Terminology
A neoplasm can best be described as?
A.a tumor lacking structural differentiation
B.the production of cancer
C.any abnormal growth of new tissue that may be harmless (benign) or cancerous (malignant)
D.genes found in the chromosomes of tumor cells
C. What is any abnormal growth of new tissue that may be harmless (benign) or cancerous (malignant)?
Rationale: A neoplasm is the abnormal proliferation of cells. It can be pre-cancerous or cancerous.
The oldest form or cancer treatment, that can eliminate cancer or reduce the risk of cancer development.
A) Chemotherapy
B) Surgical therapy
C) Radiation therapy
D) Biologic and Target therapy
B. What is Surgical therapy?
Rationale: Surgical therapy was the only effective method of cancer treatment in the past. Surgical therapy can be preventative (prophylactic mastectomy), cure or control (removal of all or a portion of the tumor), or palliative (laminectomy).
A female client with breast cancer is receiving chemotherapy and develops thrombocytopenia. The nurse identifies which intervention as the highest priority in the nursing plan of care?
a. Monitoring temperature
b. Ambulation three times daily
c. Monitoring the platelet count
d. Monitoring for pathological fractures
C. What is monitoring the platelet count?
Rationale:Thrombocytopenia indicates a decrease in the number of platelets in the circulating blood. A major concern is monitoring for and preventing bleeding. Option A relates to monitoring for infection, particularly if leukopenia is present. Options B and D, although important in the plan of care, are not related directly to thrombocytopenia.
The nurse is teaching a client about the risk factors associated with breast cancer. The nurse determines that further teaching related to breast cancer is necessary if the client identifies which of the following as an associated risk factor?
A. Age of younger than 20 years
B. Oral contraceptives
C. Family history of breast cancer
D. Radiation exposure
A. Age of younger than 20 years
Rationale: Breast cancer risk factors include age older than 25 years, a family history of the disease, oral contraceptives, and radiation exposure.
After receiving chemotherapy for breast cancer, a clients platelet count falls to 98,000 microliters. What term should the nurse use to describe this platelet count?
A. Anemia
B. Leukopenia
C. Thrombocytopenia
D. Neutropenia
C. What is thrombocytopenia?
Rationale: A normal platelet count is 150,000 microliters in adults, the clients lab value reflects reduced platelet counts or thrombocytopenia.
Mr. Miller has been diagnosed with breast cancer. You know this type of cancer is classified as:
A. Sarcoma
B. Lymphoma
C. Carcinoma
D. Melanoma
C. What is Carcinoma ?
Rationale: Ductal or lobular carcinomas; Tumors that start in the epithelial cells that line organs and tissues throughout the body.
Sarcomas (connective tissue, muscle, bone, and fat)
Lymphomas (lymph nodes, spleen and bone marrow)
Melanoma (skin)
A therapy that provides localized treatment of cancer, resulting in lethal and sublethal damage to cellular DNA.
A) Chemotherapy
B) Surgical therapy
C) Radiation therapy
D) Biologic and Target therapy
B.What is Radiation therapy?
Rationale: Radiation therapy uses x-rays, gamma rays, and particulate radiation to cause lethal and sublethal damage to cancer DNA so that cells are unable to replicate or protein synthesis is impaired enough that the cells are unable to survive.
The nurse is caring for a female client experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. The nurse plans to:
a. Restrict all visitors
b. Restrict fluid intake
c. Teach the client and family about the need for hand hygiene
d. Insert an indwelling urinary catheter to prevent skin breakdown
C. What is teaching the family about the need for hand hygiene?
Rationale: In the neutropenic client, meticulous hand hygiene education is implemented for the client, family, visitors, and staff. Not all visitors are restricted, but the client is protected from persons with known infections. Fluids should be encouraged. Invasive measures such as an indwelling urinary catheter should be avoided to prevent infections.
The primary difference between benign and malignant neoplasms is the:
A.Rate of cell proliferation
B.Site of malignant tumor
C.Requirements for cellular nutrients
D.Characteristic of tissue invasiveness
D. Characteristic of tissue invasiveness
Rationale: The clinical staging classification system determines the anatomic extent of the malignant disease process by stages. The TNM classification system is used to determine the anatomic extent of the disease involvement according to three parameters: tumor size and invasiveness (T), presence or absence of regional spread to the lymph nodes (N), and metastases to distant organ sites (M).
The male client is receiving external radiation to the neck for cancer of the larynx. The most likely side effect to be expected is:
a. Dyspnea
b. Diarrhea
c. Sore throat
d. Constipation
C. What is a sore throat
Rationale:In general, only the area in the treatment field is affected by the radiation. Skin reactions, fatigue, nausea, and anorexia may occur with radiation to any site, whereas other side effects occur only when specific areas are involved in treatment. A client receiving radiation to the larynx is most likely to experience a sore throat. Options B and D may occur with radiation to the gastrointestinal tract. Dyspnea may occur with lung involvement.
