Nokea
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.
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The nurse understands that the client should be given human papillomavirus (HPV) vaccine per the health care provider's orders. What does this vaccine help prevent?
- A. Lung cancer
- B. Breast cancer
- C. Cervical cancer
- D. Leukemia
Correct Answer: C
Rationale: The vaccines that are approved for use in the United States include the human papillomavirus (HPV), which may help prevent women from getting cervical cancer. There are no vaccines for the prevention of lung cancer, breast cancer, or leukemia.
The nurse is caring for a client who is scheduled for chemotherapy. Which is the best statement the nurse can make about the client experiencing chemotherapy-induced alopecia?
- A. The hair loss is usually temporary.'
- B. New hair growth will return without any change to color or texture.'
- C. Clients with alopecia will have delay in grey hair.'
- D. Wigs can be used after the chemotherapy is completed.'
Correct Answer: A
Rationale: Alopecia associated with chemotherapy is usually temporary and will return after the therapy is completed. New hair growth may return unchanged, but there is no guarantee and color, texture, and quality of hair may not be changed. There is no correlation between chemotherapy and delay in greying of hair. Use of wigs, scarves, and head coverings can be used by clients at any time during treatment plan.
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 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.
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.