Nokea
The nurse is caring for a client is scheduled for chemotherapy followed by autologous stem cell transplant. Which of the following statements by the client indicates a need for further teaching?
- A. I hope they find a bone marrow donor who matches.'
- B. The doctor will remove cells from my bone marrow before beginning chemotherapy.'
- C. I will receive chemotherapy until most of the cancer is gone, and then I will get my own stem cells back.'
- D. I will need to be in protective isolation for up to 3 months after treatment.'
Correct Answer: A
Rationale: An autologous stem cell transplant comes from the client not from a donor. The doctor will remove the stem cells from the bone marrow before beginning chemotherapy and treat the client until most if not all the cancer is eliminated before reinfusing the stem cells. Clients are at risk for infection and will be closely monitored for at least 3 months, but not in protective isolation.
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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.
Which of the following advice does the nurse offer clients who are undergoing unsealed radiation therapy to reduce exposure?
- A. Avoid drinking plenty of fluids.
- B. Avoid eating for 3 hours after therapy.
- C. Avoid applying skin moisturizers.
- D. Avoid kissing and sexual contact.
Correct Answer: D
Rationale: Clients who are undergoing unsealed radiation therapy are advised to avoid kissing and sexual contact due to the spread of radioactivity. Clients are encouraged to drink plenty of fluids to help flush radioactive substances. Clients may be asked to apply mild moisturizers and are not asked to avoid eating after the therapy.
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.
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.
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.