NUR 3112 EXAM 3 VERIFIED ACCURATE STUDY
GUIDE
Cancer Diagnostic Tests - Answers - •CBC and differential
•Chemistry profile
•Liver function studies
•Endoscopic exam: upper GI, colonoscopy
•Radiographic studies: Chest X-ray, CT, MRI, PET, SPECT
•Genetic tests
•Tissue biopsy
•Tumor marker assays
•Cytology studies (PAP, bronchial washings)
•Bone marrow aspiration
Example:
•Patient has elevated PSA and possible signs and symptoms of prostate cancer.
Further testing would include a digital rectal exam (DRE), possible transrectal
ultrasound and prostate biopsy (different areas of prostate)
•Colorectal cancer: lab tests (CBC (anemia), CEA (oncofetal antigen), liver enzymes
(can spread to liver)), CT or MRI of abdomen, ultrasound, colonoscopy, proctoscopy (for
possible rectal cancer), biopsy during colonoscopy or proctoscopy
breast cancer risk factors - Answers - •Age
•Genetic mutations: BRCA1 or BRCA2
•Menopause after age 55
•Menarche before age 12
•Dense breast tissue
•Personal history of breast cancer or certain non-cancerous breast diseases
•Family history of breast or ovarian cancer
-Increased almost twofold if a woman had one affected first-degree relative
-Increased threefold if she had two affected first-degree relatives
-threefold higher risk if the first-degree relative was diagnosed before age 30
Radiation to chest or breasts before age 30
Breast Cancer Risk Factors cont'd - Answers - •Not physically active
•Overweight or obese, especially after menopause
•Hormone Replacement Therapy (HRT)
•Certain oral contraceptives: risk can disappear with discontinuation (2-5 years)
•First pregnancy after age 30
•Nulliparous (women who haven't given birth to a child)
•ETOH consumption
•Bone mineral density (BMD): highest hip BMD category higher risk than lowest hip
BMD category
,Oncofetal proteins (Antigens): Tumor Markers; what specific antigens can be detected?
- Answers - Present during fetal development and with certain cancer types:
Serum lab draw (present in blood) examples:
- CEA (carcinoembryonic antigen): Colorectal
- PSA (prostate specific antigen): prostate
- AFP (alpha fetal protein): liver
- CA-125: ovarian cancer
- Estrogen receptor assay (ERA) and Progesterone receptor assay (PRA): present in
certain types of breast cancer, determine if cancer is growing with estrogen and
progesterone hormones
What is significant about Oncofetal Protein Tumor Markers? - Answers - Significance:
indicator of tumor growth
- Presence of cancer
-Could be an indicator of other disease processes
-Ex. PSA can be elevated with BPH
Treatment effectiveness
-Increased levels can indicate treatment not working
•Cancer recurrence
-Increased levels with follow-up appointments could indicate cancer return
Genetic Counseling and testing - Answers - •Obtain family and patient medical history
•Obtain and review medical records of the patient and family members
•Assist in choosing most appropriate genetic test(s)
•If determined genetic testing is needed, then:
-Obtain sample of blood, cheek, or hair cells, urine, amniotic fluid, or other body tissues
Genetic Counseling and Testing: Who should consider getting tested? - Answers -
•Several first-degree relatives (mother, father, sisters, brothers, children) with cancer
•Multiple relatives on one side of the family with same type of cancer
•Cluster of cancers in your family known to be linked to a single gene mutation
•Family member with more than 1 type of cancer
•Ethnicity (ex. Jewish ancestry is linked to ovarian and breast cancers)
•Known genetic mutation in one or more family members who already had genetic
testing
Genetic Counseling and Testing Results: Positive result - Answers - Positive Result:
have gene mutation
•Start cancer screening tests earlier (if available for cancer type)
•Screened for cancer type more often
•Screening tests used only for people at an increased cancer risk
Watch for signs or symptoms of that cancer type
, -Example: +BRCA1 mutation, preventative double mastectomy can significantly lower
breast cancer risk
The nurse is providing breast cancer education at a community facility. The American
Cancer Society recommends that women get mammograms: (select all that apply)
