Deck 14: Nursing Care of Patients with Cancer

Question 1

The nurse is concerned that a patient is at increased risk for developing cancer when which of the following is assessed?

A)aged 51, spouse deceased, downsized from employment, history of back and leg pain
B)aged 52, plays tennis twice a week, no alcohol intake, occasionally smokes a cigarette
C)aged 45, premenopausal, not planning to use hormone replacement therapy
D)aged 50, employed as a computer technician, uses the fitness center five times a week

Answer 1

aged 51, spouse deceased, downsized from employment, history of back and leg pain

Question 2

A patient with a history of smoking is diagnosed with cancer. If applying the cellular mutation theory of cancer to this patient's diagnosis, the nurse realizes that smoking impacted which of the following stages?

A)promotion
B)initiation
C)progression
D)replication

Answer 2

promotion

Question 3

The nurse is explaining the characteristics of malignant cells to a group of patients. Which statement by a patient demonstrates a good understanding of the information?

A)"The work of malignant cells is simpler than that of normal cells."
B)"Malignant cells continue to perform cellular functions."
C)"Malignant cells can reverse into benign cells if treated promptly."
D)"Malignant cells rarely break away from the primary tissue site and travel to other locations."

Answer 3

"The work of malignant cells is simpler than that of normal cells."

Question 4

A patient shows the nurse a new sore on the forearm that has been increasing in size and will not heal. The nurse caring for this patient knows that which of the following signs could also point to a diagnosis of a malignant neoplasm?

A)noncohesive, invasive, and invades and destroys surrounding tissues
B)rapid growth, well-defined borders, and cohesiveness
C)invasive, local, and does not stop at tissue border
D)slow growth, well-defined borders, and encapsulated

Question 5

A patient, diagnosed with an 8 cm tumor in the ascending colon, asks the nurse how the tumor grew so large without any major symptoms. With which of the following should the nurse respond to this patient?

A)"The pressure of the growing tumor caused the other tissue to reduce in size so the tumor could take over the space."
B)"The tumor cells bound to the tissue within the colon."
C)"The tumor cells are loosely held together so they can move about freely."
D)"The tumor cells secreted chemicals that stopped the body's normal mechanism to remove foreign tissue."

Question 6

A female patient tells the nurse that she does not want to have annual mammograms because the x-rays can cause cancer. With which of the following should the nurse respond to this patient?

A)"Breast cancer is the number one type of cancer in females.The risk of developing cancer from the x-rays is considerably lower than the risk of having undiagnosed breast cancer."
B)"I don't blame you.X-rays do cause cancer."
C)"Be sure to do monthly breast exams."
D)"Contact your doctor if you notice any breast changes, feel any lumps, or develop breast pain since these are all symptoms of active breast cancer."

Question 7

A patient asks the nurse how his cancer developed. Which of the following statements would be incorrect for the nurse to respond with to this patient?

A)"The theory of cellular mutation suggests that carcinogens cause mutations in cellular RNA."
B)"Oncogenes are genes that promote cell proliferation and are capable of triggering cancerous characteristics."
C)"Inherited cancers can become inactive by deletion or mutation."
D)"Known carcinogens include viruses, drugs, hormones, and chemical and physical agents."

Question 8

After a liver biopsy, a patient is diagnosed with anaplasia of liver cells. Which of the following will be indicated for this patient's care?

A)careful monitoring to ensure the cells do not develop into cancer
B)chemotherapy for liver cancer
C)monitoring for the onset of diabetes mellitus
D)medication to reverse the anaplastic cells

Question 9

Which of the following patients would be at a highest risk for developing cancer?

A)an African American man
B)a Native American woman
C)an Hispanic man
D)an Hispanic woman

Question 10

A college student is diagnosed with Epstein-Barr virus. The student has a history of smoking and recreational cocaine use, and works for a floor refinishing company part-time. Which factors increase this student's risk for developing cancer? Select all that apply.

A)drug use
B)occupation
C)smoking
D)viral infection
E)age

Question 11

The nurse is preparing to assess a patient who is newly diagnosed with cancer. Which of the following physical and psychologic symptoms should the nurse include in this assessment?

