UNIT F- ONCOLOGY Flashcards
(45 cards)
The nurse learning about cellular regulation understands that which process occurs during the S phase of the cell cycle? a. Actual division (mitosis) b. Doubling of DNA c. Growing extra membrane d. No reproductive activity
ANS: B
During the S phase, the cell must double its DNA content through DNA synthesis. Actual
division, or mitosis, occurs during the M phase. Growing extra membrane occurs in the G1
phase. During the G0 phase, the cell is working but is not involved in any reproductive
activity.
A nurse asks the staff development nurse what “apoptosis” means. What response best?
a. Growth by cells enlarging
b. Having the normal number of chromosomes
c. Inhibition of cell growth
d. Programmed cell death
ANS: D
Apoptosis is programmed cell death. With this characteristic, organs and tissues function with
cells that are at their peak of performance. Growth by cells enlarging is hyperplasia. Having
the normal number of chromosomes is euploidy. Inhibition of cell growth is contact
inhibition.
A nurse is learning the difference between normal cells and benign tumor cells. What
information does this include?
a. Benign tumors grow through invasion of other tissue.
b. Benign tumors have lost their cellular regulation from contact inhibition.
c. Growing in the wrong place or time is typical of benign tumors.
d. The loss of characteristics of the parent cells is called anaplasia.
ANS: C
Benign tumors are basically normal cells growing in the wrong place or at the wrong time.
Benign cells grow through hyperplasia, not invasion. Benign tumor cells retain contact
inhibition. Anaplasia is a characteristic of cancer cells.
A nurse learns that which of the following is the single biggest risk factor for developing cancer? a. Exposure to tobacco b. Advancing age c. Occupational chemicals d. Oncovirus infection
ANS: B
The single biggest risk factor for developing cancer is advancing age. As one ages, immunity
decreases and exposures increase. Tobacco use is the single most preventable cause of cancer.
Exposure to chemicals and oncoviruses cause fewer cancers.
Which statement about carcinogenesis is accurate?
a. An initiated cell will always become clinical cancer.
b. Cancer becomes a health problem once it is 1 cm in size.
c. Normal hormones and proteins do not promote cancer growth.
d. Tumor cells need to develop their own blood supply.
ANS: D
Tumors need to develop their own blood supply through a process called angiogenesis. An
initiated cell needs a promoter to continue its malignant path. Normal hormones and proteins
in the body can act as promoters. A 1-cm tumor is a detectable size, but other events have to
occur for it to become a health problem.
The nurse caring for oncology clients knows that which form of metastasis is the most common? a. Bloodborne b. Direct invasion c. Lymphatic spread d. Via bone marrow
ANS: A
Bloodborne metastasis is the most common way for cancer to metastasize. Direct invasion and
lymphatic spread are other methods. Bone marrow is not a medium in which cancer spreads,
although cancer can occur in the bone marrow.
A nurse is assessing a client with glioblastoma. What assessment is most important?
a. Abdominal palpation
b. Abdominal percussion
c. Lung auscultation
d. Neurologic examination
ANS: D
A glioblastoma arises in the brain. The most important assessment for this client is the
neurologic examination.
A nurse has taught a client about dietary changes that can reduce the chances of developing
cancer. What statement by the client indicates the nurse needs to provide additional teaching?
a. “Foods high in vitamin A and vitamin C are important.”
b. “I’ll have to cut down on the amount of bacon I eat.”
c. “I’m so glad I don’t have to give up my juicy steaks.”
d. “Vegetables, fruit, and high-fiber grains are important.”
ANS: C
To decrease the risk of developing cancer, one should cut down on the consumption of red
meats and animal fat. The other statements are correct.
A client is in the oncology clinic for a first visit since being diagnosed with cancer. The nurse
reads in the client’s chart that the cancer classification is TISN0M0. What does the nurse
conclude about this client’s cancer?
a. The primary site of the cancer cannot be determined.
b. Regional lymph nodes could not be assessed.
c. There are multiple lymph nodes involved already.
d. There are no distant metastases noted in the report.
ANS: D
TIS stands for carcinoma in situ; N0 stands for no regional lymph node metastasis; and M0
stands for no distant metastasis.
A client asks the nurse if eating only preservative- and dye-free foods will decrease cancer
risk. What response by the nurse is best?
a. “Maybe; preservatives, dyes, and preparation methods may be risk factors.”
b. “No; research studies have never shown those things to cause cancer.”
c. “There are other things you can do that will more effectively lower your risk.”
d. “Yes; preservatives and dyes are well known to be carcinogens.”
