Deck 17: Cancer

Question 1

The nurse observes a suspicious mole on the back of an older adult who is undergoing palliative radiotherapy for brain metastasis.The nurse suspects that the mole:

A)is a result of the radiation.
B)is a secondary cancer.
C)will not be screened.
D)was the primary cancer.

Answer 1

will not be screened.

Question 2

While awaiting the results of testing to determine a diagnosis of cancer,an older adult patient asks a nurse to explain what happens when cancer metastasizes.The nurse responds:

A)"It is the result of prolonged exposure to an external agent."
B)"Cancer cells convert from transformed cells into small clusters of clonal cells."
C)"Cell control mechanisms fail,giving rise to aberrant cell growth."
D)"Cancer cells move from one location to another unconnected location."

Answer 2

"Cancer cells move from one location to another unconnected location."

Question 3

An older adult patient is undergoing palliative surgery for colon cancer metastasis.The nurse explains to the family that this intervention is intended to:

A)prolong the patient's life by several months.
B)improve the effectiveness of the chemotherapy.
C)relieve the pain associated with spread of the tumor.
D)prevent further tumor growth.

Answer 3

relieve the pain associated with spread of the tumor.

Question 4

An older adult patient asks the nurse why so many of her friends are developing cancers.The nurse responds best when answering:

A)"Cancer cells generally develop as a result of prolonged exposure to external agents."
B)"The longer we live the more exposure we have to environmental toxins."
C)"Aberrant growth seems to be the risk factor in the older adult that is not well understood."
D)"As we age,our cells are less able to regulate replication appropriately."

Question 5

The daughter of an older adult woman who had a colostomy as a result of colon cancer tells the nurse,"Mom seems to be so withdrawn;she has stopped going out with her friends and I'm really concerned." The most relevant nursing diagnosis for the patient's reaction is:

A)Ineffective individual coping.
B)Dysfunctional grieving.
C)Social isolation.
D)Hopelessness.

Question 6

An older patient on chemotherapy is in the oncology clinic for follow-up.The nurse notes the patient appears depressed.What action by the nurse should occur first?

A)Assess the patient for depression.
B)Review the patient's chemotherapy.
C)Ask the patient about suicidal ideation.
D)Inquire how the patient has been feeling.

Question 7

The family of an older patient recently diagnosed with cancer reports that the patient seems to be in denial,refusing to choose treatments and planning an extended vacation.What response by the nurse is best?

A)Ask the patient how he or she feels about the diagnosis.
B)Tell the patient treatment started early has the best results.
C)Refer the patient to a licensed mental health professional.
D)Tell the family that the patient will get over it in his own time.

Question 8

An older patient getting cisplatin (Platinol)asks the nurse how it works.What is the best response?

A)Prevents RNA transcription and DNA replication
B)Interferes with synthesis of chromosomal nucleic acid
C)Formed from soil fungi;prevents RNA and DNA synthesis
D)Binds to cell proteins and inhibit mitosis

Question 9

An older adult patient diagnosed with colon cancer is being evaluated for surgical removal of the tumor.The nurse explains that the primary consideration is the:

A)absence of any chronic disorders.
B)absence of metastasis.
C)tumor's staging status.
D)patient's presurgical health status.

Question 10

When obtaining a health history,the nurse recognizes that an older adult patient has a risk factor for colorectal cancer when he reports:

A)that he is a vegetarian who eats soy products.
B)that he often needs laxatives for constipation.
C)a history of inflammatory bowel disease.
D)that diarrhea occurs at least monthly.

Question 11

Which statement,if made by an older Caucasian adult man,indicates the need for further teaching about prostate cancer and its prevention?

A)"Digital rectal examinations aren't needed for screening."
B)"I should discuss having a yearly PSA test."
C)"Prostate cancer can look a lot like an enlarged prostate."
D)"I am not in a high-risk category for prostate cancer."

Question 12

An older adult patient has rheumatoid arthritis,which limits her manual dexterity and ability to perform breast self-examinations.To address the patient's need for breast health promotion,the nurse teaches the patient to:

A)use the palm of her hand to perform monthly breast examinations.
B)schedule a mammogram every 12 months.
C)check each breast while in the shower if possible.
D)visit her physician yearly for a breast examination.

