Deck 57: Caring for the Patient With Cancer

Question 1

Which assessment findings would indicate to the nurse that a patient receiving vincristine is experiencing a toxic reaction? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) The patient reports being too weak to get out of bed much of last week.
B) The patient has lost her hair.
C) The patient reports constipation.
D) The patient reports that she cannot feel her feet.
E) The patient has a high fever and shaking chills this morning.

Answer 1

The patient reports being too weak to get out of bed much of last week.
The patient reports that she cannot feel her feet.
The patient has a high fever and shaking chills this morning.

Question 2

A patient who was treated for colorectal cancer last year now has a malignant tumor in the lung. The nurse realizes that this patient is most likely experiencing which phenomenon?

A) Metastasis
B) Contact inhibition
C) Differentiation
D) Hypertrophy

Answer 2

Metastasis

Question 3

The patient undergoing radiation treatment has developed dry desquamation of the skin over the treatment area. How should the nurse care for this damaged skin? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Shave the area carefully to remove irritating hair or stubble.
B) Tape a light, absorbent bandage over the area to collect drainage.
C) Have the patient expose the area to 20 minutes of sunlight each day.
D) Cover the area with a hydrophilic moisturizing lotion.
E) Wash the area with lukewarm water only.

Answer 3

Cover the area with a hydrophilic moisturizing lotion.
Wash the area with lukewarm water only.

Question 4

A patient diagnosed with breast cancer is receiving 5-fluorouracil 5-FU). Based on anticipated adverse effects or side effects of this medication, which interventions should the nurse perform? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Test stool for occult blood.
B) Monitor for electrocardiogram changes.
C) Administer antiemetics as needed.
D) Instruct the patient to drink extra fluids prior to treatment.
E) Encourage the patient to wear sunscreen.

Question 5

A patient's carcinoembryonic antigen CEA) level was initially16 ng/mL. The current level is 6 ng/mL. How would the nurse evaluate this change?

A) The patient's treatment for cancer is effective.
B) The patient's treatment regimen should be more aggressive.
C) The patient has a new cancer site.
D) The patient's cancer is gone.

Question 6

A patient diagnosed with cancer tells the nurse that he does not want to experience any more pain. What information should the nurse consider when formulating a response? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Up to 50% of cancer patients with pain do not get adequate relief.
B) The presence of pain and fatigue makes other cancer symptoms more difficult to manage.
C) The nurse can provide only the pain relief measures that are ordered.
D) The majority of cancer pain comes from tissue destruction by tumor cells.
E) The nurse should adhere to evidence-based guidelines as the plan of care for this patient's pain.

Question 7

A patient's gynecologic examination reveals dysplasic changes of the cervix. Which historical information would the nurse interpret as indicating an increased risk that these changes are related to cervical cancer?

A) The patient was treated for human papillomavirus 2 years ago.
B) The patient reports "getting drunk" a few times a year.
C) The patient did not become sexually active until marriage at age 2
D) The patient reports eating fast food several times a week.

Question 8

A patient diagnosed with cancer and scheduled to begin biotherapy asks the nurse how the therapy will treat the cancer. How should the nurse respond?

A) "It changes the body processes that caused the cancer by enhancing your own immunity."
B) "It uses radiation implanted into the cancerous organ."
C) "It uses laser therapy to remove the cancer."
D) "It causes the blood flow to the tumor to be interrupted."

Question 9

A patient will be receiving busulfan Myleran) as treatment for leukemia. Which interventions should the nurse include in the patient's plan of care? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Assess for infection.
B) Monitor for hearing loss.
C) Monitor for a decrease in BUN level.
D) Institute fall precautions.
E) Reduce the amount of sodium in the patient's diet.

Question 10

A patient tells the nurse that she has a benign tumor that has spread into her lymph glands and that surgery is planned. How should the nurse respond?

A) "What did your doctor tell you about the tumor?"
B) "I hope the tumor can be removed before it spreads any further."
C) "That's a good thing that the tumor is benign."
D) "If the tumor is benign, why are you going to have surgery to remove it?"

Question 11

A patient is diagnosed with metaplasia of esophageal tissue. The nurse understands that this patient's first course of treatment will likely include which activity?

