NCLEX Questions: Cancer – Flashcards
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While being prepared for a biopsy of a lump in the right breast, the patient asks the nurse what the difference is between a benign tumor and a malignant tumor. The nurse explains that a benign tumor differs from a malignant tumor in that benign tumors a. do not cause damage to adjacent tissue. b. do not spread to other tissues and organs. c. are simply an overgrowth of normal cells. d. frequently recur in the same site.
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B Rationale: The major difference between benign and malignant tumors is that malignant tumors invade adjacent tissues and spread to distant tissues and benign tumors never metastasize. Both types of tumors may cause damage to adjacent tissues. The cells differ from normal in both benign and malignant tumors. Benign tumors usually do not recur.
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A patient with a large stomach tumor that is attached to the liver is scheduled to have a debulking procedure. The nurse explains that the expected outcome of this surgery is a. control of the tumor growth by removal of malignant tissue. b. promotion of better nutrition by relieving the pressure in the stomach. c. relief of pain by cutting sensory nerves in the stomach. d. reduction of the tumor burden to enhance adjuvant therapy.
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D Rationale: A debulking surgery reduces the size of the tumor and makes radiation and chemotherapy more effective. Debulking surgeries do not control tumor growth. The tumor is debulked because it is attached to the liver, a vital organ (not to relieve pressure on the stomach). Debulking does not sever the sensory nerves, although pain may be lessened by the reduction in pressure on the abdominal organs.
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Which action by a nursing assistant (NA) caring for a patient with a temporary radioactive cervical implant indicates that the RN should intervene? a. The NA places the patient's bedding in the laundry container in the hallway. b. The NA flushes the toilet once after emptying the patient's bedpan. c. The NA stands by the patient's bed for an hour talking with the patient. d. The NA gives the patient an alcohol-containing mouthwash for oral care.
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C Rationale: Because patients with temporary implants emit radioactivity while the implants are in place, exposure to the patient is limited. Laundry and urine/feces do not have any radioactivity and do not require special precautions. Cervical radiation will not affect the oral mucosa, and alcohol-based mouthwash is not contraindicated.
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A patient with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. An important nursing intervention for the patient is to a. teach about the importance of nutrition during treatment. b. have the patient eat large meals when nausea is not present. c. administer prescribed antiemetics 1 hour before the treatments. d. offer dry crackers and carbonated fluids during chemotherapy.
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C Rationale: Treatment with antiemetics before chemotherapy may help to prevent anticipatory nausea. Although nausea may lead to poor nutrition, there is no indication that the patient needs instruction about nutrition. The patient should eat small, frequent meals. Offering food and beverages during chemotherapy is likely to cause nausea.
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A chemotherapeutic agent known to cause alopecia is prescribed for a patient. To maintain the patient's self-esteem, the nurse plans to a. suggest that the patient limit social contacts until regrowth of the hair occurs. b. encourage the patient to purchase a wig or hat and wear it once hair loss begins. c. have the patient wash the hair gently with a mild shampoo to minimize hair loss. d. inform the patient that hair loss will not be permanent and that the hair will grow back.
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B Rationale: The patient is taught to anticipate hair loss and to be prepared with wigs, scarves, or hats. Limiting social contacts is not appropriate at a time when the patient is likely to need a good social support system. The damage occurs at the hair follicle and will occur regardless of gentle washing or use of a mild shampoo. The information that the hair will grow back is not immediately helpful in maintaining the patient's self-esteem.
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Which information noted by the nurse reviewing the laboratory results of a patient who is receiving chemotherapy is most important to report to the health care provider? a. Hemoglobin of 10 g/L b. WBC count of 1700/µl c. Platelets of 152,000/µl d. Serum creatinine level of 1.2 mg/dl
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B Rationale: Neutropenia places the patient at risk for severe infection and is an indication that the chemotherapy dose may need to be lower or that white blood cell (WBC) growth factors such as filgrastim (Neupogen) are needed. The other laboratory data do not indicate any immediate life-threatening adverse effects of the chemotherapy.
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A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the RN caring for the patient indicates that the nurse should take action? a. The patient's visitors bring in some fresh peaches from home. b. The patient ambulates several times a day in the room. c. The patient uses soap and shampoo to shower every other day. d. The patient cleans with a warm washcloth after having a stool.
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A Rationale: Fresh, thinned-skin peaches are not permitted in a neutropenic diet because of the risk of bacteria being present. The patient should ambulate in the room rather than the hospital hallway to avoid exposure to other patients or visitors. Because overuse of soap can dry the skin and increase infection risk, showering every other day is acceptable. Careful cleaning after having a bowel movement will help to prevent perineal skin breakdown and infection.
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A with tumor lysis syndrome (TLS) is taking allopurinol (Xyloprim). Which laboratory value should the nurse monitor to determine the effectiveness of the medication? a. Blood urea nitrogen (BUN) b. Serum phosphate c. Serum potassium d. Uric acid level
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D Rationale: Allopurinol is used to decrease uric acid levels. BUN, potassium, and phosphate levels are also increased in TLS but are not affected by allopurinol therapy.
