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Brunner Suddarth Test Bank Chapter 15 Study Guide Rated A

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Brunner & Suddarth: Test Bank (Chapter 15) Study Guide Rated A+ 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 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 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 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 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 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 7). While a patient is receiving IV doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize what action? A) Stopping the administration of the drug immediately B) Notifying the patient's physician C) Continuing the infusion but decreasing the rate D) Applying a warm compress to the infusion site 8). A patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe? A) Pruritis (itching) B) Nausea and vomiting C) Altered glucose metabolism D) Confusion 9). A patient on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in patients at risk for thrombocytopenia? A) Interrupted sleep pattern B) Hot flashes C) Epistaxis (nose bleed) D) Increased weight 10). The nurse is orienting a new nurse to the oncology unit. When reviewing the safe administration of antineoplastic agents, what action should the nurse emphasize? A) Adjust the dose to the patient's present symptoms. B) Wash hands with an alcohol-based cleanser following administration. C) Use gloves and a lab coat when preparing the medication. D) Dispose of the antineoplastic wastes in the hazardous waste receptacle. 11). A nurse provides care on a bone marrow transplant unit and is preparing a female patient for a hematopoietic stem cell transplantation (HSCT) the following day. What information should the nurse emphasize to the patient's family and friends? A) Your family should likely gather at the bedside in case there's a negative outcome. B) Make sure she doesn't eat any food in the 24 hours before the procedure. C) Wear a hospital gown when you go into the patient's room. D) Do not visit if you've had a recent infection. 12). A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection-related death in oncology patients? A) Encourage several small meals daily. B) Provide skin care to maintain skin integrity. C) Assist the patient with hygiene, as needed. D) Assess the integrity of the patient's oral mucosa regularly. 13). You are caring for an adult patient who has developed a mild oral yeast infection following chemotherapy. What actions should you encourage the patient to perform? (Select all that apply) A) Use a lip lubricant. B) Scrub the tongue with a firm-bristled toothbrush. C) Use dental floss every 24 hours. D) Rinse the mouth with normal saline. E) Eat spicy food to aid in eradicating the yeast. 14). The nurse on a bone marrow transplant unit is caring for a patient with cancer who is preparing for HSCT. What is a priority nursing diagnosis for this patient? A) Fatigue related to altered metabolic processes B) Altered nutrition: less than body requirements related to anorexia C) Risk for infection related to altered immunologic response D) Body image disturbance related to weight loss and anorexia 15). An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do? A) Periodically apply ice to the area. B) Keep the area cleanly shaven. C) Apply petroleum jelly to the affected area. D) Avoid using soap on the treatment area. 16). The nurse is caring for a patient who has just been given a 6-month prognosis following a diagnosis of extensive-stage small-cell lung cancer. The patient states that he would like to die at home, but the team believes that the patient's care needs are unable to be met in a home environment. What might you suggest as an alternative? A) Discuss a referral for rehabilitation hospital. B) Panel the patient for a personal care home. C) Discuss a referral for acute care. D) Discuss a referral for hospice care. 17). The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient? A) These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and x-ray studies. B) These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer. C) Try not to be concerned about these symptoms. Every patient feels this way after having radiation therapy. D) Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying. 18). A 16-year-old female patient experiences alopecia resulting from chemotherapy, prompting the nursing diagnoses of disturbed body image and situational low self-esteem. What action by the patient would best indicate that she is meeting the goal of improved body image and self-esteem? A) The patient requests that her family bring her makeup and wig. B) The patient begins to discuss the future with her family. C) The patient reports less disruption from pain and discomfort. D) The patient cries openly when discussing her disease. 19). A 50-year-old man diagnosed with leukemia will begin chemotherapy. What would the nurse do to combat the most common adverse effects of chemotherapy? A) Administer an antiemetic. B) Administer an antimetabolite. C) Administer a tumor antibiotic. D) Administer an anticoagulant. 20). A 58-year-old male patient has been hospitalized for a wedge resection of the left lower lung lobe after a routine chest x-ray shows carcinoma. The patient is anxious and asks if he can smoke. Which statement by the nurse would be most therapeutic? A) Smoking is the reason you are here. B) The doctor left orders for you not to smoke. C) You are anxious about the surgery. Do you see smoking as helping? D) Smoking is OK right now, but after your surgery it is contraindicated. 21). An oncology nurse educator is providing health education to a patient who has been diagnosed with skin cancer. The patient's wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite? A) Malignant cells contain more fibronectin than normal body cells. B) Malignant cells contain proteins called tumor-specific antigens. C) Chromosomes contained in cancer cells are more durable and stable than those of normal cells. D) The nuclei of cancer cells are unusually large, but regularly shaped. 