A) Identification and removal of the irritant causing the metaplasia
B) Surgical removal of the involved tissue
C) Chemotherapy
D) Radiation therapy

Question 12

The nurse is providing care to a patient undergoing brachytherapy. Which actions should the nurse take for personal protection? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Wear a lead apron from the radiology department.
B) Encourage the patient to provide as much self-care as possible.
C) Rotate care of the patient with other nurses.
D) Conduct assessment from the doorway.
E) Limit time in the room to 30 minutes per shift per nurse.

Question 13

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

A) "You do have a growth in your abdomen, but it is encapsulated and, after being removed, will not come back."
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 14

Biopsy of a skin lesion reveals anaplastic changes. The nurse would prepare this patient for which intervention?

A) Careful monitoring to ensure the cells do not develop into cancer
B) Chemotherapy for skin cancer
C) Removal of the anaplastic cells
D) Medication to reverse the anaplasia

Question 15

A patient diagnosed with cancer has been receiving radiation treatments to shrink the tumor. After several weeks, the patient tells the nurse that she has not needed as much pain medication. What should the nurse consider when responding to this report?

A) The radiation treatments have probably reduced the pressure of the tumor on adjacent tissues.
B) The tumor is secreting pain-control chemicals initiated by the radiation.
C) The patient may be developing tolerance to the pain.
D) The patient is probably continuing to have pain but is benefiting from the placebo effect of taking action against the tumor.

Question 16

A patient diagnosed with cancer is admitted with a weight loss of 25 lbs. over the last month as well as progressive anorexia and muscle wasting. The nurse would plan care around which condition?

A) Anorexia-cachexia syndrome
B) Syndrome of inappropriate antidiuretic hormone SIADH)
C) Superior vena cava syndrome SVC)
D) Sepsis

Question 17

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

A) The lesion is darker than the surrounding skin.
B) The shape of the lesion is asymmetric.
C) The lesion is raised.
D) The lesion is 4 mm in diameter.

Question 18

After assessing several patients in the clinic, the nurse would be most concerned about which patient's risk of developing cancer?

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

Question 19

A patient has been diagnosed with cancer. Which finding in the patient's social history would the nurse evaluate as contributing to cancer development both in the initiation stage and the promotion stage?

A) The patient was exposed to radiation during an industrial accident 5 years ago.
B) The patient has taken vitamin C supplements for many years.
C) The patient's menses began at age 10.
D) The patient reports drinking one or two glasses of wine each week.

Question 20

A 20-year-old college student is diagnosed with Epstein-Barr virus. The student has a history of smoking and alcohol use and works part-time as a manual laborer for a floor refinishing company. Which factors increase the student's risk of developing cancer? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Alcohol use
B) Occupation
C) Smoking
D) Viral infection
E) Age

Question 21

The TNM classification system is being used to stage a patient's cancer. The nurse would plan to care for a patient with an advanced lesion spreading into adjacent organs if the primary tumor size T) classification is T_____.

Question 22

The nurse is teaching a group of middle-school children about avoiding carcinogens. The nurse would divide the carcinogens into which categories? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Vascular factors
B) Biologic factors
C) Chemical factors
D) Psychological factors
E) Environmental factors

Question 23

The nurse is participating in a community education event on cancer and is planning a display describing the difference between malignant and benign tumors. Which information would the nurse include as characteristic of malignancy? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Malignant tumors grow in an infiltrative pattern.
B) Malignant tumors grow rapidly.
C) Malignant tumors grow within a fibrous capsule.
D) Malignant tumors are poorly differentiated.
E) Malignant tumors have a good blood supply.

Question 24

A patient's relative asks the nurse what type of gift would be appropriate for a patient who has an absolute neutrophil count ANC) of 600. What should the nurse suggest?

A) "Flavored bottled water would be a nice change for her."
B) "Perhaps a fresh fruit basket would help to stimulate her appetite."
C) "A beautiful potted plant would certainly cheer up her room."
D) "She told me yesterday how much she would enjoy some sushi."

Question 25

The nurse has provided discharge instructions to a patient who has metastatic lung cancer and stomatitis. The nurse would evaluate that understanding has occurred when the patient makes which statement?

A) "I probably should not brush my teeth or floss until the sores heal."
B) "I will rinse my mouth with full-strength peroxide every hour until the sores heal."
C) "I will clean my mouth before and after every meal."
D) "I will swab my mouth with mouthwash every 4 hours to reduce the sores."

