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A bowel resection is scheduled for a client with the diagnosis of colon cancer with metastasis to the liver and bone. Which statement by the nurse best explains the purpose of the surgery?
- A. Removing the tumor is a primary treatment for colon cancer.'
- B. This surgery will prevent further tumor growth.'
- C. Once the tumor is removed, cell pathology can be determined.'
- D. Tumor removal will promote comfort.'
Correct Answer: D
Rationale: Palliative surgeries, such as bowel resection, may be performed to promote comfort by relieving pain and pressure on organs within the abdominal cavity. Primary treatment refers to surgery that is likely to provide a cure, which is not likely in metastatic disease. With metastasis, primary tumor removal does not prevent further tumor growth in distant sites. The diagnosis of colon cancer with metastasis suggests cell pathology has already been determined.
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The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise?
- A. Eat wholesome meals.
- B. Avoid spicy and fatty foods.
- C. Avoid intake of fluids.
- D. Eat warm or hot foods.
Correct Answer: B
Rationale: The nurse advises a client undergoing chemotherapy to avoid hot and very cold liquids and spicy and fatty foods. The nurse also encourages the client to have small meals and appropriate fluid intake.
A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed?
- A. I guess the doctor could not remove the entire tumor.'
- B. I am so glad the doctor was able to remove the entire tumor.'
- C. I will be glad to finally be done with treatments for this thing.'
- D. Thank goodness the tumor is contained and curable.'
Correct Answer: A
Rationale: Debulking is a reference made when a tumor cannot be completely removed, often due to its extension far into healthy tissue. Without complete removal, this is not a cure and, the cancer cells will continue to replicate and require adjuvant therapies to prevent further invasion. The physician, not the nurse, will need to clarify the details of the surgery.
The nurse is caring for a client with a newly discovered tumor that may be benign or malignant. The client asks, 'What makes a malignant tumor different from a benign one?' What should the nurse include in the response? Select all that apply.
- A. The cells of the tumor bear little resemblance to the cells in the tissue where the tumor started.'
- B. It grows by invasion and infiltrates the surrounding tissues.'
- C. The tumor grows slowly and may stop.'
- D. It does not spread to other areas of the body through blood and lymph channels.'
- E. The tumor may regress after its initial growth.'
Correct Answer: A,B
Rationale: The nurse should include the statements 'The cells of the tumor bear little resemblance to the cells in the tissue where the tumor started' and 'It grows by invasion and infiltrates the surrounding tissues' in the response. Undifferentiated cells and growth by invasion are both characteristics of malignant tumors. Benign tumors are characterized by slow growth, not metastasizing, and the possibility of regression, while malignant tumors are not.
A client asks the nurse what is causing the fatigue following radiotherapy. What is the nurse's best response?
- A. The cancer is spreading to other parts of the body.
- B. The cancer cells are dying in large numbers.
- C. Fighting off infection is an exhausting venture.
- D. Substances are released when tumor cells are destroyed.
Correct Answer: D
Rationale: Fatigue results from substances being released when tumor cells are destroyed during radiotherapy. The spreading of cancer can cause many symptoms dependent on location and type of cancer, but it is not a significant factor in the development of fatigue with radiotherapy. The production of healthy cells can increase metabolic rate, but death of cancer cells does not support fatigue in this case. Fighting infection can cause fatigue, but there is no evidence provided to support the presence of infection in this client.
The nurse is providing an educational presentation on dietary recommendations for reducing the risk of cancer. Which of the following food selections would demonstrate a good understanding of the information provided in the presentation? Select all that apply.
- A. Egg white omelet with spinach and mushrooms
- B. Crispy chicken Caesar Salad
- C. Steamed broccoli and carrots
- D. Turkey breast on whole wheat bread
- E. Smoked salmon
- F. Vegetable and cheddar quiche
Correct Answer: A,C,D
Rationale: Foods high in fat and those that are smoked or preserved with salt or nitrates are associated with increased cancer risks. An omelet made of egg whites and vegetables is a healthy low-fat selection as are steamed broccoli/carrots and turkey breast on whole grain bread. A salad can be a healthy selection, but Caesar salads contain much fat from the dressing and addition of cheeses and fried chicken. Salmon that is not smoked would be a good selection. Quiche usually contains high-fat milk, cr?¨me, eggs, and cheese.