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A male client is diagnosed as having a bowel tumor and several diagnostic tests are prescribed. The nurse understands that which test will confirm the diagnosis of malignancy? A. Biopsy of the tumor B. Abdominal ultrasound C. Magnetic resonance imaging D. Computerized tomography scan
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A.
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Nurse Kent is teaching a male client to perform monthly testicular self-examinations. Which of the following points would be appropriate to make? A. Testicular cancer is a highly curable type of cancer B. Testicular cancer is very difficult to diagnose. C. Testicular cancer is the number one cause of cancer deaths in males. D. Testicular cancer is more common in older men.
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A.
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Nurse Farah is caring for a client following a mastectomy. Which assessment finding indicates that the client is experiencing a complication related to the surgery? A. Pain at the incisional site B. Arm edema on the operative side C. Sanguineous drainage in the Jackson-Pratt drain D. Complaints of decreased sensation near the operative site
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B.
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Sarah, a hospice nurse visits a client dying of ovarian cancer. During the visit, the client expresses that "If I can just live long enough to attend my daughter's graduation, I'll be ready to die." Which phrase of coping is this client experiencing? A. Anger B. Denial C. Bargaining D. Depression
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C.
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The nurse is interviewing a male client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer? A. Duodenal ulcers B. Hemorrhoids C. Weight gain D. Polyps
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D. Colorectal polyps are common with colon cancer. Duodenal ulcers and hemorrhoids aren't preexisting conditions of colorectal cancer. Weight loss — not gain — is an indication of colorectal cancer.
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A female client with cancer is receiving chemotherapy and develops thrombocytopenia. The nurse identifies which intervention as the highest priority in nursing plan of care? A. Monitoring temperature B. Ambulation three times daily C. Monitoring the platelet count D. Monitoring for pathological fractures
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C.Thrombocytopenia indicates a decrease in the number of platelets in the circulating blood. A major concern is monitoring for the preventing bleeding. Option A elates to monitoring for infection, particularly if leukopenia is present. Option B & D, although important in the plan of care, are not related directly to thrombocytopenia."
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The nurse is caring for a client with cancer of the prostate following a prostatectomy. The nurse provides discharge instructions to the client and tells the client to: A. avoid driving the car for 1 week B. restrict fluid intake to prevent incontinence C. avoid lifting objects heavier than 20 lb for at least 6 weeks D. notify the physician if small blood clots are noticed during urination
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C. Small pieces of tissue or blood clots can be passed during urination for up to 2 weeks after surgery. Driving a car and sitting for long periods of time are restricted for at least 3 weeks. A high daily fluid intake should be maintained to limit clot formation and prevent infection. Option C is an accurate discharge instruction following prostatectomy.
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A female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy? A. . Urine output of 400 ml in 8 hours B. Serum potassium level of 3.6 mEq/L C. Blood pressure of 120/64 to 130/72 mm Hg D. Dry oral mucous membranes and cracked lips
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D. Dry oral mucous membraines and cracked lips can indicate the patient is dehydrated.
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A male client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer? A. Persistent nausea B. Rash C. Indigestion D. Chronic ache or pain
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C.
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A child with cancer has the following lab result: WBC 10,000, RBC 5, and plts of 20,000. When planning this child's care, which risk should the nurse consider most significant? A. Infection B. Hemorrhage C. Pain D. Anemia
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B.
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Following a shift report on an oncology unit, a nurse determines that which client should be assessed first? A. A client with breast cancer who has an order for ondansetron (Zofran) 8 mg intravenously (IV) 30 minutes prior to chemotherapy B. A client just admitted with a temperature of 101 degrees F (38.3 degrees C), diaphoresis, and an absolute neutrophil count of 98/mm3 C. A client with breast cancer who is scheduled for external beam radiation in 15 minutes D. A client with stomatitis associated with tonsilar cancer who receives gastrostomy tube feedings
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B: The newly admitted client should be assessed first because the client is neutropenic, showing signs of infection, and microorganisms from other clients would be less likely to be transmitted to the client if seen first. The client should be placed on neutropenic precautions. The client is at risk for severe sepsis if the absolute neutrophils count is less than 100/mm3.
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A patient recovering from a lobectomy has a chest tube attached to a water-seal drainage system. The healthcare provider notices the fluid in the water-seal column has stopped fluctuating. Which of the following would explain why the fluctuations have stopped. Select all that apply. A. The lung has begun to collapse. B. Positive intrapleural pressure has increased. C. The lung has fully expanded. D. There may be fibrin clots in the tubing. E. The drainage system has a leak in it.
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C,D The fluctuation in the water seal (tidaling) occurs as intrapleural pressure changes during inspiration and expiration There should be patency between the intrapleural space and the chest tube system, so a blockage in the system may cause the tidaling to stop. Gradual reduction of the tidaling is expected as the lung re-expands, and will eventually stop when the lung has re-expanded..
