Nokea
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.
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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.
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 client diagnosed with cancer makes the following statement to the nurse: 'I guess I will tell my health care provider to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die.' Which of the following facts supports the use of chemotherapy for this client?
- A. Nausea and vomiting are only a factor for the first 24 hours after treatment.
- B. Most clients believe the discomfort is well worth the cure for cancer.
- C. Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.
- D. Clinical trials are opening up new cancer treatments all the time.
Correct Answer: C
Rationale: Chemotherapy is not one drug for all clients. The therapy can be specifically designed to optimize effects while limiting adverse effects with supplemental anti emetics to control the nausea and vomiting. It is true that nausea and vomiting are most prevalent in the first 24 hours after each chemotherapy treatment, but this fact does not eliminate the fears expressed by this client. No one can state the worth of any treatment, and a cure is never promised. Clinical trials open new options for treatment, but the process is lengthy and is not a certainty for a client in need of immediate treatment.
The nurse is caring for a client with a newly discovered tumor that may be benign or malignant. The client asks, 'What makes a malignant tumor different from a benign one?' What should the nurse include in the response? Select all that apply.
- A. The cells of the tumor bear little resemblance to the cells in the tissue where the tumor started.'
- B. It grows by invasion and infiltrates the surrounding tissues.'
- C. The tumor grows slowly and may stop.'
- D. It does not spread to other areas of the body through blood and lymph channels.'
- E. The tumor may regress after its initial growth.'
Correct Answer: A,B
Rationale: The nurse should include the statements 'The cells of the tumor bear little resemblance to the cells in the tissue where the tumor started' and 'It grows by invasion and infiltrates the surrounding tissues' in the response. Undifferentiated cells and growth by invasion are both characteristics of malignant tumors. Benign tumors are characterized by slow growth, not metastasizing, and the possibility of regression, while malignant tumors are not.
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.