A. Yearly starting at age 45.
B. After the birth of the first child.
C. After the first menstrual period and annually thereafter.
D. Every 3 years after age 20.
E. Every 2 years starting after age 55.
F. Annually is optional for ages 40-44 - Answers - A. Yearly starting at age 45.
E. Every 2 years starting after age 55
F. Annually is optional for ages 40-44
Breast cancer screening; Mammogram Recommendations - Answers - Mammograms
•Age 40-44: option to start annual mammograms
•Ages 45-54: annual mammograms (yearly)
•Ages > 55: can switch to mammograms every two years (or continue yearly screening)
Clinical and Self Breast Exams
•Current guidelines do not recommend either due to advances in mammography
•Women should be aware of normal look and feel of their breasts and report any
changes to HCP, especially if between regular mammograms.
Colorectal Cancer Risk Factors - Answers - •Inflammatory bowel disease
•Personal or family history of colorectal cancer or colorectal polyps
•Lack of regular physical activity
•Low-fiber, high-fat and high-protein diet
•Overweight or obesity
•ETOH consumption (>2 drinks/day men, >1 drink/day women)
•Tobacco use (ex. long-term smoker)
•Genetic syndrome such as familial adenomatous polyposis (<1%) or Lynch syndrome
(approx. 3%)
•History of genital cancer (endometrial cancer, ovarian cancer) or breast cancer
(women)
•African-American or Ashkenazi Jewish
•Male gender
•Type 2 Diabetes
Colorectal Cancer Screening: Age - Answers - Regular screening: age 45-75
Ages 76-85: discussion with HCP about continuing screening
Beginning at age 50 (ACS recommends 45)
What is the gold standard colorectal screening? What other diagnostic tests? - Answers
- > Colonoscopy every ten years (ONLY screening req. every 10 years)
GUIDE
Cancer Diagnostic Tests - Answers - •CBC and differential
•Chemistry profile
•Liver function studies
•Endoscopic exam: upper GI, colonoscopy
•Radiographic studies: Chest X-ray, CT, MRI, PET, SPECT
•Genetic tests
•Tissue biopsy
•Tumor marker assays
•Cytology studies (PAP, bronchial washings)
•Bone marrow aspiration
Example:
•Patient has elevated PSA and possible signs and symptoms of prostate cancer.
Further testing would include a digital rectal exam (DRE), possible transrectal
ultrasound and prostate biopsy (different areas of prostate)
•Colorectal cancer: lab tests (CBC (anemia), CEA (oncofetal antigen), liver enzymes
(can spread to liver)), CT or MRI of abdomen, ultrasound, colonoscopy, proctoscopy (for
possible rectal cancer), biopsy during colonoscopy or proctoscopy
breast cancer risk factors - Answers - •Age
•Genetic mutations: BRCA1 or BRCA2
•Menopause after age 55
•Menarche before age 12
•Dense breast tissue
•Personal history of breast cancer or certain non-cancerous breast diseases
•Family history of breast or ovarian cancer
-Increased almost twofold if a woman had one affected first-degree relative
-Increased threefold if she had two affected first-degree relatives
-threefold higher risk if the first-degree relative was diagnosed before age 30
Radiation to chest or breasts before age 30
Breast Cancer Risk Factors cont'd - Answers - •Not physically active
•Overweight or obese, especially after menopause
•Hormone Replacement Therapy (HRT)
•Certain oral contraceptives: risk can disappear with discontinuation (2-5 years)
•First pregnancy after age 30
•Nulliparous (women who haven't given birth to a child)
•ETOH consumption
•Bone mineral density (BMD): highest hip BMD category higher risk than lowest hip
BMD category
,Oncofetal proteins (Antigens): Tumor Markers; what specific antigens can be detected?
