CHAPTER 19 CANCER DEVELOPMENT | ATI MED SURG
ONCOLOGY| COMPLETE SOLUTION RATED A+
The 33-year-old client diagnosed with Stage IV Hodgkin's lymphoma is at the five (5)-
year remission mark. Which information should the nurse teach the client?
1. Instruct the client to continue scheduled screenings for cancer.
2. Discuss the need for follow-up appointments every five (5) years.
3. Teach the client that the cancer risk is the same as for the general population.
4. Have the client talk with the family about funeral arrangements. - ✅1. The five (5)-
year mark is a time for cel- ebration for clients diagnosed with cancer, but the therapies
can cause secondary malignancies and there may be a genetic predisposition for the
client to develop cancer. The client should continue to be tested regularly.
2. Follow-up appointments should be at least yearly.
3. The client's risk for developing cancer has in- creased as a result of the therapies
undergone for the lymphoma.
4. This client is in remission, and death is not imminent.
TEST-TAKING HINT: The test taker should look at the time frames in the answer op-
tions. It would be unusual for a client to be told to have a checkup every five (5) years.
Option "4" can be eliminated by the stem, which clearly indicates the client is progress-
ing well at the five (5)-year remission mark. Content - Medical: Integrated Nursing
Process - Planning: Client Needs - Health Promotion and Maintenance: Cognitive Level
- Synthesis:
Concept - Nursing Roles
Lymphoma Hematological 5 Disorders. Davis success
,23. The nurse and an unlicensed assistive personnel (UAP) are caring for clients in a
bone marrow transplantation unit. Which nursing task should the nurse delegate?
1. Take the hourly vital signs on a client receiving blood transfusions.
2. Monitor the infusion of antineoplastic medications.
3. Transcribe the HCP's orders onto the medication administration record (MAR).
4. Determine the client's response to the therapy. - ✅1. After the first 15 minutes during
which the client tolerates the blood transfusion, it is appropriate to ask the UAP to take
the vital signs as long as the UAP has been given specific parameters for the vital signs.
Any vital sign outside the normal parameters must have an intervention by the nurse.
2. Antineoplastic medication infusions must be monitored by a chemotherapy-certified,
com- petent nurse.
3. This is the responsibility of the ward secre- tary or the nurse, not the unlicensed
assistive personnel.
4. This represents the evaluation portion of the nursing process and cannot be
delegated.
Lymphoma Hematological 5 Disorders. Davis success
22. Which clinical manifestation of Stage I non- Hodgkin's lymphoma would the nurse
expect to find when assessing the client?
1. Enlarged lymph tissue anywhere in the body.
2. Tender left upper quadrant.
3. No symptom in this stage.
4. Elevated B-cell lymphocytes on the CBC. - 1. Enlarged lymph tissue would occur in
Stage III or IV Hodgkin's lymphoma.
2. A tender left upper quadrant would indicate spleen infiltration and occurs at a later
stage.
✅3. Stage I lymphoma presents with no symptoms; for this reason, clients are usually
not diagnosed until the later stages of lymphoma.
4. B-cell lymphocytes are the usual lymphocytes involved in the development of
lymphoma, but a serum blood test must be done specifi- cally to detect B cells. They are
not tested on a CBC.
Lymphoma Hematological 5 Disorders. Davis success
21. Which information about reproduction should be taught to the 27-year-old female
client diagnosed with Hodgkin's disease?
,1. The client's reproductive ability will be the
same after treatment is completed.
2. The client should practice birth control for at
least two (2) years following therapy.
3. All clients become sterile from the therapy
and should plan to adopt.
4. The therapy will temporarily interfere with
the client's menstrual cycle. - 1. This is a false promise. Many clients undergo
premature menopause as a result of the can- cer therapy.
✅2. The client should be taught to practice birth control during treatment and for
at least two (2) years after treatment has ceased. The therapies used to treat the can-
cer can cause cancer. Antineoplastic medica- tions are carcinogenic, and radiation
therapy has proved to be a precursor to leukemia. A developing fetus would be
subjected to the internal conditions of the mother.
