Questions and Answers
A patient has the following laboratory values: white blood cell count 2100 mm3; neutrophils segmented 23%; neutrophils band 6%; hemoglobin 8.9 g/dl; and, platelets 100,000 mm3. The nurse's initial patient teaching includes?
A patient is receiving the first dose of paclitaxel. The nurse should be prepared to treat the patient for?
A patient who completed treatment for malignant melanoma one year ago complains of still feeling tired. The nurse anticipates an order for?
A patient receiving 10 mg of sustained-release oxycodone every 12 hours requires 5 mg of immediate-release oxycodone five to six times daily. The best adjustment in the pain medication regimen is to request an order for?
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A patient with prostate cancer is taking oxycodone orally every four hours as needed for pain. At a home visit, the nurse learns the patient is experiencing constant, dull back pain and has not moved his bowels for three days. These symptoms most likely indicate?
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Which terms are associated with malignant tumors originating in the epithelial tissue?
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The severe pain associated with post-herpetic neuropathy is most effectively treated by?
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An oncology nurse teaching a cancer biology class explains that a proto-oncogene's role is to?
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Which of the following statements by a patient most likely indicates the need for further education about preventing infection?
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A 69-year-old patient who received chemotherapy seven days ago calls the nurse to report a temperature of 101°F (38.3°C) and lightheadedness. The nurse's initial response is to instruct the patient to?
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A patient expresses anger about his diagnosis of cancer and the need to receive his first chemotherapy treatment. The nurse's best response is to?
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A patient with lymphoma reports persistent nausea, muscle cramps, weakness, and paresthesia of the fingers two days after receiving the first cycle of chemotherapy. The patient most likely is experiencing?
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During the initial evaluation of a patient, the treatment plan is outlined and includes amputation of the right leg. The patient begins to scream and cry, stating, 'But I have small children. I need to be able to run, walk, and play with them.' The nurse's best response is?
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Which of the following is a complication that can occur after a percutaneous lung biopsy is performed?
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A survivor of colon cancer expresses his desire to change jobs. He is concerned that he will be unable to obtain health insurance at a new job due to his history of cancer. The nurse's best intervention is to?
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It is important to assess attitudes about illness and care-seeking in a patient from different racial and ethnic groups in order to?
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A patient who does not speak English is eligible to participate in a phase II clinical trial. The patient's grandson wishes to translate to obtain informed consent. Which of the following actions would be most appropriate?
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A patient newly diagnosed with cancer experiences restlessness, insomnia, diarrhea, heart palpitations, and irritability. The patient states he is nervous and jittery and requests something for nerves. The nurse's best response is to?
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While administering doxorubicin peripherally, a patient complains of itching at the infusion site. The nurse observes red streaking along the vein with blood return. The nurse's initial response is to?
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A patient with a history of cardiac disease is being evaluated for chronic leukemia. The patient reports tachycardia and dyspnea. A complete blood cell count with differential is obtained. Which of the following findings would most likely indicate the cause?
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A patient with lung cancer is scheduled to receive her fourth dose of chemotherapy. The patient tells the nurse that she has begun to experience nausea when driving to her appointments. Which of the following types of nausea is the patient experiencing?
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A patient with a history of ovarian cancer reports being bloated and feeling full and vomiting after eating small amounts of food. The patient has noticed a 10-pound weight gain over the last week and states she is eating less. The nurse instructs the patient to?
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During counseling, a patient with breast cancer asks the nurse, 'After I finish chemotherapy, how long should I wait to get pregnant?' The nurse's best response is?
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The nurse informs a patient that a required premedication may cause drowsiness. The patient requests that treatment be delayed so he can be alert enough to pray at sunset. The nurse should?
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A patient receiving interleukin-2 has persistent fever and chills and an absolute neutrophil count of 1500/mm³. The nurse knows that these symptoms represent:
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A patient newly diagnosed with prostate cancer states, 'I have quit going to all my community activities since my diagnosis.' The nurse's best initial response is:
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A patient is to begin temozolomide. The nurse instructs the patient that:
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Which of the following ethnic groups in the United States has the highest incidence and mortality for prostate cancer?
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A patient with cancer who is taking opioids for pain complains of pruritus. This may be managed with:
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A 20-year-old woman with a family history of BRCA1 and BRCA2 breast cancer asks when she should have a mammogram. The nurse recommends:
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A patient with testicular cancer who is scheduled for a unilateral orchiectomy asks the nurse about reproduction. The nurse responds with the understanding that he is likely to have:
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A patient newly diagnosed with cancer tells the nurse, 'The doctor ordered all of these tests for clinical staging. What does that mean?' The nurse's best response is based on the knowledge that staging:
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A patient with small cell lung cancer has a four-pound weight gain, headache, and excessive thirst. These symptoms indicate:
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A 62-year-old patient with CD33-positive acute myeloid leukemia in first relapse presents with a left ejection fraction of 40%. The nurse anticipates an order for:
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Which of the following medications can cause increased sedation when administered with opioids?