ANS:A
Dietary factors related to cancer development are poorly understood, although dietary
practices are suspected to alter cancer risk. Suspected dietary risk factors include low-fiber
intake and a high intake of red meat or animal fat. Preservatives, preparation methods, and
additives (dyes, flavorings, sweeteners) may have cancer-promoting effects. It is correct to say
that other things can lower risk more effectively, but this does not give the client concrete
information about how to do so, and also does not answer the client’s question.
The nurse learning about cancer development remembers characteristics of normal cells. Which characteristics does this include? (Select all that apply.) a. Differentiated function b. Large nucleus-to-cytoplasm ratio c. Loose adherence d. Nonmigratory e. Specific morphology f. Orderly and specific growth
ANS: A, D, E, F
Normal cells have the characteristics of differentiated function, nonmigratory, specific
morphology, a smaller nucleus-to-cytoplasm ratio, tight adherence, and orderly and
well-regulated growth
The nurse working with oncology clients understands that interacting factors affect cancer
development. Which factors does this include? (Select all that apply.)
a. Exposure to carcinogens
b. Genetic predisposition
c. Immune function
d. Normal doubling time
e. State of euploidy
ANS: A, B, C
The three interacting factors needed for cancer development are exposure to carcinogens,
genetic predisposition, and immune function
A nurse is participating in primary prevention efforts directed against cancer. In which
activities is this nurse most likely to engage? (Select all that apply.)
a. Demonstrating breast self-examination methods to women
b. Instructing people on the use of chemoprevention
c. Providing vaccinations against certain cancers
d. Screening teenage girls for cervical cancer
e. Teaching teens the dangers of tanning booths
f. Educating adults about healthy eating habits
ANS: B, C, E, F
Primary prevention aims to prevent the occurrence of a disease or disorder, in this case cancer.
Secondary prevention includes screening and early diagnosis. Primary prevention activities
include teaching people about chemoprevention, providing approved vaccinations to prevent
cancer, teaching teens the dangers of tanning beds, and educating adults on eating habits to
reduce the risk of getting cancer. Breast examinations and screening for cervical cancer are
secondary prevention methods.
A nurse is providing community education on the seven warning signs of cancer. Which signs are included? (Select all that apply.) a. A sore that does not heal b. Changes in menstrual patterns c. Indigestion or trouble swallowing d. Near-daily abdominal pain e. Obvious change in a mole f. Frequent indigestion
ANS: A, B, C, E, F
The seven warning signs for cancer can be remembered with the acronym CAUTION:
changes in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge,
thickening or lump in the breast or elsewhere, indigestion or difficulty swallowing, obvious
change in a wart or mole, and nagging cough or hoarseness. Abdominal pain is not a warning
sign.
A nurse in the oncology clinic is providing preoperative education to a client just diagnosed
with cancer. The client has been scheduled for surgery in 3 days. What action by the nurse is
best?
a. Call the client at home the next day to review teaching.
b. Give the client information about a cancer support group.
c. Provide all the preoperative instructions in writing.
d. Reassure the client that surgery will be over soon.
ANS: A
Clients are often overwhelmed at a sudden diagnosis of cancer and may be more
overwhelmed at the idea of a major operation so soon. This stress significantly impacts the
client’s ability to understand, retain, and recall information. The nurse would call the client at
home the next day to review the teaching and to answer questions. The client may or may not
be ready to investigate a support group, but this does not help with teaching. Giving
information in writing is important (if the client can read it), but in itself will not be enough.
Telling the client that surgery will be over soon is giving false reassurance and does nothing
for teaching.
A nurse is caring for a client admitted for Non-Hodgkin’s lymphoma and chemotherapy. The
client reports nausea, flank pain, and muscle cramps. What action by the nurse is most
important?
a. Request an order for serum electrolytes and uric acid.
b. Increase the client’s IV infusion rate.
c. Instruct assistive personnel to strain all urine.
d. Administer an IV antiemetic.
ANS: A
This client’s reports are consistent with tumor lysis syndrome, for which he or she is at risk
due to the diagnosis. Early symptoms of TLS stem from electrolyte imbalances and can
include lethargy, nausea, vomiting, anorexia, flank pain, muscle weakness, cramps, seizures,
and altered mental status. The nurse would notify the primary health care provider and request
an order for serum electrolytes. Hydration is important in both preventing and managing this
syndrome, but the nurse would not just increase the IV rate. Assistive personnel may need to
strain the client’s urine and the client may need an antiemetic, but first the nurse would assess
the situation further by obtaining pertinent lab tests.
A new nurse has been assigned a client who is in the hospital to receive iodine-131 treatment.