3. NSome Nclients—but Nnot Nall—do Nbecome Nsterile. NThe Nclient Nmust Nunderstand Nthe
Nrisks Nof Nther- Napy, Nbut Nthe Nnurse Nshould Ngive Na Nrealistic Npic- Nture Nof Nwhat Nthe Nclient
Ncan Nexpect. NIt Nis Ncorrect Nprocedure Nto Ntell Nthe Nclient Nthe Nnurse Ndoes Nnot Nknow Nthe
Nabsolute Noutcome Nof Ntherapy. NThis Nis Nthe Nethical Nprinciple Nof Nveracity.
4. NThe Ntherapy Nmay Ninterfere Nwith Nthe Nclient's Nmenses, Nbut Nit Nmay Nbe Ntemporary.
Lymphoma NHematological N5 NDisorders. NDavis Nsuccess
20. NWhich Nclient Nshould Nbe Nassigned Nto Nthe Nexperienced Nmedical-surgical Nnurse Nwho
Nis Nin Nthe Nfirst Nweek Nof Norientation Nto Nthe Noncology Nfloor?
1. NThe Nclient Ndiagnosed Nwith Nnon-Hodgkin's
lymphoma Nwho Nis Nhaving Ndaily Nradiation
treatments.
2. NThe Nclient Ndiagnosed Nwith NHodgkin's
disease Nwho Nis Nreceiving Ncombination
chemotherapy.
3. NThe Nclient Ndiagnosed Nwith Nleukemia Nwho
has Npetechiae Ncovering Nboth Nanterior Nand Nposterior Nbody Nsurfaces.
4. NThe Nclient Ndiagnosed Nwith Ndiffuse Nhistolytic
lymphoma Nwho Nis Nto Nreceive Ntwo N(2) Nunits Nof Npacked Nred Nblood Ncells N- N N1. NThis Nclient
Nis Nreceiving Ntreatments Nthat Ncan Nhave Nlife-threatening Nside Neffects; Nthe Nnurse Nis Nnot
Nexperienced Nwith Nthis Ntype Nof Nclient
, 2. NChemotherapy Nis Nadministered Nonly Nby Nnurses Nwho Nhave Nreceived Ntraining Nin
Nchemotherapy Nmedications Nand Ntheir Neffects Non Nthe Nbody Nand Nare Naware Nof
Nnecessary Nsafety Nprecautions; Nthis Nnurse Nis Nin Nthe Nfirst Nweek Nof Norientation.
3. NThis Nis Nexpected Nin Na Nclient Nwith Nleukemia, Nbut Nit Nindicates Na Nseverely Nlow Nplatelet
Ncount; Na Nnurse Nwith Nmore Nexperience Nshould Ncare Nfor Nthis Nclient.
✅4. NThis Nclient Nis Nreceiving Nblood. NThe Nnurse Nwith Nexperience Non Na Nmedical-surgical
Nfloor Nshould Nbe Nable Nto Nadminister Nblood Nand Nblood Nproducts.
TEST-TAKING NHINT: NThe Nkey Nto Nthis Nquestion Nis Nthe Nfact, Nalthough Nthe Nnurse Nis Nan
Nexperi- Nenced Nmedical-surgical Nnurse, Nthe Nnurse Nis Nnot Nexperienced Nin Noncology. NThe
Nclient Nwho Ncould Nreceive Na Ntreatment Non Na Nmedical-sur- Ngical Nfloor Nshould Nbe
Nassigned Nto Nthe Nnurse. NContent N- NNursing NManagement: NIntegrated NNursing NProcess
N- NPlanning: NClient NNeeds N- NSafe NEffective NCare NEnvironment, NManagement Nof NCare:
NCognitive NLevel N- NSynthesis: NConcept N- NNursing.
