Med-Surg Ch25: Patient with Cancer; Study guide and NCLEX questions

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The nurse is caring for a pt who is sched-

uled for a biopsy of a tumor. The pt asks
what distinguished a benign tumor from D. Malignant tumors are composed of
a malignant tumor. Which info should the disorganized, abnormal cells that may
nurse provide? spread to other parts of the body

A. Benign tumors are usually composed Malignant tumors are composed of dis-
of more rapidly growing cells organized cells that may metastasize to
B. Benign tumors are incapable of caus- other sites. Benign tumor cells usually
ing damage to surrounding tissues or have a slow growth rate. Benign tumors
organs can cause tissue damage if they grow
C. Whereas malignant tumors are usual- enough to put pressure on or obstruct
ly encapsulated, benign tumors lack spe- body organs. Whereas benign tumors
cific form are usually encapsulated, malignant tu-
D. Malignant tumors are composed of mors may lack specific form.
disorganized, abnormal cells that may
spread to other parts of the body
C. "I have a blister on my toe that never
Which pt statement alerts the nurse to a
seems to get well"
warning sign of cancer?
A sore that does not heal is a warning
A. "I have a BM every 4 days"
sign of cancer. A bowel movement every
B. I had a wart on my finger that lasted
4 days does not indicate any change in
for 2 weeks"
bowel habits. Warts often last for several
C. "I have a blister on my toe that never
weeks, and the patient did not describe
seems to get well"
any change in appearance. Moderately
D. I experience moderately heavy bleed-
heavy bleeding in conjunction with men-
ing with my periods every month"
struation is normal and not unusual.
B. Remove fresh apple and orange from
The nurse is caring for a pt who requires
tray
compromised host precautions. Which
action is most important for the nurse to
The patient is at a significantly increased
take before delivering the pt's breakfast
risk for infection. Fresh produce can har-
tray?
bor bacteria that can lead to infection,
so the apple and orange should be re-
A. Ask pt if she feels like eating at this
moved from the tray. Assessing the qual-
time
ity of the patient's appetite does not pro-
B. Remove fresh apple and orange from
tect against infection. Although dispos-
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 Med-Surg Ch25: Patient with Cancer; Study guide and NCLEX questions
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able utensils are not harmful, sterilized
tray standard utensils do not pose an overt
C. Call dietary department and ask for risk for infection. Limiting clutter in the
disposable utensils room is an action that would protect the
D. Declutter room before assisting pt to patient with a low platelet count in case
to couch to eat of a fall but would not decrease infection
risk.
A nurse is obtaining a health history on
a pt who was admitted with lung cancer.
D. "Can you tell me more about the prob-
Which question is most important for the
lem that caused you to come to the hos-
nurse to ask to gather data about chief
pital?"
complaint?
The chief complaint is the patient's main
A. "How often, if ever, do you drink alco-
complaint or concern, and the nurse
hol"
should seek a complete description of
B. "Do you see a primary care health
the problem with related signs and symp-
provider regularly?"
toms. Asking about alcohol consumption
C. "Do you have any history of serious
and medical checkups are components
diseases or cancer in your immediate
of a functional assessment. Incidence of
family?"
familial diseases is part of the family his-
D. "Can you tell me more about the prob-
tory.
lem that caused you to come to the hos-
pital?"
A patient has recently undergone
surgery to remove a large melanoma
from his back. The patient is experi-
B. Constipation
encing severe, incision-related pain and
has been prescribed an opioid analgesic
Opioids can cause constipation and
medication by the health care provider.
changes in bowel function when used
Which symptoms is the patient likely to
to alleviate pain. Opiate analgesic med-
experience?
ications are not likely to cause diarrhea,
peripheral neuropathy, or extrapyramidal
A. Diarrhea
symptoms.
B. Constipation
C. Peripheral neuropathy
D. Extrapyramidal symptoms
What type of information is most rele-
vant to a 21-year-old patient who will be
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 Med-Surg Ch25: Patient with Cancer; Study guide and NCLEX questions
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undergoing surgery and radiotherapy for B. A discussion about sperm banking be-
treatment of cancer of the testis? cause of possible sterility

