Deck 16: Cancer

Question 1

While being prepared for a biopsy of a lump in the right breast, the patient asks the nurse about the difference between a benign tumor and a malignant tumor. Which response by the nurse is correct?

A) "Benign tumors do not cause damage to other tissues."
B) "Benign tumors are likely to recur in the same location."
C) "Malignant tumors may spread to other tissues or organs."
D) "Malignant cells reproduce more rapidly than normal cells."

Answer 1

"Malignant tumors may spread to other tissues or organs."

Question 2

Which nursing action will be most effective in improving oral intake for a patient with the nursing diagnosis of imbalanced nutrition: less than body requirements related to painful oral ulcers?

A) Offer the patient frequent small snacks between meals.
B) Assist the patient to choose favorite foods from the menu.
C) Provide education about the importance of nutritional intake.
D) Apply the ordered anesthetic gel to oral lesions before meals.

Answer 2

Apply the ordered anesthetic gel to oral lesions before meals.

Question 3

A patient with ovarian cancer is distressed because her husband rarely visits and tells the nurse, "He just doesn't care." The husband indicates to the nurse that "I never know what to say to help her." An appropriate nursing diagnosis is

A) compromised family coping related to disruption in lifestyle.
B) impaired home maintenance related to perceived role changes.
C) risk for caregiver role strain related to burdens of caregiving responsibilities.
D) dysfunctional family processes related to effect of illness on family members.

Answer 3

dysfunctional family processes related to effect of illness on family members.

Question 4

A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. Which patient statement indicates that the nurse's teaching about management of the skin reaction has been effective?

A) "I can buy some aloe vera gel to use on the area."
B) "I will expose the treatment area to a sun lamp daily."
C) "I can use ice packs to relieve itching in the treatment area."
D) "I will scrub the area with warm water to remove the scales."

Question 5

Which information obtained by the nurse about a patient with colon cancer who is scheduled for external radiation therapy to the abdomen indicates a need for patient teaching?

A) The patient swims a mile 5 days a week.
B) The patient has a history of dental caries.
C) The patient eats frequently during the day.
D) The patient showers with Dove soap daily.

Question 6

The nurse is teaching a postmenopausal patient with stage III breast cancer about the expected outcomes of her cancer treatment. Which patient statement indicates that the teaching has been effective?

A) "After cancer has not recurred for 5 years, it is considered cured."
B) "The cancer will be cured if the entire tumor is surgically removed."
C) "Cancer is never considered cured, but the tumor can be controlled with surgery, chemotherapy, and radiation."
D) "I will need to have follow-up examinations for many years after I have treatment before I can be considered cured."

Question 7

A 40-year-old divorced mother of four school-age children is hospitalized with metastatic ovarian cancer. The nurse finds the patient crying, and she tells the nurse that she does not know what will happen to her children when she dies. The most appropriate response by the nurse is

A) "Why don't we talk about the options you have for the care of your children?"
B) "Perhaps your ex-husband will take the children when you can't care for them."
C) "For now you need to concentrate on getting well, not worry about your children."
D) "Many patients with cancer live for a long time, so there is time to plan for your children."

Question 8

A patient with Hodgkin's lymphoma who is undergoing external radiation therapy tells the nurse, "I am so tired I can hardly get out of bed in the morning." An appropriate intervention for the nurse to plan with the patient is to

A) minimize activity until the treatment is completed.
B) exercise vigorously when fatigue is not as noticeable.
C) establish a time to take a short walk almost every day.
D) consult with a psychiatrist for treatment of depression.

Question 9

When reviewing the chart for a patient with cervical cancer, the nurse notes that the cancer is staged as Tis, N0, M0. The nurse will teach the patient that

A) the cancer is localized to the cervix.
B) the cancer cells are well-differentiated.
C) further testing is needed to determine the spread of the cancer.
D) it is difficult to determine the original site of the cervical cancer.

Question 10

When the nurse is administering a vesicant chemotherapeutic agent intravenously, an important consideration is to

A) infuse the medication over a short period of time.
B) stop the infusion if swelling is observed at the site.
C) administer the chemotherapy through small-bore catheter.
D) hold the medication unless a central venous line is available.

Question 11

The nurse in the outpatient clinic is caring for a 50-year-old who smokes heavily. To reduce the patient's risk of dying from lung cancer, which action will be best for the nurse to take?

