NURS 372 EXAM 1 QUESTIONS & ANSWERS
Causes of Cancer - Answers -1. Age (increased risk for people over 65)
2. Gender (more cancers deaths in men than women per year)
3. Geographic location
4. Genetics (accounts for 15% of cancers. Cancers with familial relationships include
breast, colon, lung, ovarian, and prostate)
5. Immune disturbance (viruses increase risk: Epstein-Barr, herpes, papillomavirus, hep
B, cytomegalovirus (CMV))
6. Chemical agents (exposure to carcinogens)
7. Race (higher rates of cancer in African Americans)
8. Tobacco, Alcohol, Diet
What is the best test to confirm cancer? - Answers -Biopsies; make sure to know med
hx beforehand and if on blood thinners
Primary Prevention of Cancer - Answers -- Avoid/Limit tobacco & alcohol use
- Fight off Infections (HPV, HIV, H. Pylori)
- Limit UV radiation & use sunscreen
- Achieve and maintain a healthy weight throughout life
- adequate rest
- learn and practice self exams
- reduce stress
- have regular leisure/relaxation time
- Adopt a physically active lifestyle.
- Consume a healthy, balanced diet with an emphasis on plant food
Breast Cancer Screenings - Answers -- Women 45 - 54 y/o = mammography screening
- Can start at 40 y/o if fly hx
- 55+ = biennial screening
Cervical Cancer Screening - Answers -- Women 21 - 65 y/o = PAP screen q 3 yrs
- Women 30 - 65 y/o = PAP + HPV screening (preferred)
- Women 66+ y/o = can choose not to get PAP
Endometrial Cancer Screening - Answers -- watch for menopausal bleeding
Prostate Cancer Screenings - Answers -- Screening not routinely recommended
- Men > 50 y/o with 10+ year life expectancy
- Digital rectal exam and PSA
Testicular Cancer Screenings - Answers -- Can occur at any age; commonly dx: 20 -
34y/o
- self-exams!!!
,Colorectal Cancer Screenings - Answers -- Screening begins @ 50 y/o for average risk
- Non-invasive exams (Fecal Occult Blood test (FOBT), fecal immunochemical test
(FIT), Stool DNA)
- Home testing recommended
- Various endoscopic exams (Flex sig q 5 years), colonoscopy q 10 years)
Lung Cancer Screenings - Answers -- Smokers w/ 30 pack-year HX (quit 15 yrs to be a
non smoker)
- LDCT (low dose helical CT scan)- expensive and not done often
CAUTION - Answers -C - hange in bowel or bladder habits
A - sore that does not heal
U - nusual bleeding or discharge from any body orifice
T - hickening or a lump in the breast or elsewhere
I - ndigestion or difficulty in swallowing
O- bvious change in a wart or mole
N - agging cough or hoarseness
Clinical Staging Classification System of Cancer - Answers -Stage 0: Cancer in situ
Stage I: Tumor limited to the tissue of origin; localized tumor growth
Stage II: Limited local spread
Stage III: Extensive local and regional spread
Stage IV: Metastasis
Benign Tumors vs Malignant Tumors - Answers -Benign: well differentiated; usually
encapsulated; metastasis is absent; rarely recur
Malignant: range from well differentiated to undifferentiated; able to metastasize;
frequent recurrence; rarely encapsulated; moderate to marked vascularity
How many years until considered cancer free? - Answers -5 yrs
Goal of Cancer Treatments - Answers -- Cure (surgery)
- Control (debulking/cytoreductive procedure, chemo, radiation)
- Comfort (Palliative)
Neoadjuvant therapy - Answers -administration of therapeutic agents before a main
treatment (hormone therapy prior to radical radiotherapy for adenocarcinoma of the
prostate)
Adjuvant therapy - Answers -therapy that is given in addition to the primary, main, or
initial therapy to maximize its effectiveness; modifies the effect of another agent
(marijuana TX in conjunction with opioids for pain management)
, Cancer Treatment: Chemo - Answers -- Action: Use of chemicals given as a systemic
therapy for cancer; mainstay for most solid tumors and hematologic cancers; can offer
cure, control, or palliative care; cannot distinguish between normal and cancer cells
- Implications: may pose an occupational hazard (drugs may be absorbed through skin,
inhalation, during preparation, transportation, and administration); only properly trained
personnel should handle drugs; monitor and report infection or bleeding
- Methods of Admin: Oral, IM, IV (most common), Intracavitary, Intrathecal, Intraarterial
Central vascular access device (VAD) administration - Answers -placement in large
blood vessels; frequent, continuous, or intermittent administration; can be used to
administer other fluids (blood, electrolytes, etc.)