A)hyperglycemia and body image concerns
B)altered taste and smell and increased leukocytes
C)hypoglycemia and grief
D)decreased intracranial pressure and acute pain

Question 12

A patient, diagnosed with cancer, tells the nurse that he does not want to experience anymore pain. Which of the following can the nurse do to help this patient?

A)Discuss pain control options.
B)Explain that every patient with cancer has pain.
C)Review ways to reduce pain without the use of medication.
D)Instruct on why pain will continue throughout treatment.

Question 13

A patient with a history of using recreational cocaine tells the nurse that he would rather be addicted to cocaine that be diagnosed with cancer. With which of the following should the nurse respond with to this patient?

A)"Cocaine has been linked to the development of cancer."
B)"I guess if that's what you would prefer."
C)"People who use cocaine do have a lower risk of developing cancer."
D)"As long as the cocaine is pure and not mixed with toxic chemicals."

Question 14

A patient with a history of cancer is surprised to learn that new cancer has been diagnosed in another body part. The nurse realizes that this patient is most likely experiencing which of the following?

A)metastasis
B)contact inhibition
C)destructive force from a benign neoplasm
D)a solid mass

Question 15

A female patient asks the nurse why she needs a procedure to remove part of her cervix that was infected with a virus. With which of the following should the nurse explain to this patient?

A)Human papillomavirus can cause cervical cancer.
B)The medication to treat this virus is toxic to the body.
C)If left untreated, it could spread to the liver.
D)If left untreated, it could spread to the breast.

Question 16

A patient tells the nurse that he has a benign tumor that has spread into his lymph glands. With which of the following should the nurse respond to this patient?

A)"What did your doctor tell you about the tumor?"
B)"Benign tumors do not spread."
C)"That's a good thing that the tumor is benign."
D)"Since it is benign are you going to have surgery to remove it?"

Question 17

A patient, diagnosed with cancer, has been receiving radiation treatments to shrink the tumor. After several weeks, the patient tells the nurse that he has not needed as much pain medication. Which of the following would explain why this patient's pain has been reduced?

A)The radiation treatments reduced the size of the tumor on adjacent tissues.
B)The tumor is secreting pain-control chemicals initiated by the radiation.
C)The patient is getting used to having pain.
D)The patient is continuing to have pain but believes the radiation treatments are reducing the pain.

Question 18

After learning that he has a benign tumor in his abdomen, the patient is overheard telling his wife that he has cancer. Which of the following should the nurse say to the patient and spouse?

A)"There is a growth in the abdomen but it is encapsulated and after being removed, will not recur."
B)"This type of cancer is easily treated."
C)"This type of cancer will not spread to other tissues."
D)"Even though this growth has invaded other tissues, it can be contained."

Question 19

A patient diagnosed with cancer is admitted with a weight loss of 25 lbs. over the last month with progressive anorexia. The nurse suspects this patient is experiencing which of the following physiological effects of cancer?

A)anorexia-cachexia syndrome
B)paraneoplastic syndrome
C)infection
D)esophageal obstruction

Question 20

A patient is diagnosed with hyperplasia of lung tissue. The nurse realizes that this patient's first course of treatment will most likely include which of the following?

A)identification and removal of the irritant causing the hyperplasia
B)antibiotic therapy
C)chemotherapy
D)radiation therapy

Question 21

Which of the following assessment findings would indicate to the nurse that a patient receiving vincristine is experiencing a toxic reaction?

A)pain and motor weakness
B)hypotension
C)cardiac dysrhythmias
D)stomatitis and alopecia

Question 22

A patient, diagnosed with cancer and scheduled to begin biotherapy, asks the nurse how the therapy will treat the cancer. With which of the following should the nurse respond to this patient?

A)"It changes the body processes that caused the cancer by enhancing your own immunity."
B)"It uses radiation implanted into the organ with the cancer."
C)"It uses laser therapy to remove the cancer."
D)"It uses stem cells to treat the cancer."

Question 23

Which of the following should the nurse instruct a patient to do who is scheduled to receive a course of external radiation therapy for cancer treatment?

