Deck 6: Neoplasia

Question 1

Which of the following characteristics could apply to healthy somatic cells rather than cancerous cells?

A) A high rate of mutation exists in the cells.
B) The cells have a reduced tendency to cluster together.
C) They remain viable and multiply without attachments to other cells and the extracellular matrix.
D) The cells are unable to proliferate except by mitotic division.

Answer 1

The cells are unable to proliferate except by mitotic division.

Question 2

Following a biopsy, a 54-year-old man has been diagnosed as having a benign neoplastic tumor. Which of the following characteristics most likely applies to his tumor?

A) The tumor is poorly approximated and has the potential to break loose.
B) The tumor may secrete hormones or cytokines.
C) The well-differentiated, neoplastic cells are clustered together in a single mass.
D) It has a rapid rate of growth and can induce ischemia.

Answer 2

The well-differentiated, neoplastic cells are clustered together in a single mass.

Question 3

A 77-year-old male client with a diagnosis of stomach cancer has been found to have metastases in his liver. The client and his family are surprised at this turn of events, stating that they do not see how he could have developed cancer in his liver. Which of the following facts would underlie the reply that the care team provides?

A) The parenchymal tissue of the liver is particularly susceptible to secondary malignancies.
B) The portal circulatory system brings venous blood from the GI tract into the liver.
C) Hepatic stromal tissue shares characteristics with cancerous cells, including lack of anchorage dependence.
D) The proximity of the liver to the stomach allows for direct spread of cancerous cells due to a lack of contact inhibition.

Answer 3

The portal circulatory system brings venous blood from the GI tract into the liver.

Question 4

A 41-year-old female with a family history of breast cancer has had a baseline mammogram. She states that she performs monthly self-breast exams but really has a hard time evaluating her lumps since she has numerous cysts. At her annual mammogram, the technician views a suspicious area and refers her to the radiologist. She asks the nurse in the office, "How can a lump appear so quickly?" The nurse's response is based on which of the following principles?

A) A tumor is undetectable until it has doubled 30 times and contains at least 1 billion cells.
B) Many tumor cells never leave the M-phase of the cell cycle.
C) Cancer cells are undifferentiated and come in various shapes and sizes.
D) If the breast has a lot of cysts, then the fluid within those sacs makes it difficult to feel the hard lumps of a cancer.

Question 5

Unbeknownst to her or her care team, a 51-year-old woman's breast cancer has an etiology rooted in the fact that tumor-suppressing genes are present but have been silenced. Consequently, she has not synthesized normal cancer-suppressing proteins, and neoplasia has resulted. What process has accounted for the woman's cancer?

A) Chromosomal translocation
B) The "two-hit" hypothesis of carcinogenesis
C) Epigenetic mechanisms
D) A DNA repair defect

Question 6

Which of the following patients of a primary care physician would not require extra screening for cancer?

A) A 51-year-old woman whose grandmother died of breast cancer
B) A 48-year-old man who takes immunosuppressant drugs following a kidney transplant
C) A 50-year-old male who is obese and has a low-fiber, high-fat diet
D) A 38-year-old female with Down syndrome and congenital scoliosis

Question 7

Blood-borne cancerous cells have recently spread from a woman's primary tumor in her pancreas to her bones. Which of the following components of the woman's immune system are likely to be directly involved in the attempt to eradicate the potential metastasis? Select all that apply.

A) T lymphocytes
B) Macrophages
C) Natural killer (NK) cells
D) B cells
E) Mast cells

Question 8

A woman is surprised to read on the Internet that certain infections can cause cancer and has sought clarification from her family physician during an office visit. How can the physician best respond to the woman's query?

A) "Though it's not particularly common, it's true that certain bacteria and viruses can lead to cancer."
B) "Most cancers that cannot be attributed to family history or lifestyle are in fact associated with viruses."
C) "There are many viruses, but only a very few of them have been shown to cause cancer in humans."
D) "This is true; for example, HIV has been shown to cause cancer in some patients.

Question 9

The family of a 68-year-old man who is in the end stages of small cell lung cancer are distraught at his visible body wasting that has worsened in recent weeks. Which of the following phenomena best accounts for the client's anorexia and cachexia?

A) Inadequate cellular metabolism of glucose results from tumor factors.
B) High fat losses coupled with preservation of muscle mass exaggerate the appearance of wasting.
C) Products of the tumor itself as well as a hypermetabolic state cause cachexia.
D) Inadequate food intake due to symptoms and treatment results in loss of both muscle and fat.

