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Chapter 15: Oncology: Nursing Management in Cancer Care
1. The public health nurse is presenting a health-promotion class to a group at a local
community center. Which intervention most directly addresses the leading cause of cancer
deaths in North America?
A) Monthly self-breast exams
B) Smoking cessation
C) Annual colonoscopies
D) Monthly testicular exams
ANS: B
Cancer is second only to cardiovascular disease as a leading cause of death in the United
States. Although the numbers of cancer deaths have decreased slightly, more than 570,000
Americans were expected to die from a malignant process in 2011. The leading causes of
cancer death in the United States, in order of frequency, are lung, prostate, and colorectal
cancer in men and lung, breast, and colorectal cancer in women, so smoking cessation is the
health promotion initiative directly related to lung cancer.
PTS: 1 DIF: Moderate REF: Page 311 OBJ: 4
TOP: Epidemiology of Cancer
KEY: Client Needs: Health Promotion and Maintenance | Cognitive Level: Application |
Integrated Process: Teaching/Learning MSC: Chapter: 15
2. A nurse who works in an oncology clinic is assessing a patient who has arrived for a
2-month follow-up appointment following chemotherapy. The nurse notes that the patient's
skin appears yellow. Which blood tests should be done to further explore this clinical sign?
A) Liver function tests (LFTs)
B) Complete blood count (CBC)
C) Platelet count
D) Blood urea nitrogen and creatinine
ANS: A
Yellow skin is a sign of jaundice and the liver is a common organ affected by metastatic
disease. An LFT should be done to determine if the liver is functioning. A CBC, platelet
count and tests of renal function would not directly assess for liver disease.
PTS: 1 DIF: Easy REF: Page 365 OBJ: 7
TOP: Table 15-12
KEY: Client Needs: Physiological Integrity: Basic Care and Comfort | Cognitive Level:
Application | Integrated Process: Nursing Process MSC: Chapter: 15
Copyright © Lippincott, Williams and Wilkins 1
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3. The school nurse is teaching a nutrition class in the local high school. One student states that
he has heard that certain foods can increase the incidence of cancer. The nurse responds,
“Research has shown that certain foods indeed appear to increase the risk of cancer.” Which
of the following menu selections would be the best choice for potentially reducing the risks
of cancer?
A) Smoked salmon and green beans
B) Pork chops and fried green tomatoes
C) Baked apricot chicken and steamed broccoli
D) Liver, onions, and steamed peas
ANS: C
Fruits and vegetables appear to reduce cancer risk. Salt-cured foods, such as ham and
processed meats, as well as red meats, should be limited.
PTS: 1 DIF: Moderate REF: Page 317 OBJ: 3
TOP: Chart 15-2
KEY: Client Needs: Health Promotion and Maintenance | Cognitive Level: Application |
Integrated Process: Teaching/Learning MSC: Chapter: 15
4. Traditionally, nurses have been involved with tertiary cancer prevention. However, an
increasing emphasis is being placed on both primary and secondary prevention. What would
be an example of primary prevention?
A) Yearly Pap tests
B) Testicular self-examination
C) Teaching patients to wear sunscreen
D) Screening mammograms
ANS: C
Primary prevention is concerned with reducing the risks of cancer in healthy people through
practices such as use of sunscreen. Secondary prevention involves detection and screening to
achieve early diagnosis, as demonstrated by Pap tests, mammograms, and testicular exams.
PTS: 1 DIF: Moderate REF: Page 318 OBJ: 4
TOP: Primary Prevention
KEY: Client Needs: Health Promotion and Maintenance | Cognitive Level: Comprehension |
Integrated Process: Teaching/Learning MSC: Chapter: 15
Copyright © Lippincott, Williams and Wilkins 2
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5. The nurse is caring for a 39-year-old woman with a family history of breast cancer. She
requested a breast tumor marking test and the results have come back positive. As a result,
the patient is requesting a bilateral mastectomy. This surgery is an example of what type of
oncologic surgery?
