NUR 201 Oncology

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Define Cancer.
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Disease process that begins when an abnormal cell is transformed by the genetic mutation of the cellular DNA
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“oma”
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the suffix that means cancer
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Mitosis
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Replication of the cell in which each of the daughter cell has the same characteristic of the parent cell
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Doubling
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Rate of formation of the cancer cells
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Nadir
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Lowest point of white cell depression after therapy has been given, it has a toxic effect on bone marrow and prevents WBC from forming
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Warning signs of cancer? CAUTION
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Change in bowel or bladder habits, A sore that does not heal, Unusual bleeding or discharge, Thickening or lump in the breast or elsewhere, Indigestion, Obvious change in a wart or mole, Nagging cough or hoarseness.
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What are considered carcinogens?
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Carcinogens include chemical agents, environmental factors, dietary substances, viruses, lifestyle factors, defective genes, and medically prescribed interventions.
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Which of the following is a term used to describe the process of programmed cell death?
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Apoptosis Mitosis is the phase of the cell cycle in which cell division occurs. Carcinogenesis is the process by which cancer arises. Angiogenesis is the process by which a new blood supply is formed.
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Which type of surgery is utilized in an attempt to relieve complications of cancer?
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Palliative surgery is performed to relieve complications of cancer.
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A serum sodium level lower than 110 mEq/L is associated with
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seizures, abnormal reflexes, papilledema, coma, and death
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The nurse is evaluating bloodwork results of a patient with cancer who is receiving chemotherapy. The patient’s platelet count is 60,000/mm3. Which of the following is an appropriate nursing action?
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Avoiding use of products containing aspirin, Patients with a platelet count of 60,000/mm3 are at mild risk for bleeding.
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During the last 2 cycles of chemotherapy, the client developed severe thrombocytopenia requiring multiple platelet transfusions. The client is now scheduled to receive a third cycle. How can the nurse best detect early signs and symptoms of thrombocytopenia?
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Closely observe the client’s skin for petechiae and bruising.
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Following a BMT the patient should be monitored for at least
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3 months
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Based on the understanding of the effects of chemotherapy, the nurse would anticipate which of the following clinical findings in a client 2 weeks post therapy?
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Ease of bruising
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TNM
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T- extent of the primary Tumor N- absence/presence and extent of regional lymph Node metastasis M- absence/presence of distant Metatasis
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According to the TNM classification system, T0 means there is
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T0 means that there is no evidence of primary tumor. N0 means that there is no regional lymph node metastasis. M0 means that there is no distant metastasis. M1 means that there is distant metastasis.
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Following surgery for adenocarcinoma, the client learns the tumor stage is T3,N1,M0. What treatment mode will the nurse anticipate?
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T3 indicates a large tumor size N1 indicating regional lymph node involvement M0 suggest no metastasis following with adjuvant (chemotherapy or radiation therapy) treatment is indicated to prevent the spread of cancer outside the lymph to other organs.
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TIS, N0, M0.
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Carcinoma in situ, no abnormal regional lymph nodes, and no evidence of distant metastasis
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For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan?
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Because thrombocytopenia impairs blood clotting, the nurse should inspect the client regularly for signs of bleeding, such as petechiae, purpura, epistaxis, and bleeding gums.
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The nurse is completing an admission assessment on a patient receiving interstitial implants for his prostate cancer. The nurse documents this as being which of the following?
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Brachytherapy is the only term used to denote use of internal radiation implants.
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Which type of vaccine uses the patient’s own cancer cells that are prepared for injection back into the patient?
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Autologous vaccines are made from the patient’s own cancer cells, which are obtained during diagnostic biopsy or surgery.
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Define auto logous stem cell transplant
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An autologous stem cell transplant comes from the client not from a donor. The doctor will remove the stem cells from the bone marrow before beginning chemotherapy and treat the client until most if not all the cancer is eliminated before reinfusing the stem cells. Clients are at risk for infection and will be closely monitored for at least 3 months.
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Which type of hematopoietic stem cell transplantation (HSCT) is characterized by cells from a donor other than the patient?
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Allogeneic- if the source of donor cells is from a donor other than the patient. Autologous donor cells come from the patient. Syngeneic donor cells are from an identical twin. Homogenic is not a type of stem cell transplant.
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The nurse performs a breast exam on a client and finds a firm, non-movable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest?
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A fast-growing lump is suggestive of a malignant tumor.
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When the client complains of increased fatigue following radiotherapy, the nurse knows this is most likely to be related to which factor?
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Radiation can result in myelosuppression.
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A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed?
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“I guess the doctor could not remove the entire tumor.”
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A client has cancer of the neck and is receiving external beam radiation therapy to the site. The client is experiencing trauma to the irradiated skin. The nurse does all of the following.
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• assesses the client for any sun exposure • avoids shaving the irradiated skin
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Prophylactic surgery
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involves removing nonvital tissues or organs that are likely to develop cancer
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Palliative surgery
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is performed to relieve complications of cancer.
