Nokea
A client diagnosed with cancer makes the following statement to the nurse: 'I guess I will tell my health care provider to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die.' Which of the following facts supports the use of chemotherapy for this client?
- A. Nausea and vomiting are only a factor for the first 24 hours after treatment.
- B. Most clients believe the discomfort is well worth the cure for cancer.
- C. Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.
- D. Clinical trials are opening up new cancer treatments all the time.
Correct Answer: C
Rationale: Chemotherapy is not one drug for all clients. The therapy can be specifically designed to optimize effects while limiting adverse effects with supplemental anti emetics to control the nausea and vomiting. It is true that nausea and vomiting are most prevalent in the first 24 hours after each chemotherapy treatment, but this fact does not eliminate the fears expressed by this client. No one can state the worth of any treatment, and a cure is never promised. Clinical trials open new options for treatment, but the process is lengthy and is not a certainty for a client in need of immediate treatment.
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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.
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.
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.
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.