Question 13

An older adult patient expresses concern about developing cancer in the future and asks the nurse advice about cancer prevention.The nurse shares that:

A)"Eating foods high in protein,such as chicken and fish,promote cell growth and repair,thus minimizing the risk."
B)"Although there are some behaviors that can help minimize your risk,the possibility of developing cancer is usually determined by age 65."
C)"Most cancers that develop after age 65 generally respond well to cancer treatment modalities."
D)"Cancers that develop late in life are generally slow growing,so they generally do not contribute to this group's mortality."

Question 14

When planning an educational program on cancer for a group of older adults,the nurse incorporates information regarding racial and ethnic patterns of cancer in the United States that includes evidence that:

A)the incidence of cancer is highest among African Americans.
B)Native Americans have the highest overall incident rates of cancer.
C)incidence rates for lung cancer are lowest for white women.
D)Hispanic women have the lowest incidence rates of cervical cancer.

Question 15

A patient is admitted to the hospital for chemotherapy and has severe mucositis.What action by the nurse is best?

A)Provide frequent oral care with saline.
B)Have the family bring the favorite mouthwash.
C)Document the patient's oral assessment.
D)Ensure teeth are brushed with a firm toothbrush.

Question 16

The nurse is admitting a patient to the hospital who has cancer and a neutrophil count of 430/mm³.What action by the nurse is best?

A)Place the patient in a private room.
B)Use good handwashing with all contact.
C)Place the patient in protective precautions.
D)Initiate contact precautions.

Question 17

An older adult patient with breast cancer is reluctant to agree to the suggested treatment plan because "I have heard such horrible things about radiation therapy." The nurse responds:

A)"Radiation therapy no longer causes such terrible side effects."
B)"Your chances of recovery are best when radiation is included."
C)"Ask the oncologist if there are alternative treatments."
D)"Actually there is very effective symptom control now."

Question 18

The family of an older adult diagnosed with cancer asks the nurse to explain how gene therapy might be beneficial.The nurse responds:

A)"The treatment decreases blood flow to the tumor and it dies."
B)"A virus is injected into the tumor and then it can't grow."
C)"The cancer cell's nucleus is destroyed and the cell shrivels."
D)"Photosensitizers are introduced into the cells so lasers can kill them."

Question 19

A patient has severe watery diarrhea from chemotherapy and is embarrassed having to be cleaned up frequently.The nurse notes several open areas on the patient's rectal area that cause pain.What nursing diagnosis takes priority?

A)Acute pain
B)Impaired skin integrity
C)Ineffective coping
D)Decreased cardiac output

Question 20

After a course of chemotherapy for cancer of the throat,an older adult patient is admitted to the hospital with persistent nausea and vomiting.The nurse should initially assess the patient for:

A)weight loss and weak gag reflex.
B)anemia and poor muscle tone.
C)oral inflammation and ulceration.
D)dehydration and infection.

Question 21

The nurse suspects the older adult patient will require diagnostic testing for possible lung cancer when the patient does which of the following? (Select all that apply. )

A)Reports smoking two packs of cigarettes daily
B)Reports severe chest pain
C)Loses 10 pounds in 1 month
D)Takes several naps daily
E)Locates a palpable lump on the left lateral chest

Question 22

The nurse is using a tool to assess the quality of life of a hospice patient.The nurse addresses the appropriate areas of concern when asking which of the following questions? (Select all that apply. )

A)"Are you able to bathe yourself?"
B)"Did your grandson get the grass cut like he planned?"
C)"How would you rate your pain on a scale of 1 to 10?"
D)"Do you still have concerns about your will?"
E)"Can we talk about why you never remarried?"

Question 23

The nurse is preparing discharge education for an older patient and his family.The patient's hemoglobin is currently 8.2 mg/dL as a result of cancer treatment therapy.To best address the patient's hematology status,the nurse includes instructions to do what? (Select all that apply. )

A)Include eggs or an egg substitute into the daily diet.
B)Avoid strenuous exercise until hemoglobin improves.
C)Regularly take both a mid-morning and mid-afternoon nap.
D)Have a green leafy salad with vegetables at meals.
E)Check for bruising to the extremities and the gums.