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Oncology I:

1. What are the 2 types of cancer?

solid tumors, hematologic malignancies

2. What is the #1 cause of preventable cancer?

tobacco

3. What is the most important risk factor for cancer?

aging

4. Name 3 things that are considered primary prevention for cancer.

No smoking, exercise and good nutrition, maintain normal body weight, limit or eliminate
alcohol intake, vaccines for preventable viral exposures (Hep B & HPV), and avoid exposure to known
carcinogens.

5. Name 3 things that are considered secondary prevention for the female.
Monthly BSE (breast self-exam) starting at age 20, yearly clinical breast exams at age 40 > and
every 3 years from ages 20-39, Pap smear at age 21 and every 3 years if no problems, colonoscopy at
age 50 with repeat every 10 years if no problems, fecal occult blood yearly at age 50

6. Name 3 things that are considered secondary prevention for the male.
BSE information, yearly clinical testicular exams, teach TSE, digital rectal exam and PSA at age
50, colonoscopy at age 50 with repeat every 10 years if no problems, fecal occult blood yearly at age 50

7. List 2 examples of tertiary care/prevention for cancer clients.

support groups. Rehab programs

8. What does the acronym CAUTION describe related to general signs and symptoms of

cancer?
Change in bowel/bladder habits,
A sore that doesn’t heal,
Unusual bleeding/discharge,
Thickening or lump in breast or elsewhere,
Indigestion or difficulty swallowing,
Obvious change in wart or mole,
Nagging cough or hoarseness

9. What is the number 1 symptom that clients complain of with a diagnosis of cancer?
fatigue

10. Why does the client who has had a total laryngectomy need to have a tracheostomy?
because the epiglottis has been removed. No airway protection left

11. Why does the client who had a total laryngectomy need to be positioned in Fowler’s

position?
to decrease edema around airway
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12. Why does the laryngectomy client need to have NG feedings?

to protect suture line

13. Why is it important that the laryngectomy client have frequent mouth care?
to prevent mouth bacteria from moving down to surgical site or to lungs

14. What types of activities are restricted for a client with a total laryngectomy?
no whistling, no drinking through a straw, no smoking and no swimming

15. What are the 3 primary goals of cancer treatment?

cure, control and palliation

16. What are the 4 reasons that surgery will be used for cancer treatment?
prevention, diagnosis, treatment and reconstruction

17. Explain the post op care for a client who has had a mastectomy.
Elevate arm on the affected side; protect the extremity, brush hair, squeeze tennis ball, wall
climbing-promote circulation and mobility; check for bleeding..

18. Why is it so important that the mastectomy client elevate her arm on the affected side?
lymphatic system may have been damaged, and this will prevent swelling

19. Why is it important that the client exercise the affected side after a mastectomy?
promotes circulation and mobility

20. List discharge teaching precautions for the mastectomy client

no constriction, no BP or injections, wear gloves when gardening, watch for cuts, protect
extremity

21. What 3 things determine whether surgery for cancer has been successful?
Could the cancer be completely removed, had the cancer spread at the time of surgery, and was
the surgeon able to get adequate margins

22. What are the 3 principles that guide the general precautions for internal radiation?
time, distance, shielding

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23. Explain nursing assignments for internal radiation clients.

rotate assignments daily, nurse should care for only one radiation client per shift

24. When a client has an internal radiation implant, why do we put them on a low fiber diet?
to help prevent dislodgment that could occur if intestines become distended

25. Why does this client have an indwelling catheter?

to help keep bladder non distended (could promote dislodgment). If bladder becomes distended
the implant could be pushed out
26. Why do we want to keep the client with an internal radiation implant on bed rest?
to help
prevent dislodgment

27. When a client has a radiation implant, there is a chance it will become dislodged. What

would you do?

get gloves, using forceps pick it up and put it in a lead lined container. Call radiation department

28. Explain the nursing care for the markings that a client will have when they are receiving

external radiation therapy.

Do not wash them off or put lotion on them. Protect the site from sunlight and UV exposure for
1 year after therapy completed

Oncology II

29. List basic side effects of chemotherapy.

alopecia, decrease in appetite, N/V, pancytopenia, impaired taste, decreased WBC

30. What are the most common body systems affected by the side effects of chemotherapy?
blood, GI, skin and hair (integu.)

31. What equipment is required with full precautions with handling chemotherapy?
chemotherapy gown, 2 pairs of chemo gloves, goggles and/or mask if splashing or inhalation can
occur

32. What is required to manage a chemotherapy spill?

Handle as a hazardous chemical spill, obtain spill kit and us all protective equipment for cleanup,
including gown, gloves, facemask, goggles and yellow chemo waste containers

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33. What is a vesicant?

a chemo drug. If a vesicant infiltrates it will cause massive tissue necrosis

34. What do you do if a vesicant infiltrates (extravasates)?

stop infusion, ice packs to promote vasoconstriction and decrease absorption of drug

35. What is the danger of a vesicant infiltrating?

tissue necrosis

36. List the signs of rejection of a transplant that the nurse should assess for regularly.
Abdominal cramps, nausea, vomiting, diarrhea, jaundice or other liver problems, dark
teacolored urine, and skin rash, itching and redness on areas of the skin.

37. List 6 general ways to prevent infection in the client receiving chemotherapy.
Private room; wash hands; have own supplies in room; limit people (visitors and nurses) in
room; change dressing and IV tubing daily; cough and deep breathe; no fresh flowers or potted plants;
avoid crowds, do not share toiletries; bathe warm moist areas twice a day (groin and under the arms);
wash hands after touching pet; avoid raw fruits and vegetables; drink only fresh water; slight increase in
temp may mean sepsis; monitor ANC

38. What is the best way to assess neutropenia?

calculate and ANC

39. List 3 risk factors for neutropenia in the cancer client.

Age (very old and very young), advanced metastatic disease, malnourishment, B12 and folic acid
deficiencies, impaired tissue integrity, presence of other diseases, hematologic malignancies, and as a
result of cancer treatment (i.e. chemo).

40. Why is malignancy a large risk factor for the development of a DVT?
Prolonged bedrest, surgery, use of a central line, external compression of vessels by the tumor,
invasion of vessels by the tumor and certain chemotherapy drugs

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41. What should be included in a bleeding assessment specific to thrombocytopenia?

History of risk factors, vital signs, pulse oximetry, change in LOC, c/o headache, pupil changes,
conjunctival hemorrhages, petechiae, ecchymosis, and purpura, oozing from puncture sites or surgical
sites and bleeding from the rectum, ears, nose, or mouth.

42. What does leukoreduction do to make blood products safe?

makes it CMV (cytomegalovirus) negative=safe

43. List 6 non-pharmacologic treatments for chemotherapy induced nausea/vomiting (CINV).

ginger, aromatherapy, acupuncture or acupressure, distraction and relaxation techniques

44. What classification of medications are considered the “gold standard” for treating cancer

pain?
opioids

45. List 3 alternative therapies that are accepted practice for pain management of the cancer

client.
Complimentary/alternative therapies, acupressure/acupuncture, Cannabis (marijuana),
distraction therapies, hydrotherapy and massage.