Cancer

What are the signs?

100

Name the 7 sign of cancer (Hint C-A-U-T-I-O-N)

Change in bowel and bladder habits. Any sore that does not heal. Unusual bleeding or discharge. Thickening or lump in breast or elsewhere. Indigestion. Obvious change in wart or mole. Nagging cough or hoarseness.

200

What are some warning signs that may indicate a cancerous brain tumor?

Headache (that is worse in the morning and worsens with cough, sneezing or bending over), Mental and personality changes, Stroke like symptoms, seizures, and nausea and vomiting.

300

What are the warning signs of breast cancer?

Change in look or feel of breast. Retraction, dimpling, lump, hard knot or thickening, edema, warmth, redness or darkening, change in size, discharge, pain (most often because it metastasized).

400

Signs of colon cancer:

Bloody stools (stools can be black-tarry in appearance or bright red depending on location of bleed), change in stool frequency (diarrhea or constipation for more than a few days), abdominal pain, constant fatigue and weight loss.

500

Signs of lung cancer:

Cough that last more than few weeks, blood tinge sputum (hemoptysis), Shortness of breath (dyspnea), Pain (shoulder, back, chest or arms), Repeated infections (pneumonia or bronchitis).

When do you assess/ Risk factors:

100

Breast cancer exams starting at:

Breast self-exam (BSE) start by age 20 done monthly, Clinical breast exam done during yearly check-up, Mammograms start at 50 and have done every 2 years or earlier if FMH indicates cancer.

200

Colon cancer exams starting at:

When presence of polyps, family hx of cancer, or IBD or other diseases processes that effect the GI tract start before age 50. If FMH of colon cancer start 10 before their age of dx or by 50.

300

What age group is more likely to develop brain cancer?

Overall age 65 and older but depends on the type and location of cancer.

400

Bladder cancer risk factors:

Smoking, Workplace chemical exposure (ex: benzidine and beta-naphthylamine), being Caucasian (are twice as likely to develop), age 55 or older, More common in men, Chronic bladder infections, any personal of family hx of UT cancers, bladder exstrophy (born with bladder outside of the body) and other bladder birth defects, Chemotherapy and radiation, Arsenic exposure (most likely from well water), and low fluid consumption.

500

Pancreatic cancer risk factors:

Diabetes, African-American race, obesity or being over-weight, FMH or personnel hx of pancreatic cancer, smoking, genetics, and hx of pancreatitis.

NCLEX Style Questions r/t Risk

100

Which of the following clients would be at greatest risk for developing colorectal cancer? A) Client who has been smoking for 20 years. B) The client who eats a high fiber diet. C) A client who has been treated for Crohn’s disease for 20 years. D) The client who has a family history of lung cancer.

C) Try to eliminate first. Smoking and history of lung cancer put the client at greatest risk for lung cancer. A high in fiber is not a risk factor. However, a diet low in fiber with fatty foods is considered at an increased risk. The client who has a history of Crohn’s would experience the most amount of irritation to bowels and would be most likely to develop colorectal cancer.

200

Which of the following cancers has been linked to a high fat diet? A) Liver B) ovarian C) Colon D) Lung

C) The colon would be most likely to be effected by the high fat diet. The other cancers have no such evidence suggesting they are directly affected.

300

A 24 y/o male undergoes bone marrow aspiration at a clinic to try to establish whether he has lymphoma. Which are the correct discharge instructions? (Select all that apply) A) I can take Tylenol for pain B) I can take Aspirin for pain C) I will not be able to play basketball for 2 days D) I can apply a cold compress to the site E) I don’t need to look at the site. .

A, C, D are correct. You do not want the client taking aspirin because of increased risk for bleeding. Contact sports should be avoided for the first few days. Cool compress is good practice to reduce swelling and bruising. The puncture site needs to be looked at q2h in order to assess for possible signs bleeding and excessive bruising

400

Which of the following is at greatest risk for developing skin cancer? A) 45 y/o Nurse B) 15 y/o high school student C) 70 y/o farmer D) 70 y/o mountain biker

D) The 70 y/o mountain biker would over his life-time have spent the most amount of time in the sun. We must also factor in the altitude when thinking of exposure. The farmer is also a good choice but it is not the best answer when all is taken into consideration. The other choices are younger in age and would not be the greatest risk for developing skin cancer.