A) Salvage surgery
B) Palliative surgery
C) Prophylactic surgery
D) Reconstructive surgery
ANS: C
Prophylactic surgery is used when there is an extensive family history and nonvital tissues
are removed. Salvage surgery is an additional treatment option that uses an extensive surgical
approach to treat the local recurrence of a cancer after the use of a less extensive primary
approach. Palliative surgery is performed in an attempt to relieve complications of cancer,
such as ulceration, obstruction, hemorrhage, pain, and malignant effusion. Reconstructive
surgery may follow curative or radical surgery in an attempt to improve function or obtain a
more desirable cosmetic effect.
PTS: 1 DIF: Moderate REF: Page 323 OBJ: 5
TOP: Prophylactic Surgery
KEY: Client Needs: Physiological Integrity: Reduction of Risk Potential | Cognitive Level:
Application | Integrated Process: Nursing Process MSC: Chapter: 15
6. The nurse is caring for a patient who is to begin receiving external radiation for a malignant
tumor of the neck. While providing patient education, what potential adverse effects should
the nurse discuss with the patient?
A) Impaired nutritional status
B) Cognitive changes
C) Diarrhea
D) Alopecia
ANS: A
Alterations in oral mucosa, change and loss of taste, pain, and dysphasia often occur as a
result of radiotherapy to the head and neck. The patient is at an increased risk of impaired
nutritional status. Radiotherapy does not cause cognitive changes. Diarrhea is not a likely
concern for this patient. Radiation only results in alopecia when targeted at the whole brain;
radiation of other parts of the body does not lead to hair loss.
PTS: 1 DIF: Easy REF: Page 357 OBJ: 6
TOP: Anorexia
KEY: Client Needs: Physiological Integrity: Physiological Adaptation | Cognitive Level:
Application | Integrated Process: Teaching/Learning MSC: Chapter: 15
Copyright © Lippincott, Williams and Wilkins 3
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Chapter 15: Oncology: Nursing Management in Cancer Care
1. The public health nurse is presenting a health-promotion class to a group at a local
community center. Which intervention most directly addresses the leading cause of cancer
deaths in North America?
A) Monthly self-breast exams
B) Smoking cessation
C) Annual colonoscopies
D) Monthly testicular exams
ANS: B
Cancer is second only to cardiovascular disease as a leading cause of death in the United
States. Although the numbers of cancer deaths have decreased slightly, more than 570,000
Americans were expected to die from a malignant process in 2011. The leading causes of
cancer death in the United States, in order of frequency, are lung, prostate, and colorectal
cancer in men and lung, breast, and colorectal cancer in women, so smoking cessation is the
health promotion initiative directly related to lung cancer.
PTS: 1 DIF: Moderate REF: Page 311 OBJ: 4
TOP: Epidemiology of Cancer
KEY: Client Needs: Health Promotion and Maintenance | Cognitive Level: Application |
Integrated Process: Teaching/Learning MSC: Chapter: 15
2. A nurse who works in an oncology clinic is assessing a patient who has arrived for a
2-month follow-up appointment following chemotherapy. The nurse notes that the patient's
skin appears yellow. Which blood tests should be done to further explore this clinical sign?
A) Liver function tests (LFTs)
B) Complete blood count (CBC)
C) Platelet count
D) Blood urea nitrogen and creatinine
ANS: A
Yellow skin is a sign of jaundice and the liver is a common organ affected by metastatic
disease. An LFT should be done to determine if the liver is functioning. A CBC, platelet
count and tests of renal function would not directly assess for liver disease.
PTS: 1 DIF: Easy REF: Page 365 OBJ: 7
TOP: Table 15-12
KEY: Client Needs: Physiological Integrity: Basic Care and Comfort | Cognitive Level:
Application | Integrated Process: Nursing Process MSC: Chapter: 15
Copyright © Lippincott, Williams and Wilkins 1
CLASSROOM CLASSROOM CLASSROOM
,CLASSROOM CLASSROOM CLASSROOM
3. The school nurse is teaching a nutrition class in the local high school. One student states that
he has heard that certain foods can increase the incidence of cancer. The nurse responds,
“Research has shown that certain foods indeed appear to increase the risk of cancer.” Which
of the following menu selections would be the best choice for potentially reducing the risks
of cancer?
