has just been admitted with an elevated temperature
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An outpatient client is receiving photodynamic therapy. Which environmental factor is a priority for the client to adjust for protection? Storing drugs in dark locations at room temperature Wearing soft clothing Wearing a hat and sunglasses when going outside Reducing all direct and indirect sources of light
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Reducing all direct and indirect sources of light
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Which manifestation of an oncologic emergency requires the nurse to contact the health care provider immediately? New onset of fatigue Edema of arms and hands Dry cough Weight gain
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Edema of arms and hands Edema of the arms and hands indicates worsening compression of the superior vena cava consistent with superior vena cava syndrome. The compression must be relieved immediately, often with radiation therapy, because death can result without timely intervention
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Which potential side effects does the nurse include in the teaching plan for a client undergoing radiation therapy for laryngeal cancer? (Select all that apply.) Fatigue Changes in color of hair Change in taste Changes in skin of the neck Difficulty swallowing
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Fatigue Change in taste Changes in skin of the neck Difficulty swallowing
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When caring for the client receiving cancer chemotherapy, which signs or symptoms related to thrombocytopenia should the nurse report to the health care provider? (Select all that apply.) Bruises Fever Petechiae Epistaxis Pallor
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Petechiae Epistaxis Bruises
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When monitoring a client with suspected syndrome of inappropriate antidiuretic hormone (SIADH), the nurse reviews the client's medical record, which contains the following information. The nurse notifies the health care provider for which signs and symptoms consistent with this syndrome? (Select all that apply.) Physical Assessment Findings Diagnostic Findings Medications Neuro: Episodes of confusion Cardiac: Pulse 88 and regular Musculoskeletal: Weakness, tremors Na: 115 K: 4.2 Creatinine: 0.8 ondansetron (Zofran) cyclophosphamide (Cytoxan) Hyponatremia Mental status changes Azotemia Bradycardia Weakness
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Hyponatremia Mental status changes Weakness
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When caring for a client who has had a colostomy created during treatment for colon cancer, which nursing actions help support the client in accepting changes in appearance or function? (Select all that apply.) Explain to the client that the colostomy is only temporary. Encourage the client to participate in changing the ostomy. Obtain a psychiatric consultation. Offer to have a person who is coping with a colostomy visit. Encourage the client and family members to express their feelings and concerns.
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Encourage the client to participate in changing the ostomy. Offer to have a person who is coping with a colostomy visit. Encourage the client and family members to express their feelings and concerns.
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The nurse has received in report that a client receiving chemotherapy has severe neutropenia. Which interventions does the nurse plan to implement? (Select all that apply.) Assess for fever. Observe for bleeding. Administer pegfilgrastim (Neulasta). Do not permit fresh flowers or plants in the room. Do not allow the client's 16-year-old son to visit. Teach the client to omit raw fruits and vegetables from the diet.
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Assess for fever Administer pegfilgrastim (Neulasta). Do not permit fresh flowers or plants in the room. Teach the client to omit raw fruits and vegetables from the diet.
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The nurse is teaching a client who is receiving an antiestrogen drug about the side effects she may encounter. Which side effects does the nurse include in the discussion? (Select all that apply.) Heavy menses Smooth facial skin Hyperkalemia Breast tenderness Weight loss Deep vein thrombosis
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Breast tenderness Deep vein thrombosis