A. A discussion about deep breathing to Individuals in childbearing age or func-

prevent pneumonia tion should be informed of possible treat-
B. A discussion about sperm banking be- ment-related changes and implications
cause of possible sterility to reproduction. The Look Good, Feel
C. A referral to the Look Good, Feel Bet- Better program is not as relevant as the
ter program because of altered body im- reproductive concerns. Pneumonia is not
age a common issue for the 21-year-old pa-
D. A referral to the Agency for Healthcare tient. A referral for cancer pain is not nec-
Research and Quality to manage cancer essary at this point and is not as relevant
pain to the 21-year-old patient.
A 55-year-old patient with a BMI of 29
is concerned that her identical twin has
just been diagnosed with breast cancer.
C. Attain and maintain a healthy body
She is highly motivated to reduce her
weight.
risk for developing cancer. According to
the American Cancer Society, which diet
Evidence supports that lowering body
and lifestyle factors are recommended
weight reduces an individual's risk for de-
for reducing cancer risk?
veloping cancer. Grains, cereals, pasta,
and beans should not be avoided. En-
A. Avoid grains, cereals, pasta, and
gaging in physical activity once a week is
beans.
not frequent enough to be a health bene-
B. Engage in physical activity once a
fit. A diet rich in preserved and cured food
week.
is actually a risk factor for developing
C. Attain and maintain a healthy body
cancer.
weight.
D. Consume a diet rich in preserved and
cured foods.

A. A fecal occult blood stool test

A 58-year-old male patient is being seen
B. A prostate-specific antigen test
by the health care provider for an annu-
D. A digital rectal examination
al physical. According to the American
Cancer Society, which cancer screen-
Evidence supports that proactive and
ings should be recommended every year
timely cancer screening reduces the like-
for asymptomatic men? (Select all that
lihood of developing cancer. Cancer di-
apply.)
agnosed at a lower stage has a greater
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 Med-Surg Ch25: Patient with Cancer; Study guide and NCLEX questions
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likelihood of cure. A fecal occult blood
stool test and a prostate-specific anti-
A. A fecal occult blood stool test
gen test are recommended annually. The
B. A prostate-specific antigen test
digital rectal examination is recommend-
C. A Papanicolaou test
ed annually. The Papanicolaou test and
D. A digital rectal examination
pelvic examination are tests for women's
E. A pelvic examination
health. A colonoscopy is recommended
F. A colonoscopy
every 10 years for low-risk patients.
A. Limit intake of fatty foods.
A patient presents to the clinic for her an- B. Abstain from alcohol consumption.
nual mammogram. She asks the nurse E. Participate in moderate exercise for at
what actions she can take to reduce her least 30 minutes most days of the week.
risk for breast cancer. Which actions are
most appropriate? (Select all that apply.) Breast cancer has been linked to high-fat
diets. High alcohol intake is associated
A. Limit intake of fatty foods. with breast cancer. Moderate exercise
B. Abstain from alcohol consumption. 30 minutes in length helps maintain a
C. Drink 6 to 8 glasses of water each day. healthy weight and reduces breast can-
D. Consume at least three servings of cer risk. Adequate hydration does not re-
fruits and vegetables each day. duce the risk for breast cancer. Three dai-
E. Participate in moderate exercise for at ly servings of fruit and vegetables are in-
least 30 minutes most days of the week. adequate (five servings are recommend-
ed).

A. Instruct the patient to limit intake of

spicy foods.
The nurse is caring for a patient who
C. Determine the best time for the patient
is experiencing severe chemotherapy-in-
to eat and drink.
duced nausea. Which actions can the
D. Encourage the patient to take small,
nurse take to try to reduce the patient's
frequent sips of water.
nausea? (Select all that apply.)
E. Administer sedatives as ordered while
antineoplastic drugs are being adminis-
A. Instruct the patient to limit intake of
tered.
spicy foods.
B. Instruct the patient to avoid room tem-
Spicy foods can exacerbate nausea and
perature foods.
should be avoided. Certain patients ex-
C. Determine the best time for the patient
perience less nausea when eating at
to eat and drink.
specific times, either before or after
treatment. Small, frequent sips of water
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 Med-Surg Ch25: Patient with Cancer; Study guide and NCLEX questions
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throughout the day help to reduce nau-
sea and maintain hydration. Sedatives
D. Encourage the patient to take small, are sometimes ordered in conjunction
frequent sips of water. with antineoplastic medications so the
E. Administer sedatives as ordered while patient can sleep and to decrease the
antineoplastic drugs are being adminis- amount of time the patient is awake and
tered. nauseated. Patients should eat food at
room temperature and should avoid ex-
tremely hot and cold foods.
1. Press on normal tissues an compete
with normal cells for nutrients

