Question 1

During an assessment,the nurse notes that a patient receiving radiation treatments for breast cancer has excoriated skin.What is the priority nursing diagnosis?

Accepted Answer

Excoriated skin increases the risk of infection, especially in patients with compromised immune systems such as those undergoing radiation treatments. Therefore, the priority nursing diagnosis should be Risk for Infection.

Question 2

The nurse is caring for a patient who had a bone marrow transplant for the treatment of leukemia several weeks ago.The patient requires protective isolation.Which statement by the patient's family indicates understanding of this type of isolation?

Accepted Answer

Protective isolation is used to reduce the risk of infection for immunocompromised patients. It involves strict hand hygiene and the use of personal protective equipment. Restricting all visitors is not necessary, as long as visitors are screened for illness and follow proper hygiene protocols. Administering medications by IM injection is not a requirement for protective isolation. Encouraging oral hygiene is important for overall health but not specific to protective isolation. Therefore, the best choice is D as it indicates the understanding of the need for visitors to practice meticulous hand washing.

Question 3

The nurse is assisting the health-care provider with a bone marrow aspiration and biopsy on a patient who has leukemia.The patient also has thrombocytopenia.Upon completing of the test,which intervention is a priority for the nurse?

Accepted Answer

The priority intervention for the nurse after a bone marrow aspiration and biopsy on a patient with thrombocytopenia is to hold pressure on the wound for approximately five minutes to prevent bleeding and hematoma formation. Making certain the patient understands the purpose of the test, labeling and refrigerating the specimen obtained by the physician, and disposing of the equipment used and cleaning the area properly are important interventions as well, but they are not the priority in this situation.

Question 4

The nurse is preparing a seminar that discusses the risk and incidence of cancer and culture.What information is considered culturally correct when teaching about the risk of developing cancer?

Accepted Answer

The answer of The nurse is preparing a seminar that...

Question 5

The nurse is caring for a patient with leukemia.Which treatment should the nurse expect to be prescribed?

Accepted Answer

Leukemia is a cancer of the blood cells and is commonly treated with chemotherapy, which targets and kills fast-growing cells, including cancer cells. IV fluid therapy, diuretic therapy, and electrolyte replacement therapy are important treatments for various medical conditions but are not specific to leukemia treatment.

Question 6

The nurse has completed a seminar teaching a group in the community about ways to reduce cancer risks.The nurse returns a month later to evaluate the effectiveness of the seminar.Which statements made by members of the group indicate retention and application of the material presented by the nurse to reduce the risk of developing cancer?

Accepted Answer

Stopping the use of tanning booths is a behavior change that reduces the risk of skin cancer, which was likely discussed in the seminar.

Answer: None of the other options 
 Reducing fiber intake, increasing red meat consumption, and drinking red wine are not behaviors that reduce the risk of developing cancer, and may even increase the risk in some cases. These statements indicate a lack of retention or application of the material presented by the nurse.

Question 7

A patient is receiving chemotherapy for the treatment of leukemia.While providing care for this patient,which clinical manifestations would indicate tumor lysis syndrome?

Accepted Answer

Tumor lysis syndrome is a potential complication of chemotherapy, particularly in patients with rapidly growing tumors such as leukemia. It results from the rapid destruction of cancer cells, which leads to the release of intracellular contents such as potassium, phosphate, and uric acid. As a result, electrolyte imbalances and metabolic abnormalities such as hyperkalemia, hyperphosphatemia, and hyperuricemia can occur. These metabolic disturbances can lead to multiple organ dysfunction, including central nervous system dysfunction, which can manifest as altered levels of consciousness. Thrombocytopenia, respiratory distress, and upper-extremity edema are not specific clinical manifestations of tumor lysis syndrome. Thrombocytopenia may be a side effect of chemotherapy, but it is not directly related to tumor lysis syndrome. Respiratory distress could occur if the cancer is affecting the lungs, but it is not specific to tumor lysis syndrome. Upper-extremity edema could be a sign of a blood clot or lymphedema, but it is not typically associated with tumor lysis syndrome.

Question 8

A nurse is caring for a patient with leukemia who is neutropenic.Which intervention will the nurse implement to ensure this patient's safety?

Accepted Answer

Placing the patient in reverse isolation (also called protective isolation) can help prevent infection by limiting exposure to potential sources of infection. This is especially important for neutropenic patients, as they have a decreased ability to fight off infection due to low levels of neutrophils in their blood. Standard precaution isolation (B) would not provide the same level of protection as reverse isolation. Administering a prophylactic gram-negative antibiotic (C) may be appropriate, but it is not the best choice without further information about the patient's infectious status. Administering N-CSF (D) may also be appropriate, but it is not directly related to ensuring the patient's safety from infection.

Question 9

A patient has just been told that a colectomy and ileostomy are needed to treat a new diagnosis of colon cancer.Which nursing diagnosis should the nurse use to plan this patient's preoperative nursing care?

Accepted Answer

The answer of A patient has just been told that...

Question 10

The nurse accompanies the health-care provider into the patient's room and listens as the diagnosis of cancer is shared with the patient and family.Once the health-care provider leaves the room,the nurse notes that the patient and family are teary-eyed regarding the diagnosis.What is the nurse's most appropriate intervention at this time?

Accepted Answer

The nurse's most appropriate intervention at this time is to provide emotional support in coping with the diagnosis. The patient and family are likely experiencing a range of emotions and may need someone to talk to and provide comfort. While it is important to educate the patient and family about treatment options and prognosis, providing emotional support should be the priority at this time. The nurse should also assess the patient and family's understanding of the diagnosis and provide further education and resources as needed. Arranging for a medical power of attorney form is not necessary at this time and should be reserved for later discussions.

