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MS Quiz 11-The Patient With Cancer
Questions And Answers, With Rationales|
Newly Updated 2025
- Which statement best defines concepts to be included in a teaching plan for a patient with cancer? a. Cancer is a group of diseases. The cancer cells are different from the cells in the tissue of its origin in both the growth and spreading of abnormal cells. b. Cancer is the third leading cause of death in the United States. Many hospitals have the highest number of patients with this diagnosis. c. Americans who have a diagnosis of cancer die within 1 year or less. d. When a person is genetically predisposed to a type of cancer, nothing can be done to prevent its occurrence. ANS: a. Cancer is a group of diseases. The cancer cells are different from the cells in the tissue of its origin in both the growth and spreading of abnormal cells. Information about the disease and disease process is helpful to allay anxiety, as well as to instruct about its pathophysiologic changes.
- A nurse explains that the seven warning signs of cancer written by the American Cancer Society (ACS) can be recalled by the acronym CAUTION. What should
the nurse change to point out that the A in the acronym represents? a. A sore that will not heal b. Alopecia c. Abscess d. Anorexia ANS: A. A sore that will not heal The acronym is a change in bowel or bladder habits, a sore that will not heal, unusual bleeding or discharge, a thickening or lump in the breast or elsewhere, indigestion or difficulty swallowing, and a nagging cough or hoarseness.
- A home health nurse is compiling a patient profile on a 23-year-old obese woman who smokes one-half pack of cigarettes a day and drinks 1 beer a week. She works as a cook in a long-term care facility. She has two children and eats a diet high in fats. She exercises 30 minutes a day. Both parents are dead of heart disease. How many risk factors for cancer in this profile should the nurse identify? a. 2 b. 3 c. 5 d. 6
d. Both may press on nearby surrounding tissues, such as nerves and blood vessels, causing pain. ANS: D .Both may press on nearby surrounding tissues, such as nerves and blood vessels, causing pain. Both benign and malignant tumors may create pressure on or obstruct an organ.
- A patient newly diagnosed with cancer says, "I feel like I've lost my future. I feel so much harm has been done to me that I'm overwhelmed." To what type of coping strategies should the nurse recognize this attitude will most likely lead the patient? a. Avoidant b. Problem solving c. Approach oriented d. Confrontational ANS: A.. Avoidant Persons who appraise their cancer diagnosis as harm or loss are more likely to use avoidant coping strategies.
DIF: Cognitive Level: Comprehension REF: p. 404 OBJ: 6 TOP: Coping Styles KEY: Nursing Process Step: Assessment
- A patient has a cancer that has been TNM staged as T3 (1-4, size of primary tumor), N2 (0-3, degree of spread to regional lymph nodes), and M2 (0-1, presence of metastasis). He has an as needed order of 4 mg of morphine intramuscularly every 3 to 4 hours. He requests another pain injection approximately hours after the last one. What is the most appropriate nursing action? a. Inform the patient that this narcotic may be given only every 4 hours to prevent addiction. b. Ignore the call bell for 20 minutes and then take at least 10 minutes to prepare and administer the injection. c. Give the morphine and evaluate the results of pain relief. Arrange for the physician to evaluate for breakthrough pain. d. Ask the family to assist in helping the patient accept waiting longer to receive an addicting medication such as morphine. ANS: C.Give the morphine and evaluate the results of pain relief. Arrange for the physician to evaluate for breakthrough pain. Terminal care does not include concerns about morphine addiction. Medication
- A nurse explains that drugs such as cannabinoids, Benadryl, and Vistaril are frequently ordered for patients with cancer who are taking chemotherapy. What do these types of drugs accomplish? a. Promote amnesia to dampen the fear. b. Maintain fluid retention to prevent dehydration. c. Control nausea, vomiting, and taste disorders caused by the therapy. d. Control bouts of diarrhea or uncomfortable constipation. ANS: C. Control nausea, vomiting, and taste disorders caused by the therapy. Cannabinoids, Benadryl, and Vistaril are useful to help control nausea.
