Question 1

A client with prostate cancer calls the clinic to ask for a physical therapy (PT) consult because his back has been hurting. Which action by the nurse is most appropriate?
A) Advise the client to try a heating pad for 3 days before initiating a PT consult.
B) Call in a prescription for nonsteroidal anti-inflammatory medications.
C) Collaborate with the physician to arrange the physical therapy consult.
D) Instruct the client to come in for a back x-ray immediately.

Accepted Answer

In a client with known cancer, new-onset back pain is a red flag signaling possible spinal cord compression. If not treated, this can lead to permanent neurologic damage, including paralysis. This client needs immediate evaluation to rule out this oncologic emergency.

Question 2

A client undergoing a course of chemotherapy feels lonely and isolated and tells the nurse he wants to resume some normal activities. The precaution that the nurse should give the client when resuming activities is
A) avoid crowds.
B) do not eat outside the home.
C) drink only bottled water.
D) use only the client's own bathroom.

Accepted Answer

The nurse should teach chemotherapy clients measures to protect against infection: maintain adequate nutrition and fluid intake and avoid crowds, people with infections, and clients recently vaccinated with live or attenuated vaccines. The other three options are not standard precautions for the client receiving chemotherapy.

Question 3

The nurse is developing a long-term plan for a 45-year-old client with a malignancy. The factor that would disqualify this client from receiving hospice services is
A) a life expectancy of less than 6 months.
B) an annual income of more than $30,000.
C) initiation of a course of curative chemotherapy.
D) living alone in an apartment complex.

Accepted Answer

To qualify for hospice services, clients must have a life expectancy of less than 6 months and must be receiving only supportive treatment.

Question 4

A client has the nursing diagnosis Hopelessness, related to concern over cancer diagnosis. The nurse can encourage hope in this client by (Select all that apply)
A) affirming the client's worth as a human.
B) assisting with goal setting.
C) providing symptom relief as needed by the client.
D) reviewing mortality statistics for this type of cancer.

Accepted Answer

According to research, nurses need to inspire and support clients' positivity and hope while they undergo treatment for cancer. Options a, b, and c have all been shown to be valuable nursing interventions to support hope in the cancer client. Option d might reduce hope if the statistics were not favorable.

Question 5

A 31-year-old male client who is to receive chemotherapy for treatment of lymphoma has expressed concern about the possible side effects of chemotherapy on reproduction and fertility. An appropriate response by the nurse to these concerns is to
A) discuss pretreatment sperm banking as a reproductive alternative.
B) reassure the client that sexual function will return to normal after treatments.
C) review sexual functioning and discuss the previous pregnancy.
D) suggest artificial insemination for the client's wife.

Accepted Answer

Pretreatment sperm banking offers the possibility of retaining reproductive capacity for some clients. Surgery, XRT, and chemotherapy can affect sexual health and functioning, so option b is not appropriate. The client has not indicated a need for information on basic sexual functioning, and a discussion of a previous pregnancy would not be helpful, so option c would not be beneficial. Artificial insemination might be an option if the client is sterile, but the nurse does not have that information.

Question 6

The nurse caring for a client receiving chemotherapy assesses for indication of thrombocytopenia. Based on laboratory values, the client becomes at high risk for hemorrhage at the point when the platelet count is less than A) 60,000/mm³. B) 50,000/mm³. C) 25,000/mm³. D) 20,000/mm³.

Accepted Answer

Thrombocytopenia increases a client's risk of bleeding. A high risk of hemorrhage exists when the platelet count is less than 20,000/mm³.

Question 7

The client whose father and uncle died of colorectal cancer asks the nurse how to modify a diet to reduce the risk of this cancer. The nurse can suggest
A) decreasing consumption of alcohol.
B) decreasing consumption of unrefined whole-grain products.
C) increasing consumption of organ meats.
D) increasing consumption of vitamin A.

Accepted Answer

Alcohol consumption and a sedentary lifestyle are contributing risk factors for colorectal cancer. Diet modification includes a high-fiber, low-fat diet and increased intake of vitamins C and E.

Question 8

The nurse assesses that the client most at risk for breast cancer is the
A) 26-year-old multipara whose father died from lung cancer.
B) 38-year-old primigravida who had menarche at age 9.
C) 42-year-old multipara who had menarche at age 14.
D) 68-year-old nullipara receiving treatment for osteoporosis.

Accepted Answer

Women especially at risk for breast cancer had early menarche and late menopause, are nulliparous, and have a first-degree relative with breast cancer.

Question 9

A client with an advanced stage laryngeal cancer with widespread metastases is scheduled for surgery tomorrow morning. The nurse realizes that preoperative teaching has been effective when the client states
A) "After the operation, how soon will I know if they got it all?"
B) "I will be glad to have this tumor removed so I can breathe better."
C) "My family can't wait for this to be over so we can travel to Europe."
D) "So what is the cure rate for this kind of cancer?"

Accepted Answer

Surgery can be used for diagnosis, cure, palliation, reconstruction, or prevention of cancer. In this case, with an advanced cancer and widespread metastases, the client is probably undergoing surgery for palliation of symptoms, specifically airway obstruction.

Question 10

The nurse caring for a neutropenic, 75-year-old man undergoing treatment for prostate cancer assesses an oral temperature of 100.4° F. The most appropriate interpretation of this finding is that the client
A) is experiencing an expected, systemic chemotherapeutic effect.
B) is experiencing the expected increase in metabolism that accompanies malignancy.
C) may have a medical emergency and needs prompt further assessment.
D) may have a urinary tract infection causing a low-grade fever.

Accepted Answer

Fever is the cardinal, and often the only, manifestation of infection in the neutropenic client. The development of fever in a neutropenic client should be treated as a medical emergency and mandates prompt assessment, diagnosis, and intervention. The source could be a urinary tract infection, but the client needs a work-up to determine the source of any infection (e.g., blood cultures, a chest x-ray, and a urinalysis).

Quiz 17: Clients with Cancer

A client with prostate cancer calls the clinic to ask for a physical therapy (PT) consult because his back has been hurting. Which action by the nurse is most appropriate?

A client undergoing a course of chemotherapy feels lonely and isolated and tells the nurse he wants to resume some normal activities. The precaution that the nurse should give the client when resuming activities is

The nurse is developing a long-term plan for a 45-year-old client with a malignancy. The factor that would disqualify this client from receiving hospice services is

A client has the nursing diagnosis Hopelessness, related to concern over cancer diagnosis. The nurse can encourage hope in this client by (Select all that apply)

A 31-year-old male client who is to receive chemotherapy for treatment of lymphoma has expressed concern about the possible side effects of chemotherapy on reproduction and fertility. An appropriate response by the nurse to these concerns is to

The nurse caring for a client receiving chemotherapy assesses for indication of thrombocytopenia. Based on laboratory values, the client becomes at high risk for hemorrhage at the point when the platelet count is less than

The client whose father and uncle died of colorectal cancer asks the nurse how to modify a diet to reduce the risk of this cancer. The nurse can suggest

The nurse assesses that the client most at risk for breast cancer is the

A client with an advanced stage laryngeal cancer with widespread metastases is scheduled for surgery tomorrow morning. The nurse realizes that preoperative teaching has been effective when the client states

The nurse caring for a neutropenic, 75-year-old man undergoing treatment for prostate cancer assesses an oral temperature of 100.4° F. The most appropriate interpretation of this finding is that the client