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A patient recently diagnosed with liver cancer presents with mild ascites and complaints of early satiety and bloating. Which of the following increases the risk of developing malignant ascites?
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An 85-year-old patient's physician recommends major surgery and chemotherapy for his cancer. His family advocates palliative care. The patient asks the nurse to help him decide what to do. The most appropriate initial nursing action would be to:
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A patient receiving hospice care is refusing to take prescribed opiates and tells the nurse, 'Pain is a part of life.' The initial step the nurse takes is to:
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A patient with lymphedema is seen in the outpatient clinic and reports using reflexology to improve circulation in the affected arm. The nurse's best response is:
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Following surgery for cancer, a patient has been told that adjuvant chemotherapy is needed. The nurse explains that adjuvant chemotherapy refers to:
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Which of the following actions must be performed first when developing an educational program?
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The adult children of a patient who has just died approach the nurse expressing feelings of sadness, helplessness, and numbness. The nurse can provide support to this family by:
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When assessing the level of pain, the primary source of information is the patient's:
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Palliative care is focused on the patient and family to:
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Long-term exposure to radon has been associated with which of the following cancers?
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A patient receiving thalidomide is requesting an adjunct treatment option for neuropathy. Based on current evidence, the nurse suggests:
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Nursing interventions for the management of nausea include encouraging patients to:
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Prostate cancer most frequently metastasizes to the:
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An abnormal finding on the third postoperative day following a bowel resection with a colostomy for colon cancer is:
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Which of the following is prescribed for a patient diagnosed with surgically unresectable renal cell carcinoma that has metastasized to the liver?
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A patient receiving doxorubicin through a peripheral IV catheter reports burning at the site, but there is no notable swelling. The nurse's first action is to:
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When considering general principles of rehabilitation in a patient with cancer, the nurse should:
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A patient with lymphoma reports numbness in the feet, weakness when ambulating, and dribbling urine. The nurse suspects:
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A patient with stage I non-small cell lung cancer has impaired pulmonary function. The nurse anticipates the treatment of choice will be:
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A patient scheduled for chemotherapy complains of shortness of breath, fatigue, and facial swelling. Physical assessment reveals neck vein distention, edema of the hands, tachycardia, and cyanosis. The nurse calls the physician and instructs the patient to:
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A patient with colon mesothelioma is scheduled for chemotherapy to be administered in the peritoneal space. The nurse expects the patient to have which type of access for this treatment?
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After a physician discusses the need for a descending colostomy with a patient who has colorectal cancer, the nurse informs the patient that the stoma site will be located:
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In addition to decreasing inflammation, corticosteroids:
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A patient is ordered opiates around the clock for pain control. Prior to initiating opioid therapy, the nurse anticipates an order for:
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In order to assist in resolving the patient's spiritual pain during end-stage disease, the priority nursing intervention is to:
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An example of adaptive or specific immunity is:
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A patient with acute lymphoid leukemia experiences hyperkalemia, hyperphosphatemia, and hypocalcemia within a week of initiating chemotherapy. These symptoms are most likely indicative of:
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A nurse mistakenly administers a long-acting morphine tablet instead of the prescribed long-acting oxycodone. What is the nurse's next step?
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A 21-year-old patient recently withdrew from college classes secondary to cancer recurrence. His parents report that the patient is moody and is no longer seeing friends and classmates. The nurse initiates strategies aimed at achieving which of the following patient outcomes?
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To reduce the risk of complications from thrombocytopenia, patients are taught to avoid:
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A patient in remission complains of dysthymic behaviors for the past several weeks. The nurse knows to assess for:
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Initial treatment of a patient in early septic shock includes the administration of:
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A patient has signed a consent form prior to beginning chemotherapy and has questions regarding treatment. The nurse:
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The first step in using evidence-based practice in the oncology clinical setting is to:
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A survivor of breast cancer tearfully states, 'I knew lymphedema could happen, but I never thought it would happen to me.' The nurse's priority intervention is to:
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Study Notes
Laboratory Values and Infection Prevention
- A white blood cell count of 2100 mm3 indicates immunosuppression; frequent handwashing is crucial in preventing infection.
Paclitaxel Treatment Response
- Patients receiving paclitaxel may experience hypersensitivity reactions; pretreatment with cimetidine, diphenhydramine, and dexamethasone can mitigate these effects.
Cancer-Related Fatigue Management
- Methylphenidate is used to alleviate cancer-related fatigue in patients, showing promising results but requiring further research.