Question 10

The nurse caring for a lung cancer patient with metastasis to the brain suspects the patient has developed a paraneoplastic syndrome known as syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Which laboratory result in this patient who has gained 3 lb in a day would alert the nurse to the possibility of SIADH?

A) Serum potassium of 5.0 mmol/L
B) Serum sodium of 115 mmol/L
C) BUN of 8 mg/dL
D) Hematocrit of 40%

Question 11

A 60-year-old man has presented to a clinic and is requesting screening for tumor markers after reading about them in a magazine. What can the clinician most accurately tell the man about the clinical use of tumor markers?

A) "Tumor markers are a very useful screening tool, but they only exist for a very few types of cancer."
B) "Tests for the presence of tumor markers are limited by the fact that they are only accurate in the very early stages of cancer."
C) "Tumor markers are an excellent screening tool, but it's only practical to test for those cancers that you're at risk of."
D) "Tumor markers alone aren't enough to confirm whether you have cancer or not, so they're not a very useful screening tool."

Question 12

A 51-year-old female has been found to have a metastatic lesion in her lung, and her oncologist is unsure of the site of the primary tumor. Which of the following procedures is most likely to aid in this determination?

A) Immunohistochemistry
B) Tumor markers
C) Microarray technology
D) Tissue biopsy

Question 13

Which target of both chemotherapy and radiation treatment accounts for adverse as well as therapeutic effects?

A) Cell surface receptors
B) Circulating hormone levels
C) Blood vessels
D) Rapidly proliferating cells

Question 14

Upon entering the room of a 74-year-old client receiving brachytherapy for cervical cancer, you find the radiation implant and the position-holding device in the client's bed. What is the nurse's first best action?

A) Assess the client's mental status.
B) Use tongs to place the implant in the radiation container.
C) Notify the physician and move the client to a different room.
D) Don gloves and attempt to reposition the implant and positioning device.

Question 15

A cancer patient has been prescribed 5-fluorouracil, an antimetabolite chemotherapy agent. This medication stops normal development and division by interrupting the S-phase of the cell cycle. When teaching this patient, the nurse explains that during the S-phase of the cell cycle,

A) the cell is in a prolonged resting state and only leaves this state when cellular destruction is occurring.
B) the DNA synthesis stops, but RNA synthesis continues.
C) nuclear division occurs.
D) the synthesis of DNA occurs, causing two separate sets of chromosomes to develop.

Question 16

A 61-year-old male client is scheduled to begin chemotherapy for the treatment of his bone cancer shortly. Staff at the cancer center have educated the man and his wife about the goals, course, and expectations of his treatment. Which of the following medications and treatments might the man anticipate needing during and after his course of treatment?

A) Analgesia and corticosteroids
B) Antiemetics and packed red blood cell (PRBC) transfusions
C) Whole blood transfusion and antiplatelet aggregators
D) Diuretics and selective serotonin reuptake inhibitors (SSRIs)

Question 17

A patient with malignant melanoma has been prescribed alpha interferon, a biologic response modifier. Since this drug prolongs the cell cycle, increasing the percentage of ^{cells in the G}0 ^{phase, and stimulates NK cells and T-lymphocyte killer cells, the nurse} can anticipate that he may experience which of the following common side effects?

A) Fever, chills, and fatigue
B) Nausea, vomiting, and diarrhea
C) Opportunistic infections like Candida
D) Renal damage with an increased creatinine level

Question 18

An oncology nurse who has worked for many years providing care for children with cancer has taken a job on an adult oncology unit of a hospital. What differences might the nurse anticipate in this new job?

A) There will be a greater number of cancers that are epithelial in origin.
B) A greater proportion of the clients will have cancer that involves the hematopoietic system.
C) The nurse will be working with more clients who have blastomas.
D) More clients will be receiving treatment for leukemia.

Question 19

A 26-year-old man who survived childhood acute lymphocytic leukemia (ALL), one of the most common childhood cancers, now complains of weakness, fatigue, and shortness of breath. His treatment for ALL likely included anthracyclines. What is the most likely cause of his symptoms?

A) Recurrence of ALL
B) CNS problems resulting from childhood chemotherapy
C) Heart failure resulting from childhood chemotherapy
D) Hormonal dysfunction resulting from childhood chemotherapy

Question 20

The mother of an 18-month-old child is concerned that her child is lethargic and is not eating foods that he normally enjoys. She takes him to the pediatrician for a check-up. Which of the following clinical manifestations would lead the health care provider to suspect the child may have a neuroblastoma? Select all that apply.

A) Large protruding abdomen
B) Excessive burping
C) Weight loss
D) Large amount of pale urine
E) Crying when position is changed.