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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.
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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 working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant?
- A. Monitor the client's toilet patterns.
- B. Monitor the client closely to prevent infection.
- C. Monitor the client's physical condition.
- D. Monitor the client's heart rate.
Correct Answer: B
Rationale: Until transplanted stem cells begin to produce blood cells, these clients have no physiologic means to fight infection, which makes them very prone to infection. They are at high risk for dying from sepsis and bleeding before engraftment. Therefore, a nurse must closely monitor clients and take measures to prevent infection. Monitoring client's toilet patterns, physical condition, and heart rate does not prevent the possibility of the client getting an infection.
A client diagnosed with cancer makes the following statement to the nurse: 'I guess I will tell my health care provider to forego the chemotherapy. I do not want to be throwing up all the time. I would rather die.' Which of the following facts supports the use of chemotherapy for this client?
- A. Nausea and vomiting are only a factor for the first 24 hours after treatment.
- B. Most clients believe the discomfort is well worth the cure for cancer.
- C. Chemotherapy treatment can be adjusted to optimize effects while limiting adverse effects.
- D. Clinical trials are opening up new cancer treatments all the time.
Correct Answer: C
Rationale: Chemotherapy is not one drug for all clients. The therapy can be specifically designed to optimize effects while limiting adverse effects with supplemental anti emetics to control the nausea and vomiting. It is true that nausea and vomiting are most prevalent in the first 24 hours after each chemotherapy treatment, but this fact does not eliminate the fears expressed by this client. No one can state the worth of any treatment, and a cure is never promised. Clinical trials open new options for treatment, but the process is lengthy and is not a certainty for a client in need of immediate treatment.
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 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.