Lymphoma NHematological N5 NDisorders. NDavis Nsuccess
19. NWhich Ntest Nis Nconsidered Ndiagnostic Nfor NHodgkin's Nlymphoma?
1. NA Nmagnetic Nresonance Nimage N(MRI) Nof Nthe Nchest.
2. NA Ncomputed Ntomography N(CT) Nscan Nof Nthe Ncervical Narea.
3. NAn Nerythrocyte Nsedimentation Nrate N(ESR).
4. NA Nbiopsy Nof Nthe Ncervical Nlymph Nnodes. N- N N1. NAn NMRI Nof Nthe Nchest Narea Nwill
Ndetermine Nnumerous Ndisease Nentities, Nbut Nit Ncannot Ndetermine Nthe Nspecific
Nmorphology Nof NReed-Sternberg Ncells, Nwhich Nare Ndiagnostic Nfor NHodgkin's Ndisease.
2. NA NCT Nscan Nwill Nshow Ntumor Nmasses Nin Nthe Narea, Nbut Nit Nis Nnot Ncapable Nof
Npathological Ndiagnosis.
3. NESR Nlaboratory Ntests Nare Nsometimes Nused Nto Nmonitor Nthe Nprogress Nof Nthe
Ntreatment Nof NHodgkin's Ndisease, Nbut NESR Nlevels Ncan Nbe Nelevated Nin Nseveral Ndisease
Nprocesses.
✅4. NCancers Nof Nall Ntypes Nare Ndefinitively Ndiagnosed Nthrough Nbiopsy Nprocedures. NThe
Npathologist Nmust Nidentify NReed- NSternberg Ncells Nfor Na Ndiagnosis Nof NHodgkin's
Ndisease.
TEST-TAKING NHINT: NThe Ntest Ntaker Ncan Nelimi- Nnate Nthe Nfirst Nthree N(3) Nanswer
Noptions Nbased Non Nthese Ntests Ngiving Ngeneral Ninformation Non Nmultiple Ndiseases. NA
Nbiopsy Nprocedure Nof Nthe Ninvolved Ntissues Nis Nthe Nonly Nprocedure Nthat Nprovides Na
Ndefinitive Ndiagnosis.
Content N- NMedical: NIntegrated NNursing NProcess N- NDiagnosis: NClient NNeeds N-
NPhysiological NIntegrity, NReduction Nof NRisk NPotential: NCognitive N
ONCOLOGY| COMPLETE SOLUTION RATED A+
The 33-year-old client diagnosed with Stage IV Hodgkin's lymphoma is at the five (5)-
year remission mark. Which information should the nurse teach the client?
1. Instruct the client to continue scheduled screenings for cancer.
2. Discuss the need for follow-up appointments every five (5) years.
3. Teach the client that the cancer risk is the same as for the general population.
4. Have the client talk with the family about funeral arrangements. - ✅1. The five (5)-
year mark is a time for cel- ebration for clients diagnosed with cancer, but the therapies
can cause secondary malignancies and there may be a genetic predisposition for the
client to develop cancer. The client should continue to be tested regularly.
2. Follow-up appointments should be at least yearly.
3. The client's risk for developing cancer has in- creased as a result of the therapies
undergone for the lymphoma.
4. This client is in remission, and death is not imminent.
TEST-TAKING HINT: The test taker should look at the time frames in the answer op-
tions. It would be unusual for a client to be told to have a checkup every five (5) years.
Option "4" can be eliminated by the stem, which clearly indicates the client is progress-
ing well at the five (5)-year remission mark. Content - Medical: Integrated Nursing
Process - Planning: Client Needs - Health Promotion and Maintenance: Cognitive Level
- Synthesis:
Concept - Nursing Roles
Lymphoma Hematological 5 Disorders. Davis success
,23. The nurse and an unlicensed assistive personnel (UAP) are caring for clients in a
bone marrow transplantation unit. Which nursing task should the nurse delegate?
1. Take the hourly vital signs on a client receiving blood transfusions.
2. Monitor the infusion of antineoplastic medications.
3. Transcribe the HCP's orders onto the medication administration record (MAR).
4. Determine the client's response to the therapy. - ✅1. After the first 15 minutes during
which the client tolerates the blood transfusion, it is appropriate to ask the UAP to take
the vital signs as long as the UAP has been given specific parameters for the vital signs.
Any vital sign outside the normal parameters must have an intervention by the nurse.
