Deck 56: Care of the Patient with Cancer

Question 1

What measures would the home health nurse, designing nursing interventions for a patient receiving external radiation treatments for a malignancy, recommend to protect the patient's skin?

A) Applying warm compresses to damaged skin
B) Encouraging patient to apply fragrant lotion to skin
C) Patting the skin dry after the bath
D) Exposing skin to sun for 10 minutes a day

Answer 1

Patting the skin dry after the bath

Question 2

How many minutes of daily exercise does the American Cancer Society recommend as a prevention of cancer?

A) 10 minutes
B) 15 minutes
C) 20 minutes
D) 30 minutes

Answer 2

20 minutes

Question 3

A home health patient undergoing radiation therapy says, "I feel so useless. I have no energy, no appetite and I fall asleep whenever I sit down." What is the nurse's most therapeutic response?

A) "Fatigue is part of your illness. Taking several long naps in the daytime is helpful."
B) "Fatigue is an unfortunate side effect of radiation. It will improve when you finish treatment."
C) "You really shouldn't be fatigued. Let me make an appointment with your physician to get this checked out."
D) "Don't worry about it. You probably deserve the rest!"

Answer 3

"Fatigue is an unfortunate side effect of radiation. It will improve when you finish treatment."

Question 4

Which of the following people should avoid visiting a patient being treated with internal radiation therapy?

A) A 78-year-old using a walker
B) An18-year-old woman
C) A woman pregnant in the third trimester
D) A 24-year-old nursing mother

Question 5

What should the home health nurse advise the patient who found a lump in her breast a week ago during breast self-examination?

A) Arrange for an examination by her physician
B) Wait until her next ovulatory cycle and check the lump again
C) Postpone appointment until the lump enlarges
D) Apply warm, moist compresses

Question 6

The nurse caring for a patient who is being treated for cancer of the cervix by a radioactive implant discovers that the applicator with the radioactive material has become dislodged and is lying in the bed between the patient's legs. What should the nurse do?

A) Using long-handled forceps grasp the applicator and wrap it in a towel
B) Help the patient to a chair and cover the applicator with a rubber sheet
C) Reassure the patient by staying at the bedside and call for help
D) Notify the charge nurse

Question 7

Which of the following is a meal that would represent foods that help prevent cancer?

A) Broiled steak, baked potato, whole wheat roll, soy milk
B) Baked ham, rice and gravy, apples stewed in butter, whole milk
C) Fried pork chops, candied sweet potatoes, white rolls and butter, iced tea
D) Broiled chicken, cabbage with onion and garlic, and soy milk

Question 8

How would the nurse explain to the patient who is taking cyclophosphamide (Cytoxan), an alkylating agent, about how the medication works?

A) It inhibits DNA and RNA synthesis
B) It interferes with DNA replication
C) It damages the cell in S phase of replication
D) It alters the hormonal environment that promotes cancer growth

Question 9

A patient, age 63, has terminal cancer of the liver and is cared for by his wife at home. His abdominal pain has become increasingly severe, and he now says it is intense most of the time. The nurse recognizes that teaching regarding pain management has been effective based on which measure implemented by this patient?

A) Limiting the use of opiate analgesics to prevent addiction
B) Using analgesics only when the pain becomes more than he can tolerate
C) Taking analgesics around the clock on a regular schedule, using additional doses for breakthrough pain
D) Resigning himself to the fact that pain is an inevitable consequence of cancer

Question 10

Which of the following men should be highest priority for referral for a prostate-specific antigen (PSA)?

A) 43-year-old Hispanic man
B) 45-year-old African American man
C) 49-year-old Korean man
D) 50-year-old Native American man

Question 11

A patient, age 39, receiving chemotherapy for treatment of her cancer has a white blood cell count of 1600/mm³. This finding requires nursing interventions to provide which of the following?

A) Adequate fluid intake
B) Protection from falls
C) Protection against infection
D) Frequent small nutritious snacks

Question 12

A female patient, age 59, has lost 10 lb in the first 3 weeks of her chemotherapy and does not eat because nothing tastes good. What would be the appropriate nursing diagnosis for the plan of care?