Question 11

A patient receiving radiation therapy as treatment for colorectal cancer is experiencing nausea and vomiting.What should the nurse encourage the patient to do?

Accepted Answer

Delaying the intake of a meal until three to four hours after treatment may help to reduce nausea and vomiting. The other options may actually exacerbate the symptoms. Using a commercial mouthwash may contain alcohol, which can dry out the mouth and cause further nausea. Eating spicy or well-seasoned foods can irritate the gastrointestinal tract, making nausea and vomiting worse. Avoiding all food and liquid can lead to dehydration and further complications.

Question 12

A nurse is caring for a patient with cancer.The nurse teaches the patient about which potentially undesirable cellular alterations that can occur during the cell cycle?

Accepted Answer

Hyperplasia is a potentially undesirable cellular alteration that can occur during the cell cycle, as it involves an overgrowth of cells that can lead to the formation of tumors (including cancer). Dysphagia refers to difficulty swallowing, which is not directly related to cellular alterations. Adaptation and differentiation are normal processes in the cell cycle that can help cells function properly.

Question 13

A patient with anemia caused by chemotherapy is prescribed synthetic erythropoietin.When teaching the patient about the therapeutic effect of this treatment,which is appropriate for the nurse to include?

Accepted Answer

Synthetic erythropoietin is a medication that stimulates the production of red blood cells in the bone marrow, which helps to increase the patient's hemoglobin and reduce anemia caused by chemotherapy.

Question 14

A patient being treated with chemotherapy for cancer complains of fatigue,pallor,progressive weakness,exertional dyspnea,headache,and tachycardia.Which diagnosis should the nurse use as the priority when planning this patient's care?

Accepted Answer

The symptoms described suggest that the patient is experiencing activity intolerance, which is defined as insufficient physiological or psychological energy to tolerate or complete necessary or desired activities. The patient's chemotherapy treatment can cause anemia, which can contribute to fatigue, pallor, and weakness; exertional dyspnea can also suggest anemia or cardiotoxicity from the chemotherapy medication. Headache and tachycardia can be signs of anemia, dehydration or electrolyte imbalances, and are further evidence of the patient's inability to tolerate activity. Therefore, addressing the underlying physiological condition of anemia and implementing measures to improve the patient's tolerance for activities of daily living should be the priority.

Question 15

A patient with terminal colon cancer is refusing all food and fluids.The patient has a living will that states no artificial nutrition is to be provided;however,the family is asking for a gastrostomy tube.What should the nurse do?

Accepted Answer

The nurse should honor the patient's wishes as stated in the living will and provide supportive care to the patient and family during this difficult time. It is important to help the family come to terms with the situation and provide emotional support rather than pursuing a medical intervention that the patient has refused. If there is conflict between the family and the patient's wishes, the case can be taken to the hospital's ethics committee for further discussion and resolution.

Question 16

During a treatment meeting on an oncology unit,the nurse learns that a patient is scheduled for chemotherapy before surgery.What are the purposes for this patient to receive chemotherapy at this specific time?

Accepted Answer

The purpose of administering chemotherapy before surgery is to shrink the tumor, which may make it easier to remove during surgery. Additionally, preoperative chemotherapy may help to prevent the spread of cancer cells during surgery. It is not intended to improve wound healing, eradicate all cancer cells, or allow the immune system to kill cancer cells.

Question 17

A patient being treated for cancer has a tumor designation of Stage IV,T4,N3,M1.What does this staging indicate to the nurse?

Accepted Answer

The tumor designation of Stage IV,T4,N3,M1 indicates that the tumor has metastasized with lymph node involvement (N3) and has spread to other parts of the body (M1). It also suggests that the tumor is large in size (T4). This staging indicates a more advanced and potentially aggressive form of cancer, which may require more intensive treatment options.

Question 18

The nurse is caring for an adolescent Asian patient with a strong family history of breast cancer.What should the nurse teach the patient regarding cancer prevention?

Accepted Answer

The nurse should teach the patient to perform monthly breast self-examination as a preventative measure for breast cancer, especially given the strong family history of the disease. While discussing cancer fears with the healthcare provider and talking to family members who have the disease can be helpful, these actions alone do not constitute cancer prevention. Teaching about the side effects of cancer treatment is important but is not a preventative measure.

Question 19

The nurse is caring for a patient with leukemia who is experiencing neutropenia as a result of chemotherapy.Which action should the nurse include in the plan of care for this patient?

Accepted Answer

Neutropenia is a decrease in the number of neutrophils, which are a type of white blood cell that play an important role in fighting infections. Patients with neutropenia are at increased risk for infections, so it is important to restrict visitors with communicable illnesses to prevent the spread of infection. Restricting fluid intake (A) is not necessary for neutropenia. Both hand hygiene and gloves (B) are important for preventing infections, but replacing hand hygiene with gloves is not appropriate as proper hand hygiene is still necessary. Inserting an indwelling urinary catheter (D) is not necessary for neutropenia and can actually increase the risk of infection.

Question 20

The nurse is teaching a patient scheduled for a colonoscopy on pre- and postprocedure care.Which statement by the patient indicates the need for further teaching?

Accepted Answer

The statement "It might be quite painful" indicates that the patient may not have a clear understanding of the procedure and the use of sedation to minimize discomfort. Further teaching may be needed to clarify this point.

Quiz 13: Overview of Cancer Care