Chapter 12 Oncologic Management
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
Feedback:
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.
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
Feedback:
, 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.
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, ìResearch has shown that certain foods indeed appear to
increase the risk of cancer.î 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
Feedback:
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.
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
Feedback:
,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.
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
Feedback:
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.
, 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 Feedback:
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.
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
Feedback:
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.
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
Feedback:
, 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.
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, ìResearch has shown that certain foods indeed appear to
increase the risk of cancer.î 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
Feedback:
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.
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
Feedback:
,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.
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
Feedback:
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.
, 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 Feedback:
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.
