NURS 5461 Oncology Exam Questions With Correct Answers

NURS 5461 Oncology Exam Questions With Correct Answers Cancer - answer58% of all cases of cancer occur in people over 65 - Women over 65 have 61-78% of lung and colon cancers Between ages 20-60 incidence of cancers is about the same in both genders; after age 60 aaa cancer rates increase for men-- 70% higher In patients over 65 years - answerWomen get colon, pancreas and gastric cancers most often - Men get prostate, colon and bladder cancer most often Second Tumors - answer- XRT for Hodgkin's disease may result in subsequent lung or breast cancer in the treated field - Patients with colon cancer may have second operable colon cancer rather than a recurrence - Strong link between viruses and specific human cancers - answer• Hepatocellular cancer with Hepatitis B and Hepatitis C • Burkitt's tumor, nasopharynx cancer with EBV • Cervical cancer with HPV 16 and 18 • Kaposi's sarcoma with HIV Prevention - answerAvoid carcinogens - Radiation; tobacco - Organic dyes; benzene - Arsenic; asbestos - Chromium Avoid sunlight - Linked to preventing skin cancers Screening - answerBreast Cancer - Monthly self breast exams after menses begins - First screening mammogram at age 35 - Second screening exam at age 40, then yearly mammograms thereafter - Women aged 65-74/Women over age 75 - answer• Breast exam yearly; mammogram every 2 years/• If life expectancy and general health goodaa - Breast exam yearly; mammogram every 2 years • If notaaa - Monthly self breast exam Screening/Prostate Cancer - - answerMen aged 50 and over • DRE • PSA • US of prostate if indicated • Start earlier in African Americans and men with positive family history Screening/colon Cancer - answerColon Cancer - All adults over 50 need flexible sigmoidoscopy and stools for OB • In patients with polyps ---> colonoscopy needed • After 3 normal flexible sigmoidoscopies at 3 year intervals, can stop surveillance Screening Bladder Cancer - answer- Test urine of OB, more than 2-3 RBC per field otherwise its not microscopic hematirua-unlinkey to be ca Screening Endometrial Cancer - answer- Evaluate abnormal uterine bleeding in woman on Tamoxifen or HRT EXAM STUDY MATERIALS July 30, 2024 11:26 AM Aging: Impact on Disease and Therapy - answerStudies have shown that seniors are not uniformly infirm and they tolerate chemo as well as people under age under 70 Elderly [>70] are excluded from oncologic clinical trials Studies have shown that response and toxicities of treatment are not influenced by age Clinical Assessment - answer?Symptoms of weight loss, fever, night sweats, jaundice, anorexia and pain should lead to high index of suspicion of cancer Abnormal bleeding or discharge needs attention Headache, vision change and change in coordination and strength should be noted History - answerHistory should include questions about occupation and exposure to meds - Occupational exposure to metals, chemicals and asbestos - Medication use such as HRT and maternal diethylstilbestrol [DES] Ask about smoking and ETOH use Exposure to hepatitis Physical Exam - answerTargeted PE - Look for jaundice, anemia, petechiae or weight loss - Assess for skin nodules, ulcers and nevi larger than 5-7 mm • Carefully assess back in men and posterior calves in women Targeted PE - Examine mouth for ulcers, leukoplakia or lumps - Carefully palpate lymph nodes • **Nodes more than 1 cm should be biopsied - Inspect/palpate both breasts Diagnosis and Staging - answerStaging requires additional tests that specify location or locations of disease Must separate treatable cancers [lymphoma, breast, ovarian, prostate or thyroid] from untreatable cancers [pancreas, stomach or lung] Treatment - answerSurgery - Mainstay of cancer therapy Radiation - XRT plays a major role in curative therapy and in palliation aaa • Also used to treat prostate cancer and palliation of bone metastasis Chemotherapy and Hormonal Therapy - Adjuvant chemo or hormone therapy are effective in a variety of cancers - Leukopenia/anemia • More prevalent in seniors • Use of growth factors helps to maintain marrow reserves Breast Cancer - answerThree common masses found in the breast - Fibroadenoma - Fibrocystic breast changes - Cancer Fibroadenoma - answerCommon benign lesion Occurs in women within 20 years after puberty, 15-35 year age group Peak age is 20-25 years Multiple tumors in one or both breasts found in 10-15% of patients Tends to occur at an earlier age in African American women than in Caucasian women Tumor is round, rubbery, discrete, movable, nontender mass 1-5 cm. in diameter, without associated calcium deposition Fibroadenoma 2 - answerDoes not occur normally after menopause but menopausal woman can occasionally develop fibroadenoma a