Flashcards About Lung Cancer
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The nurse is taking the social history of a client diagnosed with SCLC. Which information is significant for this disease? a. Worked with asbestos for a short time many years ago. b. Has no family Hx of this type of lung cancer. c. Has numerous tattoos on upper and lower arms. d. Has smoked 2 packs of cigarettes/day for 20 years.
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D Smoking is greatest risk for LC.
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The nurse writes a problem of 'impaired gas exchange' for a client diagnosed with cancer of the lung. Which interventions should be included for the plan of care? Select all that apply. a. Apply O2 via nasal cannula. b. Have the dietician plan for 6 small meals per day. c. Place the client in resp. isolation. d. Assess vital signs for fever. e. Listen to lung sounds every shift.
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A. Correct. Resp. distress is common. B. Correct. Fatigue occurs with eating. C. Wrong. Cancer is not communicable. D. Correct. Immunity is lowered. E. Correct. Assessment of lungs is routine and PRN.
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The nurse is discussing cancer statistics with a group from the community. Which information about death rates from lung cancer is accurate? a. LC is the number 2 cause of cancer deaths in both men and women. b. LC is the number 1 cause of cancer deaths in both men and women. c. LC deaths are not significant in relation to other cancers. d. LC deaths have continued to increase in the male population.
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B LC is the number 1 cause of cancer deaths in both men and women.
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The client diagnosed with lung cancer has been told that the cancer has metastasized to the brain. Which intervention should the nurse implement? a. Discuss implementing an advance directive. b. Explain the use of chemotherapy for brain involvement. c. Teach the client to discontinue driving. d. Have the significant other make decisions for the client.
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A This is a terminal situation. End of life decisions must be made.
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The client diagnosed with lung cancer is in an investigational program and receiving a vaccine to treat the cancer. Which information regarding investigational regimens should the nurse teach? a. Investigational regimens provide a better chance of survival for the client. b. Investigational treatments have not been proved helpful to clients. c. Clients will be paid to participate in a investigational program. d. Only clients that are dying qualify for investigational treatments.
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B There is no guarantee that the Tx will help.
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The client diagnosed with LC is being discharged. Which statement made by the client indicates that more teaching is needed? a. It doesn't matter if I smoke now. I already have cancer. b. I should see the oncologist at my scheduled appt. c. If I begin to run a fever I should notify my HCP. d. I should plan for periods of rest throughout the day.
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A Smoking interferes with Tx.
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The client is 4 hours post-lobectomy for lung cancer. Which assessment data warrant immediate intervention by the nurse? a. Intake of 1500 mL IV and output of 1000 mL. b. 450 mL of bright red drainage in the chest tube. c. Complaining of pain at a 10 on a 1-10 scale. d. Absent lung sound o the side of surgery.
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B This is about a pint of blood and could indicate a hemorrhage. HINT: Blood is always a priority.
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The client is admitted to the outpatient surgery center for a bronchoscopy to rule out lung cancer. Which info should the nurse teach? a. The test will confirm the MRI results. b. The client can eat and drink immediately after the test. c. The HCP can do a biopsy of the tumor through the scope. d. There is no discomfort associated with this procedure.
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C The HCP can do a biopsy of the tumor through the scope.
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Which clinical manifestation would the nurse expect to find in newly diagnosed intrinsic LC? a. Dysphagia b. Foul smelling breath c. Hoarseness d. Weight loss
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C Hoarseness is an early sign.
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Which psychosocial problem would the nurse write for the client diagnosed with LC metastasis to the brain? a. Seizures b. Grieving c. Body Image d. Nutrition
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B Patient is dying.
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A patient who smokes tells the nurse, "I want to have a yearly chest x-ray so that if I get cancer, it will be detected early." Which response by the nurse is most appropriate? a. "Chest x-rays do not detect cancer until tumors are already at least a half-inch in size." b. "Annual x-rays will increase your risk for cancer because of exposure to radiation." c. "Insurance companies do not authorize yearly x-rays just to detect early lung cancer." d. "Frequent x-rays damage the lungs and make them more susceptible to cancer."
