Deck 17: Care of the Patient With Cancer

Question 1

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

Answer 1

Taking analgesics around the clock on a regular schedule, using additional doses for breakthrough pain

Question 2

A patient, age 53, has discovered a lump in her breast while performing her monthly breast self-examination. Which action is recommended next for this patient?

A) A prompt examination by her physician is needed.
B) It is best to wait at least 1 month to be sure the lump remains.
C) A physical examination should be postponed until the lump enlarges.
D) Warm, moist compresses should be applied at least three times a day to help reduce the size.

Answer 2

A prompt examination by her physician is needed.

Question 3

A patient has been told she will have a palliative surgery for her ovarian cancer. She wants to know what type of surgery that is and how it will help her. The nurse tells her that the surgery will

A) reduce symptoms.
B) remove tumors while still in the benign stage.
C) result in a cure.
D) aid in confirming a diagnosis.

Answer 3

reduce symptoms.

Question 4

Which food is recommended by the National Cancer Institute to reduce a person's cancer risk?

A) Potatoes
B) Beets
C) Celery
D) Broccoli

Question 5

A patient, age 72, is receiving chemotherapy for treatment of malignant lymphoma. Chemotherapeutic agents work by

A) destroying only cancer cells.
B) interfering with the cells' ability to reproduce.
C) reducing the production of hydrochloric acid.
D) interfering with the movement of cells from one part of the body to another.

Question 6

Which is a type of biopsy?

A) Syringe
B) Aspiration
C) Polypectomy
D) Puncture

Question 7

An effective antiemetic drug given intravenously to block receptors on the endings of nerve cells in the brain and gastrointestinal tract, given once a day in a 5-minute infusion, is called

A) prochlorperazine (Compazine).
B) metoclopramide (Reglan).
C) granisetron (Kytril).
D) pentoxifylline (Trental).

Question 8

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 the 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 9

A patient, age 62, has been receiving external radiation and chemotherapy for oropharyngeal carcinoma. His oral mucosa is denuded and edematous. He has ulcerations over his bucca and tongue, and his saliva is thick and ropey. Which intervention does the nurse teach to this patient?

A) Use a soft diet until the acute reaction subsides.
B) Gargle and rinse his mouth several times a day with a commercial mouthwash.
C) Use cotton-tipped swabs dipped in hydrogen peroxide to clean his teeth.
D) Avoid hot beverages.

Question 10

A patient is admitted to the unit for an autologous bone marrow transplant. During teaching, the nurse would tell the patient that the bone marrow for transplant will come from

A) an anonymous donor.
B) her closest living relative.
C) her own marrow.
D) a friend.

Question 11

A patient, age 39, has been receiving chemotherapy for treatment of her cancer of the breast. She has a white blood cell count of 1,600/mm³. A person who has leukopenia has a special need for which nursing intervention?

A) Provision of adequate fluid intake
B) Protection from falls
C) Protection against infection
D) Limitation of activities

Question 12

A patient, age 53, is receiving chemotherapy for Hodgkin's disease, stage IV. As a side effect of chemotherapy, he is experiencing stomatitis. Which nursing diagnosis would be identified for planning the nursing interventions for this patient?

A) Fatigue, related to stomatitis
B) Imbalanced nutrition: less than body requirements
C) Risk for disuse syndrome
D) Risk for ineffective breathing pattern

Question 13

A patient is undergoing internal radiation therapy. In planning her care for the day, the nurse must remember to

A) stand at the greatest distance away from the site where an internal radiation device is in the patient's body.
B) spend as much time as possible with the patient because of the patient's fear.
C) retrieve the applicator and replace if it becomes dislodged.
D) provide the patient's family with chairs near the patient.

Question 14

The patient, age 63, has a diagnosis of cancer of the prostate gland with metastasis and is experiencing cachexia. This state is best described by the characteristics of:

A) Poor health, malnutrition, and wasting
B) Increased appetite and nervousness
C) Irritability and anger
D) Depression, fear, and anxiety

Question 15

Using the TNM staging classification system, a tumor staged as T₄N₃M₂ would 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) large tumor, lymph node involvement, and distant metastasis.
D) medium-sized tumor, no lymph node involvement, and distant metastasis.

