Nokea
The nurse is caring for a client who has been diagnosed with a breast lump. The physician states that studies indicate a cancerous tumor in situ. The client is anxious and wants to know what may come next. The nurse is most correct to support physician instruction of which of the following?
- A. Since your tumor appears localized, removal of the tumor is indicated.
- B. A mastectomy is recommended for all clients in this situation.
- C. The next step is just as the physician described. We can have the physician talk to you again.
- D. Chemotherapy and radiation are typical treatments prescribed by the oncologist.
Correct Answer: A
Rationale: The nurse is correct to restate the information that the physician has just discussed. Many times, anxious clients have a difficult time understanding information. The nurse realizes that a tumor that is in situ has developed in a localized area without invading the surrounding tissue. This criterion would allow the removal of tissue from only that area, not an entire mastectomy. When the client asks for the next step, chemotherapy and radiation, as indicated, would be initiated after removal of the tumor.
You may also like to solve these questions
The nurse is caring for a client following breast reconstruction surgery using autogenous tissue. When assessing wounds from the surgical procedure, in which area would the nurse assess the wound from which tissue was taken?
- A. The vastus lateralis
- B. The rectus femoris
- C. Gluteus maximus
- D. Rectus abdominis
Correct Answer: D
Rationale: The area in which tissue is taken for breast reconstruction surgery is from the rectus abdominis muscle in a manner similar to a 'tummy tuck.' The nurse must assess this site for healing or complications.
The nurse is caring for a client whose physician has ordered a sentinel lymph node mapping. The physician explained the procedure and desired outcome. Which statement, made by the client, indicates a need for further instruction?
- A. The procedure allows for an understanding of the spread of cancer cells.
- B. The procedure allows for conservation of breast tissue.
- C. The procedure removes all cancer from the body.
- D. The procedure includes minimal surrounding tissue damage.
Correct Answer: C
Rationale: Sentinel lymph node mapping involves identifying the first (sentinel) lymph nodes through which the breast cancer cells would spread to regional lymph nodes in the axilla. Validating the lack of lymph node metastasis allows the surgeon to preserve more breast tissue, axillary tissue and chest muscle. Further instruction would be needed to explain that the sentinel lymph node biopsy does not remove cancer from the body.
The nurse is caring for a client experiencing metastatic cancer-related pain. Which drug of choice does the nurse anticipate being ordered?
- A. Ibuprofen (Motrin)
- B. Alprazolam (Xanax)
- C. Morphine (MS Contin)
- D. Propofol (Diprivan)
Correct Answer: C
Rationale: In treating clients with metastatic cancer-related pain, the opioid analgesics morphine (MS Contin) and fentanyl are the drugs most often used for pain relief. Morphine (MS Contin) can be given orally, rectally, subcutaneously, intravenously, intramuscularly, or by epidural catheter. Ibuprofen (Motrin) is given for mild to moderate pain. Alprazolam (Xanax) is provided to relieve anxiety. Propofol (Diprivan) is an anesthetic given, frequently for short procedures.
The nurse is caring for four clients in an oncology unit. Following report, which client would the nurse identify as having the most life-threatening diagnosis?
- A. A client with stage IV cancer receiving palliative care
- B. A client diagnosed with a stage one tumor with no lymph node involvement
- C. A client receiving chemotherapy and radiation with a low blood count
- D. A client with an estrogen receptor-positive tumor receiving oral chemotherapy
Correct Answer: A
Rationale: The client with stage IV cancer, indicating metastasis, and receiving palliative care, which includes comfort measures, is in highest life-threatening condition. A client with a stage I tumor and no lymph node involvement has a good prognosis as the cancer has been caught at an early stage. A low blood count is common when the client is receiving chemotherapy. It is common to have chemotherapy and radiation as a treatment regimen. Clients have experienced good prognosis with estrogen receptor positive tumor treatment of oral chemotherapy.
A client with breast cancer is scheduled to undergo chemotherapy with aromatase inhibitors. Which rationale does the nurse give for the use of this group of drugs?
- A. They prevent prehormones from becoming estrogen, blocking the tumor's ability to use it.
- B. They block progesterone-dependent tumors from growing.
- C. They attack to endogenous protein receptors to slow the growth of cancerous cells.
- D. They stimulate the immune system to attack a protein common in many tumors.
Correct Answer: A
Rationale: Aromatase inhibitors prevent prehormones from becoming estrogen thereby interfering with the ability of hormone-sensitive tumors to use estrogen for growth. Antiprogogestin drug, such as antipeptide, blocks progesterone-dependent breast cancers. A monoclonal antibody, resuzumab attacks to protein receptors to slow the growth of cancer cells. A breast cancer vaccine is under investigation in Italy. This vaccine stimulates the immune system to attack a protein called mammaglobin-A, which is found in 80% of breast cancer tumors.