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The nurse is preparing a patient for a biopsy of a lump in the right breast and the patient asks the nurse about the difference between a benign tumour and a malignant tumour. Which of the following responses by the nurse is correct?
- A. Benign tumours do not cause damage to other tissues.
- B. Benign tumours are likely to recur in the same location.
- C. Malignant tumours may spread to other tissues or organs.
- D. Malignant cells reproduce more rapidly than normal cells.
Correct Answer: C
Rationale: The major difference between benign and malignant tumours is that malignant tumours invade adjacent tissues and spread to distant tissues and benign tumours never metastasize. The other statements are inaccurate. Both types of tumours may cause damage to adjacent tissues. Malignant cells do not reproduce more rapidly than normal cells. Benign tumours do not usually recur.
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Which statement by a patient who is scheduled for a needle biopsy of the prostate indicates that the nurse's teaching about the purpose of the biopsy has been effective?
- A. The biopsy will remove the cancer in my prostate gland.
- B. The biopsy will determine how much longer I have to live.
- C. The biopsy will help decide the treatment for my enlarged prostate.
- D. The biopsy will indicate whether the cancer has spread to other organs.
Correct Answer: C
Rationale: A biopsy is used to determine whether the prostate enlargement is benign or malignant and determines the type of treatment that will be needed. Biopsy does not give information about metastasis, life expectancy, or the impact of cancer on the patient's life; the three remaining statements indicate a need for patient teaching.
The nurse is teaching a patient who is postmenopausal and has stage III breast cancer about the expected outcomes of her cancer treatment. Which patient statement indicates that the teaching has been effective?
- A. After cancer has not recurred for 5 years, it is considered cured.
- B. The cancer will be cured if the entire tumour is surgically removed.
- C. Cancer is never considered cured, but the tumour can be controlled with surgery, chemotherapy, and radiation.
- D. I will need to have follow-up examinations for many years after I have treatment before I can be considered cured.
Correct Answer: D
Rationale: The risk of recurrence varies by the type of cancer. For breast cancer in postmenopausal women the patient needs at least 20 disease-free years to be considered cured. Some cancers are considered cured after a shorter time span, or after surgery, but stage III breast cancer will require additional therapies and ongoing follow-up.
When reviewing the chart for a patient with cervical cancer, the nurse notes that the cancer is staged as Tis, N0, M0. Which of the following statements is accurate related to this staging?
- A. The cancer is localized to the cervix.
- B. The cancer cells are well differentiated.
- C. Further testing is needed to determine the spread of the cancer.
- D. It is difficult to determine the original site of the cervical cancer.
Correct Answer: A
Rationale: Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time. Cell differentiation is not indicated by clinical staging. Because the cancer is in situ, the origin is the cervix. Further testing is not indicated given that the cancer has not spread.
A patient with a large stomach tumour that is attached to the liver is scheduled to have a debulking procedure. When teaching the patient, which of the following is the expected outcome of this surgery?
- A. Relief of pain by cutting sensory nerves in the stomach
- B. Control of the tumour growth by removal of malignant tissue
- C. Decrease in tumour size to improve the effects of other therapy
- D. Promotion of better nutrition by relieving the pressure in the stomach
Correct Answer: C
Rationale: A debulking surgery reduces the size of the tumour and makes radiation and chemotherapy more effective. Debulking surgeries do not control tumour growth. The tumour is debulked because it is attached to the liver, a vital organ (not to relieve pressure on the stomach). Debulking does not sever the sensory nerves, although pain may be lessened by the reduction in pressure on the abdominal organs.
The nurse is caring for a patient who is receiving chemotherapy for leukemia. Which of the following observations require intervention by the nurse?
- A. The patient ambulates several times a day in the room.
- B. The patient's temperature is 38.2°C (100.8°F).
- C. The patient cleans with a warm washcloth after having a stool.
- D. The patient uses soap and shampoo to shower every other day.
Correct Answer: B
Rationale: Any temperature above 38°C (100.4°F) in a patient receiving chemotherapy should be investigated immediately. The patient should ambulate in the room rather than the hospital hallway to avoid exposure to other patients or visitors. Because overuse of soap can dry the skin and increase infection risk, showering every other day is acceptable. Careful cleaning after having a bowel movement will help to prevent skin breakdown and infection.