Ch15-Summary&Questions

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tford7
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Ch15-Summary&Questions
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2011-09-26 18:19:23
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Ch15 Summary Questions
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  1. _________ is defined as a group of diseases characterized by abnormal growth and spread of cells.
    Cancer
  2. At least what percentage of cancer cases are caused by environmental factors, including lifestyle choices, which makes health counseling an important nursing role.
    66%
  3. What are the three goals of cancer treatment?
    • cure the cancer
    • control it's spread and manage it as a chronic illness (chronic meaning multi symptoms)
    • easy symptoms and maximize quality of life
  4. There are a wide variety of diagnostic tests for cancer, name a few.
    laboratory tests (tumor marker tests; such as - CEA & PSA; blood; urine; and other body fluids); no one value or lab test is specific for cancer they can only indicate the presence of cancer; Radiographic tests (X-ray, ultrasound, CT, MRI w/ or w/out contrast, bone scans, nuclear medicine imaging, and PET scans); Biopsies - removal of sample of tissue (determines if the mass is a tumor or a cyst, adhesion, or other structure such as calcification); and bone marrow aspiration (preformed to obtain a small amount of bone marrow for microscopic examination).
  5. What are the different types of biopsies?
    Needle (needle aspiration, stereotactic needle aspiration, and core needle procedure), surgical (preformed to procure a larger piece of tumor tissue), and bone marrow aspiration
  6. What are the three most common treatments for cancer?
    Surgery, Radiation, and Pharmacotherapy (chemotherapy)
  7. What other therapies should the nurse be aware of in regards to cancer treatment?
    hormone therapy (goal is to prevent hormones to from stimulating the growth of cancer cells); biological therapy (using substances naturally produced by the immune system to fight cancer either directly or indirectly or to lessen the side effects that may be caused by some cancer treatments); bone marrow transplantation or peripheral blood stem cell transplantation (these are procedures to restore cells necessary to produce blood cells); and complementary and alternative therapies.
  8. ________ _______ _______ is a side effect common to many cancer treatments, making risk of infection a major concern.
    Immune system suppression
  9. _________ has emerged as the most distressing and persistent treatment side effect, surpassing nausea and vomiting, which are also major nursing issues.
    Fatigue
  10. What are the three main types of myelosuppression a patient is at risk for, resulting from bone marrow suppression.
    anemia, neutropenia, and thrombocytopenia
  11. _______ _______ is a loss of the ability to remember certain things, learn new skills, and complete certain tasks.
    Cognitive impairment
  12. Throughout the diagnosis and treatment of cancer, the nurse should consider both the ________ and the _______ when offering coping strategies.
    patient; caregiver
  13. Research indicates that over ______ % of patients with cancer do not get adequate relief from pain even though therapy exist to relieve almost all cancer pain.
    40
  14. While cancer is now managed as a ______ _______, there are multiple oncological emergencies.
    chronic illness
  15. Because of the many side effects impacting the nutrition and the effect of poor nutrition on healing outlook, and comfort, the nurse should aggressively monitor what 2 things?
    0. Nutritional status & 2. Regular, even daily weights.
  16. A client was recently diagnosed with ductal cell carcinoma of the breast. The oncologist described the cancer as T2, N1, Mx. The client asked the nurse to repeat what "all those letters ad numbers mean." The nurse would reply that T2, N1, Mx means
    A) 2 tumors present, 1 lymph node involved, and many sites of metastasis
    B) 1 large tumor present, nodal involvement in 1 region, and metastasis was present
    C) 2 tumors present, 1 lymph node involved, and metastasis was present
    D) 1 tumor present which is larger than 2.5cm, nodal involvement in one region, and metastasis was unable to be determined
    D) 1 tumor present which is larger than 2.5cm, nodal involvement in one region, and metastasis was unable to be determined
    (this multiple choice question has been scrambled)
  17. A family member called the clinic to talk with the nurse regarding her sister's diagnosis of breast, bone, and lung cancers. She tells the nurse that she is extremely concerned because she was aware "ran in her family," but she could not recall that any family member had been diagnosed with bone or lung cancer. The nurse's best response would be
    a) "Well, it is apparent that your sister is not lucky. It is rare to have 3 such unrelated cancers at one time."
    b) "I think it is important for you to be tested for lung cancer ASAP because it has a strong hereditary link."
    c) "I am sorry to hear about your sister's recent diagnosis. Most probably your sister has breast cancer that has metastasized or spread to the bone and lungs."
    d) "I am sorry to hear about your sister. I think you should meet with al f your family members and share with them their increased risk for developing both lung and bone cancer."