A) Ineffective health maintenance, related to lack of knowledge of nutritional requirements during radiation therapy
B) Risk for infection, related to poor nutrition
C) Imbalanced nutrition: less than body requirements, related to anorexia
D) Ineffective therapeutic regimen management, related to refusal to eat

Question 13

After an elevation of his PSA, the patient has blood drawn for a CA-19-9. When he asks the nurses the purpose of this new test, what is the most appropriate response?

A) It tests for hepatobiliary cancer
B) It tests for colorectal cancer
C) It tests for bladder cancer
D) It tests for lung cancer

Question 14

Which statement is most appropriate for a nurse to tell a patient before insertion of the radioactive implant?

A) "Nurses will always be available, but they will spend only short periods of time at your bedside."
B) "Personal cleanliness is essential, so you will be given a complete bed bath each day."
C) "Your diet will be changed to a high-fiber diet to encourage daily bowel movements."
D) "Your bed linens will be completely changed each day to minimize radioactive contamination."

Question 15

Using the TNM staging classification system, what does a tumor staged as T4N3M2 mean?

A) No evidence of primary tumor, lymph node involvement, or distant metastasis
B) Carcinoma in situ, regional lymph node involvement, and metastasis to one site
C) Enlarging tumor, increasing lymph node involvement, and distant metastasis
D) Enlarging tumor, no lymph node involvement, or distant metastasis

Question 16

What happens during the process of immunosurveillance?

A) T cells recognizing and destroying the abnormal cell
B) White cells (WBC) destroying the abnormal cell
C) Excretion of histamine to interfere with the replication of the abnormal cell
D) B cells attaching to abnormal cell

Question 17

A patient, age 56, has been advised that his prostate-specific antigen (PSA) level is elevated. The physician then performed a digital rectal examination (DRE). What should the next definitive diagnostic test be?

A) CA-125 test
B) Transrectal ultrasound
C) Needle biopsy of the prostate
D) MRI

Question 18

When should the nurse schedule the oral administration of metoclopramide (Reglan)?

A) Only at bedtime
B) With meals
C) 30 minutes before meals
D) 30 minutes after meals

Question 19

A patient has developed stomatitis from chemotherapy. What should the appropriate intervention for this condition include?

A) Instruction in the following of a liquid diet
B) Using a commercial mouthwash after each meal
C) Cleaning teeth with a cotton swab dipped in hydrogen peroxide
D) Using a soft toothbrush

Question 20

The nurse instructs a patient who has been smoking for 5 years about the warning signs of cancer. The nurse tells him that one of cancer's seven warning signals include:

A) nagging cough or hoarseness.
B) a sore that does not heal rapidly.
C) gallbladder disease.
D) hematopoietic changes.

Question 21

Which of the following characteristics is common in malignant tumors?

A) Usually contained within a capsule
B) Divide and multiply in the same manner as normal cells
C) Proliferate and respond to treatment
D) Progress and destroy surrounding tissues while spreading to distant parts of the body

Question 22

The patient receiving radiation therapy complains of the conspicuous markings on the skin. What can the nurse explain about these markings?

A) They are residues of the treatment and can be washed off.
B) They are caused by radiation and will fade in time.
C) They are indicators of the amount of radiation the patient is receiving.
D) They are gridlines for treatment and should be left on.

Question 23

Which of the following are risk factors for cancer? (Select all that apply.)

A) Ethnicity
B) Environmental irritants
C) Alcoholism
D) Hereditary factors
E) Excessive exercise
F) Exposure to ultraviolet light

Question 24

The nurse is aware that American men and women have which of the following three sites for cancer in common? (Select all that apply.)

A) Lung
B) Brain
C) Colon
D) Liver
E) Rectum
F) Thyroid

Question 25

The nurse explains to a 43-year-old patient with a benign tumor in her right breast that a benign tumor differs from a malignant tumor in that benign tumors:

A) do not cause damage to adjacent tissue.
B) are simply an overgrowth of normal cells.
C) do not spread to other tissues and organs.
D) frequently recur in the same site.

Question 26

Which of the following are thrombocytopenic precautions?