Benign and malignant tumors are alike

Benign and malignant tumors are alike in
because both press on normal tissue
that both:
and compete with normal cells for nutri-
ents. Benign tumors usually grow slow-
1. Press on normal tissues an compete
ly, while malignant tumors typically grow
with normal cells for nutrients
rapidly but may grow slowly. Benign tu-
2. Usually grow very rapidly
mors may enlarge and expand but do
3. Invade nearby tissue or disperse cells
not invade nearby tissues or disperse
to colonize distant parts of the body
cells or colonize distant parts of the body
4. Contain cell that closely resemble the
like malignant tumors do. Benign tumor
tissue of origin
cells closely resemble those of the tissue
of origin, whereas malignant tumor cells
are not readily identifiable to the tissue of
origin.
A chemical, viral, or radioactive sub-
stance that can cause cancer is called a Carcinogen
_______________.
1. Limit alcohol consumption
The nurse is teaching a class on healthy
3. High fiber, low fat, and low calories
living. Select the dietary recommenda-
4. Variety or fruits and veggies
tion(s) believe to reduce the risk of some
5. Limited smoked and nitrate-preserved
cancer that should be included in the
foods
lesson plan. (Select all that apply)
Dietary recommendations believed to re-
1. Limit alcohol consumption
duce the risk of some cancers include
2. No dairy products or red meat
limited alcohol consumption; high-fiber,
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 Med-Surg Ch25: Patient with Cancer; Study guide and NCLEX questions
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low-fat and low-calorie diet; a variety
3. High fiber, low fat, and low calories of fruits and vegetables; and limited
4. Variety or fruits and veggies smoking and consumption of nitrate-pre-
5. Limited smoked and nitrate-preserved served foods. Ingesting dairy products
foods and red meat does not have an in-
creased risk for cancer.
3. The cancer is continuing to grow de-
spite chemo
A pt's blood level of the oncofetal anti-
Oncofetal antigens or tumor markers are
gen CA-125 has continued to rise during
substances found on fetal cells and the
6 months of chemo for ovarian cancer.
surface of cancer cells. Elevations of
What is the most likely explanation?
these antigens are associated with cer-
tain cancers. They are often used to mon-
1. The chemo is effectively destroying the
itor response to cancer treatments. Blood
cancer cells
levels will continue to rise if the cancer is
2. The pt is having an adverse response
still growing despite chemotherapy. If the
to the chemo
levels continue to rise with chemother-
3. The cancer is continuing to grow de-
apy, it means that the chemotherapy is
spite chemo
not effective. This antigen level does not
4. The pt's immune system has been
have any relationship to an adverse re-
strengthened
sponse to chemotherapy, nor does it re-
flect a strengthening of the patient's im-
mune system.

1. Always wear a lead apron when pro-

viding direct care to the pt with internal
radiation
When working with a pt who has an inter-
4. No pregnant visitors or staff should
nal radiation source, safety precautions
enter the pt's room
include which of the following? (Select all
5. Pt must be in private room
that apply)
Safety precautions when caring for a pa-
1. Always wear a lead apron when pro-
tient with an internal radiation source in-
viding direct care to the pt with internal
clude always wearing a gown when giv-
radiation
ing direct care to the patient, not allow-
2. If the radiation source comes out of the
ing pregnant visitors or staff to enter the
patient's room, and keeping the patient
in a private room. If the radiation source
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 Med-Surg Ch25: Patient with Cancer; Study guide and NCLEX questions
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comes out of the patient's body, then
immediately notify the physician and the
radiation safety personnel and do not
pt's body, gloves should be worn to pick
touch it with bare hands. Forceps and
it up
a lead container are always kept in the
3. When not providing direct care, stay at
patient's room to retrieve and contain
least 3 feet from source
the source. When not providing direct
4. No pregnant visitors or staff should
care, the amount of radiation exposure
enter the pt's room
is reduced by limiting the amount of time
5. Pt must be in private room
spent in the room and by working as far
as possible from the radiation source and
not at least 3 feet away.
Adverse effects of radiation therapy com-
4. These tissues regenerate rapidly
monly affect the bone marrow, hair fol-
licles, and GI tract. What makes these
Radiation therapy adversely affects bone
tissues especially sensitive to the effects
marrow, hair follicles, and the gas-
of radiation?
trointestinal tract because these tissues
regenerate rapidly. These tissues do
1. They have inadequate defenses
not have a special inadequate defense
against harmful substances
against harmful substances, and do not
2. These tissues attract radioactive sub-
attract radioactive substances. Also, sen-
stances
sitivity of these tissues to the adverse
3. These tissues have very poor circula-
effects of chemotherapy is not related to
tion
the circulation within these tissues.
4. These tissues regenerate rapidly