500

Which of the following would benefit the most from education about sun exposure and the risk of melanoma? A) Senior citizens with repeated exposure B) Adults older than 40 y/o C) Chemical factory employees D) Parents with children

D) Parents with children would benefit the most because they would start applying sun screen to their children. The children would also learn from their parents. Everybody else should be taught about exposure but the other groups have already been exposed longer than the children would have been.

Chemotherapy and radiation NCLEX Style Questions

100

A 42 y/o female client is prescribed Doxorubicin for her breast cancer. The client is upset about hair loss. The nurse should A) Explain hair loss is temporary B) Have the client massage their scalp to stimulate hair growth C) Provide resources for wig selections D) Recommend limited social contact

C) is the best response because you want to provide resources due to the client’s negative feelings about hair loss. A) is not providing longer term solution to the problem. B) is not helpful and will increase hair loss D) the client should be encouraged to socialize not discouraged.

200

A 72 y/o female is receiving monthly chemotherapy for treatment of stage III colon cancer. Which labs should be reported to the oncologist before the next treatment of chemotherapy? Select all that apply: A) BUN of 12mg/dL B) Hemoglobin 14.5g/dL C) Urine specific gravity of 1.020 D) Platelet count of 40,000/mm3 E) WBC 2,300/mm3 F) Temperature of 101.2

D (LOW),E (LOW) ,F (HIGH) all indicate possible infection and should be reported. A, B, C are all WNL.

300

The nurse is teaching a client about expectation of high dose chemotherapy and neutropenia. What is an EARLY indication of infection in a neutropenic client? A) FEVER B) CHILLS C) DYSPENEA D) TACHYCARDIA

A) IS THE BEST ANSWER BECAUSE BOTH B AND C ARE NOT ALWAYS SEEN OR EXPERIENCED BY THE CLIENT. TACHYCARDIA USUALLY FOLLOWS A FEVER.

400

A client receiving external beam radiation after right axilla lumpectomy should be taught to do which of the following? A) Use an ice pack under the right arm B) Place deodorant under the left arm only C) Use a heating pad under the right arm D) immobilize the arm after treatment

B) Is the only correct choice. Both A and C are contraindicated and you want the client to continue to use the arm to prevent tissue breakdown and atrophy.

500

A client is receiving external beam radiation for treatment of lung cancer. The nurse should assess the client for? A) Normal WBC count B) Diarrhea C) Improved energy level D) Dysphagia

D) R/T the client receiving radiation to the chest. Diarrhea would be expected if the treatment field was the abdomen. You would expect decreased energy level and WBC count.

Management of Symptoms

100

The nurse should recommend to a client receiving to head and neck who has been experiencing stomatitis. The nurse recommend which of the following: A) Evaluation by a dentist B) Artificial saliva C) Vigorous brushing D) alcohol-based mouth wash

Artificial saliva is the best choice because it will treat the dry mouth of the client and prevent further complication of stomatitis. Both C and D will increase irritation. You want a dentist consult prior to treatment.

200

The client with lymphedema has an increased risk for developing cellulitis and lymphangitis because of: A) Fragile capillaries B) Stagnation of accumulated fluid C) Increase use of extremity

C ) Stagnation of fluid can cause infection.

300

The most common issues that effect a cancer clients ability to sleep in a hospital setting is: A) Social B) Nutritional C) Cultural D) Psychological

D) Psychological r/t depression and anxiety (Pain is often a factor as well)

400

The nurse expect which client to be receiving a single donor platelet order? A) Client receiving multiple transfusions B) Client deficient in coagulation factors C) Client who has a platelet count greater than 60,000/mm3

A) The client receiving several transfusions, because the client could develop antigens thereby decreasing the number of platelets available

500

Terminal ill 89 y/o client in hospice and experiencing nausea and vomiting because of a partial SBO. The first action by the nurse to control the nausea and vomiting would be: A) NG tube placement B) I.V. anti-emetics C) laxatives D) clear liquid diet

D) Clear liquid Diet is least invasive