Brachytherapy consists of:
a)Insertion of radioactive materials directly into the tumor
b)Implantation of radioactive materials in close proximity adjacent to the tumor
c)Radiation from a megavoltage treatment machine
d)Both a and b
D. What is a and b insertion of radioactive materials directly into the tumor and implantation of radioactive materials in close proximity adjacent to the tumor?
Rationale: Brachytherapy consists of the implantation or insertion of radioactive materials directly into the tumor or in close proximity adjacent to the tumor
The nurse is caring for a patient experiencing neutropenia as a result of chemotherapy and develops a plan of care for the client. The nurse plans to:
A) Restrict all visitors.
B) Restrict fluid intakes.
C) Teach the client and family about the need for hand hygiene.
D) Insert an indwelling urinary catheter to prevent skin breakdown.
C.What is, teach the client and family about the need for hand hygiene?
Rationale: In a neutropenic client, meticulous hand hygiene education is implemented for the client, family, visitors and staff. Not all visitors are restricted, but the client is protected from persons with known infection. Fluids should be encouraged. Invasive measures such as an indwelling urinary catheter should be avoided to prevent infections.
For a female client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the plan of care?
a. Administering aspirin if the temperature exceeds 102° F (38.8° C).
b. Inspecting the skin for petechiae once every shift.
c. Providing for frequent rest periods.
d. Placing the client in strict isolation.
B. What is inspecting the skin for petechiae once every shift?
Rationale: Thrombocytopenia impairs blood clotting, the nurse should inspect the client regularly for signs of bleeding, such as petechiae, purpura, epistaxis, and bleeding gums. The nurse should avoid administering aspirin because it may increase the risk of bleeding. Frequent rest periods are indicated for clients with anemia, not thrombocytopenia. Strict isolation is indicated only for clients who have highly contagious or virulent infections that are spread by air or physical contact
A characteristic of the stage of progression in the development of cancer is:
A. Oncogenic viral transformation of target cells
B. A reversible steady growth facilitated by carinogens
C. A period of latency before clinical detection of cancer
D. Proliferation of cancer cells in spite of host control mechanisms
D. What is Proliferation of cancer cells in spite of host control mechanisms
Rationale: Progression is the final stage of cancer. This stage is characterized by increased growth rate of the tumor, increased invasiveness, and spread of the cancer to a distant site (i.e., metastasis). Progression occurs as a result of the following characteristics of cancer cells: rapid proliferation, decreased cell adhesion, and production of metalloproteinase enzymes.
Nurse Bea is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which of the following would the nurse expect to note specifically in this disorder?
a. Increased calcium
b. Increased white blood cells
c. Decreased blood urea nitrogen level
d. Decreased number of plasma cells in the bone marrow
A. What is increased calcium?
Rationale: Findings indicative of multiple myeloma are an increased number of plasma cells in the bone marrow, anemia, hypercalcemia caused by the release of calcium from the deteriorating bone tissue, and an elevated blood urea nitrogen level. An increased white blood cell count may or may not be present and is not related specifically to multiple myeloma.
Benign tumor is?
a) Undifferentiated
b) Fairly normal similar to parent cells
c) Capable of metastasis
d) Categorized as harmful to the body
B. What is fairly normal similar to parent cells
Rationale: Benign neoplasm is well differentiated, fairly normal similar to parent cells
Nurse Joy is caring for a client with an internal radiation implant. When caring for the client the nurse should observe which of the following principles?
A) Limit the time with the client to 1 hour per shift.
B) Do not allow pregnant women into the client’s room.
C) Remove the dosimeter badge when entering the client’s room.
D) Individuals younger than 16 years old may enter the room as long as they are 6 feet away from the client.
B. What is, do not allow pregnant women into the client’s room?
Rationale: The time that the nurse spends in a room of a client with an internal radiation implant is 30 minutes per 8 hour shift. The dosimeter badge must be worn when in the client’s room. Children younger than 16 and pregnant women are not allowed in the room.
During chemotherapy, an oncology client has a nursing diagnosis of impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to decrease the pain of stomatitis?
a. Recommending that the client discontinue chemotherapy.
b. Providing an alcohol free and sugar free mouth rinse.
c. Monitoring the client’s platelet and leukocyte counts.
d. Checking regularly for signs and symptoms of stomatitis.