1. CSFs stimulate the production of

WBCs by the bone marrow
A pt asks why she is receiving a CSF as 3. CSFs reduce the risk of anemia that
part of her cancer tx. Which replies by commonly occurs with chemo
the nurse are accurate? (Select all that
apply) Colony-stimulating factors (CSFs) are
also called hematopoietic growth factors.
1. CSFs stimulate the production of Because antineoplastic drugs suppress
WBCs by the bone marrow the bone marrow, CSFs can be used to
2. With CSFs, the dosage of chemo stimulate the bone marrow to produce
drugs can be reduced platelets, red blood cells, and white blood
cells in patients receiving chemotherapy.
CSFs help to reduce the risk of infection
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by shortening the period of neutropenia,
when white blood cells are low, and re-
3. CSFs reduce the risk of anemia that ducing the risk of anemia that is also
commonly occurs with chemo associated with chemotherapy. CSFs do
4. CSFs eliminate the need for bone mar- not have any effect upon the dose of
row or stem cell transplantation chemotherapy given, nor do they reduce
5. CSFs reduce the nausea and vomiting the need for bone marrow or stem cell
associated with chemo transplantation. CSFs have no antiemet-
ic properties to reduce nausea and vom-
iting associated with chemotherapy.
3. Bone marrow suppression

Bone marrow suppression is the most

dangerous side effect of antineoplastic
To monitor pts who are taking antineo- drugs. Nausea and vomiting are likely
plastic drugs, the nurse must be aware to be the most distressing to patients
that the most dangerous adverse effect because antineoplastic drugs simultane-
is: ously irritate the lining of the digestive
tract and stimulate the vomiting center in
1. GI bleeding the brain. Gastrointestinal bleeding is not
2. Increased intracranial pressure a significant side effect of these drugs.
3. Bone marrow suppression Neurotoxic effects of these drugs are
4. Nausea and vomiting mostly associated with numbness and
tingling of extremities, paralytic ileus, and
loss of deep tendon reflexes but do not
increase the patient's intracranial pres-
sure.

2. Promote the body's natural defenses

against cancer cells
Which of the following describes the ac-
tion of BRMs? Biologic response modifiers (BRMs) are
used to promote and boost the body's
1. Treat mental depression that is com- existing defenses against cancer cells.
mon during cancer tx BRMs act directly on malignant cells
2. Promote the body's natural defenses or stimulate the immune system to act
against cancer cells against them. They are most effective if
the immune system is functioning ade-
quately. A skin test can be performed
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to evaluate the immune response before
therapy is started. Examples of BRMs
are interferons and interleukins. General-
3. Immunize pts against some type of
ized side effects of BRMs include flu-like
cancer
symptoms. BRMs have no actions that
4. Prevent the spread of cancer cells be-
can help treat mental depression or im-
fore metastasis occurs
munize patients against certain types of
cancer. BRMs also do not prevent any
metastasis of cancer.
3 pts at a urology clinic received dx
of prostate cancer. All were in an early
stage and had similar expectations of 4. They are all normal reactions
cure. Mr. A asked many questions and
started to plan his work schedule around All of these patients are experiencing
his tx. Mr. B stalked out of the office and normal reactions to grief. Normal reac-
slammed the door. Mr. C was stunned tions to grief include being sad or tearful,
and seemed unable to take in any more verbalization of feelings of loss, talking
info at the time. Which of these pts re- about the loss and looking at or touch-
sponses would be considered "normal" ing the affected part, asking many ques-
in this situation. tions, and planning a personal schedule
around treatments. Some patients exhib-
1. Mr. A's it anger and others are stunned and un-
2. Mr. B's able to accept any more information.
3. Mr. C's
4. They are all normal reactions