A) Smoked salmon and green beans
B) Pork chops and fried green tomatoes
C) Baked apricot chicken and steamed broccoli
D) Liver, onions, and steamed peas
ANS: C
Fruits and vegetables appear to reduce cancer risk. Salt-cured foods, such as ham and
processed meats, as well as red meats, should be limited.
PTS: 1 DIF: Moderate REF: Page 317 OBJ: 3
TOP: Chart 15-2
KEY: Client Needs: Health Promotion and Maintenance | Cognitive Level: Application |
Integrated Process: Teaching/Learning MSC: Chapter: 15
4. Traditionally, nurses have been involved with tertiary cancer prevention. However, an
increasing emphasis is being placed on both primary and secondary prevention. What would
be an example of primary prevention?
A) Yearly Pap tests
B) Testicular self-examination
C) Teaching patients to wear sunscreen
D) Screening mammograms
ANS: C
Primary prevention is concerned with reducing the risks of cancer in healthy people through
practices such as use of sunscreen. Secondary prevention involves detection and screening to
achieve early diagnosis, as demonstrated by Pap tests, mammograms, and testicular exams.
PTS: 1 DIF: Moderate REF: Page 318 OBJ: 4
TOP: Primary Prevention
KEY: Client Needs: Health Promotion and Maintenance | Cognitive Level: Comprehension |
Integrated Process: Teaching/Learning MSC: Chapter: 15
Copyright © Lippincott, Williams and Wilkins 2
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, CLASSROOM CLASSROOM CLASSROOM
5. The nurse is caring for a 39-year-old woman with a family history of breast cancer. She
requested a breast tumor marking test and the results have come back positive. As a result,
the patient is requesting a bilateral mastectomy. This surgery is an example of what type of
oncologic surgery?
A) Salvage surgery
B) Palliative surgery
C) Prophylactic surgery
D) Reconstructive surgery
ANS: C
Prophylactic surgery is used when there is an extensive family history and nonvital tissues
are removed. Salvage surgery is an additional treatment option that uses an extensive surgical
approach to treat the local recurrence of a cancer after the use of a less extensive primary
approach. Palliative surgery is performed in an attempt to relieve complications of cancer,
such as ulceration, obstruction, hemorrhage, pain, and malignant effusion. Reconstructive
surgery may follow curative or radical surgery in an attempt to improve function or obtain a
more desirable cosmetic effect.
PTS: 1 DIF: Moderate REF: Page 323 OBJ: 5
TOP: Prophylactic Surgery
KEY: Client Needs: Physiological Integrity: Reduction of Risk Potential | Cognitive Level:
Application | Integrated Process: Nursing Process MSC: Chapter: 15
6. The nurse is caring for a patient who is to begin receiving external radiation for a malignant
tumor of the neck. While providing patient education, what potential adverse effects should
the nurse discuss with the patient?
A) Impaired nutritional status
B) Cognitive changes
C) Diarrhea
D) Alopecia
ANS: A
Alterations in oral mucosa, change and loss of taste, pain, and dysphasia often occur as a
result of radiotherapy to the head and neck. The patient is at an increased risk of impaired
nutritional status. Radiotherapy does not cause cognitive changes. Diarrhea is not a likely
concern for this patient. Radiation only results in alopecia when targeted at the whole brain;
radiation of other parts of the body does not lead to hair loss.
PTS: 1 DIF: Easy REF: Page 357 OBJ: 6
TOP: Anorexia
KEY: Client Needs: Physiological Integrity: Physiological Adaptation | Cognitive Level:
Application | Integrated Process: Teaching/Learning MSC: Chapter: 15
Copyright © Lippincott, Williams and Wilkins 3
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