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A Rationale: A tumor must be at least 1 cm large before it is detectable by an x-ray and may already have metastasized by that time. Radiographs have low doses of radiation, and an annual x-ray alone is not likely to increase lung cancer risk. Insurance companies do not usually authorize x-rays for this purpose, but it would not be appropriate for the nurse to give this as the reason for not doing an x-ray. A yearly x-ray is not a risk factor for lung cancer.
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The nurse has identified the nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste sensation in a patient with lung cancer who has had a 10% loss in weight. An appropriate nursing intervention that addresses the etiology of this problem is to a. provide foods that are highly spiced to stimulate the taste buds. b. avoid presenting foods for which the patient has a strong dislike. c. add strained baby meats to foods such as soups and casseroles. d. teach the patient to eat whatever is nutritious since food is tasteless.
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B Rationale: The patient will eat more if disliked foods are avoided and foods that patient likes are included instead. Additional spice is not usually an effective way to enhance taste. Adding baby meats to foods will increase calorie and protein levels, but does not address the issue of taste. Patients will not improve intake by eating foods that are beneficial but have unpleasant taste.
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The client with which of the following types of lung cancer has the best prognosis? a. Adenocarcinoma b. Oat cell c. Squamous cell d. Small cell
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ANSWER C. Squamous cell carcinoma is a slow-growing, rarely metastasizing type of cancer. Adenocarcinoma is the next best lung cancer to have in terms of prognosis. Oat cell and small cell carcinoma are the same. Small cell carcinoma grows rapidly and is quick to metastasize.
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Warning signs and symptoms of lung cancer include persistent cough, bloody sputum, dyspnea, and which of the other following symptoms? a. Dizziness b. Generalized weakness c. Hypotension d. Recurrent pleural effusion
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ANSWER D. Recurring episodes of pleural effusions can be caused by the tumor and should be investigated. Dizziness, generalized weakness, and hypotension aren't typically considered warning signals, but may occur in advanced stages of cancer.
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Which of the following interventions is the key to increasing the survival rates of clients with lung cancer? a. Early bronchoscopy b. Early detection c. High-dose chemotherapy d. Smoking cessation
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ANSWER B. Early detection of cancer when the cells may be premalignant and potentially curable would be most beneficial. However, a tumor must be 1 cm in diameter before it's detectable on a chest x-ray, so this is difficult. A bronchoscopy may help identify cell type but may not increase survival rate. High-dose chemotherapy has minimal effect on long-term survival. Smoking cessation won't reverse the process but may help prevent further decompensation.
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A client has been diagnosed with lung cancer and requires a wedge resection. How much of the lung is removed? a. One entire lung b. A lobe of the lung c. A small, localized area near the surface of the lung. d. A segment of the lung, including a bronchiole and its alveoli.
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ANSWER C. A small area of tissue close to the surface of the lung is removed in a wedge resection. An entire lung is removed in a pneumonectomy. A segment of the lung is removed in a segmental resection and a lobe is removed in a lobectomy.
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When a client has a lobectomy, what fills the space where the lobe was? a. The space stays empty. b. The surgeon fills the space with gel c. The lung space fills up with serous fluid d. The remaining lobe or lobes overexpand to fill the space.
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ANSWER D. The remaining lobe or lobes overexpand slightly to fill the space previously occupied by the removed tissue. The diaphragm is carried higher on the operative side to further reduce the empty space. The space can't remain "empty" because truly empty would imply a vacuum, which would interfere with the intrathoracic pressure changes that allow breathing. The surgeon doesn't use a gel to fill the space. Serous fluid overproduction would compress the remaining lobes, diminish their function and possibly, cause a mediastinal shift.