    • c) "I am sorry to hear about your sister's recent diagnosis. Most probably your sister has breast cancer that has metastasized or spread to the bone and lungs."
    • Rationae: Common sites for metastasis related to breast cancer are the lungs and the bone
  18. During the planning of a community-wide cancer program, the nurse shares that focus is on secondary prevention. Related activities, would include:
    a) a smoking cessation class
    b) information on dietary guidelines that include foods rich in antioxidants
    c) instruction on testicular self-exam
    d) instruction on herbal supplements that are chemo-protective
    • c) instruction on testicular self-exam
    • Rationale: Screening is part of secondary prevention due to early detection
  19. In caring for a client during the time of nadir, the nurse must be sure to assess for which of the following?
    A) Low potassium levels
    B) High creatinine levels
    C) Low absolute neutrophil count
    D) High thrombocyte count
    C) Low absolute neutrophil count
    (this multiple choice question has been scrambled)
  20. In providing instruction to a client after external beam radiation therapy for skin cancer, the nurse instructs the client to:
    a) wash off all marking applied in the radiation department between treatments
    b) apply cold to irradiated area for 15 minute intervals at least 3 times a day to decrease discomfort
    c) limit creams or lotions used on irradiated areas to those that have been approved by the oncology HCP
    d) avoid close contact with others for at least 2 weeks to reduce their exposure to radiation
    • c) limit creams or lotions used on irradiated areas to those that have been approved by the oncology HCP
    • Rationale: Damage to the skin must be avoided and many OTC creams and lotions contain alcohol which can dry
  21. As the nurse is preparing to administer doxorubicin (Adriamycin) to a client in the outpatient cancer clinic, approximately 30mL of the fluid leaks onto the counter. The most appropriate nursing action is:
    a) wipe up the spill with a paper towel and cleanse the surface with alcohol
    b) call the pharmacy and have a technician come to the floor to clean up the spill
    c) locate the chemotherapy spill kit on the client unit and follow the instructions for clean up
    d) request the client care assistant wipe up the spill and prepare to administer the medication
    • c) locate the chemotherapy spill kit on the client unit and follow the instructions for clean up
    • Rationale: All chemotherapeutic agents are considered vesicants, so special care should be taken
  22. In providing nursing care to a client who has a cesium implant in place for the treatment of cervical cancer, the nurse should be aware that:
    A) the client will be up ad-lib with bathroom privileges
    B) no special radiation precautions must be observed
    C) shielding oneself and visitors from radiation is the single most important precaution
    D) both the staff and visitors must limit time spent in the client's room
    D) both the staff and visitors must limit time spent in the client's room
    (this multiple choice question has been scrambled)
  23. A client is started on the colony-stimulating factor Neupogen after 10 days of chemotherapy. Which of the following lab values would be most indicative of the effectiveness of the neumega (Filgrastim)?
    A) Absolute neutrophil 1100/mm3
    B) Absolute neutrophil count 750/mm3
    C) Hemaglobin 6.5 g/dL
    D) Hemaglobin 10 g/dL
    A) Absolute neutrophil 1100/mm3
    (this multiple choice question has been scrambled)
  24. A client is diagnosed with stage III colon cancer. He underwent external beam radiation prior to abdominal surgery. In considering the treatment approach, the nurse is aware that the client is at increased risk for:
    A) fatigue
    B) dehiscence
    C) anemia
    D) body image disturbance
    B) dehiscence
    (this multiple choice question has been scrambled)
  25. A female client, age 54, comes to the clinic and shares that her best friend was recently diagnosed with colon cancer. The client wants to know which cancer screening test she should have based on her age and sex. The nurse informs the client that ACS recommendations include the following:
    A) Flexible sigmoidoscopy every 3-5 years after age 50; mammogram and clinical breast exam every year after age 40; pap smear every year after age 18; and an annual physical that checks for a variety of other cancers.
    B) Flexible sigmoidoscopy every 10 years after age 50; mammogram and clinical breast exam every year after age 35; pap smear after age 21
    C) Colonoscopy every 7 years after age 45; mammogram and clinical breast exam after age 50; pap smear every year after age 18; and annual physical that checks for a variety of other cancers
    D) Colonoscopy every 3-5 years after age 50; mammogram and clinical breast exam every year after age 50; pap smear every year after age 21
    A) Flexible sigmoidoscopy every 3-5 years after age 50; mammogram and clinical breast exam every year after age 40; pap smear every year after age 18; and an annual physical that checks for a variety of other cancers.
    (this multiple choice question has been scrambled)

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