Nokea
The nurse is providing an educational presentation on dietary recommendations for reducing the risk of cancer. Which of the following food selections would demonstrate a good understanding of the information provided in the presentation? Select all that apply.
- A. Egg white omelet with spinach and mushrooms
- B. Crispy chicken Caesar Salad
- C. Steamed broccoli and carrots
- D. Turkey breast on whole wheat bread
- E. Smoked salmon
- F. Vegetable and cheddar quiche
Correct Answer: A,C,D
Rationale: Foods high in fat and those that are smoked or preserved with salt or nitrates are associated with increased cancer risks. An omelet made of egg whites and vegetables is a healthy low-fat selection as are steamed broccoli/carrots and turkey breast on whole grain bread. A salad can be a healthy selection, but Caesar salads contain much fat from the dressing and addition of cheeses and fried chicken. Salmon that is not smoked would be a good selection. Quiche usually contains high-fat milk, cr?¨me, eggs, and cheese.
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The nurse is caring for a client with the diagnosis of colon cancer with metastasis to the liver. Which statement made by the client indicates an understanding of the diagnosis?
- A. Once the colon tumor is removed, I will be fine.'
- B. I will be happy once all the cancer is cut out.'
- C. How could I be so unlucky to get cancer twice?'
- D. My cancer has now spread to my liver.'
Correct Answer: D
Rationale: The client stating the cancer has spread to the liver shows that the client has an understanding the primary cancer of the colon with spread to the liver. The client's expectation of being 'fine' and 'happy' once the tumor is removed shows a lack of understanding that metastases are not always resectable. The client mentioning having cancer twice is incorrect because it demonstrates a misunderstanding of metastasis.
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.
The client is scheduled for a breast lump excision and sentinel node biopsy. What should the nurse know in planning care for the client with a positive biopsy?
- A. A lump excision is not necessary.
- B. A wide excision of lump will be performed.
- C. The lump and all axillary lymph nodes will be excised.
- D. The entire breast and all regional lymph nodes will be excised.
Correct Answer: B
Rationale: The sentinel node is the first node in which a tumor will drain; if no malignant cells are found there, additional excision or radical removal will not be necessary. Excision of the lump along with a wide margin of cancer-free tissue is standard treatment for malignant tumors.
The nurse is providing client teaching for a client undergoing chemotherapy. What dietary modifications should the nurse advise?
- A. Eat wholesome meals.
- B. Avoid spicy and fatty foods.
- C. Avoid intake of fluids.
- D. Eat warm or hot foods.
Correct Answer: B
Rationale: The nurse advises a client undergoing chemotherapy to avoid hot and very cold liquids and spicy and fatty foods. The nurse also encourages the client to have small meals and appropriate fluid intake.
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.