Which of the following normal cells are

most sensitive to radiation? (Select all
that apply)
2. GI/GU tract lining
1. Nail beds
5. Lymph tissue
2. GI/GU tract lining
6. Ovaries
3. Respiratory tract lining
9. Testes
4. Skin
10. Hair follicle
5. Lymph tissue
11. Bone marrow
6. Ovaries
7. Kidney's
8. Lungs
9. Testes
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 Med-Surg Ch25: Patient with Cancer; Study guide and NCLEX questions
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10. Hair follicle
11. Bone marrow
Due to damage to the most sensitive
cells during radiation therapy, which are
the related side effects of therapy? (Se-
lect all that apply)
1. Bone marrow suppression
2. Alopecia
1. Bone marrow suppression
3. Anorexia
2. Alopecia
6. Nausea and vomiting
3. Anorexia
4. Heart failure
5. Liver failure
6. Nausea and vomiting
Regardless of the site treated with ra-
diation therapy, which 2 common side
effects occur?
2. Skin changes
1. Dry mouth
4. Fatigue
2. Skin changes
3. Diarrhea
4. Fatigue
5. Esophagitis
Which of the following are warning signs
of cancer? (Select all that apply)

1. Nausea and vomiting 2. nagging cough and hoarseness

2. nagging cough and hoarseness 3. Change in bowel and bladder habits
3. Change in bowel and bladder habits 5. Sores that do not heal
4. Heart palpitations and tachycardia 7. Change in warts of moles
5. Sores that do not heal
6. Dyspnea and trouble breathing
7. Change in warts of moles
There is a limited spread of cancer in
the local areas, usually to nearby lymph B. Type II
nodes

A. Type I
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 Med-Surg Ch25: Patient with Cancer; Study guide and NCLEX questions
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The malignant cells are confined to tis-
sue of origin; there is no invasion of other
tissues
The cancer has metastasized to distant
D. Type IV
parts of the body
The tumor is larger or has spread from
site of origin into nearby tissues, or both; C. Type III
regional lymph nodes are likely involved
High fat diets C. Cancers of breast, colon, and prostate
B. Cancers of the colon, breast, prostate,
Obesity
gallbladder, ovary, and uterus
D. Cancers of oral cavity, larynx, esoph-
High alcohol intake
agus, liver, colon, and breast
Diets high in salt-cured, smoked, and ni-
A. Esophageal and stomach cancers
trate-cured foods
Which are included in the recommended
diet for health promotion and prevention
of cancer? (Select all that apply)
1. Low fat
1. Low fat 3. Limited smoked and nitrate-preserved
2. Decreased fiber foods
3. Limited smoked and nitrate-preserved 5. Decreased calories
foods
4. 2 servings of fruits and veggies daily
5. Decreased calories
What is the 2nd most common cause of
death in the US?
1. Heart disease
2. Cancer
2. Cancer
3. Accident
4.Stroke
What is the effect on cells and tissue
when DNA of a normal cell is exposed
to a carcinogen and irreversible changes
occur in the DNA?

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 Med-Surg Ch25: Patient with Cancer; Study guide and NCLEX questions
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1. The cell appears abnormal but contin-
ues to function normally
2. The cell is in a latent period before
1. The cell appears abnormal but contin-
increased growth forms tumors
ues to function normally
3. A tumor develops
4. Transformed cells relocated to remote
sites
A pt whose primary tumor has grown and
spreads to regional lymph nodes, but not
to distant sites is staged?
2. T2N1M0
1. T1N2M1
2. T2N1M0
3. T0N3M1
4. T4N0M0
A pt has cancer that has been stages
T1N0M0. The nurse would interpret this
info as:

1. Minimal size and extension of tumor

1. Minimal size and extension of tumor
2. No sign of tumor
3. Malignancy in epithelial tissue nut not
in basement membrane
4. Progressively increasing size and ex-
tension
A tx likely to be curative when tumors are
confined to one area is;

