Cancer And Oncology | NCLEX Quiz 151

1. A patient who smokes tells the nurse. "I want to have a yearly chest x-ray so that if I get cancer. it will be detected early." Which response by the nurse is most appropriate?

“Chest x-rays do not detect cancer until tumors are already at least a half-inch in size.”

“Annual x-rays will increase your risk for cancer because of exposure to radiation.”

“Insurance companies do not authorize yearly x-rays just to detect early lung cancer.”

“Frequent x-rays damage the lungs and make them more susceptible to cancer.”

A tumor must be at least 1 cm large before it is detectable by an x-ray and may already have metastasized by that time. Radiographs have low doses of radiation. and an annual x-ray alone is not likely to increase lung cancer risk. Insurance companies do not usually authorize x-rays for this purpose. but it would not be appropriate for the nurse to give this as the reason for not doing an x-ray. A yearly x-ray is not a risk factor for lung cancer.

Explanation

A tumor must be at least 1 cm large before it is detectable by an x-ray and may already have metastasized by that time. Radiographs have low doses of radiation. and an annual x-ray alone is not likely to increase lung cancer risk. Insurance companies do not usually authorize x-rays for this purpose. but it would not be appropriate for the nurse to give this as the reason for not doing an x-ray. A yearly x-ray is not a risk factor for lung cancer.

2. Which statement by a patient who is scheduled for a needle biopsy of the prostate indicates that the patient understands the purpose of a biopsy?

“The biopsy will tell the doctor whether the cancer has spread to my other organs.”

“The biopsy will help the doctor decide what treatment to use for my enlarged prostate.”

“The biopsy will determine how much longer I have to live.”

“The biopsy will indicate the effect of the cancer on my life.”

A biopsy is used to determine whether the prostate enlargement is benign or malignant and determines the type of treatment that will be needed. Biopsy does not give information about metastasis. life expectancy. or the impact of cancer on the patient’s life; the three remaining statements indicate a need for patient teaching.

Explanation

A biopsy is used to determine whether the prostate enlargement is benign or malignant and determines the type of treatment that will be needed. Biopsy does not give information about metastasis. life expectancy. or the impact of cancer on the patient’s life; the three remaining statements indicate a need for patient teaching.

3. While being prepared for a biopsy of a lump in the right breast. the patient asks the nurse what the difference is between a benign tumor and a malignant tumor. The nurse explains that a benign tumor differs from a malignant tumor in that benign tumors

Do not cause damage to adjacent tissue.

Do not spread to other tissues and organs.

Are simply an overgrowth of normal cells.

Frequently recur in the same site.

The major difference between benign and malignant tumors is that malignant tumors invade adjacent tissues and spread to distant tissues and benign tumors never metastasize. Both types of tumors may cause damage to adjacent tissues. The cells differ from normal in both benign and malignant tumors. Benign tumors usually do not recur.

Explanation

The major difference between benign and malignant tumors is that malignant tumors invade adjacent tissues and spread to distant tissues and benign tumors never metastasize. Both types of tumors may cause damage to adjacent tissues. The cells differ from normal in both benign and malignant tumors. Benign tumors usually do not recur.

4. Surgical procedure to treat breast cancer involves the removal of the entire breast. pectoralis major muscle and the axillary lymph nodes is:

Simple mastectomy

Modified radical mastectomy

Halstead Surgery

Radical mastectomy

Removal of the entire breast. pectoralis major muscle and the axillary lymph nodes is a surgical procedure called modified radical mastectomy. Simple mastectomy is the removal of the entire breast but the pectoralis muscles and nipples remain intact. Halstead surgery also called radical mastectomy involves the removal of entire breast. pectoralis major and minor muscles and neck lymph nodes. It is followed by skin grafting.

Explanation

Removal of the entire breast. pectoralis major muscle and the axillary lymph nodes is a surgical procedure called modified radical mastectomy. Simple mastectomy is the removal of the entire breast but the pectoralis muscles and nipples remain intact. Halstead surgery also called radical mastectomy involves the removal of entire breast. pectoralis major and minor muscles and neck lymph nodes. It is followed by skin grafting.

5. When reviewing the chart for a patient with cervical cancer. the nurse notes that the cancer is staged as Tis. N0. M0. The nurse will teach the patient that

The cancer cells are well-differentiated.

It is difficult to determine the original site of the cervical cancer.

Further testing is needed to determine the spread of the cancer.

The cancer is localized to the cervix.

Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time. Cell differentiation is not indicated by clinical staging. Because the cancer is in situ. the origin is the cervix. Further testing is not indicated given that the cancer has not spread.

Explanation

Cancer in situ indicates that the cancer is localized to the cervix and is not invasive at this time. Cell differentiation is not indicated by clinical staging. Because the cancer is in situ. the origin is the cervix. Further testing is not indicated given that the cancer has not spread.

6. In teaching about cancer prevention to a community group. the nurse stresses promotion of exercise. normal body weight. and low-fat diet because

Most people are willing to make these changes to avoid cancer.

Dietary fat and obesity promote growth of many types of cancer.

