Deck 7: Caring for the Cancer Survivor

Question 1

The nurse knows that the primary factor affecting a cancer survivor's quality of life is:
1) The client's precancer physical and mental health status
2) The presence of a strong support system
3) The quality and type of cancer treatment received
4) The type and number of cancer-related risk factors the client possesses

Answer 1

2
Mellon and colleagues (2006)interviewed cancer survivors and their family caregivers,finding that two of the strongest predictors for cancer survivors' quality of life (enjoyment of life)were family stressors and social support.
Precancer physical and mental health status may affect the survivors' physical recovery regarding the treatment but not their quality of life (enjoyment of life).
The quality and type of cancer treatment received may affect the survivors' chances of survival but not their quality of life (enjoyment of life).
The type and number of cancer-related risk factors the client possesses may affect the survivors' chances of survival but not their quality of life (enjoyment of life).

Question 2

Since being treated for leukemia in her early twenties,a client has experienced bilateral mastectomies and has been diagnosed with osteoporosis and hypothyroidism.This health history best reflects the lifelong impact of:
1) Cancer on a client's health and wellness
2) Cancer treatments on future health status
3) Specific cancers on the health status of survivors
4) Genetic susceptibility on the reoccurrence of cancer

Answer 2

2
The impact of cancer treatment on future health status is the correct response.The increased risk for developing a second cancer is due to cancer treatment,genetic or other susceptibility,or an interaction between treatment and susceptibility.The risk for treatment related problems is associated with the complexity of the cancer itself (e.g. ,type of tumor and stage of disease);the type,variety,and intensity of treatments used;and the age and underlying health status of the client.
While cancer itself affects the client's immediate health and wellness status,it is secondary to the long-term effects of the cancer treatments used.
Although some health effects are related to specific forms of cancer,this is not the best option available because it is much less likely to be the cause of lifelong health issues.
While genetic predisposition is a factor in cancer development it is not the most likely factor affecting lifelong health issues for the cancer survivor.

Question 3

A 78-year-old woman presents at the emergency department with complaints of shortness of breath.She has a history of radiation therapy for a lung mass 7 years ago.When the client asks the nurse if it could be cancer again,the most therapeutic response would be:
1) "At your age,shortness of breath could be a result of any number of things."
2) "That is a possibility but it could also be a result of your radiation therapy."
3) "What makes you think that? Shortness of breath can have many different causes."
4) "I wouldn't jump to that conclusion.Let's just see what your health care provider thinks."

Answer 3

2
Cancer survivors are at increased risk for cancer (either a recurrence of the cancer for which they were treated or a second cancer)and for a wide range of treatment-related problems (IOM,2006).
While shortness of breath could be caused by many things,it does not address the client's concern regarding reoccurring cancer.
While shortness of breath could be caused by many things,it does not address the client's concern regarding reoccurring cancer.
Telling the client not to jump to conclusions minimizes the client's concern.

Question 4

The nurse recognizes that the client symptomatology typical of the acute cancer survival phase includes:
1) Fear and anxiety
2) Despair and anger
3) Lethargy and alopecia
4) Dyspnea and tachycardia

Question 5

When assessing cancer survivors regarding the stressors of cancer,the nurse should first ask clients:
1) If they feel they are stressed by the cancer
2) How they believe cancer has affected their life
3) What they are doing to cope with the stress of having experienced cancer
4) What assistance they need to successfully manage the stressors of dealing with cancer

Question 6

Which of the following cancer survivors is at greatest risk for post-treatment symptoms and poor treatment outcomes?
1) An Asian dishwasher
2) A Hispanic truck driver
3) A Caucasian factory worker
4) An African-American carpenter

Question 7

Which of the following clients is most likely to experience cancer treatment-related problems in the future?
1) A 73-year-old client with heart problems
2) An otherwise healthy 6-year-old child
3) A 25-year-old professional tennis player
4) A 39-year-old with a history of depression

Question 8

In the geriatric population,the primary reason cancer is diagnosed in its later stage is:
1) Health care benefit coverage is often inadequate
2) Symptoms are often masked by the effects of aging
3) Clients are reluctant to seek help for the early symptoms
4) Symptoms are often attributed to the aging process

Question 9

A client,who recently completed treatment for cancer,shares with the nurse that she is,"a little depressed,but I guess I will be OK." The foremost reason the nurse encourages the client to discuss this situation with her primary health care provider is that the nurse realizes that:
1) The depression will not improve by itself
2) The medications can help resolve the depression
3) Depression can decrease the client's chances of recovery
4) The depression is a result of concerns about the cancer reoccurring

Question 10

The nurse understands the primary focus of education for a client who has just received a diagnosis of cancer is to:
1) Introduce self-care measures to support health
2) Discuss the management of treatment-related side effects
3) Reinforce the explanation of the risks of proposed treatments
4) Formulate long-term lifestyle changes to minimize risk factors

Question 11

Which of the following assessment data best confirms the possibility of cognitive impairment in a client with a diagnosis of lung cancer?
1) Client is observed writing questions to ask his oncologist.
2) Client states,"I seem to be a little more forgetful lately."
3) Client's wife states,"I have to remind him of everything."
4) Client overheard asking son,"Where did I put my glasses?"

Question 12

A client,who is a 7-year breast cancer survivor,tells the nurse,"My husband will help me bathe when he gets here." The nurse interprets this statement to mean that the client:
1) Is reluctant to have the staff see her chest scar
2) Prefers to protect her modesty and privacy
3) Has a healthy self-image regarding her husband
4) Is not comfortable with the care she is receiving

Question 13

Eleven months after being treated for breast cancer,a client reports difficulty sleeping and the associated fatigue while denying any other signs/symptoms.The nurse recognizes that the client may be experiencing:
1) Situational depression
2) Normal remission symptoms
3) Post-traumatic stress disorder
4) Delayed effects of chemotherapy drugs