Nokea
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.
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The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia?
- A. The hair loss is usually temporary.'
- B. New hair growth will return without any change to color or texture.'
- C. Clients with alopecia will have delay in grey hair.'
- D. Wigs can be used after the chemotherapy is completed.'
Correct Answer: A
Rationale: Alopecia associated with chemotherapy is usually temporary and will return after the therapy is completed. New hair growth may return unchanged, but there is no guarantee and color, texture, and quality of hair may not be changed. There is no correlation between chemotherapy and delay in greying of hair. Use of wigs, scarves, and head coverings can be used by clients at any time during treatment plan.
A client with a 4-cm breast mass is scheduled for biopsy with frozen section followed by lumpectomy and possible mastectomy. The client asks the nurse, 'Why can't the doctor tell me specifically whether I will need to have my entire breast removed'? Which is the best response from the nurse?
- A. The doctor will know which surgery is required, once the tumor is exposed.'
- B. The frozen section will determine presence of cancer and type of surgery required.'
- C. You need to trust your doctor to provide you with the best of care.'
- D. You seem anxious about your upcoming surgery.'
Correct Answer: B
Rationale: Although experienced surgeons can often predict the type of tumor upon opening, seeing the tumor does not determine presence or absence of cancer cells. The client may be anxious about upcoming surgery, but this response does not address the question posed by the client. Trusting the surgeon is important, but this response is not appropriate for the question asked. A frozen section during surgery allows the pathologist to quickly examine the tissue under microscope allowing the surgeon to make a decision for best surgical approach.
While completing an admission assessment, the client reports a family history of breast cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology?
- A. Inherited gene mutation
- B. Smoking and tobacco use
- C. Exposure to chemicals and spermicides
- D. Increased tumor suppressor genes
Correct Answer: A
Rationale: Tumor suppressor genes assist the body in normal cell production and death. Tobacco use and chemical carcinogens can contribute to the development of cancer, but there is not enough information provided to suggest a common link. Oncogenes are genes that have mutated and activate out-of-control cell growth. Inherited gene mutation occurs when the DNA is passed to the next generation.
The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant?
- A. Monitor the client's toilet patterns.
- B. Monitor the client closely to prevent infection.
- C. Monitor the client's physical condition.
- D. Monitor the client's heart rate.
Correct Answer: B
Rationale: Until transplanted stem cells begin to produce blood cells, these clients have no physiologic means to fight infection, which makes them very prone to infection. They are at high risk for dying from sepsis and bleeding before engraftment. Therefore, a nurse must closely monitor clients and take measures to prevent infection. Monitoring client's toilet patterns, physical condition, and heart rate does not prevent the possibility of the client getting an infection.
Chemotherapy has been used for the past 3 months to treat a client with pancreatic cancer. The CA 19-9 levels are rising. Which explanation would the nurse attribute as the most likely cause?
- A. It is normal for this antigen to rise for up to 6 months.
- B. The client is having an adverse response to the chemotherapy.
- C. The chemotherapy is effectively destroying the cancer cells.
- D. The cancer is growing despite the chemotherapy treatment.
Correct Answer: D
Rationale: Elevation of specific tumor markers, such as CA 19-9, is indicative of progression and proliferation of the cancer cells. If the chemotherapy was successful in the treating of the pancreatic cancer cells, the tumor marker would be decreased. Increased production of antibody development is not a usual adverse reaction of chemotherapy.