People who exercise and eat healthy will make other lifestyle changes.

Obesity and lack of exercise cause cancer in susceptible people.

Obesity and dietary fat promote the growth of malignant cells. and decreasing these risk factors can reduce the chance of cancer development. Many people are not willing to make these changes. Good diet and exercise habits are not a guarantee that other healthy lifestyle changes will then occur. Obesity and lack of exercise do not cause cancer. but they promote the growth of altered cells.

Explanation

Obesity and dietary fat promote the growth of malignant cells. and decreasing these risk factors can reduce the chance of cancer development. Many people are not willing to make these changes. Good diet and exercise habits are not a guarantee that other healthy lifestyle changes will then occur. Obesity and lack of exercise do not cause cancer. but they promote the growth of altered cells.

7. During a routine health examination. a 30-year-old patient tells the nurse about a family history of colon cancer. The nurse will plan to

Teach the patient about the need for a colonoscopy at age 50.

Ask the patient to bring in a stool specimen to test for occult blood.

Schedule a sigmoidoscopy to provide baseline data about the patient.

Have the patient ask the doctor about specific tests for colon cancer.

The patient is at increased risk and should talk with the health care provider about needed tests. which will depend on factors such as the exact type of family history and any current symptoms. Colonoscopy at age 50 is used to screen for individuals without symptoms or increased risk. but earlier testing may be needed for this patient because of family history. For fecal occult blood testing. patients use a take-home multiple sample method rather than bring one specimen to the clinic. The health care provider will take multiple factors into consideration before determining whether a sigmoidoscopy is needed at age 30.

Explanation

The patient is at increased risk and should talk with the health care provider about needed tests. which will depend on factors such as the exact type of family history and any current symptoms. Colonoscopy at age 50 is used to screen for individuals without symptoms or increased risk. but earlier testing may be needed for this patient because of family history. For fecal occult blood testing. patients use a take-home multiple sample method rather than bring one specimen to the clinic. The health care provider will take multiple factors into consideration before determining whether a sigmoidoscopy is needed at age 30.

8. The nurse is teaching a postmenopausal patient with breast cancer about the expected outcomes of her cancer treatment. The nurse evaluates that the teaching has been effective when the patient says

“After cancer has not recurred for 5 years. it is considered cured.”

“I will need to have follow-up examinations for many years after I have treatment before I can be considered cured.”

“Cancer is considered cured if the entire tumor is surgically removed.”

“Cancer is never considered cured. but the tumor can be controlled with surgery. chemotherapy. and radiation.”

The risk of recurrence varies by the type of cancer; for breast cancer in postmenopausal women. the patient needs at least 20 disease-free years to be considered cured. Some cancers (e.g.. leukemia) are cured by nonsurgical therapies such as radiation and chemotherapy.

Explanation

The risk of recurrence varies by the type of cancer; for breast cancer in postmenopausal women. the patient needs at least 20 disease-free years to be considered cured. Some cancers (e.g.. leukemia) are cured by nonsurgical therapies such as radiation and chemotherapy.

9. A patient with a large stomach tumor that is attached to the liver is scheduled to have a debulking procedure. The nurse explains that the expected outcome of this surgery is

Control of the tumor growth by removal of malignant tissue.

Promotion of better nutrition by relieving the pressure in the stomach.

Relief of pain by cutting sensory nerves in the stomach.

Reduction of the tumor burden to enhance adjuvant therapy.

A debulking surgery reduces the size of the tumor and makes radiation and chemotherapy more effective. Debulking surgeries do not control tumor growth. The tumor is debulked because it is attached to the liver. a vital organ (not to relieve pressure on the stomach). Debulking does not sever the sensory nerves. although pain may be lessened by the reduction in pressure on the abdominal organs.

Explanation

A debulking surgery reduces the size of the tumor and makes radiation and chemotherapy more effective. Debulking surgeries do not control tumor growth. The tumor is debulked because it is attached to the liver. a vital organ (not to relieve pressure on the stomach). Debulking does not sever the sensory nerves. although pain may be lessened by the reduction in pressure on the abdominal organs.

10. A patient who has been told by the health care provider that the cells in a bowel tumor are poorly differentiated asks the nurse what is meant by "poorly differentiated." Which response should the nurse make?

“The cells in your tumor do not look very different from normal bowel cells.”

“The tumor cells have DNA that is different from your normal bowel cells.”

“Your tumor cells look more like immature fetal cells than normal bowel cells.”

“The cells in your tumor have mutated from the normal bowel cells.”

An undifferentiated cell has an appearance more like a stem cell or fetal cell and less like the normal cells of the organ or tissue. The DNA in cancer cells is always different from normal cells. whether the cancer cells are well differentiated or not. All tumor cells are mutations form the normal cells of the tissue.

Explanation

An undifferentiated cell has an appearance more like a stem cell or fetal cell and less like the normal cells of the organ or tissue. The DNA in cancer cells is always different from normal cells. whether the cancer cells are well differentiated or not. All tumor cells are mutations form the normal cells of the tissue.