Cancer And Oncology | NCLEX Quiz 152 - Quiz, Flashcards & Trivia

1. A patient with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. An important nursing intervention for the patient is to

Teach about the importance of nutrition during treatment.

Have the patient eat large meals when nausea is not present.

Administer prescribed antiemetics 1 hour before the treatments.

Offer dry crackers and carbonated fluids during chemotherapy.

Treatment with antiemetics before chemotherapy may help to prevent anticipatory nausea. Although nausea may lead to poor nutrition. there is no indication that the patient needs instruction about nutrition. The patient should eat small. frequent meals. Offering food and beverages during chemotherapy is likely to cause nausea.

Explanation

Treatment with antiemetics before chemotherapy may help to prevent anticipatory nausea. Although nausea may lead to poor nutrition. there is no indication that the patient needs instruction about nutrition. The patient should eat small. frequent meals. Offering food and beverages during chemotherapy is likely to cause nausea.

2. When the nurse is administering a vesicant chemotherapeutic agent intravenously. an important consideration is to

Stop the infusion if swelling is observed at the site.

Infuse the medication over a short period.

Administer the chemotherapy through small-bore catheter.

Hold the medication unless a central venous line is available.

Swelling at the site may indicate extravasation. and the IV should be stopped immediately. The medication should generally be given slowly to avoid irritation of the vein. The size of the catheter is not as important as administration of vesicants into a running IV line to allow dilution of the chemotherapy drug. These medications can be given through peripheral lines. although central vascular access devices (CVADs) are preferred.

Explanation

Swelling at the site may indicate extravasation. and the IV should be stopped immediately. The medication should generally be given slowly to avoid irritation of the vein. The size of the catheter is not as important as administration of vesicants into a running IV line to allow dilution of the chemotherapy drug. These medications can be given through peripheral lines. although central vascular access devices (CVADs) are preferred.

3. A patient with Hodgkin's lymphoma is undergoing external radiation therapy on an outpatient basis. After 2 weeks of treatment. the patient tells the nurse. "I am so tired I can hardly get out of bed in the morning." An appropriate intervention for the nurse to plan with the patient is to

Exercise vigorously when fatigue is not as noticeable.

Consult with a psychiatrist for treatment of depression.

Establish a time to take a short walk every day.

Maintain bed rest until the treatment is completed.

Walking programs are used to keep the patient active without excessive fatigue. Vigorous exercise when the patient is less tired may lead to increased fatigue. Fatigue is expected during treatment and is not an indication of depression. Bed rest will lead to weakness and other complications of immobility.

Explanation

Walking programs are used to keep the patient active without excessive fatigue. Vigorous exercise when the patient is less tired may lead to increased fatigue. Fatigue is expected during treatment and is not an indication of depression. Bed rest will lead to weakness and other complications of immobility.

4. A chemotherapeutic agent known to cause alopecia is prescribed for a patient. To maintain the patient's self-esteem. the nurse plans to

Suggest that the patient limit social contacts until regrowth of the hair occurs.

Encourage the patient to purchase a wig or hat and wear it once hair loss begins.

Have the patient wash the hair gently with a mild shampoo to minimize hair loss.

Inform the patient that hair loss will not be permanent and that the hair will grow back.

The patient is taught to anticipate hair loss and to be prepared with wigs. scarves. or hats. Limiting social contacts is not appropriate at a time when the patient is likely to need a good social support system. The damage occurs at the hair follicle and will occur regardless of gentle washing or use of a mild shampoo. The information that the hair will grow back is not immediately helpful in maintaining the patient’s self-esteem.

Explanation

The patient is taught to anticipate hair loss and to be prepared with wigs. scarves. or hats. Limiting social contacts is not appropriate at a time when the patient is likely to need a good social support system. The damage occurs at the hair follicle and will occur regardless of gentle washing or use of a mild shampoo. The information that the hair will grow back is not immediately helpful in maintaining the patient’s self-esteem.

5. A patient with ovarian cancer tells the nurse. "I don't think my husband cares about me anymore. He rarely visits me." On one occasion when the husband was present. he told the nurse he just could not stand to see his wife so ill and never knew what to say to her. An appropriate nursing diagnosis in this situation is

Compromised family coping related to disruption in lifestyle and role changes.

Impaired home maintenance related to perceived role changes.

Risk for caregiver role strain related to burdens of caregiving responsibilities.

Interrupted family processes related to effect of illness on family members.

The data indicate that this diagnosis is most appropriate because the family members are impacted differently by the patient’s cancer diagnosis. There are no data to suggest a change in lifestyle or role as an etiology. The data do not support impairment in home maintenance or a burden caused by caregiving responsibilities.

