Nokea
The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest?
- A. Normal finding
- B. Benign fibrocystic disease
- C. Malignant tumor
- D. Malignant tumor with metastasis to surrounding tissue
Correct Answer: C
Rationale: A fast-growing lump is suggestive of a malignant tumor. Metastasis can only be determined by cytology, not by palpation.
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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.
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.
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.
While completing an admission assessment, the client reports a family history of breast cancer among a maternal grandmother, aunt, and sister. The nurse knows that these cancers are most likely associated with what etiology?
- A. Inherited gene mutation
- B. Smoking and tobacco use
- C. Exposure to chemicals and spermicides
- D. Increased tumor suppressor genes
Correct Answer: A
Rationale: Tumor suppressor genes assist the body in normal cell production and death. Tobacco use and chemical carcinogens can contribute to the development of cancer, but there is not enough information provided to suggest a common link. Oncogenes are genes that have mutated and activate out-of-control cell growth. Inherited gene mutation occurs when the DNA is passed to the next generation.
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.