question

The nurse is presenting a community education program related to cancer prevention. Based on current cancer death rate, the nurse emphasizes what as the most important preventative action for both women and men? a. Smoking cessation b. Routine colonoscopies c. Frequent imaging tests d. Regular examination of reproductive organs

answer

a. Smoking cessation

question

What defect in cellular proliferation is involved in the development of cancer? a. A rate of cell proliferation that is more rapid than that of normal body cells. b. Shortened phases of cell life cycles with occasional skipping of GI or S phases c. Rearrangement of stem cell RNA that causes abnormal cellular protein synthesis d. Indiscriminate and continuous proliferation of cells with loss of contact inhibition

answer

d. indiscriminate and continuous proliferation of cells with loss of contact inhibition

question

What does the presence of carcinoembryonic antigens (CEAs) and a-fetoprotein (AFP) on cell membranes indicate has happened to the cells? a. They have shifted to more immature metabolic pathways and functions b. They have spread from areas of original development to different body tissues c. They produce abnormal toxins or chemicals that indicate abnormal cellular function d. They have become more differentiated as a result of repression of embryonic function

answer

a. They have shifted to more immature metabolic pathways and functions

question

What factor differentiates a malignant tumor from a benign tumor? a. It causes death b. it grows at a faster rate c. It is often encapsulated d. It invades and metastasizes

answer

d. it invades and metastasizes

question

A patient is admitted with acute myelogenous leukemia and a history of Hodgkin's lymphoma. What is the nurse most likely going to find in the patient's history? a. Work as a radiation chemist b. Epstein-Barr virus diagnosed in vitro c. Intense tanning throughout the lifetime d. Alkylating agents for treating the Hodgkin's lymphoma

answer

d. Alkylating agents for treating the Hodgkin's lymphoma

question

Which mutated tumor suppressor gene is most likely to contribute to many types of cancer, including bladder, breast, colorectal and lung? a. p53 b. APC c. BRCA1 D. BRCA2

answer

a. p53

question

Cancer cells go though stages of development. What accurately describes the stage of promotion? Select all that applies: a. Obesity is an example of a promoting factor b. The stage is characterized by increased growth rate and metastasis c. Withdrawal of promoting factors will reduce the risk of cancer development d. Tobacco smoke is a complete carcinogen that is capable of both initiation and promotion e. Promotion is the stage of cancer development in which there is an irreversible alteration in the cell's DNA

answer

a....c....d

question

The patient was told she has carcinoma in situ, and the student nurse wonders what that is. how should the nurse explain this to the student nurse? a. Evasion of the immune system by cancer cells b. Lesion with histologic features of cancer except invasion c. Capable of causing cellular alterations associated with cancer d. Tumor cell surface antigens that stimulate an immune responce

answer

b. Lesion with histologic features of cancer except invasion

question

Which word identifies a mutation of proto-oncogenes? a. Oncogenes b. Retrogenes c. Oncofetal antigens d. Tumor angiogenesis factor

answer

a. Oncogenes

question

A patient's breast tumor originates from embryonal ectoderm. It has moderate dysplasia and moderately differentiated cells. It is a small tumor with minimal lymph node involvement and no metastases. What is the best description of this tumor? a. Sarcoma, grade II T3 N4 M0 b. Leukemia, grade I T1 N2 M1 c. Carcinoma, grade II T1 N1 M0 d. Lymphoma, grade III T1 N0 M0

answer

c. Carcinoma grade II T1 N1 M0

question

The nurse is counseling a group of individuals over the age of 50 with the average risk of cancer about screening tests for cancer. Which screening recommendation should be performed to screen for colorectal cancer? a. Barium enema every year b. Colonoscopy every 10 years c. Fecal occult blood every 5 years d. Annual prostate-specific antigen (PSA) and digital rectal exam

answer

b. Colonoscopy every 10 years

question

A small lesion is discovered in a patient's lung when an x-ray is performed for cervical spine pain. What is the definitive method of determining if the lesion is malignant? a. Lung scan b. Tissue biopsy c. Oncofetal antigens d. CT or positron emission tomography (PET) scan

answer

b. Tissue biopsy

question

A patient with a genetic mutation of BRCA1 and a family history of breast cancer is admitted to the surgical unit where she is scheduled that day for a bilateral simple mastectomy. What is the reason for this procedure? a. Prevent breast cancer b. Diagnose breast cancer c. Cure or control breast cancer d. Provide palliative care for untreated breast cancer

answer

a. Prevent breast cancer

question

Which condition would be most likely to be cured with chemotherapy as a treatment measure? a. Neuroblastoma b. Small cell lung cancer c. Small tumor of the bone d. Large hepatocellular carcinoma

answer

a. Neuroblastoma

question

Which classification of chemotherapy drugs is cell cycle phase-nonspecific, breaks the DNA helix that interferes with DNA replication and crosses the blood-brain barrier? a. Nitrosureas b. Antimetabolites c. Mitotic inhibitors d. Antitumor antibiotics