Opioid Pain Management
- A sustained-release oxycodone regimen may be adjusted to increase dosage if the patient requires additional immediate-release doses, indicating the need for a change.
Symptoms Indicating Spinal Cord Compression
- Prostate cancer patients exhibiting persistent dull back pain and bowel irregularities may face impending spinal cord compression, a serious condition requiring urgent attention.
Classification of Malignant Tumors
- Malignant tumors originating from epithelial tissue are classified as adenocarcinomas and squamous cell carcinomas, among others.
Post-Herpetic Neuropathy Treatment
- Severe pain from post-herpetic neuropathy is best managed with amitriptyline, a tricyclic antidepressant effective in this scenario.
Role of Proto-Oncogenes
- Proto-oncogenes promote normal cell growth and division; alterations can lead to cancer through mutations or genetic modifications.
Infection Prevention Education
- Cancer patients should receive influenza vaccinations periodically, regardless of treatment status, to mitigate infection risks.
Neutropenia and Infection Risk
- Chemotherapy often lowers white blood cell counts, increasing infection susceptibility; immediate hospital evaluation is necessary for fever or respiratory symptoms.
Managing Patient Emotions Post-Diagnosis
- Supporting patient engagement in treatment plans can enhance their sense of control, especially when coping with cancer diagnoses.
Tumor Lysis Syndrome Symptoms
- Symptoms include muscle cramps, nausea, and weakness following chemotherapy, indicating a metabolic imbalance due to rapid tumor cell death.
Emotional Support for Anxiety
- Addressing patient concerns and feelings can aid in managing anxiety associated with a cancer diagnosis effectively.
Nursing Role in Lung Biopsy Complications
- Following a lung biopsy, watch for pneumothorax, a potential complication due to air introduction into the chest.
Employment Rights for Cancer Survivors
- The Americans with Disabilities Act ensures that cancer survivors cannot be discriminated against when seeking employment or insurance coverage.
Cultural Competence in Nursing
- Understanding individual beliefs and practices enhances personalized care and affects treatment success.
Consent Process for Non-English Speakers
- Professional interpreters should facilitate informed consent for non-English speaking patients, accompanied by family members as needed.
Post-Chemotherapy Pregnancy Considerations
- Women are advised to wait at least one year after chemotherapy to conceive, balancing the risks of recurrence and maternal health.
Spiritual and Cultural Considerations in Patient Care
- Nurses should assess the feasibility of delaying treatments to honor patient spiritual practices without compromising health.
Educational Program Development
- Assessing learning needs is the critical first step in creating an effective educational program for patients.
Grief Support for Families
- Validating the normalcy of grief reactions, such as sadness and numbness, can provide essential emotional support to bereaved family members.
Pain Assessment in Patients
- Patient self-reporting is the primary method for evaluating pain intensity and guiding treatment decisions.
Palliative Care Focus
- Palliative care prioritizes the needs and preferences of both patients and their families throughout the healthcare journey.### Palliative Care
- Palliative care prioritizes the needs of patients and their families throughout the dying process.
- Care includes emotional support for survivors and bereavement resources post-death.
Radon Exposure and Cancer
- Long-term radon exposure is linked specifically to lung cancer.
- No established connections exist between radon and cancers of the colorectal, bladder, or breast.
Neuropathy Treatment Options
- Acupuncture is recognized as an effective adjunct treatment for neuropathy in patients using thalidomide.
Managing Nausea
- Patient care strategies for nausea recommend consuming foods that are cold or at room temperature to minimize discomfort.
Prostate Cancer Metastasis
- Bone is the primary site of metastasis for prostate cancer, with rare instances of spread to the lungs or liver.
Colostomy Assessment
- A dull, gray stoma indicates possible ischemia or necrosis and necessitates immediate medical attention.
Renal Cell Carcinoma Treatment
- Temsirolimus is prescribed for metastatic renal cell carcinoma, especially when surgical options are not viable.
Intravenous Drug Administration
- Administering doxorubicin involves stopping the drug immediately upon any burning sensation at the IV site to prevent tissue damage.
Rehabilitation Principles in Cancer Care
- Rehabilitation focuses on emphasizing capabilities rather than disabilities, ensuring a balance of activity and rest.
Lymphoma and Spinal Cord Compression
- Symptoms like numbness, weakness, and urinary issues in lymphoma patients suggest possible spinal cord compression.
Treatment for Lung Cancer
- External beam radiation is anticipated as a treatment for patients with stage I non-small cell lung cancer who cannot undergo surgery.
Superior Vena Cava Syndrome
- Symptoms such as shortness of breath and swelling signal superior vena cava syndrome; the patient should be kept sitting up while awaiting chest X-ray orders.
