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The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breath and the nurses rapid assessment reveals that the patients jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct Answer: B
Rationale: SVCS occurs when there is gradual or sudden impaired venous drainage giving rise to progressive shortness of breath (dyspnea), cough, hoarseness, chest pain, and facial swelling; edema of the neck, arms, hands, and thorax and reported sensation of skin tightness and difficulty swallowing; as well as possibly engorged and distended jugular, temporal, and arm veins. Increased intracranial pressure may be a part of SVCS, but it is not what is causing the patients symptoms. The scenario does not mention a problem with the patients spinal cord. The scenario says that the cancer has metastasized, but not that it has metastasized to the neck.
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The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient?
- A. These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and x-ray studies
- B. These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer
- C. Try not to be concerned about these symptoms. Every patient feels this way after having radiation therapy
- D. Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying
Correct Answer: A
Rationale: Fatigue and weakness result from radiation treatment and usually do not represent deterioration or disease progression. The symptoms associated with radiation therapy usually decrease after therapy ends. The symptoms may concern the patient and should not be belittled. Radiation destroys both cancerous and normal cells.
A public health nurse has formed an interdisciplinary team that is developing an educational program entitled Cancer: The Risks and What You Can Do About Them. Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity?
- A. Disease prophylaxis
- B. Risk reduction
- C. Secondary prevention
- D. Tertiary prevention
Correct Answer: C
Rationale: Secondary prevention involves screening and early detection activities that seek to identify early stage cancer in individuals who lack signs and symptoms suggestive of cancer. Primary prevention is concerned with reducing the risks of disease through health promotion strategies. Tertiary prevention is the care and rehabilitation of the patient after having been diagnosed with cancer.
The school nurse is teaching a nutrition class in the local high school. One student states that he has heard that certain foods can increase the incidence of cancer. The nurse responds, Research has shown that certain foods indeed appear to increase the risk of cancer. Which of the following menu selections would be the best choice for potentially reducing the risks of cancer?
- A. Smoked salmon and green beans
- B. Pork chops and fried green tomatoes
- C. Baked apricot chicken and steamed broccoli
- D. Liver, onions, and steamed peas
Correct Answer: C
Rationale: Fruits and vegetables appear to reduce cancer risk. Salt-cured foods, such as ham and processed meats, as well as red meats, should be limited.
A 60-year-old patient with a diagnosis of prostate cancer is scheduled to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this patients subsequent plan of care?
- A. Limit the time that visitors spend at the patients bedside
- B. Teach the patient to perform all aspects of basic care independently
- C. Assign male nurses to the patients care whenever possible
- D. Situate the patient in a shared room with other patients receiving brachytherapy
Correct Answer: A
Rationale: To limit radiation exposure, visitors should generally not spend more than 30 minutes with the patient. Pregnant nurses or visitors should not be near the patient, but there is no reason to limit care to nurses who are male. All necessary care should be provided to the patient and a single room should be used.
The clinic nurse is caring for a patient whose grandmother and sister have both had breast cancer. She requested a screening test to determine her risk of developing breast cancer and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response?
- A. Research has shown that eating a healthy diet can provide all the protection you need against breast cancer
- B. Research has shown that taking the drug tamoxifen can reduce your chance of breast cancer
- C. Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer
- D. Research has shown that there is little you can do to reduce your risk of breast cancer if you have a genetic predisposition
Correct Answer: B
Rationale: Large-scale breast cancer prevention studies supported by the National Cancer Institute (NCI) indicated that chemoprevention with the medication tamoxifen can reduce the incidence of breast cancer by 50% in women at high risk for breast cancer. A healthy diet and regular exercise are important, but not wholly sufficient preventive measures.