2. Antineoplastic medication infusions must be monitored by a chemotherapy-certified,
com- petent nurse.
3. This is the responsibility of the ward secre- tary or the nurse, not the unlicensed
assistive personnel.
4. This represents the evaluation portion of the nursing process and cannot be
delegated.
Lymphoma Hematological 5 Disorders. Davis success
22. Which clinical manifestation of Stage I non- Hodgkin's lymphoma would the nurse
expect to find when assessing the client?
1. Enlarged lymph tissue anywhere in the body.
2. Tender left upper quadrant.
3. No symptom in this stage.
4. Elevated B-cell lymphocytes on the CBC. - 1. Enlarged lymph tissue would occur in
Stage III or IV Hodgkin's lymphoma.
2. A tender left upper quadrant would indicate spleen infiltration and occurs at a later
stage.
✅3. Stage I lymphoma presents with no symptoms; for this reason, clients are usually
not diagnosed until the later stages of lymphoma.
4. B-cell lymphocytes are the usual lymphocytes involved in the development of
lymphoma, but a serum blood test must be done specifi- cally to detect B cells. They are
not tested on a CBC.
Lymphoma Hematological 5 Disorders. Davis success
21. Which information about reproduction should be taught to the 27-year-old female
client diagnosed with Hodgkin's disease?
,1. The client's reproductive ability will be the
same after treatment is completed.
2. The client should practice birth control for at
least two (2) years following therapy.
3. All clients become sterile from the therapy
and should plan to adopt.
4. The therapy will temporarily interfere with
the client's menstrual cycle. - 1. This is a false promise. Many clients undergo
premature menopause as a result of the can- cer therapy.
✅2. The client should be taught to practice birth control during treatment and for
at least two (2) years after treatment has ceased. The therapies used to treat the can-
cer can cause cancer. Antineoplastic medica- tions are carcinogenic, and radiation
therapy has proved to be a precursor to leukemia. A developing fetus would be
subjected to the internal conditions of the mother.
3. NSome Nclients—but Nnot Nall—do Nbecome Nsterile. NThe Nclient Nmust Nunderstand Nthe
Nrisks Nof Nther- Napy, Nbut Nthe Nnurse Nshould Ngive Na Nrealistic Npic- Nture Nof Nwhat Nthe Nclient
Ncan Nexpect. NIt Nis Ncorrect Nprocedure Nto Ntell Nthe Nclient Nthe Nnurse Ndoes Nnot Nknow Nthe
Nabsolute Noutcome Nof Ntherapy. NThis Nis Nthe Nethical Nprinciple Nof Nveracity.
4. NThe Ntherapy Nmay Ninterfere Nwith Nthe Nclient's Nmenses, Nbut Nit Nmay Nbe Ntemporary.
Lymphoma NHematological N5 NDisorders. NDavis Nsuccess
20. NWhich Nclient Nshould Nbe Nassigned Nto Nthe Nexperienced Nmedical-surgical Nnurse Nwho
Nis Nin Nthe Nfirst Nweek Nof Norientation Nto Nthe Noncology Nfloor?
1. NThe Nclient Ndiagnosed Nwith Nnon-Hodgkin's
lymphoma Nwho Nis Nhaving Ndaily Nradiation
treatments.
2. NThe Nclient Ndiagnosed Nwith NHodgkin's
disease Nwho Nis Nreceiving Ncombination
chemotherapy.
3. NThe Nclient Ndiagnosed Nwith Nleukemia Nwho
has Npetechiae Ncovering Nboth Nanterior Nand Nposterior Nbody Nsurfaces.
4. NThe Nclient Ndiagnosed Nwith Ndiffuse Nhistolytic
lymphoma Nwho Nis Nto Nreceive Ntwo N(2) Nunits Nof Npacked Nred Nblood Ncells N- N N1. NThis Nclient
Nis Nreceiving Ntreatments Nthat Ncan Nhave Nlife-threatening Nside Neffects; Nthe Nnurse Nis Nnot
Nexperienced Nwith Nthis Ntype Nof Nclient
, 2. NChemotherapy Nis Nadministered Nonly Nby Nnurses Nwho Nhave Nreceived Ntraining Nin
Nchemotherapy Nmedications Nand Ntheir Neffects Non Nthe Nbody Nand Nare Naware Nof
Nnecessary Nsafety Nprecautions; Nthis Nnurse Nis Nin Nthe Nfirst Nweek Nof Norientation.