22). A patient's most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the patient's cancer cells spread? A) Hematologic spread B) Lymphatic circulation C) Invasion D) Angiogenesis 23). The nurse is describing some of the major characteristics of cancer to a patient who has recently received a diagnosis of malignant melanoma. When differentiating between benign and malignant cancer cells, the nurse should explain differences in which of the following aspects? (Select all that apply) A) Rate of growth B) Ability to cause death C) Size of cells D) Cell contents E) Ability to spread 24). A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The patient states, "They tell me my cancer is malignant, while my coworker's breast tumor was benign. I just don't understand at all." When preparing a response to this patient, the nurse should be cognizant of what characteristic that distinguishes malignant cells from benign cells of the same tissue type? A) Slow rate of mitosis of cancer cells B) Different proteins in the cell membrane C) Differing size of the cells D) Different molecular structure in the cells 25). An oncology patient will begin a course of chemotherapy and radiation therapy for the treatment of bone metastases. What is one means by which malignant disease processes transfer cells from one place to another? A) Adhering to primary tumor cells B) Inducing mutation of cells of another organ C) Phagocytizing healthy cells D) Invading healthy host tissues 26). The nurse is performing an initial assessment of an older adult resident who has just relocated to the long-term care facility. During the nurse's interview with the patient, she admits that she drinks around 20 ounces of vodka every evening. What types of cancer does this put her at risk for? (Select all that apply) A) Malignant melanoma B) Brain cancer C) Breast cancer D) Esophageal cancer E) Liver cancer 27). The clinic nurse is caring for a patient whose grandmother and sister have both had breast cancer. She requested a screening test to determine her risk of developing breast cancer and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response? A) Research has shown that eating a healthy diet can provide all the protection you need against breast cancer. B) Research has shown that taking the drug tamoxifen can reduce your chance of breast cancer. C) Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer. D) Research has shown that there is little you can do to reduce your risk of breast cancer if you have a genetic predisposition. 28). A public health nurse has formed an interdisciplinary team that is developing an educational program entitled Cancer: The Risks and What You Can Do About Them. Participants will receive information, but the major focus will be screening for relevant cancers. This program is an example of what type of health promotion activity? A) Disease prophylaxis B) Risk reduction C) Secondary prevention D) Tertiary prevention 29). A 62-year-old woman diagnosed with breast cancer is scheduled for a partial mastectomy. The oncology nurse explained that the surgeon will want to take tissue samples to ensure the disease has not spread to adjacent axillary lymph nodes. The patient has asked if she will have her lymph nodes dissected, like her mother did several years ago. What alternative to lymph node dissection will this patient most likely undergo? A) Lymphadenectomy B) Needle biopsy C) Open biopsy D) Sentinel node biopsy 30). You are caring for a patient who has just been told that her stage IV colon cancer has recurred and metastasized to the liver. The oncologist offers the patient the option of surgery to treat the progression of this disease. What type of surgery does the oncologist offer? A) Palliative B) Reconstructive C) Salvage D) Prophylactic

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Brunner & Suddarth: Test Bank (Chapter 15)
Study Guide Rated A+

1). 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) Smoking Cessation

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). 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) Liver function tests (LFTs)

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). 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



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, 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) Baked apricot chicken and steamed broccoli

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). 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) Teaching patients to wear sunscreen

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). 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


Feedback:


PaperStoc.com Page 2 of 18

, 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). 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) Impaired nutritional status

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.


7). 7). while a patient is receiving iv doxorubicin hydrochloride for the treatment of cancer, the
nurse observes swelling and pain at the iv site. the nurse should prioritize what action?

a) stopping the administration of the drug immediately
b) notifying the patient's physician
c) continuing the infusion but decreasing the rate
d) applying a warm compress to the infusion site

 Ans: A) Stopping the administration of the drug immediately

Feedback:
Doxorubicin hydrochloride is a chemotherapeutic vesicant that can cause severe tissue
damage. The nurse should stop the administration of the drug immediately and then
notify the patient's physician. Ice can be applied to the site once the drug therapy has
stopped.


8). 8). a patient newly diagnosed with cancer is scheduled to begin chemotherapy treatment
and the nurse is providing anticipatory guidance about potential adverse effects. when



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