A) Requesting an order for aspirin for discomfort
B) Trimming toenails close
C) Using an electric razor
D) Vigorous tooth cleaning

Question 27

The nurse knows which of the following to be characteristics of malignant tumors?

A) Smooth, well defined; movable when palpated
B) Resembles parent tissue; rarely fatal
C) Rate of growth varies; rarely contained within a capsule
D) Remains localized; slow growth

Question 28

The difference between an excisional biopsy and an incisional biopsy is that an excisional biopsy involves the:

A) use of a needle to obtain fluid samples.
B) removal of the entire lesion.
C) taking a "bite" from the lesion for study.
D) shaving of the superficial layers of the lesion.

Question 29

A patient who has malignant cancer secondary to a high-grade lymphoma has been admitted with muscle weakness, tetany, paresthesia, and convulsion. The nurse notices the patient is being treated for tumor lysis syndrome (TLS) and initial treatment has not been successful. What should the nurse tell the family is the next step in treatment?

A) Whole blood transfusion
B) A bone marrow biopsy
C) Immediate radiation treatment
D) Dialysis

Question 30

What would the nurse encourage the patient to look for during self-testicular testing? (Select all that apply.)

A) Smooth consistency of testicle
B) Stomachache
C) Breast enlargement
D) Heavy feeling in the scrotum
E) Enlarged blood vessels in scrotum
F) Hematuria

Question 31

Nursing interventions for the nursing diagnosis of Imbalanced nutrition: less than body requirements would include all these except:

A) provide adequate, easily digestible, soft, bland foods.
B) give small, frequent, highly nutritional meals.
C) allow extra time to eat.
D) offer three regular meals of highly nutritious foods.

Question 32

What are the signs and symptoms of prostatic enlargement? (Select all that apply.)

A) Rotten egg odor to urine
B) Hematuria
C) Swollen scrotum
D) Difficulty starting urine flow
E) Strong flow of urine

Question 33

What is the function of organizations like The Lost Chord Club, Reach for Recovery, and I Can Cope?

A) Arrange for transportation to a clinic
B) Provide a small amount of financial support to patients
C) Send volunteers to speak with a person facing a lifestyle change
D) Arrange for reduced drug costs

Question 34

Men over age 50 should consider an annual _________ test and rectal examination.

Question 35

Select the foods that are recommended for prevention of colorectal cancer in men. (Select all that apply.)

A) Oranges
B) Ham
C) Skinless chicken
D) Asparagus
E) Cheddar cheese
F) Squash

Question 36

The term ____________ refers to the process by which a normal cell is transformed into a cancer cell.

Question 37

Why is seeking medical attention when any cancer warning signs occur frequently delayed?

A) Difficulty accessing a physician or getting a referral consult.
B) Lack of knowledge of the seven warning signs of cancer.
C) Fear of the possible diagnosis of cancer and hoping signs will go away.
D) Self-examination being complex and difficult to perform.

Question 38

Which of the following are nursing interventions for the nursing diagnosis of Imbalanced nutrition: less than body requirements? (Select all that apply.)

A) Provide adequate, easily digestible, soft, bland foods.
B) Give small, frequent, highly nutritional meals.
C) Allow extra time to eat.
D) Offer three regular meals of highly nutritious foods.

Question 39

A male patient is undergoing external radiation therapy on an outpatient basis for treatment of Hodgkin disease. After 2 weeks of treatment, he tells the nurse that he is so tired he can hardly get out of bed in the morning. Which is an appropriate goal?

A) Take two rest periods during the day
B) Ambulate in the hall four times a day
C) Select two activities for distraction
D) Investigate a consultation with a psychiatrist for treatment of depression

Question 40

How do cancer cells differ from normal cells? (Select all that apply.)

A) They replicate in an organized manner.
B) They have larger nuclei.
C) They have an irregular shape.
D) They have a different number of chromosomes.
E) They have a different mitosis process.

Question 41

A ___________ test screens for occult blood in the stool.

Question 42

The nurse remarks that the American Cancer Society (ACS) reports that cancer is the ______ leading cause of death in the United States.

Question 43

The American Cancer Society recommends a clinical breast examination by a health care professional for women between the age of 20 and 39 years every ________ years.