A) Educate the patient about the seven warning signs of cancer.
B) Plan to monitor the patient's carcinoembryonic antigen ( CEA ) level.
C) Discuss the risks associated with cigarettes during every patient encounter.
D) Teach the patient about the use of annual chest x-rays for lung cancer screening.

Question 12

During a routine health examination, a 30-year-old patient tells the nurse about a family history of colon cancer. Which action should the nurse take next?

A) Educate the patient about the need for a colonoscopy at age 50.
B) Teach the patient how to do home testing for fecal occult blood.
C) Obtain more information from the patient about the family history.
D) Schedule a sigmoidoscopy to provide baseline data about the patient.

Question 13

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 the hair will grow back once the chemotherapy is complete.

Question 14

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) offer dry crackers and carbonated fluids during chemotherapy.
D) administer prescribed antiemetics 1 hour before the treatments.

Question 15

After the nurse has finished teaching a patient who is scheduled to receive external beam radiation for abdominal cancer about appropriate diet, which dietary selection by the patient indicates that the teaching has been effective?

A) Fresh fruit salad
B) Roasted chicken
C) Whole wheat toast
D) Cream of potato soup

Question 16

External-beam radiation is planned for a patient with endometrial cancer. The nurse teaches the patient that an important measure to prevent complications from the effects of the radiation is to

A) test all stools for the presence of blood.
B) maintain a high-residue, high-fiber diet.
C) clean the perianal area carefully after every bowel movement.
D) inspect the mouth and throat daily for the appearance of thrush.

Question 17

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) relief of pain by cutting sensory nerves in the stomach.
B) control of the tumor growth by removal of malignant tissue.
C) decrease in tumor size to improve the effects of other therapy.
D) promotion of better nutrition by relieving the pressure in the stomach.

Question 18

Which statement by a patient who is scheduled for a needle biopsy of the prostate indicates that the nurse's teaching about the purpose of the biopsy has been effective?

A) "The biopsy will remove the cancer in my prostate gland."
B) "The biopsy will determine how much longer I have to live."
C) "The biopsy will help decide the treatment for my enlarged prostate."
D) "The biopsy will indicate whether the cancer has spread to other organs."

Question 19

A patient is receiving intravesical bladder chemotherapy. The nurse will monitor for

A) nausea.
B) alopecia.
C) mucositis.
D) hematuria.

Question 20

A patient receiving head and neck radiation has ulcerations over the oral mucosa and tongue and thick, ropey saliva. The nurse will teach the patient to

A) remove food debris from the teeth and oral mucosa with a stiff toothbrush.
B) use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth.
C) gargle and rinse the mouth several times a day with an antiseptic mouthwash.
D) rinse the mouth before and after each meal and at bedtime with a saline solution.

Question 21

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) Hematocrit of 30%
B) Platelets of 95,000/µl
C) Hemoglobin of 10 g/L
D) WBC count of 1700/µl

Question 22

When assessing the need for psychologic support after the patient has been diagnosed with stage I cancer of the colon, which question by the nurse will provide the most information?

A) "How long ago were you diagnosed with this cancer?"
B) "Do you have any concerns about body image changes?"
C) "Can you tell me what has been helpful to you in the past when coping with stressful events?"
D) "Are you familiar with the stages of emotional adjustment to a diagnosis like cancer of the colon?"

Question 23

The nurse at the clinic is interviewing a 61-year-old woman who is 5 feet, 3 inches tall and weighs 125 pounds (57 kg). The patient has not seen a health care provider for 20 years. She walks 5 miles most days and has a glass of wine 2 or 3 times a week. Which topics will the nurse plan to include in patient teaching about cancer screening and decreasing cancer risk (select all that apply)?

A) Pap testing
B) Tobacco use
C) Sunscreen use
D) Mammography
E) Colorectal screening

Question 24

Interleukin-2 (IL-2) is used as adjuvant therapy for a patient with metastatic renal cell carcinoma. The nurse teaches the patient that the purpose of therapy with this agent is to

A) enhance the patient's immunologic response to tumor cells.
B) stimulate malignant cells in the resting phase to enter mitosis.
C) prevent the bone marrow depression caused by chemotherapy.
D) protect normal cells from the harmful effects of chemotherapy.

Question 25

When caring for a patient who is pancytopenic, which action by nursing assistive personnel (NAP) indicates a need for the RN to intervene?