- Answers - Present during fetal development and with certain cancer types:
Serum lab draw (present in blood) examples:
- CEA (carcinoembryonic antigen): Colorectal
- PSA (prostate specific antigen): prostate
- AFP (alpha fetal protein): liver
- CA-125: ovarian cancer
- Estrogen receptor assay (ERA) and Progesterone receptor assay (PRA): present in
certain types of breast cancer, determine if cancer is growing with estrogen and
progesterone hormones
What is significant about Oncofetal Protein Tumor Markers? - Answers - Significance:
indicator of tumor growth
- Presence of cancer
-Could be an indicator of other disease processes
-Ex. PSA can be elevated with BPH
Treatment effectiveness
-Increased levels can indicate treatment not working
•Cancer recurrence
-Increased levels with follow-up appointments could indicate cancer return
Genetic Counseling and testing - Answers - •Obtain family and patient medical history
•Obtain and review medical records of the patient and family members
•Assist in choosing most appropriate genetic test(s)
•If determined genetic testing is needed, then:
-Obtain sample of blood, cheek, or hair cells, urine, amniotic fluid, or other body tissues
Genetic Counseling and Testing: Who should consider getting tested? - Answers -
•Several first-degree relatives (mother, father, sisters, brothers, children) with cancer
•Multiple relatives on one side of the family with same type of cancer
•Cluster of cancers in your family known to be linked to a single gene mutation
•Family member with more than 1 type of cancer
•Ethnicity (ex. Jewish ancestry is linked to ovarian and breast cancers)
•Known genetic mutation in one or more family members who already had genetic
testing
Genetic Counseling and Testing Results: Positive result - Answers - Positive Result:
have gene mutation
•Start cancer screening tests earlier (if available for cancer type)
•Screened for cancer type more often
•Screening tests used only for people at an increased cancer risk
Watch for signs or symptoms of that cancer type
, -Example: +BRCA1 mutation, preventative double mastectomy can significantly lower
breast cancer risk
The nurse is providing breast cancer education at a community facility. The American
Cancer Society recommends that women get mammograms: (select all that apply)
A. Yearly starting at age 45.
B. After the birth of the first child.
C. After the first menstrual period and annually thereafter.
D. Every 3 years after age 20.
E. Every 2 years starting after age 55.
F. Annually is optional for ages 40-44 - Answers - A. Yearly starting at age 45.
E. Every 2 years starting after age 55
F. Annually is optional for ages 40-44
Breast cancer screening; Mammogram Recommendations - Answers - Mammograms
•Age 40-44: option to start annual mammograms
•Ages 45-54: annual mammograms (yearly)
•Ages > 55: can switch to mammograms every two years (or continue yearly screening)
Clinical and Self Breast Exams
•Current guidelines do not recommend either due to advances in mammography
•Women should be aware of normal look and feel of their breasts and report any
changes to HCP, especially if between regular mammograms.
Colorectal Cancer Risk Factors - Answers - •Inflammatory bowel disease
•Personal or family history of colorectal cancer or colorectal polyps
•Lack of regular physical activity
•Low-fiber, high-fat and high-protein diet
•Overweight or obesity
•ETOH consumption (>2 drinks/day men, >1 drink/day women)
•Tobacco use (ex. long-term smoker)
•Genetic syndrome such as familial adenomatous polyposis (<1%) or Lynch syndrome
(approx. 3%)
•History of genital cancer (endometrial cancer, ovarian cancer) or breast cancer
(women)
•African-American or Ashkenazi Jewish
•Male gender
•Type 2 Diabetes
Colorectal Cancer Screening: Age - Answers - Regular screening: age 45-75
Ages 76-85: discussion with HCP about continuing screening
Beginning at age 50 (ACS recommends 45)
What is the gold standard colorectal screening? What other diagnostic tests? - Answers
- > Colonoscopy every ten years (ONLY screening req. every 10 years)