3. NThis Nis Nexpected Nin Na Nclient Nwith Nleukemia, Nbut Nit Nindicates Na Nseverely Nlow Nplatelet
Ncount; Na Nnurse Nwith Nmore Nexperience Nshould Ncare Nfor Nthis Nclient.
✅4. NThis Nclient Nis Nreceiving Nblood. NThe Nnurse Nwith Nexperience Non Na Nmedical-surgical
Nfloor Nshould Nbe Nable Nto Nadminister Nblood Nand Nblood Nproducts.
TEST-TAKING NHINT: NThe Nkey Nto Nthis Nquestion Nis Nthe Nfact, Nalthough Nthe Nnurse Nis Nan
Nexperi- Nenced Nmedical-surgical Nnurse, Nthe Nnurse Nis Nnot Nexperienced Nin Noncology. NThe
Nclient Nwho Ncould Nreceive Na Ntreatment Non Na Nmedical-sur- Ngical Nfloor Nshould Nbe
Nassigned Nto Nthe Nnurse. NContent N- NNursing NManagement: NIntegrated NNursing NProcess
N- NPlanning: NClient NNeeds N- NSafe NEffective NCare NEnvironment, NManagement Nof NCare:
NCognitive NLevel N- NSynthesis: NConcept N- NNursing.
Lymphoma NHematological N5 NDisorders. NDavis Nsuccess
19. NWhich Ntest Nis Nconsidered Ndiagnostic Nfor NHodgkin's Nlymphoma?
1. NA Nmagnetic Nresonance Nimage N(MRI) Nof Nthe Nchest.
2. NA Ncomputed Ntomography N(CT) Nscan Nof Nthe Ncervical Narea.
3. NAn Nerythrocyte Nsedimentation Nrate N(ESR).
4. NA Nbiopsy Nof Nthe Ncervical Nlymph Nnodes. N- N N1. NAn NMRI Nof Nthe Nchest Narea Nwill
Ndetermine Nnumerous Ndisease Nentities, Nbut Nit Ncannot Ndetermine Nthe Nspecific
Nmorphology Nof NReed-Sternberg Ncells, Nwhich Nare Ndiagnostic Nfor NHodgkin's Ndisease.
2. NA NCT Nscan Nwill Nshow Ntumor Nmasses Nin Nthe Narea, Nbut Nit Nis Nnot Ncapable Nof
Npathological Ndiagnosis.
3. NESR Nlaboratory Ntests Nare Nsometimes Nused Nto Nmonitor Nthe Nprogress Nof Nthe
Ntreatment Nof NHodgkin's Ndisease, Nbut NESR Nlevels Ncan Nbe Nelevated Nin Nseveral Ndisease
Nprocesses.
✅4. NCancers Nof Nall Ntypes Nare Ndefinitively Ndiagnosed Nthrough Nbiopsy Nprocedures. NThe
Npathologist Nmust Nidentify NReed- NSternberg Ncells Nfor Na Ndiagnosis Nof NHodgkin's
Ndisease.
TEST-TAKING NHINT: NThe Ntest Ntaker Ncan Nelimi- Nnate Nthe Nfirst Nthree N(3) Nanswer
Noptions Nbased Non Nthese Ntests Ngiving Ngeneral Ninformation Non Nmultiple Ndiseases. NA
Nbiopsy Nprocedure Nof Nthe Ninvolved Ntissues Nis Nthe Nonly Nprocedure Nthat Nprovides Na
Ndefinitive Ndiagnosis.
Content N- NMedical: NIntegrated NNursing NProcess N- NDiagnosis: NClient NNeeds N-
NPhysiological NIntegrity, NReduction Nof NRisk NPotential: NCognitive N