answer

a. Nitrosureas

question

The nurse uses many precautions during IV administration of vesicant chemotherapy agents primarily to prevent? a. septicemia b. extravasation c. catheter occlusion d. anaphylactic shock

answer

b. extravasation

question

Which factors will assist a patient in coping positively with having cancer? (select all that applies) a. Feeling of control b. Strong support system c. Internalization of feelings d. Possibility of cure or control e. Easier adaptability of a young person f. Not having had to cope with previous stressful events

answer

a...b...d

question

The patient with advanced cancer is having difficulty controlling her pain. She says she is afraid she will become addicted to the opioids. What is the FIRST thing the nurse should do for this patient? a. Administer a nonsteroidal anti-inflammatory drug b. Assess the patient's vital signs and behavior to determine the medication to use c. Have the patient keep a pain diary to better assess the patient's potential addiction d. Obtain a detailed pain history including quality, location, intensity, duration, and type of pain

answer

d. Obtain a detailed pain history including quality, location, intensity duration and type of pain

question

During initial chemotherapy, a patient with leukemia develops hyperkalemia and hyperuricemia. The nurse recognizes these symptoms as an oncologic emergency and anticipates that the priority treatment will be to: a. increase urine output with hydration therapy b. establish ECG monitoring c. administer a bisphosphonate such as pamidronate d. restrict fluids and administer hypertonic sodium chloride solution

answer

a. increase urine output with hydration therapy

question

For which type of malignancy should the nurse expect the use of the intravesical route of regional chemotherapy delivery? a. Bladder b. Leukemia c. Osteogenic sarcoma d. Metastasis to the brain

answer

a. Bladder

question

Which delivery system would be used to deliver regional chemotherapy for metastasis from a primary colorectal cancer? a. Intrathecal b. Intraarterial c. Intravenous d. Intraperitoneal

answer

d. Intraperitoneal

question

When teaching a patient with cancer about chemotherapy, which approach should the nurse take? a. Avoid telling the patient about possible side effects of the drugs to prevent anticipatory anxiety b. Assure the patient that the side effects from chemotherapy are uncomfortable but never life threatening c. Explain that antiemetics, antidiarrheals, and analgesics will be provided as needed to control the side effects d. Inform the patient that chemotherapy related alopecia is usually permanent but can be managed with lifelong use of wigs

answer

c. Explain that antiemetics, antidiarrheals, and analgesics will be provided as needed to control the side effects

question

Which normal tissues manifest early, acute responses to pelvic radiation therapy? a. Spleen and liver b. kidney and nervous tissue c. Bone marrow and GI mucosa d. Hollow organs such as stomach and bladder

answer

c. Bone marrow and GI mucosa

question

The patient is learning about skin care related to external radiation that he is receiving. Which instructions should the nurse include in this teaching? a. Keep area shaved of hair b. Keep the area covered if it is sore c. Dry the skin thoroughly after cleansing it d. Avoid extreme temperatures to the area

answer

d. Avoid extreme temperatures to the area

question

When a patient is undergoing brachytherapy, what is important for the nurse to be aware of when caring for this patient? a. The patient will undergo simulation to identify and mark the field of treatment b. The patient is a source of radiation, and personnel must wear film badges during care c. The goal of this treatment is only palliative, and the patient should be aware of the expected outcome d. Computerized dosimetry is used to determine the maximum dose of radiation to the tumor within an acceptable dose to normal tissue

answer

b. The patient is a source of radiation, and personnel must wear film badges during care

question

To prevent the debilitating cycle of fatigue-depression-fatigue in patients receiving radiation therapy, what should the nurse encourage the patient to do? a. Implement a walking program b. Ignore the fatigue as much as possible c. Do the most stressful activities when fatigue is tolerable d. Schedule rest periods throughout the day whether fatigue is present or not

answer

a. Implement a walking program

question

When the patient asks about the late effects of chemotherapy and high-dose radiation, what areas of teaching should the nurse plan to include when describing these effects? a. Third space syndrome b. Secondary malignancies c. Chronic nausea and vomiting d. Persistent myelosuppression

answer

b. secondary malignancies

question

What describes a primary use of immunotherapy in cancer treatment? a. Protects normal, rapidly reproducing cells of the GI system from damage during chemotherapy b. Prevents the fatigue associated with chemotherapy and high-dose radiation as seen with bone marrow depression c. Enhances or supplement the effects of the host's immune responses to tumor cells that produce flu-like symptoms d. Depresses the immune system and circulating lymphocytes as well as increase a sense of well-being by replacing central nervous system deficits

answer

c. Enhances or supplement the effects of the host's immune responses to tumor cells that produce flu-like symptoms

question

While caring for a patient who is at the nadir of chemotherapy, the nurse establishes the highest priority for nursing actions related to: a. diarrhea b. grieving c. risk for infection d. inadequate nutritional intake

