NCLEX Cancer ALL KINDS, Questions and answers, 100% Accurate, 2022/2023.

NCLEX Cancer ALL KINDS, Questions and answers, 100% Accurate, 2022/2023. Document Content and Description Below NCLEX Cancer ALL KINDS, Questions and answers, 100% Accurate, 2022/2023. The community health nurse is instructing a group of young female clients bout breast self-examination. The nurse should ins truct the clients to perform the examination at which time? A. At the onset of menstruation B. Every month during ovulation C. Weekly at the same time of day D. 1 week after menstruation begins - Answer: D Rationale: The breast self-examination should be performed monthly, 7 days after the onset of the menstrual period. Performing the examination weekly is not recommended. At the onset of menstruation and during ovulation, hormonal changes occur that may alter breast tissue. The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm? A. Placing cool compresses on the affected arm B. Elevating the affected arm on a pillow above heart level C. Avoiding arm exercises in the immediate post-operative period. D. Maintaining an intravenous site below the antecubital area of the affected side - Answer: B Rationale: Following mastectomy, the arm should be elevated above the level of the heart. Simple arm exercises should be encouraged. No blood pressure readings, injections, intravenous lines, or blood draws should be performed on the affected arm. Cool compresses are not a suggested measure to prevent lymphedema from occurring While being prepared for a biopsy of a lump in the right breast, the patient asks the nurse what the difference is between a benign tumor and a malignant tumor. The nurse explains that a benign tumor differs from a malignant tumor in that benign tumors A. Do not cause damage to adjacent tissue. B. Do not spread to other tissues and organs. C. Are simply an overgrowth of normal cells. D. Frequently recur in the same site. - Answer: B Rationale: The major difference between benign and malignant tumors is that malignant tumors invade adjacent tissues and spread to distant tissues and benign tumors never metastasize. Both types of tumors may cause damage to adjacent tissues. The cells differ from normal in both benign and malignant tumors. Benign tumors usually do not recur. For a female client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client? A. "Client verbalizes feelings of anxiety." B. "Client doesn't guess at prognosis." C. "Client uses any effective method to reduce tension." D. "Client stops seeking information." - Answer: A Rationale: Verbalizing feelings are the client's first step in coping with the situational crisis. It also helps the health care team gain insight into the client's feelings, helping guide psychosocial care. Suppressing speculation may prevent the client from coming to terms with the crisis and planning accordingly. Some methods of reducing tension, such as illicit drug or alcohol use, may prevent the client from coming to terms with the threat of death as well as cause physiologic harm. Seeking information can help a client with cancer gain a sense of control over the crisis A patient has undergone a mastectomy. The nurse determines that the client is having the most difficulty adjusting to the loss of the breast if which behavior is observed? A. Performs arm exercises B. Refuses to look at the dressing C. Reads the post operative care booklet D. Requests pain medication when needed - Answer: B Rationale: The patient demonstrated the most difficult adjustments to the loss if she refuses to look at the dressing. This indicates that the client is not ready or willing to begin to acknowledge and cope with the surgery. Performing arm exercises is an action oriented behavior on the part of the patient and is considered a positive sign of adjustment. Reading the post operative care booklet indicates an interest in self care and is a positive action oriented option that is helpful, although there is no direct connection to adjustment to the loss of the breast. A nurse is counseling the family of patient who has terminal breast cancer about palliative care. The nurse explains that which of the following are goals of palliative care? Select all that apply. A. Delays death B. Offers a support system C. Provides relief from pain D. Enhances the quality of life E. Focuses only on the patient not the family F. Manages symptoms of disease and therapies - Answers: B, C, D, F Rationale: Palliative care is a philosophy of total care. Palliative care goals include the following: providing relief from pain and other distressing symptoms, affirming life and regarding dying as a normal process, neither hastening nor postponing death, integrating psychological and spiritual aspects of client care, offering a support system to help the client live as actively as possible until death, offering a support system to help families cope during the client's illness and their own bereavement, and enhancing the quality of life. The nurse is caring for a client admitted to the surgical unit following a right modified radical mastectomy. The nurse includes which of the following in the nursing plan of care? A. Take blood pressure in the right arm only. B. Draw serum laboratory samples from the right arm only. C. Position the client supine with the right arm elevated on a pillow. D. Check the right posterior axilla area when assessing the surgical dressing. - Answer: D Rationale: If there is drainage or bleeding from the surgical site after a mastectomy, gravity will cause the drainage to seep down and soak the posterior axillary portion of the drainage first. The nurse checks this area to detect early bleeding. The patient should be positioned with the head of the bed in semi-Fowler's position and the arm elevated on pillows to decrease edema. Edema is