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Reconstructive surgery
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may follow curative or radical surgery and is carried out in an attempt to improve function or obtain a more desirable cosmetic effect.
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Salvage surgery
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is an additional treatment option that uses an extensive surgical approach to treat the local recurrence of a cancer after the use of a less-extensive primary approach.
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Which of the following classes of antineoplastic agents is cell cycle-specific?
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Antimetabolites (5-FU) are cell cycle-specific (S phase).
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Which of the following classes of antineoplastic agents are cell cycle-nonspecific?
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Antitumor antibiotics, Alkylating agents, Nitrosoureas are cell cycle-nonspecific
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5-Fluorouracil (5-FU) is classified as which type of antineoplastic agent?
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Antimetabolite
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The drug interleukin-2 is an example of which type of biologic response modifier?
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Cytokine
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A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician orders mitomycin (Mutamycin) and other chemotherapeutic agents for palliative treatment. How does mitomycin exert its cytotoxic effects?
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It inhibits deoxyribonucleic acid (DNA) synthesis.
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A nurse is administering daunorubicin (DaunoXome) to a patient with lung cancer. Which situation requires immediate intervention?
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A red, swollen I.V. site indicates possible infiltration. Daunorubicin is a vesicant chemotherapeutic agent and can be very damaging to tissue if it infiltrates. The nurse should immediately stop the medication, apply ice to the site, and notify the physician.
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The nurse is caring for a patient with cancer who is treating her cancer with deep tissue massage in addition to radiation therapy. The nurse documents the use of which of the following on the patient’s chart?
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Integrative medicine is the use of therapies in conjunction with conventional medicine. This is also known as complementary medicine. Alternative therapies are used instead of conventional medicine.
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A decrease in circulating white blood cells is
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Leukopenia. Granulocytopenia is a decrease in neutrophils. Thrombocytopenia is a decrease in the number of platelets. Neutropenia is an abnormally low ANC.
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which of the following types of cancer have the highest prevalence among both men and women?
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Lung and colon Men- Prostate, lung, and colon Women- Breast, lung, and colon
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The nurse is providing an educational presentation on dietary recommendations for reducing the risk of cancer. Which of the following food selections would demonstrate a good understanding of the information provided in the presentation?
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Foods high in fat and those that are smoked or preserved with salt or nitrates are associated with increased cancer risks.
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Growth fraction
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The ratio of dividing cells to resting cells
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Cell cycle phases
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G1-RNA and protein synthesis occur S- DNA synthesis occur G2- premitotic phase, DNA syn complete, mitotic spindle forms Mitosis- cell division occurs
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M phase agents
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vinca or plant alkaloids halt mitotic spindle formation
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Grade 1
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similar to properties in normal tissue, well differentiated, responds well to treatment
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Grade 4
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not similar to properties in normal tissue, not well differentiated, doesn’t respond well to tx, aggressive and fast growing
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Staging
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determines the size of tumor, extent of local evasion, and distant metatasis
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SEER
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Surveillance, epidemiology, and end results. Uses statistics to predict tx results
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ANC Absolute Neutrophil Count
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Assess pt risk for infection. Under 500 severe risk, below 100
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Anemia
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Critical levels less than 5gm/dl
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Thrombocytopenia
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low blood platelet count. Normally, you have anywhere from 150,000 to 450,000 platelets per microliter of circulating blood.
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Normal international normalized ratio (INR)
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0.8-1.2
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A male client has been unable to return to work for 10 days following chemotherapy as the result of ongoing fatigue and inability to perform usual activities. Laboratory test results are WBCs 2000/mm³, RBCs 3.2 x 10¹²/L, and platelets 85,000/mm³. The nurse notes that the client is anxious. Which of the following is the priority nursing diagnosis?
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Risk for infection related to inadequate defenses
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Which of the following terms refers to cells that lack normal cellular characteristics and differ in shape and organization with respect to their cells of origin?
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Anaplasia Usually, anaplastic cells are malignant. Neoplasia refers to uncontrolled cell growth that follows no physiologic demand. Dysplasia refers to bizarre cell growth resulting in cells that differ in size, shape, or arrangement from other cells of the same type of tissue. Hyperplasia refers to an increase in the number of cells of a tissue, most often associated with a period of rapid body growth.
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The nurse is assessing a 75-year-old woman who had a total hysterectomy when she was 30 years old and normal Pap test results for the past 10 years. The client asks about continuing the Pap test. The nurse states:
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The American Cancer Society recommendations for women 70 years or older, who have had normal Pap tests for 10 years, and who have had a total hysterectomy may choose to stop cervical cancer screening as in a Pap test.
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A client has received several treatments of bleomycin. It is now important for the nurse to assess
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Bleomycin has cumulative toxic effects on lung function.
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You are an oncology nurse caring for a client who is taking antineoplastic agents. What symptoms must you consider when monitoring this client?
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Symptoms of gout

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