- While bathing a patient with cancer, a nurse assessed several large new bruises on the patient's upper arms and thighs. What is the best understanding of the possible causes and the correct nurse's actions for these findings? a. The patient must have fallen last night walking to the bathroom. Teach the patient to use the call bell when assistance is needed. b. The patient may have disseminated intravascular coagulation. The size, shape, location, color, and tenderness must be reported and recorded fully. c. An intravascular fluid overload is occurring because of the chemotherapy. Place
the patient on strict input/output (I/O) status and limit fluids. d. The patient must have had a drug-induced seizure, which caused arm and leg thrashing and the bruises. Report and record the findings, and pad the side rails. ANS: B.The patient may have disseminated intravascular coagulation. The size, shape, location, color, and tenderness must be reported and recorded fully. These signs of hemorrhage may indicate the oncologic emergency of disseminated intravascular coagulation. Serious signs need to be reported in a timely manner and fully described.
- What manifestations might be assessed by a nurse when a patient is diagnosed with the oncologic emergency hypercalcemia? a. Hypertension and bradycardia b. Fatigue, confusion, and weakness c. Laboratory test results of potassium 3.5 mEq/L, sodium 143 mEq/L d. Urine output less than 30 mL/hr ANS: B.Fatigue, confusion, and weakness The indications for hypercalcemia are fatigue, confusion, weakness, and poor muscle tone. If left untreated, renal failure and death may occur.
a. The primary tumor has shrunk, although some lymph nodes remain involved. Teach the patient that this is good news. b. The primary tumor has now responded to a combination of chemotherapy and radiation. The patient should now receive much less analgesic medication. c. The primary tumor is quite large and has extended to lymph glands and distant areas. Gentle touch and therapeutic listening will be especially helpful. d. After the series of radiation treatments, the distant metastases are still present. Prepare the patient to accept only the cure of the primary tumor. ANS: C. The primary tumor is quite large and has extended to lymph glands and distant areas. Gentle touch and therapeutic listening will be especially helpful. Correct interpretation and differentiating components of staging data are used to plan effective nursing care.
- Which symptom reported by a patient taking doxorubicin (Adriamycin) should be considered a priority for intervention? a. Nausea b. Visual disturbances c. Headache and dizziness d. Rapid heartbeat
ANS: D.Rapid heartbeat Adriamycin is cardiotoxic medication and can cause heart failure.
- A diagnosis of breast cancer is first made at stage T1 N0 M0. Which nursing diagnosis would be appropriate? a. "Risk for disturbed body image, related to threats of anticipated changes." b. "Risk of anxiety, related to outcome of treatments." c. "Risk for infection, related to decreased white blood cell count." d. "Risk for ineffective coping, related to husband's expectations regarding anticipated treatments." ANS: b. "Risk of anxiety, related to outcome of treatments. Early stages of cancer create anxiety about the outcome of treatments for the patient.
- What is the most common site of cancer in adult women? a. Breast b. Lung c. Kidney d. Uterus
c. Pancreas d. Prostate ANS: D. Prostate Gender defines some of the potential risks for cancer. Prostate cancer accounts for 33% of the reported cases of cancer in men.
- Which patient assessment should lead a nurse to conclude a patient diagnosed with cancer is beginning the acceptance stage? a. Begins to act in a cheerful manner b. Inquires about support groups c. Cries over loss of health d. Actively interacts with his or her family ANS: B. Inquires about support groups Directed planning for support for the diagnosis is indicative of acceptance. Crying and a cheerful manner are not necessarily positive. Interaction with the family is not indicative of acceptance.
- A family is concerned about the possibility of addiction as a result of the frequent doses of Roxanol. What is the nurse's best response? a. "At this stage, addiction is the least of our worries."
b. "This is a low-dose drug, and it controls pain without the problems of addiction." c. "Addiction is rare, but we have drugs that can counteract the effect of this narcotic." d. "You may want to share your concerns with the physician. He can order another drug that is not addictive." ANS: B. This is a low-dose drug, and it controls pain without the problems of addiction." Roxanol is a low-dose narcotic with very little potential for addiction.