likely to occur because lymph drainage channels have been resected during the surgical procedure. Blood pressure management, venipuncture, and intra-venous sites should not involve use of the operative arm. The nurse is caring for a young woman who is dying from breast cancer. The nurse determines that a defining characteristic of anticipatory grieving is present when the young woman: A. Discusses thoughts and feelings related to the loss. B. Has prolonged emotional reactions and outbursts. C. Verbalizes unrealistic goals and plans for the future. D. Ignores untreated medical conditions that require treatment. - Answer: A Rationale: The nurse can determine the client's stage of grief by observing the client's behavior. This is important because the appropriate nursing diagnoses must be developed so that the plan of care is appropriate. A 58 year old female is concerned about her risk for developing breast cancer. She began menarche at age 14, had 3 children before the age of 35, went through menopause at age 50 with an associated weight gain of 20 lbs. Which of the risk factors would contribute to this client's risk of developing breast cancer? A. menarche at age 14 B. children before the age of 35 C. postmenopausal obesity D. menopause at age 50 - Answer: C Rationale: Postmenopausal obesity is a risk factor for developing breast cancer A nurse is teaching a group of women about the appropriate method for performing a breast self-exam (BSE). Which of the following statements regarding breast self-exam demonstrates correct comprehension of the material? A. "Breast exams should begin around age 30." B. "Breast exams should be done one week prior to the menstrual cycle." C. "Breast exams should incorporate both feeling and looking at the breasts." D. "Breast exams should be done during the middle of the menstrual cycle." - Answer C Rationale: Breast exams should incorporate both feeling and looking at the breasts. Premenstrual swelling and tenderness of the breasts may be present one week prior. Breast self-examination should begin as early as possible, preferably when the individual is an adolescent. At a senior citizen program, the nurse who was invited to speak to the group is teaching them about detecting the early signs of cancer. Which of the following should the nurse include? A: Do not overexpose yourself to the sun B: Exercise for no more than 7 minutes a day C: Lower the amount of fats in your diet D: Do a monthly breast self-exam - Answer: D: Do a monthly breast self-exam Rationale: Monthly breast exams aid in early detection of cancer. Changing the patients diet and limiting exposure to the sun may help with prevention but not detection. The nurse is caring for a 35-year old patient receiving radiation and chemotherapy. Which statement by the patient indicates that he is using a positive coping mechanism that is useful during treatments? A: I may miss my own hair, but I have chosen a nice wig to wear B: Losing my hair won't bother me at all C: I'm never going to leave the house if I am bald D: I will not lose my hair and I'll make sure of that - Answer: A: I may miss my own hair, but I have chosen a nice wig to wear Rationale: Expressing personal feelings and positive interventions demonstrate positive coping mechanisms The nurse is visiting a patient receiving radiation therapy. Which of the following statements is incorrect and requires additional teaching? A: "I may lose the ability to sweat" B: "To keep the radiation from burning my skin, I will use lotion" C: "I need to check my mouth frequently for signs of irritation" D: "During radiation therapy, I may lose some of my hair and foods may not taste right" - Answer: B: "To keep the radiation from burning my skin, I will use lotion" Rationale: Skin products must be prescribed by the physician because they can irritate the skin A client undergoing radiation therapy has a severely depressed WBC count. The nurse should include which priority nursing intervention in the plan of care? A: Place the client in a private room and maintain strict aseptic technique with all procedures B: Encourage the client to include fresh fruits and vegetables in the diet C: Educate the client to avoid shaving with a razor D: Encourage frequent visitors to reduce the client's feelings of isolation - Answer: A: Place the client in a private room and maintain strict aseptic technique with all procedures Rationale: The immunosuppressed client is at a high risk for infection. A private room, maintaining aseptic technique, and limiting visitors will reduce exposure and risk. The nurse is making a home visit to a client receiving external radiation therapy on an outpatient basis. Further teaching is necessary when the nurse observes the client doing which of the following? A: Washing radiation site with plain water and patting skin dry B: Protecting skin with soft, loose clothing C: Applying lotion to irritated skin D: Inspecting skin for damage - Answer: C: Applying lotion to irritated skin Rationale: Lotion, deodorant, and powders should not be applied to the radiation site during the treatment period to avoid further irritation to the skin. A hospitalized client with an internal radiation implant calls the nurse to the room to report the implant is dislodged and is lying in the bed. The nurse's actions would include which of the following? A: Apply gloves and place implant in a biohazard bag B: Use long-handled forceps to pick up the implant and place it into lead container C: Have client pick up the implant and place it into lead container D: Notify infection control personnel to dispose of implant - Answer: B: Use long-handled forceps to pick up the implant and place it into lead container Rationale: Direct handling of the implant causes exposure to radiation and no one should directly touch the implant. Gloves