Nokea
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.
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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.
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 public health nurse is teaching a local community group about warning signs of cancer. What should the nurse include in the teaching? Select all that apply.
- A. Sores that do not heal
- B. Unusual bleeding or discharge
- C. Unexplained weight gain
- D. Tenderness or pain
- E. Persistent indigestion
Correct Answer: A,B,D,E
Rationale: Warning signs of cancer include sores that do not heal, unusual bleeding or discharge, tenderness or pain, and persistent indigestion. Unexplained weight loss, not weight gain, is a warning sign of cancer.
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.
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.