A)Wash the radiation site with plain water and no soap.
B)Shave the treated area with a straight razor.
C)Apply ice packs to the treatment site to help reduce pain.
D)Use a sunscreen for three months after the conclusion of the treatments.

Question 24

A patient is scheduled for a nephrectomy for renal cancer. The nurse realizes that the goal of this surgery will be which of the following?

A)removing the kidney because the remaining kidney will maintain renal functioning
B)remove the organ since the function of the organ can be replaced chemically
C)to bypass an obstruction
D)decrease the tumor size

Question 25

A patient is having a procedure, which is done by cutting through the skin, to diagnose a mass located in the left breast. This procedure is most likely which of the following?

A)incisional biopsy
B)fine-needle biopsy
C)needle core biopsy
D)excisional biopsy

Question 26

The nurse has identified the diagnosis Risk for Infection for a patient receiving chemotherapy for cancer. Which of the following should be included in this patient's plan of care?

A)Teach the patient to avoid crowds.
B)Encourage socialization with small children.
C)Contact physician with a temperature elevation.
D)Limit intake of protein and vitamin C.

Question 27

A 34-year-old patient is being instructed on early screening for breast cancer. The patient has a sister and mother with a history of breast cancer. Which action by the patient demonstrates good screening techniques for someone with her family history?

A)routine breast exams to begin after age 35
B)reporting of any changes in breast tissue to the healthcare provider at the next routine visit
C)annual screening mammography staring at age 40
D)clinical breast examination every three years

Question 28

A patient's carcinoembryonic antigen level was initially 16 ng/mL. The level is currently 6 ng/mL. The nurse realizes that this decreased level would indicate which of the following for the patient?

A)The patient's treatment for cancer is effective.
B)The patient's treatment for cancer is not effective.
C)The patient has a new site of cancer.
D)The patient's cancer has metastasized.

Question 29

A male patient's prostate specific antigen level was 2 ng/mL, however, the patient was diagnosed with prostate cancer. Which additional laboratory test was done to determine this diagnosis?

A)acid phosphatase
B)albumin
C)bilirubin
D)calcium

Question 30

A patient diagnosed with cancer contacted an attorney about a will and a church to arrange funeral and cemetery arrangements. Which of the following do this patient's activities suggest to the nurse?

A)The patient is participating in anticipatory grieving.
B)The patient feels he is going to die soon.
C)The patient's family will not be willing to make funeral arrangements.
D)The patient wants something to do while waiting for chemotherapy treatments.

Question 31

A patient diagnosed with breast cancer is receiving 5-Fluorouracil (5-FU). Based on the knowledge of this medication, and anticipated adverse effects or side effects, which action should the nurse perform?

A)Test stool for occult blood.
B)Monitor ECG.
C)Assess lung sounds.
D)Encourage daily fluid intake of 2-3 liters.

Question 32

A patient diagnosed with prostate cancer is demonstrating signs of renal failure. Which of the following does this assessment finding suggest to the nurse?

A)obstructive uropathy
B)spinal cord compression
C)urethral strictures from radiation
D)bladder irritation from chemotherapy

Question 33

The nurse is providing instructions to a patient diagnosed with renal cancer regarding when to call for help after discharge. Which statement by the patient indicates that teaching has been successful?

A)"I should call my physician if I experience new bleeding from any site."
B)"I should call my physician if I have an oral temperature higher than 100.5° F."
C)"I should call my physician if I have an episode of diarrhea."
D)"I should call my physician if I experience an occasional headache."

Question 34

A nurse, caring for a patient undergoing brachytherapy, should implement which of the following precautions when caring for this patient?

A)Wear a monitoring device to measure whole-body exposure.
B)Care for this patient regardless of pregnancy status.
C)Maintain the least possible distance form the patient.
D)Avoid indirect exposure with radioisotopes containers.

Question 35

A patient with cancer is experiencing lower extremity numbness and loss of motor function. Which of the following should be done to assist this patient?

A)Assess for spinal cord compression.
B)Provide intravenous fluids.
C)Administer oxygen.
D)Turn and reposition every two hours.