and biohazard bags do not offer protection from radiation. Long-handled forceps should be used to pick up the implant and lead containers are necessary to prevent exposure to radiation. When teaching safety precautions to the client with internal radiation implant, the nurse would include which statement in explanations to the client? A: No precautions are necessary for internal radiation therapy implants B: The client poses a risk of radiation exposure to others C: The client must remain in solitary isolation for the entire hospitalization D: Visitors should maintain a distance of 30 feet from the client at all times - Answer: B: The client poses a risk of radiation exposure to others Rationale: Internal radiation is emitted outward to people in close contact as long as the implant is in place. Therefore, certain precautions to protect others must be taken: The client should have a private room, and visitors should maintain a distance of 6 feet and limit visits to 10-30 minutes. A recently divorced male who has undergone radiation therapy for testicular cancer tells the nurse he is unable to achieve an erection. Which of the following nursing diagnoses is most appropriate? A: Ineffective coping related to the effects of radiation therapy B: Sexual dysfunction related to the effects of radiation therapy C: Disturbed body image related to the effects of radiation therapy D: Imbalanced nutrition: Less than body requirements related to radiation therapy - Answer: B: Sexual dysfunction related to the effects of radiation therapy Rationale: Radiation may cause sexual dysfunction. Libido may only be temporarily affected, and the client should be provided with emotional support. Nausea and vomiting are common adverse effects of radiation. When should a nurse administer antiemetics? A: 30 minutes before the initiation of therapy B: With the administration of therapy C: Immediately after nausea begins D: When therapy is completed - Answer: A: 30 minutes before the initiation of therapy Rationale: Antiemetics are most beneficial when given before the onset of nausea and vomiting. If the antiemetic was given with the medication or after the medication, it could lose its maximum effectiveness when needed. After surgery for gastric cancer, a client is scheduled to undergo radiation therapy. It will be most important for the nurse to include information about which of the following in the client's teaching plan? A: Nutritional intake B: Management of alopecia C: Exercise and activity levels D: Access to community resources - Answer: A: Nutritional intake Rationale: Clients who have had gastric surgery are prone to postoperative complications, such as dumping syndrome and postprandial hypoglycemia, which can affect nutritional intake. Vitamin absorption can also be an issue, depending on the extent of the gastric surgery. Radiation therapy to the upper gastrointestinal area also can affect nutritional intake by causing anorexia, nausea, and esophagitis. The client would not be expected to develop alopecia. Exercise and activity levels as well as access to community resources are important teaching areas, but nutritional intake is a priority need. Which of the following is correct about the rate of cell growth in relation to chemotherapy? A. Faster growing cells are less susceptible to chemotherapy B. Non dividing cells are more susceptible to chemotherapy C. Faster growing cells are more susceptible to chemotherapy D. Slower growing cells are more susceptible to chemotherapy - ANSWER C The faster the cell grows the more susceptible it is to chemotherapy, During the administration of a chemotherapeutic drug, the nurse observes that there is a lack of blood return from the intravenous catheter. The priority action by the nurse would be to A. stop the administration of the drug immediately B. reposition the client's arm and continue with the administration of the drug C. apply a tourniquet to the patient's affected arm and notify the doctor D. continue to administer the drug and assess for edema at the IV site - Answer A Chemotherapeutic agents are irritating to tissues. Lack of blood return from the IV catheter indicates that it is out of vein. Therefore, administration of the drug should be stopped immediately 3) A nurse is instructing a client how to decrease nausea secondary to chemotherapy and radiation. The nurse understands that the client needs more teaching if the client states, "I will try A. eating small, frequent meals" B. Staying upright for at least on hour during meals" C. Avoiding a lot of liquids with my meals" D. Increasing the amount of unsaturated fats in my diet" - Answer - D - increasing the amount of unsaturated fats in my diet" 4) The nurse is developing a plan of care for a client being admitted to the hospital who is immunosuppressed and will be placed on neutropenic precautions. With regard to neutropenic precautions, which intervention is incorrect? A) admitting the client to a semi-private room B) placing a precaution sign on the door to the room C) placing a mask on the client if the client leaves the room D) removing a vase with fresh flowers left by a previous client - Answer: A - admitting the client to a semiprivate room 5) A nurse is caring for a client who was admitted to receive chemotherapy for treatment of ovarian cancer. The client vomited after each previous dose of chemotherapy. Which of the following actions should the nurse take to prevent vomiting? A. Speak to the provider about decreasing the chemotherapy dose B. Withhold food and fluids prior to and during treatment C. Provide the client with an emesis basin during treatment D. Administer and antiemetic prior to chemotherapy - Answer: D - Administer an antiemetic prior to chemotherapy 6) Previous administrations of chemotherapy agents to a cancer patient have resulted in