ch 12 Flashcards
Which of the following options should the nurse incorporate into the plan of care as a primary prevention strategy for reduction of the risk for cancer?
a. Yearly mammography for women aged 40 years and older
b. Using skin protection during sun exposure while at the beach
c. Colonoscopy at age 50 and every 10 years as follow-up
d. Yearly prostate specific antigen (PSA) and digital rectal exam for men aged 50
and over
ANS: B
Primary prevention of cancer involves avoidance to known causes of cancer, such as sun exposure. Secondary screening involves physical and diagnostic examination.
While the nurse is collecting a health history on a patient admitted for colon cancer, which of the following questions should the nurse ask as a priority?
a. “Have you noticed any blood in your stool?”
b. “Have you been experiencing nausea?”
c. “Do you have back pain?”
d. “Have you noticed any swelling in your abdomen?”
ANS: A
Early colon cancer is often asymptomatic, with occult or frank blood in the stool being an assessment finding in a patient diagnosed with colon cancer. If pain is present, it is usually lower abdominal cramping. Constipation and diarrhea are more frequent findings than nausea or ascites.
While planning care for a patient experiencing fatigue due to chemotherapy, which of the following is the most appropriate nursing intervention?
a. Prioritization and administration of nursing care throughout the day
b. Completing all nursing care in the morning so the patient can rest the remainder
of the day
c. Completing all nursing care in the evening when the patient is more rested
d. Limiting visitors, thus promoting the maximal amount of hours for sleep
ANS: A
Pacing activities throughout the day conserves energy, and nursing care should be paced as well. Fatigue is a common side effect of cancer and treatment; and while adequate sleep is important, an increase in the number of hours slept will not resolve the fatigue. Restriction of visitors does not promote healthy coping and can result in feelings of isolation.
The nurse is caring for a patient who received a recent bone marrow transplant. The nurse would monitor for which of the following clinical manifestations that could indicate a potentially life-threatening situation?
a. Mucositis
b. Confusion
c. Depression
d. Mild temperature elevation
ANS: D
The earliest sign of infection in an immunosuppressed patient can be a mild fever. Mucositis, confusion, and depression are possible clinical manifestations but are representative of less life-threatening complications.
While the nurse is obtaining the health history of a 75-year-old female patient, which of the following has the greatest implication for the development of cancer?
a. Being a woman
b. Family history of hypertension
c. Cigarette smoking as a teenager
d. Advancing age
ANS: D
Aging is a non-modifiable risk factor for the development of cancer with an associated increase seen with aging. In terms of gender and age, lifetime risk is higher for males than females. Family history of co-morbidities such as hypertension is not directly correlated with cancer development. Cigarette smoking as a teenager for the patient is a risk factor but may have mitigated impact at this point in time based on the patient’s stated age and length of time as a non-smoker.
In caring for a patient admitted with lung cancer, which of the following should the nurse expect to find on assessment? a. No use of accessory muscles during respirations
b. Orthostatic hypotension upon change of positioning
c. Clear sputum
d. Weight loss compared to last admission
ANS: D
Common signs/symptoms of lung cancer include coughing, hemoptysis, and weight loss, shortness of breath and chest pain. The nurse should expect to see weight loss and altered breathing patterns. Clear sputum and orthostatic blood pressure changes would not be seen.
A female patient complains of a “scab that just won’t heal” under her left breast. During your conversation, she also mentions chronic fatigue, loss of appetite, and slight cough, attributed to allergies. What is the nurse’s best action?
a. Continue to conduct a symptom analysis to better understand the patient’s
symptoms and concerns.
b. End the appointment and tell the patient to use skin protection during sun
exposure.
c. Suggest further testing with a cancer specialist and provide the appropriate
literature.
d. Tell her to put a bandage on the scab and set a follow-up appointment in 1 week.
ANS: A
A comprehensive health history is vital to treating and caring for the patient. Often times, symptoms are vague. The nurse should conduct a symptom analysis to gather as much information as possible. Questions should address the duration of the symptoms and include the location, characteristics, aggravating and relief factors, and any treatments taken thus far.
A patient with prostate cancer is taking hormonal therapy to control tumor growth. He reports that his left calf is swollen and painful. Which of the following would be the nurse’s best action?
a. Instruct the patient to keep the leg elevated.
b. Measure the calf circumference and compare the measurement with the right calf
circumference measurement.
c. Apply ice to the calf after a 10-minute massage of the area.
d. Document assessment findings as an expected response with estrogen therapy.
ANS: B
A nurse should be aware of potential complications from hormonal therapy such as the development of thrombus formation. Massaging a calf that is swollen and painful is never correct, because this action might break a clot, causing formation of an embolus, which could then travel to the lungs.
A patient being evaluated for breast cancer is not certain whether she and her family should participate in a genetic screening plan since no one can guarantee the results. What is the nurse’s best response?
a. “If you have a family history of breast cancer, the chances for you to have this
type of cancer increases.”
b. “The decision is up to you in the final analysis.”
c. “If there is no family history, then there is no need to go through the process.”
d. “If your insurance will pay for the screening, then there is no associated risk.”
ANS: A
Individuals with a family history of breast cancer (especially 1st degree relatives) are at increased risk for disease occurrence. The nurse should inform the patient of the outcome measures of the screening plan. The nurse should not dissuade the patient from the process based on stating there is no family history, as there is no evidence that an adequate family history has been obtained. Similarly, to correlate the need for genetic testing with insurance and no implied risk cannot be stated equivocally. Although the decision is up to the patient in the final analysis, that response does not address relevant information about the purpose of genetic screening.
A nurse is reviewing assessment findings for a female patient admitted to the oncology unit. Which finding should alert the nurse to contact the physician?
a. Blood pressure 130/88
b. Noticeable difference in circumference of lower legs
c. Presence of goiter previously identified on prior admission d. Negative guaiac test
ANS: B
Examination findings relative to oncology patients and neoplastic growth manifest as visible lesions, physical asymmetry, palpable masses, abnormal sounds or the presence of blood on screening tests. A blood pressure of 130/88 is within normal range as is a negative guaiac test. Observation of a previous goiter which is consistent with a prior admission is not a concern. The detection of physical asymmetry as seen by a difference in circumference should be reported to the physician.