Question 36

The nurse is explaining the different types of chemotherapy to a patient recently diagnosed with cancer. Which of the following statements would be incorrect for the nurse to state to the patient?

A)"Antitumor antibiotics disrupt RNA replication and DNA transcription."
B)"The main hormones used in cancer therapy are the corticosteroids, which are phase specific."
C)"Mitotic inhibitors are drugs that act to prevent cell division during the M phase."
D)"Alkylating agents basically act on preformed nucleic acids by creating defects in tumor DNA."

Question 37

A patient, with a history of squamous cell lung cancer, is admitted to the hospital with arm and periorbital edema. After a few hours, the patient exhibits dyspnea, cyanosis, tachypnea, and an altered level of consciousness. Which action should the nurse take first?

A)Administer oxygen.
B)Call the physician.
C)Monitor vital signs.
D)Initiate seizure precautions.

Question 38

A patient will be receiving busulfan (Myleran) as treatment for leukemia. Which of the following interventions would the nurse include in the plan of care for this patient?

A)Assess for infection.
B)Administer anti-emetic prior to chemotherapy.
C)Assess oral mucous membranes.
D)Check stool for occult blood.

Question 39

The nurse suspects that a patient being treated for cancer is developing septic shock when which of the following is assessed?

A)high fever, peripheral edema, hypotension
B)cardiac dysrhythmia and increased urine output
C)hypertension and confusion
D)subnormal temperature and thirst

Question 40

A patient, diagnosed with neck cancer, is scheduled for a diagnostic test to determine the success of treatment. The test that would provide the best information regarding this patient's treatment would be which of the following?

A)magnetic resonance imaging
B)computed tomography
C)x-ray imaging
D)ultrasonography

Question 41

Which of these interventions is appropriate care of the radiation site teaching for the patient receiving radiation therapy? Select all that apply.

A)Clean radiation site with soap and water.
B)Apply lotion daily to prevent scaling.
C)Apply ice pack to radiation site if pain or itching occurs.
D)If needed use an electric razor for shaving.
E)Wear tight fighting clothing over the area to protect it.

Question 42

Which of the following are causes of the malnutrition seen in patients with cancer? Select all that apply.

A)decreases in metabolism resulting from increased cancer cell production
B)decreased available nutrients due to the cancers parasitic activity
C)loss of appetite due to side effects of chemotherapy
D)decreased absorption in the gastrointestinal tract
E)parenteral nutrition supplements administered via venous access devices

Question 43

Place an "X" at the site where a mediastinal or thoracic tumor is located in this diagram causing superior vena cava syndrome.

Question 44

Which of the following interventions would be appropriate for the patient with cancer receiving chemotherapy who is at greater risk for infection? Select all that apply.

A)Monitoring red blood cell counts monthly.
B)Teaching the patient to avoid small children.
C)Teaching the patient to apply lotion daily to clean skin to prevent drying.
D)Encouraging the patient to consume a diet high in protein and vitamin C.
E)Teaching the patient to report an oral temperature above 98° F.

Question 45

Which patient or patients' cancer type, pathophysiology, and symptoms are consistent with oncological emergency of superior vena cava syndrome. 11ea992e_0a71_8b1a_9f38_5146345c585b

A)Patient C
B)Patient D
C)Patient A only
D)Patient A and B

Question 46

The family of a patient with terminal metastatic cancer asks the nurse for guidelines regarding when to call for help when the patient is discharged to home. Which of the following would indicate this patient needs medical intervention? Select all that apply.

A)oral temperature greater than 100° F
B)difficulty breathing
C)onset of bleeding
D)resting comfortably, and reading
E)extreme hunger

Question 47

Which of the patient diagnostic findings are consistent with the presence of a malignancy? Select all that apply.

A)high levels of tumor markers
B)positive biopsy results
C)low levels of tumor markers
D)decreased white blood cell count
E)increased hemoglobin and hematocrit

Question 48

Which of the following descriptions is consistent with malignant neoplasms? Select all that apply.

A)localized encapsulated growths
B)growths demonstrating contact inhibition
C)irregularly shaped growths
D)neoplasms that cause bleeding and inflammation
E)growths that remain stable in size