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Which of the following is the primary goal for surgical resection of lung cancer? a. To remove the tumor and all surrounding tissue. b. To remove the tumor and as little surrounding tissue as possible. c. To remove all of the tumor and any collapsed alveoli in the same region. d. To remove as much as the tumor as possible, without removing any alveoli.
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ANSWER B. The goal of surgical resection is to remove the lung tissue that has a tumor in it while saving as much surrounding tissue as possible. It may be necessary to remove alveoli and bronchioles, but care is taken to make sure only what's absolutely necessary is removed.
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If the client with lung cancer also has preexisting pulmonary disease, which of the following statements best describes how the extent of that can be performed? a. It doesn't affect it. b. It may require a whole lung to be removed. c. The entire tumor may not be able to be removed d. It may prevent surgery if the client can't tolerate lung tissue removal.
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ANSWER D. If the client's preexisting pulmonary disease is restrictive and advanced, it may be impossible to remove the tumor, and the client may have to be treated with on;t chemotherapy and radiation.
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The client with a benign lung tumor is treated in which of the following ways? a. The tumor is treated with radiation only. b. The tumor is treated with chemotherapy only. c. The tumor is left alone unless symptoms are present. d. The tumor is removed, involving the least possible amount of tissue.
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D The tumor is removed to prevent further compression of the lung tissue as the tumor grows, which could lead to respiratory decompensation. If for some reason it can't be removed, then radiation or chemotherapy may be used to try to shrink the tumor.
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In the client with terminal lung cancer, the focus of nursing care is on which of the following nursing interventions? a. Provide emotional support b. Provide nutritional support c. Provide pain control d. Prepare the client's will
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C The client with terminal lung cancer may have extreme pleuritic pain and should be treated to reduce his discomfort. Preparing the client and his family for the impending death and providing emotional support is also important but shouldn't be the primary focus until the pain is under control. Nutritional support may be provided, but as the terminal phase advances, the client's nutritional needs greatly decrease. Nursing care doesn't focus on helping the client prepare the will.
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Which of the following nursing interventions would be most helpful in making the respiratory effort of a client with metastatic lung cancer more efficient? a. Teaching the client diaphragmatic breathing techniques b. Administering cough suppressants as ordered c. Teaching and encouraging pursed-lip breathing d. Placing the client in a low semi-Fowlers position
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C For clients with obstructive versus restrictive disorders, extending exhalation through pursed-lip breathing will make the respiratory effort more efficient. The usual position of choice for this client is the upright position, leaning slightly forward to allow greater lung expansion. Teaching diaphragmatic breathing techniques will be more helpful to the client with a restrictive disorder. Administering cough suppressants will not help respiratory effort. A low semi-Fowlers position does not encourage lung expansion. Lung expansion is enhanced in the upright position.
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A 58-year-old man is going to have chemotherapy for lung cancer. He asks the nurse how the chemotherapeutic drugs will work. The most accurate explanation the nurse can give is which of the following? a. "Chemotherapy affects all rapidly dividing cells." b. "The molecular structure of the DNA is altered." c. "Cancer cells are susceptible to drug toxins." d. "Chemotherapy encourages cancer cells to divide."
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A There are many mechanisms of action for chemotherapeutic agents, but most affect the rapidly dividing cells—both cancerous and noncancerous. Cancer cells are characterized by rapid cell division. Chemotherapy slows cell division. Not all chemotherapeutic agents affect molecular structure. All cells are susceptible to drug toxins, but not all chemotherapeutic agents are toxins.
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A pneumonectomy is a surgical procedure sometimes indicated for treatment of non-small-cell lung cancer. A pneumonectomy involves removal of: a. An entire lung field b. A small, wedge-shaped lung surface c. One lobe of a lung d. One or more segments of a lung lobe
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A A pneumonectomy is the removal of an entire lung field. A wedge resection refers to removal of a wedge-shaped section of lung tissue. A lobectomy is the removal of one lobe. Removal of one or more segments of a lung lobe is called a partial lobectomy.