- Which cytologic test, usually performed in outpatient settings, suggests the probability of a need for further testing for cancer cells? a. Chest radiography b. Koch test c. Papanicolaou (Pap) test d. Tine test ANS: C. Papanicolaou (Pap) test Preventive testing (Pap test) and screening reduce the risks for cancer and increase the chances of early treatment and is the most commonly performed screening test.
d. Spaghetti with tomato sauce, cheddar cheese toast strips, six celery sticks with peanut butter, and 8 oz of whole milk ANS: B.Broiled chicken with rice, 1-oz slice of plain American cheese, one- quarter cup of spinach, one-half ripe banana, and 8 oz of grape juice Food choices for a nauseated patient should be mild and easily digested, with no spicy sauces or dark colas.
- A patient is close to death with terminal liver cancer with widespread metastases and calls the nursing staff to his room every 5 minutes. Which interventions will be most supportive and in the best interest of the patient? a. Encourage and insist that the family request a transfer to hospice care because the general hospital does not have enough staff members to keep responding to the patient's end-stage frequent calling and requests for minor help. b. Use fixed interval and cocktail medication administration. Frequently evaluate for breakthrough pain and anxieties. Answer the call bell quickly on the intercom or in person. c. Tell the family that as of this afternoon, all of the patient's questions, comments, and expressed fears of dying and financial worries will be referred to the social worker, physician, or clergy. Otherwise, one of them can come in and sit beside the bed.
d. Plan to limit strictly the time spent with the patient because the nurse cannot do much that could be beneficial at this point. ANS: B.Use fixed interval and cocktail medication administration. Frequently evaluate for breakthrough pain and anxieties. Answer the call bell quickly on the intercom or in person. Therapeutic touch, the nurse's presence, and sufficient pain medication to make the patient comfortable are appropriate nursing actions. We have an expert-written solution to this problem!
- Which statement by a patient should lead the nurse to conclude that the precolonoscopy instruction provided has been effective? a. "I know that the lighted tube he will use will help the doctor look at my tumor, and he might take a small piece of tissue to look at in the lab." b. "I know that the light on the tube will help cure my cancer." c. "I know the colonoscopy is very painful and embarrassing, and I hope no one sees me in that position."
Increased age, hormonal changes, chronic irritation of internal tissue, and a poor diet are possible sources of increased incidence of cancer in middle-aged persons.
- What recommendations should a nurse make to a visitor of a patient who has an internal radiation implant? (Select all that apply.) a. Avoid visitation if you are pregnant. b. Take off all metals, such as your watch and belt. c. Limit your visitation time. d. Wear a protective lead apron. e. Stay at least 6 feet away from bedside. a. Avoid visitation if you are pregnant. c. Limit your visitation time. e. Stay at least 6 feet away from bedside. Visitors are important to reduce the isolation of the patient who is undergoing radiation, but pregnant women should not visit. The visits of all persons should be limited to a few minutes, and they should be at least 6 feet from the bedside. Removing metal objects and wearing protective devices are not necessary.
- Why is adjuvant therapy given to patients with cancer who are free of signs of the disease? (Select all that apply.) a. Ensures eradication of undetected cells
b. Stabilizes normal cells c. Diminishes recurrence of breast cancer d. Reduces the extent of the tumor before surgery or radiation e. Changes the pH of the system to inhibit cell growth ANS: A, C a. Ensures eradication of undetected cells c. Diminishes recurrence of breast cancer Adjuvant therapy is given to symptom-free patients with cancer to eradicate undetected cells and to diminish the recurrence of breast cancer. Administration before surgery or radiation to reduce tumor bulk is called nonadjuvant therapy. The therapy does not stabilize normal cells or alter the pH.
- What action should a nurse implement if an intravenous vesicant cancer drug has extravasated? (Select all that apply.) a. Place a warm compress on the area. b. Chill the area with an ice pack. c. Raise the patient's arm above the level of the heart. d. Stop the infusion. e. Notify the charge nurse.