1. radiotherapy 4. surgery
2. chemotherapy
3. immunotherapy
4. surgery
Radiation has immediate and delayed ef-
fects on cells; the immediate effect is:
1. cell death
1. cell death
2. alteration of DNA, which impairs cell's
ability to reprodude
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3. interruption of clotting cascade
4. cell starvation
Which side effect occurs in pts undergo-
ing radiotherapy and also in pts taking
antineoplastic drugs?
3. Alopecia
1. Phlebitis at infusion site
2. Erythema and peeling of skin
3. Alopecia
4. Cardiomyopathy
The highest rate of death from prostate,
colon, and breast cancer occurs among:

1. Caucasians 4. African Americans

2. Latinos
3. Native Americans
4. African Americans
What is the most dangerous side effect
of antineoplastic drugs?

1. Alopecia 4. Bone marrow suppression

2. N&V (nausea and vomiting)
3. Electrolyte imbalance
4. Bone marrow suppression
A drug that boosts the body's natural
defenses to combat malignant cells is:

1. Vincristine 2. Interferon
2. Interferon
3. Doxorubicin (Adriamycin)
4. Paclitaxel (Taxol)

Invasive procedures are minimized in pts

with:
2. Thrombocytopenia
1. Leukopenia
2. Thrombocytopenia
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3. Anemia
4. Agranulocytosis
Compromised host precautions may be
needed for pts with:

1. Leukopenia 1. Leukopenia
2. Thrombocytopenia
3. Anemia
4. Weight loss
Which tumor is malignant?

1. Fibroma
3. Melanoma
2. Lipoma
3. Melanoma
4. Myoma
Which diagnostic procedure is used to
detect cancer of the CNS, spinal column,
and joints?
1. MRI
1. MRI
2. CT
3. PET
4. Contrast radiograph
Of the following drugs, which types of
antineoplastic drugs are frequently used
in chemo? (Select all that apply)

1. Diuretics
2. Bronchodilators 3. Hormones
3. Hormones 4. Mitotic inhibitors
4. Mitotic inhibitors 6. Alkylating agents
5. Narcotics 11. Hypnotics
6. Alkylating agents 13. BRMs (biologic response modifiers)
7. Antithyroid drugs
8. Antiemetics
9. Sedatives
10. Antihypertensives
11.Antitumor antibiotics
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12. Hypnotics
13. BRMs (biologic response modifiers)
Which are major systemic side effects
of antineoplastic rugs? (Select all that
apply)

1. Dry mouth
2. Bone marrow suppression 2. Bone marrow suppression
3. Urinary retention 5. N&V
4. Sedation 8. Alopecia
5. N&V
6. Constipation
7. Dizziness
8. Alopecia
9. Electrolyte imbalance
The nurse observes that a female pt with
breast cancer is experiencing alopecia,
as a side effect of her chemo. Which is a
correct response the nurse should say to
the pt?

1. Increase protein in your diet to encour- 4. Your new hair may be different color
age new hair growth and texture
2. increase fluid intake so new hair
growth will not be dry
3. examine your scalp for bleeding, which
may be a temporary response to chemo
4. Your new hair may be different color
and texture
A pt with cancer is complaining of N&V
associated with chemo. Which food and
beverages should the nurse recommend
1. Clear broth
for this pt? (Select all that apply)
3. White rice
4. Crackers or pretzels
1. Clear broth
5. Yogurt
2. Coffee
3. White rice
4. Crackers or pretzels
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5. Yogurt
6. Cooked broccoli
A pt is receiving radiation tx to her head
and neck. Which is a special problem for
this pt, putting her at risk for infections of
the gums and teeth?
1. Dry mouth (xerostomia)
1. Dry mouth (xerostomia)
2. N&V
3. Bone marrow suppression
4. Anorexia
A pt receiving Andriamycin for tx of can-
cer is experiencing signs of cardiomy-
opathy. Which finding should the nurse
report to the health care provider, if ex-
perienced by the pt?
2. Dyspnea
1. Dehydration
2. Dyspnea
3. Alopecia
4. Urinary retention
A cancer pt has the lower abd irradiated.
Which is a priority nursing activity for the
pt?