Regional Administration of Chemo - Answers -delivery of drug directly into tumor site;
higher concentrations of drug can be delivered with less systemic toxicity; delivery
methods are intraarterial, intraperitoneal, intrathecal, and intravesical
Intraarterial Chemotherapy - Answers -delivers drug through arteries supplying tumor;
method has been used for the treatment of osteogenic sarcoma, cancers of the head
and neck, bladder, brain, and cervix, melanoma, primary liver cancer, and metastatic
liver disease
Intraperitoneal Chemotherapy - Answers -delivers drug to peritoneal cavity for
treatment of peritoneal metastases; chemotherapy is generally infused into the
peritoneum in 1 to 2 L of fluid and allowed to "dwell" in the peritoneum for a period of 1
to 4 hours; following the "dwell time," the fluid is drained from the peritoneum.
Intrathecal or Intraventricular Chemotherapy - Answers -Involves lumbar puncture and
injection of chemotherapy into subarachnoid space
Intravesical Bladder Chemotherapy - Answers -Agent added to bladder by urinary
catheter and retained for 1 to 3 hours
Management of Cancer Pain - Answers -- Drug options for pain management
(Morphine, Dilaudid); think about addiction
- Analgesics taken on a scheduled basis - with additional doses for breakthrough pain
- Relaxation therapy and imagery
Management of Cancer Treatment Related Nausea - Answers -- prophylactic
administration of antiemetics (Zofran)
- avoid offending odors
- assess for signs & symptoms of alkalosis, dehydration, and I & O
- tell caregiver to avoid eating in front of pt who is on chemo
- monitor carefully to avoid weight loss
- weigh twice weekly
- recommend small, frequent meals & nutritional supplements (cold foods, bland foods,
avoid spicy)
Causes of Cancer - Answers -1. Age (increased risk for people over 65)
2. Gender (more cancers deaths in men than women per year)
3. Geographic location
4. Genetics (accounts for 15% of cancers. Cancers with familial relationships include
breast, colon, lung, ovarian, and prostate)
5. Immune disturbance (viruses increase risk: Epstein-Barr, herpes, papillomavirus, hep
B, cytomegalovirus (CMV))
6. Chemical agents (exposure to carcinogens)
7. Race (higher rates of cancer in African Americans)
8. Tobacco, Alcohol, Diet
What is the best test to confirm cancer? - Answers -Biopsies; make sure to know med
hx beforehand and if on blood thinners
Primary Prevention of Cancer - Answers -- Avoid/Limit tobacco & alcohol use
- Fight off Infections (HPV, HIV, H. Pylori)
- Limit UV radiation & use sunscreen
- Achieve and maintain a healthy weight throughout life
- adequate rest
- learn and practice self exams
- reduce stress
- have regular leisure/relaxation time
- Adopt a physically active lifestyle.
- Consume a healthy, balanced diet with an emphasis on plant food
Breast Cancer Screenings - Answers -- Women 45 - 54 y/o = mammography screening
- Can start at 40 y/o if fly hx
- 55+ = biennial screening
Cervical Cancer Screening - Answers -- Women 21 - 65 y/o = PAP screen q 3 yrs
- Women 30 - 65 y/o = PAP + HPV screening (preferred)
- Women 66+ y/o = can choose not to get PAP
Endometrial Cancer Screening - Answers -- watch for menopausal bleeding
Prostate Cancer Screenings - Answers -- Screening not routinely recommended
- Men > 50 y/o with 10+ year life expectancy
- Digital rectal exam and PSA
Testicular Cancer Screenings - Answers -- Can occur at any age; commonly dx: 20 -
34y/o
- self-exams!!!