Explanation

The data indicate that this diagnosis is most appropriate because the family members are impacted differently by the patient’s cancer diagnosis. There are no data to suggest a change in lifestyle or role as an etiology. The data do not support impairment in home maintenance or a burden caused by caregiving responsibilities.

6. A patient receiving head and neck radiation and systemic chemotherapy has ulcerations over the oral mucosa and tongue and thick. ropey saliva. An appropriate intervention for the nurse to teach the patient is to

Remove food debris from the teeth and oral mucosa with a stiff toothbrush.

Use cotton-tipped applicators dipped in hydrogen peroxide to clean the teeth.

Gargle and rinse the mouth several times a day with an antiseptic mouthwash.

Rinse the mouth before and after each meal and at bedtime with a saline solution.

The patient should rinse the mouth with a saline solution frequently. A soft toothbrush is used for oral care. Hydrogen peroxide may damage tissues. Antiseptic mouthwashes may irritate the oral mucosa and are not recommended.

Explanation

The patient should rinse the mouth with a saline solution frequently. A soft toothbrush is used for oral care. Hydrogen peroxide may damage tissues. Antiseptic mouthwashes may irritate the oral mucosa and are not recommended.

7. External-beam radiation is planned for a patient with endometrial cancer. The nurse teaches the patient that an important measure to prevent complications from the effects of the radiation is to

Test all stools for the presence of blood.

Inspect the mouth and throat daily for the appearance of thrush.

Perform perianal care with sitz baths and meticulous cleaning.

Maintain a high-residue. high-fat diet.

Radiation to the abdomen will affect organs in the radiation path. such as the bowel. and cause frequent diarrhea. Stools are likely to have occult blood from the inflammation associated with radiation. so routine testing of stools for blood is not indicated. Radiation to the abdomen will not cause stomatitis. A low-residue diet is recommended to avoid irritation of the bowel when patients receive abdominal radiation.

Explanation

Radiation to the abdomen will affect organs in the radiation path. such as the bowel. and cause frequent diarrhea. Stools are likely to have occult blood from the inflammation associated with radiation. so routine testing of stools for blood is not indicated. Radiation to the abdomen will not cause stomatitis. A low-residue diet is recommended to avoid irritation of the bowel when patients receive abdominal radiation.

8. Which action by a nursing assistant (NA) caring for a patient with a temporary radioactive cervical implant indicates that the RN should intervene?

The NA places the patient’s bedding in the laundry container in the hallway.

The NA flushes the toilet once after emptying the patient’s bedpan.

The NA stands by the patient’s bed for an hour talking with the patient.

The NA gives the patient an alcohol-containing mouthwash for oral care.

Because patients with temporary implants emit radioactivity while the implants are in place. exposure to the patient is limited. Laundry and urine/feces do not have any radioactivity and do not require special precautions. Cervical radiation will not affect the oral mucosa. and alcohol-based mouthwash is not contraindicated.

Explanation

Because patients with temporary implants emit radioactivity while the implants are in place. exposure to the patient is limited. Laundry and urine/feces do not have any radioactivity and do not require special precautions. Cervical radiation will not affect the oral mucosa. and alcohol-based mouthwash is not contraindicated.

9. Which information obtained by the nurse about a patient with colon cancer who is scheduled for external radiation therapy to the abdomen indicates a need for patient teaching?

The patient swims a mile 5 days a week.

The patient eats frequently during the day.

The patient showers with Dove soap daily.

The patient has a history of dental caries.

The patient is instructed to avoid swimming in salt water or chlorinated pools during the treatment period. The patient does not need to change the habits of eating frequently or showering with a mild soap. A history of dental caries will not impact the patient who is scheduled for abdominal radiation.

Explanation

The patient is instructed to avoid swimming in salt water or chlorinated pools during the treatment period. The patient does not need to change the habits of eating frequently or showering with a mild soap. A history of dental caries will not impact the patient who is scheduled for abdominal radiation.

10. A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. The nurse knows that teaching about management of the skin reaction has been effective when the patient says

“I can use ice packs to relieve itching in the treatment area.”

“I can buy a steroid cream to use on the itching area.”

“I will expose the treatment area to a sun lamp daily.”

“I will scrub the area with warm water to remove the scales.”

Steroid (over-the-counter [OTC] hydrocortisone) cream may be used to reduce itching in the area. Ice and sunlamps may injure the skin. Treatment areas should be cleaned gently to avoid further injury.

Explanation

Steroid (over-the-counter [OTC] hydrocortisone) cream may be used to reduce itching in the area. Ice and sunlamps may injure the skin. Treatment areas should be cleaned gently to avoid further injury.