1. Monitor pt for edema 2. Increase fluid intake and have pt empty

2. Increase fluid intake and have pt emp- bladder often
ty bladder often
3. Encourage pt to eat food high in iron
4. Observe pt for palpitations, pallor, and
excessive fatigue
Which pt should be placed in a private
room?

1. Pt with internal radiation 1. Pt with internal radiation

2. Pt with external radiation
3. Pt with chemotherapy
4. Pt requiring standard precautions
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 Med-Surg Ch25: Patient with Cancer; Study guide and NCLEX questions
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A pt experiences erythema and peeling

of the skin while receiving radiation ther-
apy. Which are appropriate nursing inter-
ventions for this pt? (Select all that apply)
1. Increase fluid intake
3. Watch for excessive bruising and
1. Increase fluid intake
bleeding
2. Use lotions
4. Report fever
3. Watch for excessive bruising and
6. Wear cotton clothing
bleeding
4. Report fever
5. Keep skin moist
6. Wear cotton clothing
3. Anemia
The outcome criterion of a pt's comple-
tion of essential activities without dysp- The outcome criterion for a patient with
nea or tachycardia is related to pts with: anemia is the
patient's completion of essential activi-
1. Alopecia ties without
2. Loss of body parts dyspnea or tachycardia. The remaining
3. Anemia three answers are not related to the pa-
4. Denial tient's ability to complete essential activ-
ities without dyspnea or tachycardia.
3. Protect extremities from injury

The priority care for patients experienc-

The priority care for pts experiencing
ing neurotoxicity
neurotoxicity from antineoplastic drugs is
from antineoplastic drugs is to protect
to:
extremities from
injury. Monitoring for edema (1), protect-
1. Monitor for edema
ing the patient
2. Protect pt from infection
from infection (2), and assessing for skin
3. Protect extremities from injury
turgor (4) are all related to the care of
4. Asses skin turgor
patients receiving antineoplastic drugs,
but they are not related to the side effect
of neurotoxicity
What is appropriate teaching for the pt
who is having external radiation therapy?

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1. "The tx may be painful for the first 5
minutes, but the pain will subside"
2. "You will be radioactive as long as the
machine is turned on"
4. "Skin over the area being treated may
3. "Skin marking made by the radiologist
become discolored and irritated"
are used to mark areas that be not be
irradiated"
4. "Skin over the area being treated may
become discolored and irritated"
Which are characteristics of malignant
tumors? (Select all that apply)

1. Usually slow growth rate

2. Invade surrounding tissue
2. Invade surrounding tissue
4. Recurrence is common after removal
3. Cells closely resemble those of tissue
5. Frequent metastasis
of origin
4. Recurrence is common after removal
5. Frequent metastasis
6. Little tissue destruction
The nurse is assisting with a staff ed-
ucation program on common oncologic
emergencies. Which are common onco-
logic emergencies? (Select all that ap-
ply) 1. Superior vena cava syndrome
4. Hypercalcemia
1. Superior vena cava syndrome 5. Syndrome of inappropriate antidiuretic
2. Pulmonary edema hormone (SIADH)
3. Hypertension 6. Spinal cord compression
4. Hypercalcemia 7. Disseminated intravascular coagula-
5. Syndrome of inappropriate antidiuretic tion
hormone (SIADH)
6. Spinal cord compression
7. Disseminated intravascular coagula-
tion
A pt receiving chemo has a WBC count
og 2000/mm3. The nurse anticipates that
3. Neutropenic precautions
the pt will be placed on:

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1. Airborne precautions
2. Contact precautions
3. Neutropenic precautions
4. Droplet precautions
A pt has received a radiation implant.
Which teaching point should the nurse
emphasize with this pt? (Select all that
apply)
1. "You will be placed in a private room"
1. "You will be placed in a private room"
3. "Visitors and staff are restricted in the
2. "Do not wash off the skin markings
amount of time they can spend in your
made by the radiation therapist"
room"
3. "Visitors and staff are restricted in the
5. "Staff and visitors will maintain some
amount of time they can spend in your
distance from you while they are in your
room"
room"
4. "Your skin over the irradiated area may
become irritated"
5. "Staff and visitors will maintain some
distance from you while they are in your
room"

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