Chemotherapy Access for Mesothelioma
- Patients receiving intraperitoneal chemotherapy typically require an implanted, large diameter silicone port for treatment.
Colostomy Location
- A descending colostomy is located in the left lower quadrant of the abdomen.
Corticosteroids Effects
- Corticosteroids, like prednisone, are known to stimulate appetite, contrary to common perceptions of weight loss.
Opioid Therapy and Bowel Management
- Stimulant laxatives are recommended as a preventative measure against constipation induced by opioid treatments.
Spiritual Pain Management in End-Stage Disease
- Acknowledging the legitimacy of a patient's spiritual pain is critical for effective support during end-of-life care.
Adaptive Immunity Example
- The cell-mediated response serves as a prime example of adaptive or specific immunity, primarily involving T-cells.
Tumor Lysis Syndrome
- Acute lymphoid leukemia may lead to tumor lysis syndrome, characterized by metabolic imbalances like hyperkalemia and hyperphosphatemia.
Medication Errors in Nursing Practice
- Quick notification to the physician and patient is essential upon realizing a medication error involving opioids to ensure safety.
Patient Communication and Support
- Open communication between patients and their families can enhance emotional support and validate feelings during treatment.
Thrombocytopenia Precautions
- Patients with thrombocytopenia should avoid walking barefoot to prevent injuries due to low platelet levels.
Assessment for Depression in Cancer Survivors
- Nurses should monitor for depression in cancer patients as it can significantly impact recovery outcomes.
Initial Sepsis Treatment
- Broad-spectrum IV antibiotics should be administered promptly to manage early septic shock, following blood cultures.
Patient Informed Consent
- Nurses play a key role in ensuring patients understand their treatment, reinforcing consent information and answering queries before proceeding.
Evidence-Based Practice in Oncology
- The first step in evidence-based practice is to assess patient needs to properly define the clinical problem being addressed.
Emotional Support for Survivors
- Allowing patients to express their feelings about conditions such as lymphedema is vital for their emotional well-being.
Interleukin-2 Side Effects
- Common side effects of interleukin-2 administration include flu-like symptoms such as fever and chills.
Breast Cancer Screening Guidelines
- Women with a family history of BRCA1/BRCA2 should consult their physicians about the appropriateness of early mammogram screenings.
Testicular Cancer and Reproduction
- Patients facing testicular cancer treatments might have concerns about fertility and should discuss these with healthcare providers.### Fertility After Orchiectomy
- Loss of one testicle due to testicular cancer generally does not affect fertility.
- Unilateral orchiectomy retains the potential for normal fertility in most individuals.
Clinical Staging of Cancer
- Staging evaluates the extent of local and potential metastatic disease.
- It helps guide optimal treatment selection for each patient.
- Staging systems incorporate clinical, surgical, pathology, and biochemical factors.
Symptoms of Small Cell Lung Cancer Complications
- Small cell lung cancer may lead to syndrome of inappropriate antidiuretic hormone (SIADH).
- Symptoms include excessive thirst, weight gain, headache, and lethargy.
- SIADH accounts for 80% of cases associated with small cell lung cancer.
Treatment for Acute Myeloid Leukemia
- Gemtuzumab ozogamicin is indicated for patients older than 60 with relapsed CD33-positive acute myeloid leukemia.
- It is preferred for those who are not candidates for cytotoxic chemotherapy.
Drug Interactions with Opioids
- Chlorpromazine, a phenothiazine, can enhance sedation when used alongside opioids.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) do not contribute to sedation effects.
Risk Factors for Malignant Ascites
- Renal disease increases the likelihood of developing malignant ascites.
- Conditions like liver cancer are primary contributors to this complication.
Decision-Making in Cancer Care
- The nurse's first action should be to assess the patient's values regarding treatment options.
- Understanding the patient's perspective is vital in a shared decision-making process.
Addressing Pain Management in Hospice Care
- Initial communication should explore the patient's meaning of pain, recognizing individual perceptions of pain.
- The aim is to provide comfort and understanding, reframing pain from negative connotations.
Communication About Alternative Therapies
- Encouraging dialogue about complementary therapies, like reflexology, fosters a supportive environment.
- Open communication is essential in discussing both conventional and alternative treatment options.
Understanding Adjuvant Chemotherapy
- Adjuvant chemotherapy is administered post-surgery to target minimal residual disease or micrometastases.
- It plays a critical role in reducing the risk of cancer recurrence following primary treatments.
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This quiz features practice test flashcards focused on nursing interventions and patient care. Students will learn about critical laboratory values and their implications for patient teaching in nursing. Prepare to enhance your understanding of nonpharmacologic interventions and improve patient outcomes.
