Deck 17: Clients with Cancer

Question 1

A client is receiving interleukin-2 (IL-2) as part of the therapeutic plan to manage malignant melanoma. The nurse should emphasize the ability of this agent to

A) increase oxygenation to cells that are not malignant.
B) physically dissolve the tumor mass.
C) replace damaged and diseased cells from bone marrow.
D) strengthen the client's immune response.

Answer 1

strengthen the client's immune response.

Question 2

After a client has a series of diagnostic tests, the studies confirm the presence of rectal cancer. The nurse's primary intervention should be to

A) assess the meaning and effect of cancer as perceived by the client.
B) determine if the client is emotionally ready to deal with the diagnosis of cancer.
C) reassure the client that many treatment modalities are available.
D) support the physician when the client is informed of the diagnosis.

Answer 2

assess the meaning and effect of cancer as perceived by the client.

Question 3

The nurse caring for a client who has an implanted radiation source should reduce self-exposure by incorporating the strategy of

A) limiting the time spent close to the client to 30 minutes per 8-hour shift.
B) remaining 6 feet away from the client except for essential care.
C) wearing a lead-shielded apron whenever entering the client's room.
D) wearing a radiation meter or film badge to measure exposure.

Answer 3

limiting the time spent close to the client to 30 minutes per 8-hour shift.

Question 4

When there is extravasation of vincristine (Oncovin), the nurse should initially

A) apply cold compresses to the site.
B) apply manual pressure to delay further circulation.
C) call the physician immediately.
D) leave the cannula in place and aspirate.

Question 5

The nurse administering granulocyte colony-stimulating factor (G-CSF; Neupogen) to a client who is also receiving chemotherapy should assess the client for

A) a rash.
B) bone pain.
C) fatigue.
D) muscle aches.

Question 6

The nurse should closely assess a client undergoing chemotherapy for a tumor that is responding to the therapy for any indication of tumor lysis syndrome, which is marked by

A) hypercalcemia.
B) hyperkalemia.
C) increase in antidiuretic hormone (ADH).
D) platelet count below 20,000/mm3.

Question 7

The client is receiving a drug in a phase I clinical trial. Regarding the type of malignancy for which the client is being treated, the nurse makes the assumption that the cancer

A) and its treatment are not covered by the client's insurance.
B) is limited in size and virulence.
C) is not following the expected disease course.
D) will not respond to other known treatments for cancer.

Question 8

When a client undergoing systemic chemotherapy reaches the nadir of treatment, priority care by the nurse should be directed toward

A) assisting the client to eat an adequate amount of food to maintain nutrition.
B) enhancing the effects of chemotherapy by encouraging mild activity.
C) improving the mental state of the client by using mental imagery.
D) protecting the client from infection and bleeding.

Question 9

Yesterday a 28-year-old client was diagnosed with rectal cancer. The nurse has made the nursing diagnosis of Anxiety Related to Fear of the Unknown, as manifested by anger. The best approach for the nurse to take in relation to the client's need for information is to

A) offer suggestions to modify the client's expressions of anger.
B) provide the client with a detailed plan for future interventions.
C) provide the client with simple explanations of proposed treatments.
D) specifically discuss the scientific facts related to rectal cancer.

Question 10

A 32-year-old client who has a history of familial polyposis but no manifestations still wants to explore the possibility of preventive surgery. The most appropriate response the nurse can make is

A) "Cancer is not always hereditary, and you should change risk factors in your life."
B) "It is an overreaction to seek radical treatment before you develop symptoms."
C) "Monthly rectal smears may allay your anxiety without surgery."
D) "Subtotal colectomy is a procedure you might seek further information about."

Question 11

The specially prepared nurse administering chemotherapeutic drugs should

A) administer intravenous medications only through VADs.
B) apply ice to the area after an intramuscular injection of chemotherapy.
C) wear a mask during administration of the agent.
D) wear gloves and a gown during preparation and administration of the drugs.

Question 12

The nurse is reviewing the American Cancer Society (ACS) recommendations for breast cancer screening with a 50-year-old female client. The nurse should emphasize the recommendation for

A) breast examination by a health care professional semi-annually.
B) breast self-examination (BSE) monthly.
C) chest x-ray study yearly when the client is over age 40.
D) mammography when a lump is detected.

Question 13

Before the specially trained nurse gives the prescribed dose of a chemotherapeutic agent, the nurse should

A) collect an extra syringe and needle in case of contamination.
B) cover the client with a water-resistant shield.
C) explain the expected side effects of the drug to the client.
D) verify dose, drug, and schedule with another nurse.

Question 14

The nurse caring for a client with cancer of the thyroid gland has a tumor classified as T2, N1, M0. The nurse explains that the "T" in this classification schema represents

A) number of years the tumor has been present.
B) site of the tumor.
C) size of the tumor.
D) virulence of malignancy.

Question 15

The nursing action that has the highest priority for a 32-year-old client with an implanted radiation source should focus on

A) assessing the client's reaction to the diagnosis and treatment.
B) preventing skin problems related to radiation.
C) promoting regular activity while confined to the room.
D) safeguarding the client and others from unnecessary radiation exposure.

Question 16

The nurse has assigned the nursing diagnosis Imbalanced Nutrition: Less than Body Requirements, Related to Anorexia for a client with colon cancer. Nursing goals include the maintenance of present body weight. To achieve this goal, the nurse should suggest a diet that is high in

A) calories and low in cholesterol.
B) fat and calories.
C) fat and low in bulk.
D) protein and calories.

Question 17

The nurse is administering medication in phase III trials to a client with lung cancer. Assessments made in this phase of the drug investigation involve

A) determination of the maximum tolerated dose.
B) evaluation of the drug's general effectiveness.
C) explanation of how the drug compares with standard treatments.
D) description of the type and severity of side effects.

Question 18

When the client questions why the chemotherapeutic drug is being administered by intracavitary instillation, the nurse could best answer by explaining that this approach is a

A) cost-effective and more rapidly-acting method of treatment.
B) diffuse method of systemic administration that avoids side effects.
C) means to allow high concentrations of drugs to be directed at the tumor.
D) non-invasive method of administration.

Question 19

The nurse can best avoid catheter occlusion in a client with a recently inserted venous access device (VAD) by

A) administering medications in small volumes.
B) flushing the catheter per agency protocol.
C) instructing the client to keep the arm extended during administration.
D) using the catheter only for vesicant drugs.

Question 20

The recommendation the nurse should share with a 22-year-old sexually active client who is seeking information on the prevention of cervical cancer is that a Pap smear

A) is needed annually by all women over age 18.
B) should be done annually until two tests are negative, then once every 2-3 years, in women over 30.
C) should be done biannually for clients who have been sexually active for 3 years but not later than age 21.
D) should be performed twice a year for all sexually active women over age 18.

Question 21

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.

Question 22

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.

Question 23

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.

Question 24

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.

Question 25

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.

Question 26

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.

Question 27

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.

Question 28

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.

Question 29

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?"

Question 30

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.