answer

c. risk for infection

question

An allogeneic hematopoietic stem cell transplant is considered as treatment for a patient with acute myelogenous leukemia. What information should the nurse include when teaching the patient about this procedure? a. There is no risk for graft versus host disease because the donated marrow is treated to remove cancer cells b. The patient's bone marrow will be removed, treated, stored and then reinfused after intensive chemotherapy c. Peripheral stem cells are obtained from a donor who has a human leukocyte antigen match with the patient d. There is no need for posttransplant protective isolation because the stem cells are infused directly into the blood

answer

c. Peripheral stem cells are obtained from a donor who has a human leukocyte antigen match with the patient

question

Grade I

answer

Cells differ slightly from normal cells and are well differentiated (mild dysplasia and low grade)

question

Grade II

answer

Cells are more abnormal and moderately differentiated (moderate dysplasia and intermediate grade)

question

Grade III

answer

Cells are very abnormal and poorly differentiate (Severe dysplasia and high grade)

question

Grade IV

answer

Cells are immature and primitive and undifferentiated; cell of origin is difficult to determine (anaplasia and high grade)

question

Stage 0

answer

Cancer in situ

question

Stage 1

answer

tumor limited to the tissue of origin; localized tumor growth

question

Stage II

answer

Limited local spread

question

Stage III

answer

extensive local and regional spread

question

Stage IV

answer

metastasis

question

These cells have no regard for cell boundaries and grow on top of one another and also on top of or between normal cells

answer

contact inhibition

question

Where is the rate of cell proliferation rapid?

answer

bone marrow, hair follicles and epithelial lining of the GI tract

question

True or False, Cancer cells proliferate at the same rate as the normal cells of the tissue form which they arise

answer

true

question

define oncogenes

answer

tumor inducing genes

question

Burkitt's lymphoma is associated with what?

answer

Epstein-Barr visrus

question

What is the difference between initiation and promotion

answer

activity of promoters is reversible

question

Name some promoting factors

answer

dietary fat, obesity, cigarette smoking, and alcohol consumption

question

define initiation

answer

mutation in the cell's genetic structure

question

what is believed to be one of the functions of the immune system?

answer

respond to tumor-associated antigens (TAAs)

question

True or False: under most circumstances, immune surveillance prevents these transformed cells from developing into clinically detectable tumors

answer

True

question

What do B cells produce?

answer

They can produce specific antibodies that bind to tumor cells. They can be detected in the serum and saliva

question

Define immunologic escape

answer

the process by which cancer cells evade the immune system

question

Define surgical staging

answer

the extent of the disease as determined by surgical excision, exploration and or lymph node sampling.

question

What are the seven warning signs of cancer?

answer

C: change in bowel or bladder habits A: a sore that does not heal or go away U: unusual bleeding or discharge from any body orifice T: thickening or a lump in the breast or elsewhere I: indigestion or difficulty swallowing O: obvious change in a wart or mole N: nagging cough or hoarsness

question

Fine needle aspiration

answer

provides cells from the mass for cytologic examination

question

Large-core biopsy

answer

delivers an actual piece of tissue that can be analyzed with the advantage of preserving the histologic architecture of the tissue specimen

question

Excisional biopsy

answer

involves the surgical removal of the entire lesion, lymph node, nodule or mass

question

Incisional biopsy

answer

may be performed with a scalpel or dermal punch

question

What is the only definitive means to diagnose cancer?

answer

pathological evaluation of a tissue

question

What is the goal of cancer?

answer

cure, control and palliation

question

Name some supportive care measures

answer

1. Insertion of a feeding tube to maintain nutrition during head and neck cancer treatment. 2. Placement of central venous access devices to deliver chemotherapy agents 3. Prophylactic surgical fixation of bones at risk for pathologic fracture

question

Name some palliative care measures

answer

1. debulking of the tumor to relieve pain or pressure 2. Colostomy for the relief of a bowel obstruction 3. Laminectomy for the relief of a spinal cord compression

question

What does chronic toxicities involve?

answer

damage to the organs such as heart, liver, kidneys and lungs

question

What are the delayed effects of chemo

answer

nausea, vomiting, mucositis, alopecia, skin rashes, bone marrow suppression, altered bowel function and a variety of cumulative neurotoxicities

question

What are the acute toxicity effects of chemo?

answer

anaphylactic and hypersensitivity reactions, extravasation or flare reaction, anticipatory nausea and vomiting, cardiac dysrhythmias

question

What is simulation

answer

a process by which the radiation treatment fields are defined, filmed and marked out on the skin

question

True or False: Teletherapy is used in Internal radiation

answer

False: external radiation

question

What can be used to minimize the requirements for opioids and treat unrelieved pain

answer

Nerve blocks or epidural or intrathecal analgesia

question

Cardiac Tamponade symptoms and treatment

answer

symptoms: heavy feeling over chest, shortness of breath, tachycardia, cough, dysphagia, hiccups , hoarseness, decreased level of consciousness, distant or muted heart sounds Treatment: decrease fluid around heart by either surgery to create a pericardial window or an indwelling pericardial catheter. Administer O2 therapy, IV hydration and vasopressor therapy

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