Nokea
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.
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A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed?
- A. I guess the doctor could not remove the entire tumor.'
- B. I am so glad the doctor was able to remove the entire tumor.'
- C. I will be glad to finally be done with treatments for this thing.'
- D. Thank goodness the tumor is contained and curable.'
Correct Answer: A
Rationale: Debulking is a reference made when a tumor cannot be completely removed, often due to its extension far into healthy tissue. Without complete removal, this is not a cure and, the cancer cells will continue to replicate and require adjuvant therapies to prevent further invasion. The physician, not the nurse, will need to clarify the details of the surgery.
A client asks the nurse what is causing the fatigue following radiotherapy. What is the nurse's best response?
- A. The cancer is spreading to other parts of the body.
- B. The cancer cells are dying in large numbers.
- C. Fighting off infection is an exhausting venture.
- D. Substances are released when tumor cells are destroyed.
Correct Answer: D
Rationale: Fatigue results from substances being released when tumor cells are destroyed during radiotherapy. The spreading of cancer can cause many symptoms dependent on location and type of cancer, but it is not a significant factor in the development of fatigue with radiotherapy. The production of healthy cells can increase metabolic rate, but death of cancer cells does not support fatigue in this case. Fighting infection can cause fatigue, but there is no evidence provided to support the presence of infection in this client.
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.
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.
While doing a health history, a client tells the nurse that their mother, grandmother, and sister died of cancer. The client wants to know what to do to keep from getting cancer. What would be the nurse's best response?
- A. You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level is.'
- B. If you eat right, exercise, and get enough rest, you can prevent breast cancer.'
- C. With your family history, there is nothing you can do to prevent getting cancer.'
- D. Cancer often skips a generation, so don't worry about it.'
Correct Answer: A
Rationale: Specialized tests have been developed for tumor markers, specific proteins, antigens, hormones, genes, or enzymes that cancer cells release. Telling the client to make lifestyle changes and that there is nothing the client can do with the family history would be giving inaccurate information. Telling the client that cancer often skips a generation and not to worry is incorrect because it minimizes and negates the client's concern.