Which action by the nurse is best?
a. Ensure the client is placed in protective isolation.
b. Have pregnant visitors stay 6 feet from the client
c. No special action is necessary to care for this client.
d. Read the policy on handling radioactive excreta.
ANS: D
This type of radioisotope is excreted in body fluids and excreta (urine and feces) and would
not be handled directly. The nurse would read the facility’s policy for handling and disposing
of this type of waste. The other actions are not warranted.
A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months
after radiation therapy for breast cancer. What response by the nurse is most appropriate?
a. “Are you getting adequate rest and sleep each day?”
b. “It is normal to be fatigued even for months afterward.”
c. “This is not normal and I’ll let the primary health care provider know.”
d. “Try adding more vitamins B and C to your diet.”
ANS: B
Radiation-induced fatigue can be debilitating and may last for months after treatment has
ended. Rest and adequate nutrition can affect fatigue, but it is most important that the client
(and family) understands this is normal.
A client tells the oncology nurse about an upcoming vacation to the beach to celebrate
completing radiation treatments for cancer. What response by the nurse is most appropriate?
a. “Avoid getting salt water on the radiation site.”
b. “Do not expose the radiation area to direct sunlight.”
c. “Have a wonderful time and enjoy your vacation!”
d. “Remember you should not drink alcohol for a year.”
ANS: B
The skin overlying the radiation site is extremely sensitive to sunlight after radiation therapy
has been completed. The nurse would inform the client to avoid sun exposure to this area.
This advice continues for 1 year after treatment has been completed. The other statements are
not appropriate.
A client is receiving chemotherapy through a peripheral IV line. What action by the nurse is
most important?
a. Assessing the IV site and blood return every hour
b. Educating the client on side effects
c. Monitoring the client for nausea
d. Providing warm packs for comfort
ANS: A
Intravenous chemotherapy can cause local tissue destruction if it extravasates into the
surrounding tissues. Peripheral IV lines are more prone to this than centrally placed lines. The
most important intervention is prevention, so the nurse would check hourly to ensure the IV
site is patent, or frequently depending on facility policy. Education and monitoring for side
effects such as nausea are important for all clients receiving chemotherapy. Warm packs may
be helpful for some drugs, whereas for others ice is more comfortable. would monitor the site
and check for blood return to prevent injury from infiltration or extravasation.
A client with cancer is admitted to a short-term rehabilitation facility. The nurse prepares to
administer the client’s oral chemotherapy medications. What action by the nurse is most
appropriate?
a. Crush the medications if the client cannot swallow them.
b. Give one medication at a time with a full glass of water.
c. No special precautions are needed for these medications.
d. Wear personal protective equipment when handling the medications.
ANS: D
During the administration of oral chemotherapy agents, nurses must take the same precautions
that are used when administering IV chemotherapy. This includes using personal protective
equipment. These medications cannot be crushed, split, or chewed. Giving one at a time is not
needed.
The nurse working with oncology clients understands that which age-related change increases
the older client’s susceptibility to infection during chemotherapy?
a. Decreased immune function
b. Diminished nutritional stores
c. Existing cognitive deficits
d. Poor physical reserves
ANS: A
As people age, there is an age-related decrease in immune function, causing the older adult to
be more susceptible to infection than other clients. Not all older adults have diminished
nutritional stores, cognitive dysfunction, or poor physical reserves.
The nurse has educated a client on precautions to take with thrombocytopenia. What
statement by the client indicates a need to review the information?
a. “I will be careful if I need enemas for constipation.”
b. “I will use an electric shaver instead of a razor.”
c. “I should only eat soft food that is either cool or warm.”
d. “I won’t be able to play sports with my grandkids.”
ANS: A
The thrombocytopenic client is at high risk for bleeding even from minor trauma. Due to the
risk of injuring rectal and anal tissue, the client should not use enemas or rectal thermometers.
This statement would indicate the client needs more information. The other statements are
appropriate for the thrombocytopenic client.
A client has a platelet count of 9800/mm3 (9800 109/L). What action by the nurse is most
appropriate?
a. Assess the client for calf pain, warmth, and redness.
b. Instruct the client to call for help to get out of bed.
c. Obtain cultures as per the facility’s standing policy.
d. Place the client on protective Isolation Precautions.
ANS: B
A client with a platelet count this low is at high risk for serious bleeding episodes. To prevent
injury, the client would be instructed to call for help prior to getting out of bed. Calf pain,
warmth, and redness might indicate a deep vein thrombosis, not associated with low platelets.
Cultures and isolation relate to low white cell counts.
