Nokea
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.
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The nurse is invited to present a teaching program to parents of school-age children. Which topic would be of greatest value for decreasing cancer risks?
- A. Pool and water safety
- B. Breast and testicular self-exams
- C. Hand washing and infection prevention
- D. Sun safety and use of sunscreen
Correct Answer: D
Rationale: Pool and water safety as well as infection prevention are important teaching topics but will not decrease cancer risk. While performing breast and testicular self-exams may identify cancers in the early stage, this teaching is not usually initiated in school-age children. Severe sunburns that occur in young children can place the child at risk for skin cancers later in life. Because children spend much time out of doors, the use of sunscreen and protective clothing/hats can protect the skin and decrease the risk.
The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action?
- A. Extravasation
- B. Stomatitis
- C. Nausea and vomiting
- D. Bone pain
Correct Answer: A
Rationale: The nurse needs to monitor IV administration of antineoplastics (especially vesicants) to prevent tissue necrosis to blood vessels, skin, muscles, and nerves. Stomatitis, nausea/vomiting, and bone pain can be symptoms of the disease process or treatment mode but does not require immediate action.
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.
The nurse is caring for a thyroid cancer client following oral radioactive iodine treatment. Which teaching point is most important?
- A. Shield your throat area when near others.'
- B. Flush the toilet several times after every use.'
- C. Prepare food separately from family members.'
- D. Use disposable utensils for the next month.'
Correct Answer: B
Rationale: Iodine 131 is a systemic internal radiation that is excreted through body fluids, especially urine. Flushing the toilet several times after each use will avoid the exposure of others to radioactive exposure. Shielding the throat area is not effective because this form of treatment is systemic. Preparing food separately is not necessary, but the use of separate eating utensils will be necessary for the first 8 days.
Which of the following can be considered carcinogens?
- A. Parasites
- B. Medical procedures
- C. Dietary substances
- D. Infective genes
Correct Answer: C
Rationale: Carcinogens include chemical agents, environmental factors, dietary substances, viruses, defective genes, and medically prescribed interventions.