A) The NAP assists the patient to use dental floss after eating.
B) The NAP adds baking soda to the patient's saline oral rinses.
C) The NAP puts fluoride toothpaste on the patient's toothbrush.
D) The NAP has the patient rinse after meals with a saline solution.

Question 26

While teaching a patient who has a new diagnosis of acute leukemia about the complications associated with chemotherapy, the patient is restless and is looking away, never making eye contact. After the teaching, the patient asks the nurse to repeat all of the information. Based on this assessment, which nursing diagnosis is most likely for the patient?

A) Risk for ineffective adherence to treatment related to denial of need for chemotherapy
B) Acute confusion related to infiltration of leukemia cells into the central nervous system
C) Risk for ineffective health maintenance related to anxiety about new leukemia diagnosis
D) Knowledge deficit: chemotherapy related to a lack of interest in learning about treatment

Question 27

The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient may indicate a need for a change in treatment?

A) "I have frequent muscle aches and pains."
B) "I rarely have the energy to get out of bed."
C) "I experience chills after I inject the interferon."
D) "I take acetaminophen (Tylenol) every 4 hours."

Question 28

The nurse obtains information about a hospitalized patient who is receiving chemotherapy for cancer of the colon. Which information about the patient is most indicative of a need for a change in therapy?

A) Poor oral intake
B) Increase in CEA
C) Frequent loose stools
D) Complaints of nausea

Question 29

A patient with cancer has a nursing diagnosis of imbalanced nutrition: less than body requirements related to altered taste sensation. Which nursing action is most appropriate?

A) Add strained baby meats to foods such as casseroles.
B) Teach the patient about foods that are high in nutrition.
C) Avoid giving the patient foods that are strongly disliked.
D) Put extra spice in the foods that are served to the patient.

Question 30

After receiving change-of-shift report, which of these patients should the nurse assess first?

A) 35-year-old who has wet desquamation associated with abdominal radiation
B) 42-year-old who is sobbing after receiving a new diagnosis of ovarian cancer
C) 24-year-old who is receiving neck radiation and has blood oozing from the neck
D) 56-year-old who has a new pericardial friction rub after receiving chest radiation

Question 31

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 ambulates several times a day in the room.
B) The patient's visitors bring in some fresh peaches from home.
C) The patient cleans with a warm washcloth after having a stool.
D) The patient uses soap and shampoo to shower every other day.

Question 32

Which finding in a patient who is receiving interleukin-2 indicates a need for rapid action by the nurse?

A) Generalized muscle aches
B) Complaints of nausea and anorexia
C) Oral temperature of 100.6° F ( 38.1° C )
D) Crackles heard at the lower scapular border

Question 33

A patient with leukemia is considering whether to have hematopoietic stem cell transplantation. Which information will be included in patient teaching?

A) Transplant of the donated cells is painful because of the nerves in the tissue lining the bone.
B) Donor bone marrow cells are transplanted through an incision into the sternum or hip bone.
C) The transplant procedure takes place in a sterile operating room to minimize the risk for infection.
D) Hospitalization will be required for several weeks after the hematopoietic stem cell transplant (HSCT).

Question 34

The nurse teaches a patient with cancer of the liver about high-protein, high-calorie diet choices. Which snack choice by the patient indicates that the teaching has been effective?

A) Orange sherbet
B) Fresh fruit salad
C) Strawberry yogurt
D) Cream cheese bagel

Question 35

A patient with tumor lysis syndrome (TLS) is taking allopurinol (Zyloprim). Which laboratory value should the nurse monitor to determine the effectiveness of the medication?

A) Uric acid level
B) Serum potassium
C) Serum phosphate
D) Blood urea nitrogen

Question 36

A patient who has severe pain associated with terminal liver cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective?

A) The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness.
B) The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale).
C) The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.
D) The patient states that nonopioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief.

Question 37

When caring for a patient with a temporary radioactive cervical implant, which action by nursing assistive personnel (NAP) indicates that the RN should intervene?

A) The NAP flushes the toilet once after emptying the patient's bedpan.
B) The NAP stands by the patient's bed for 30 minutes talking with the patient.
C) The NAP places the patient's bedding in the laundry container in the hallway.
D) The NAP gives the patient an alcohol-containing mouthwash to use for oral care.