Question 16

A patient, age 58, has bronchogenic cancer and is hospitalized for chemotherapy. Administration of doxorubicin (a vesicant, antitumor, antibiotic) in combination with other chemotherapeutic agents is planned for her. Her husband rarely visits while she is in the hospital. She tells the nurse that she thinks her husband does not care for her anymore since she has become ill. On one occasion when the patient's husband was present, he told the nurse he just could not stand to see his wife so ill and did not know what to say to her. The nurse identifies which nursing diagnosis in this situation?

A) Compromised family coping related to necessary role changes
B) Interrupted family processes related to effect of illness on family members
C) Risk for caregiver role strain related to burdens of caregiving responsibilities
D) Impaired home maintenance related to perceived role changes

Question 17

Before insertion of the radioactive implant, the nurse tells the patient what to expect while it is in place. Which statement is accurate?

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) "Pain or discomfort is a common side effect of this type of radiation."
D) "Your bed linens will be completely changed each day to minimize radioactive contamination."

Question 18

A patient, age 59, has lost 10 pounds in the first 3 weeks of her radiation therapy and does not eat because nothing tastes good. Which is an appropriate nursing diagnosis for her?

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 19

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). Which procedure is indicated next?

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

Question 20

In the nursing interventions for a patient receiving external radiation treatments for a malignancy, the nurse must remember to

A) cleanse with soap and water the areas of entry or "ports" marked by the radiologist.
B) apply some form of ointment with a metallic base to the area of entry each time the patient goes for x-ray treatments.
C) instruct the patient to avoid irritating the "ports" by not lying on that part of the body and not wearing constricting clothing.
D) isolate the patient so he will not expose others to radiation.

Question 21

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

A) whole blood transfusion.
B) a bone marrow biopsy.
C) immediate radiation treatment.
D) dialysis.

Question 22

The only definitive way to determine the presence of malignant cells is to perform

A) laboratory tests.
B) a tissue biopsy.
C) an MRI.
D) a CT scan.

Question 23

_________ is the term for uncontrolled or abnormal growth of cells. They may be benign or malignant.

Question 24

Seeking medical attention when any cancer warning signs occur is frequently delayed because of

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 25

Men over age 50 should have annual _________ tests and rectal examinations.

Question 26

The term ____________ is used for various substances that are known to contribute to cancer.

Question 27

Chemical means of pain management include the use of opioids and nonopioids. A valuable nonopioid analgesic in the treatment of certain levels of cancer pain is

A) steroids.
B) acetaminophen.
C) codeine.
D) morphine.

Question 28

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 29

The following characteristics are 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 30

A patient is undergoing external radiation therapy on an outpatient basis for treatment of Hodgkin's 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 for him?

A) Frequent rest periods are helpful.
B) Exercise vigorously when fatigue is not as noticeable.
C) Maintain bed rest until the radiation treatment is completed.
D) Consult with a psychiatrist for treatment of depression.

Question 31

Which are 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 32

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

A) Oranges, peaches, pears
B) Pasta, bread, muffins
C) Bacon, pork, beef
D) Chicken, pinto beans, asparagus
E) Ice cream, cheese, butter
F) Pretzels, gelatin dessert, applesauce

Question 33

A patient, age 43, had a biopsy of a lump in her right breast that revealed a benign tumor. The nurse explains to her 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 34

The patient receiving radiation therapy often has conspicuous skin markings left on the skin after treatment. What is the most appropriate nursing implication regarding these markings?

A) They are residue of the treatment and must be washed off.
B) They are caused by radiation and will be permanent.
C) They indicate an allergic reaction and should be reported.
D) They are guidelines for treatment and should be left on.

Question 35

Methods of early cancer detection include

A) digital rectal examinations every year after age 60.
B) Hematest of stool for blood every year after age 70.
C) chest radiograph evaluation every year.
D) mammogram baseline at age 35 to 39, then every year after age 50 for women.

Question 36

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

Question 37

A patient receiving chemotherapy has been told he has thrombocytopenia. He is getting ready to do his morning care. Which is an appropriate teaching measure to include?

A) "Take an aspirin before beginning; it will help with your pain."
B) "Trim your toenails close to prevent infection."
C) "Use an electric shaver."
D) "Be sure to scrub your teeth vigorously."