B. What is providing an alcohol free and sugar free mouth rinse.
B. To decrease the pain of stomatitis, the nurse should provide a mouth rinse without alcohol and sugar. (ie Biotene) (Commercially prepared mouthwashes contain alcohol and sugar which may cause dryness and irritation of the oral mucosa.) The nurse also may administer viscous lidocaine or systemic analgesics as prescribed. Stomatitis occurs 7 to 10 days after chemotherapy begins; thus, stopping chemotherapy wouldn’t be helpful or practical. Instead, the nurse should stay alert for this potential problem to ensure prompt treatment. Monitoring platelet and leukocyte counts may help prevent bleeding and infection but wouldn’t decrease pain in this highly susceptible client. Checking for signs and symptoms of stomatitis also wouldn’t decrease the pain.
A 33-year-old patient has recently been diagnosed with stage II breast cancer. The nurse would understand that the patient’s cancer:
A. Is in situ.
B. Has metastasized.
C. Has spread locally.
D. Has spread extensively.
C. Has spread locally
Rationale: The clinical staging classification system determines the anatomic extent of malignant disease process. Stage 0 –cancer in situ, Stage 1- tumor is limited to the tissue of origin; localized tumorgrowth, Stage 2- limited local spread, Stage 3- extensive local and regional spread, and Stage 4- metastasis.
Vanessa, a community health nurse conducts a health promotion program regarding breast cancer to community members. The nurse determines that further information needs to be provided if a community member states that which of the following is a sign of breast cancer?
a. Alopecia
b. Lump or thickening of surrounding tissue
c. Newly inverted nipple
d. Redness or pitting of the skin
A. What is Aleopecia?
Alopecia is not an assessment finding in breast cancer. Alopecia may occur, however, as a result of radiation or chemotherapy. Options B, C, and D are assessment findings in breast cancer.
A Biopsy is?
a)The use of chemicals as a systemic therapy for cancer
b)The removal of a tissue sample
c)The emission and distribution of energy through a medium
d)A type of an X ray
B. What is the removal of a tissue sample?
Rationale: A biopsy is the removal of a tissue sample for pathologic review
A female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy?
A) Urine output of 400 ml in 8 hours.
B) Serum potassium level of 3.6 mEq/L.
C) Blood pressure of 120/64 to 130/72 mm Hg.
D) Dry oral mucous membranes and cracked lips.
D. What is dry oral mucous membranes and cracked lips?
Rationale: Chemotherapy commonly causes nausea and vomiting, which may lead to fluid and electrolyte imbalances. Signs of fluid loss include dry oral mucous membranes, cracked lips, decreased urine output (< 40ml/hr), abnormally low blood pressure, and a serum potassium level < 3.5 mEq/L
Patient with breast cancer is undergoing chemotherapy has bone marrow suppression, the nurse should:
a. Encourage family member support through multi family member visitations to prevent patient loneliness and depression.
b. Report absolute neutrophil count of 1800 as neutropenia
c. Avoid showering daily to prevent potential skin cracking and drying.
d. Report temperature of 100.4 degrees F as fever.
e. Consume fresh uncooked fruits and vegetables to increase vitamin intake during chemotherapy.
D. What is to report temperature of 100.4 ⁰ F as fever?
Rationale: Patient should be encouraged to avoid large crowds and people with infections. Neutropenia is defined by the ANC as less 1000 cells; Patient should bathe or shower daily, moisturizer can be used to prevent dryness and cracking. Avoid uncooked and unwashed fruits and vegetables.
A client has an abnormal result on a Papanicolaou test. After admitting, she read her chart while the nurse was out of the room, the client asks what dysplasia means. Which definition should the nurse provide?
A. Presence of completely undifferentiated tumor cells that don’t resemble cells of the tissues of their origin
B. Increase in the number of normal cells in a normal arrangement in a tissue or an organ
C. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn’t found
D. Alteration in the size, shape, and organization of differentiated cells
C. What is the replacement of one type of fully differentiated cell by another in tissues where the second type normally isn’t found
Rationale: Dysplasia refers to an alteration in the size, shape, and organization of differentiated cells. The presence of completely undifferentiated tumor cells that don’t resemble cells of the tissues of their origin is called anaplasia. An increase in the number of normal cells in a normal arrangement in a tissue or an organ is called hyperplasia. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn’t found is called metaplasia.
Nurse Farah is caring for a client following a mastectomy. Which assessment finding indicates that the client is experiencing a complication related to the surgery?
a. Pain at the incisional site
b. Arm edema on the operative side
c. Sanguineous drainage in the Jackson-Pratt drain
d. Complaints of decreased sensation near the operative site
B. What is arm edema?
Rationale: Arm edema on the operative side (lymphedema) is a complication following mastectomy and can occur immediately postoperatively or may occur months or even years after surgery. Options A, C, and D are expected occurrences following mastectomy and do not indicate a complication