,Colorectal Cancer Screenings - Answers -- Screening begins @ 50 y/o for average risk
- Non-invasive exams (Fecal Occult Blood test (FOBT), fecal immunochemical test
(FIT), Stool DNA)
- Home testing recommended
- Various endoscopic exams (Flex sig q 5 years), colonoscopy q 10 years)
Lung Cancer Screenings - Answers -- Smokers w/ 30 pack-year HX (quit 15 yrs to be a
non smoker)
- LDCT (low dose helical CT scan)- expensive and not done often
CAUTION - Answers -C - hange in bowel or bladder habits
A - sore that does not heal
U - nusual bleeding or discharge from any body orifice
T - hickening or a lump in the breast or elsewhere
I - ndigestion or difficulty in swallowing
O- bvious change in a wart or mole
N - agging cough or hoarseness
Clinical Staging Classification System of Cancer - Answers -Stage 0: Cancer in situ
Stage I: Tumor limited to the tissue of origin; localized tumor growth
Stage II: Limited local spread
Stage III: Extensive local and regional spread
Stage IV: Metastasis
Benign Tumors vs Malignant Tumors - Answers -Benign: well differentiated; usually
encapsulated; metastasis is absent; rarely recur
Malignant: range from well differentiated to undifferentiated; able to metastasize;
frequent recurrence; rarely encapsulated; moderate to marked vascularity
How many years until considered cancer free? - Answers -5 yrs
Goal of Cancer Treatments - Answers -- Cure (surgery)
- Control (debulking/cytoreductive procedure, chemo, radiation)
- Comfort (Palliative)
Neoadjuvant therapy - Answers -administration of therapeutic agents before a main
treatment (hormone therapy prior to radical radiotherapy for adenocarcinoma of the
prostate)
Adjuvant therapy - Answers -therapy that is given in addition to the primary, main, or
initial therapy to maximize its effectiveness; modifies the effect of another agent
(marijuana TX in conjunction with opioids for pain management)
, Cancer Treatment: Chemo - Answers -- Action: Use of chemicals given as a systemic
therapy for cancer; mainstay for most solid tumors and hematologic cancers; can offer
cure, control, or palliative care; cannot distinguish between normal and cancer cells
- Implications: may pose an occupational hazard (drugs may be absorbed through skin,
inhalation, during preparation, transportation, and administration); only properly trained
personnel should handle drugs; monitor and report infection or bleeding
- Methods of Admin: Oral, IM, IV (most common), Intracavitary, Intrathecal, Intraarterial
Central vascular access device (VAD) administration - Answers -placement in large
blood vessels; frequent, continuous, or intermittent administration; can be used to
administer other fluids (blood, electrolytes, etc.)
Regional Administration of Chemo - Answers -delivery of drug directly into tumor site;
higher concentrations of drug can be delivered with less systemic toxicity; delivery
methods are intraarterial, intraperitoneal, intrathecal, and intravesical
Intraarterial Chemotherapy - Answers -delivers drug through arteries supplying tumor;
method has been used for the treatment of osteogenic sarcoma, cancers of the head
and neck, bladder, brain, and cervix, melanoma, primary liver cancer, and metastatic
liver disease
Intraperitoneal Chemotherapy - Answers -delivers drug to peritoneal cavity for
treatment of peritoneal metastases; chemotherapy is generally infused into the
peritoneum in 1 to 2 L of fluid and allowed to "dwell" in the peritoneum for a period of 1
to 4 hours; following the "dwell time," the fluid is drained from the peritoneum.
Intrathecal or Intraventricular Chemotherapy - Answers -Involves lumbar puncture and
injection of chemotherapy into subarachnoid space
Intravesical Bladder Chemotherapy - Answers -Agent added to bladder by urinary
catheter and retained for 1 to 3 hours
Management of Cancer Pain - Answers -- Drug options for pain management
(Morphine, Dilaudid); think about addiction
- Analgesics taken on a scheduled basis - with additional doses for breakthrough pain
- Relaxation therapy and imagery
Management of Cancer Treatment Related Nausea - Answers -- prophylactic
administration of antiemetics (Zofran)
- avoid offending odors
- assess for signs & symptoms of alkalosis, dehydration, and I & O
- tell caregiver to avoid eating in front of pt who is on chemo
- monitor carefully to avoid weight loss
- weigh twice weekly
- recommend small, frequent meals & nutritional supplements (cold foods, bland foods,
avoid spicy)