Question 26

Which patient would the nurse prioritize as needing information about lifestyle modifications to prevent cancer?

A) A 65-year-old woman whose body weight is within the normal range and who exercises twice a week, eats a variety of vegetables and fruits, eats red meat three times a week, and does not smoke
B) A 35-year-old Caucasian male who is overweight, has a family history of heart disease, and is a vegetarian
C) A 44-year-old African American woman whose mother had breast cancer at age 50 and who is overweight, smokes one or two cigarettes a week, and drinks three cups of coffee daily
D) A 47-year-old Hispanic female whose mother and father have a history of type 2 diabetes and who is overweight by 30 lbs., walks three times weekly, and is a nonsmoker

Question 27

The nurse is caring for a 78-year-old male with Hodgkin's disease who has received both chemotherapy and radiation. He was admitted to the hospital to evaluate an unexplained increasing fatigue and inability to care for himself. What nursing interventions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Limiting oral intake
B) Spacing activities to allow for periods of rest
C) Suggesting a consult with a nutritionist
D) Assessing hemoglobin and hematocrit
E) Encouraging the patient to move about in bed every hour.

Question 28

The nurse is providing discharge instructions to a patient newly diagnosed with leukemia. The patient says, "My physician mentioned that her survival rates for this type of cancer are good, so I guess my chances of beating this are good, too." How should the nurse respond?

A) "That means that your physician also had this type of leukemia and is a survivor."
B) "It means that your chances are better than if you were being treated by a different physician."
C) "Survival rates are a way of showing how well treatments work generally. They are not specific to an individual patient."
D) "Do not put too much faith in statistics. They seem to change all the time."

Question 29

The nurse would anticipate hormone therapy to be considered in patients with cancers of which tissues? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Brain
B) Breast
C) Prostate
D) Endometrium
E) Bone

Question 30

The nurse is caring for a patient receiving chemotherapy for breast cancer. The patient has developed a sore mouth, nausea and vomiting, and anorexia. How should the nurse respond to the patient's report of symptoms?

A) "You may be developing the flu, and I can give you an antinausea medication."
B) "These are symptoms of your cancer, and more frequent oral care will help."
C) "You may be allergic to the chemotherapy. I will place a call to the health care provider."
D) "These are the expected side effects of your chemotherapy, and the health care provider has already ordered some medications that will help."

Question 31

The nurse is caring for a 72-year-old female with head and neck cancer who had surgery 2 weeks ago to remove the tumor. She is scheduled to begin external beam radiation therapy 1 week after discharge from the hospital. Which recommendations should the nurse stress when preparing the patient for this radiation treatment? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Get lots of rest.
B) Protect the scalp from alopecia.
C) Perform meticulous skin care.
D) Monitor blood pressure.
E) Monitor weight gain.

Question 32

The nurse is teaching a group of high school students about risk factors for the development of cancer. The nurse explains that alcohol is the leading etiologic factor in cancer of the oral cavity, larynx, and esophagus. The nurse goes on to explain that the risk is even higher if alcohol is combined with which substance?

A) Spicy foods
B) Soda
C) Tobacco
D) Sweet foods

Question 33

The nurse is on a team charged with developing techniques to reduce the occurrence of serosal seeding during cancer therapy. Which procedures and interventions should be the focus of this team's work? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Biopsies
B) Tumor manipulation during surgery
C) External beam radiation
D) Brachytherapy
E) Use of pressure bandages postoperatively

Question 34

A patient is deciding on a course of therapy for advanced cancer. Which information should the nurse provide about chemotherapy? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) The only body system not adversely affected by chemotherapy is the genitourinary system.
B) Chemotherapy can result in clotting due to increased platelet counts.
C) Chemotherapy is often a painful experience.
D) Side effects can occur anywhere in the gastrointestinal tract.
E) Some chemotherapeutic agents can result in permanent heart damage.

Question 35

A patient newly diagnosed with prostate cancer says, "I know this kind of cancer spreads to other organs. Which places should I worry about getting it?" The nurse would include which anatomical locations in the response to this question? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Bowel
B) Lung
C) Liver
D) Bone
E) Brain