Module 2 Oncology Practice Quiz

A biopsy of the tumor is the most definitive test to confirm the diagnosis of malignancy. It involves removing a small sample of tissue from the tumor and examining it under a microscope to determine if cancer cells are present. This test can provide important information about the type and stage of the tumor, which is crucial for determining appropriate treatment options. Abdominal ultrasound, magnetic resonance imaging, and computed tomography scans can provide valuable information about the tumor's size, location, and characteristics, but they cannot definitively confirm malignancy.

Before administering the clear liquids diet, the nurse should prioritize assessing the client's bowel sounds. This is important because bowel sounds indicate the return of gastrointestinal function and the ability of the client to tolerate oral intake. If bowel sounds are absent or significantly decreased, it could indicate a complication such as ileus or bowel obstruction, which would require further intervention before initiating oral intake. Therefore, assessing bowel sounds is crucial in determining the client's readiness for clear liquids.

In Hodgkin's disease, a type of lymphoma, the lymph nodes become enlarged due to the abnormal growth of lymphocytes. This is a characteristic finding in this disease and is caused by the accumulation of cancerous cells in the lymph nodes. Fatigue and weakness can be present in many conditions, while weight gain is not typically associated with Hodgkin's disease. Therefore, the nurse would expect to note specifically enlarged lymph nodes in a client with suspected Hodgkin's disease.

A calcium level of 12mg/dL in a client with bladder cancer and bone metastasis is consistent with hypercalcemia. Hypercalcemia is an oncological emergency that occurs when there is an excessive amount of calcium in the blood. This can be caused by the release of calcium from the bones due to bone metastasis. Hypercalcemia can lead to various symptoms such as fatigue, confusion, constipation, and kidney stones. Prompt intervention is necessary to treat hypercalcemia and prevent further complications.

The nurse's initial action should be to pick up the radiation implant with long-handled forceps and place it into a lead container. This is the correct answer because it follows proper protocol for handling radioactive materials. By using long-handled forceps, the nurse can minimize their exposure to radiation and safely transfer the implant into a lead container, which is designed to contain radiation. Calling the physician may be necessary, but the immediate action should be to secure the implant. Reinserting the implant or flushing it down the toilet would be unsafe and inappropriate.

Elevating the affected arm on a pillow above heart level can assist in preventing lymphedema of the affected arm. Lymphedema is a condition that occurs when there is an accumulation of lymph fluid in the tissues, leading to swelling and discomfort. By elevating the arm, the nurse helps to promote lymphatic drainage and prevent the buildup of fluid. This position allows gravity to assist in the movement of fluid away from the affected area.

Pregnant women should not be allowed into the client's room because radiation exposure can be harmful to the developing fetus. This principle is important to ensure the safety of both the pregnant woman and the fetus.

The nurse is teaching the client about the risk of bleeding during the period of bone marrow suppression. Aspirin is a blood thinner and can increase the risk of bleeding. Therefore, taking aspirin for a headache would not be appropriate during this time. The other statements show an understanding of the risk for bleeding and self-care, such as avoiding blowing the nose, considering a platelet transfusion if the platelet count is low, and monitoring the number of pads and tampons used during menstruation.

The passage of flatus indicates that the colostomy is beginning to function. Flatus is the gas that is produced in the intestines, and its passage through the colostomy indicates that there is movement and functioning of the bowels. This is a positive sign that the client's gastrointestinal system is starting to work properly after the surgery. Absent bowel sounds, the client's inability to tolerate food, and bloody drainage from the colostomy are all negative findings that would suggest a problem or complication with the colostomy.

The most appropriate nursing assessment of the client's pain would include the client's pain rating. This is because the client's self-report of pain is considered the most reliable and valid indicator of their pain experience. It allows the nurse to understand the intensity of the pain and guide appropriate interventions for pain relief. Nonverbal cues from the client and the nurse's impression of the client's pain can provide additional information, but they should not replace the client's self-report. Pain relief after appropriate nursing intervention is an important outcome to assess, but it does not provide a comprehensive assessment of the client's pain.

After a ureterostomy, the nurse should expect to note a red and moist stoma. This indicates a healthy stoma with good blood supply and proper functioning. A dry stoma may suggest dehydration or inadequate blood supply, while a pale stoma may indicate poor circulation. A dark-colored stoma could be a sign of ischemia or necrosis, which are serious complications. Therefore, a red and moist stoma is the expected and desirable outcome after a ureterostomy.

The correct answer is 1 week after menstruation begins. This is because the breast tissue is typically less tender and lumpy after menstruation, making it easier to detect any abnormalities. Performing the self-breast examination at this time also ensures that any changes in the breast tissue can be detected early.

The best time for examination is after a shower because warm water helps to relax the scrotal sac and makes it easier to feel any abnormalities.

The correct answer is to teach the client and family about the need for hand hygiene. Neutropenia is a condition characterized by a low level of neutrophils, a type of white blood cell that helps fight off infections. Chemotherapy can further suppress the immune system, making the client more susceptible to infections. Hand hygiene is crucial in preventing the spread of pathogens and reducing the risk of infection. By teaching the client and family about the importance of hand hygiene, the nurse is promoting a safe environment and helping to prevent potential complications.

Multiple myeloma is a type of cancer that involves the uncontrolled growth and proliferation of plasma cells within the bone marrow. These abnormal plasma cells crowd out healthy blood cells, leading to a decrease in the production of red blood cells, white blood cells, and platelets. This can result in anemia, increased susceptibility to infections, and bleeding problems. Therefore, the correct answer is "malignant proliferation of plasma cells within the bone."

Hematuria, or blood in the urine, is the most common symptom of bladder cancer. This occurs because the cancerous cells can cause bleeding in the bladder, which then mixes with the urine. Dysuria, or painful urination, urgency of urination, and frequency of urination can also be symptoms of bladder cancer, but hematuria is the most common and therefore the expected documentation in the client's history.

Electrocardiographic changes are a serious late sign of hypercalcemia in a client with metastatic prostate cancer. Hypercalcemia can lead to disturbances in the electrical conduction system of the heart, resulting in abnormal changes in the electrocardiogram. These changes can include prolonged QT interval, ST segment elevation, and T wave abnormalities. If left untreated, these cardiac manifestations can progress to life-threatening arrhythmias, cardiac arrest, or sudden death. Therefore, recognizing and addressing electrocardiographic changes promptly is crucial in managing hypercalcemia as an oncological emergency.

Serosanguineous drainage is a normal finding in the immediate postoperative period. It is a combination of serum and blood and is expected after an abdominal perineal resection. Changing the dressing as prescribed is the appropriate nursing intervention in this situation. It allows for assessment of the wound, promotes cleanliness, and prevents infection.

The client's statement about feeling as if she is voiding through the vagina suggests the development of a vesicovaginal fistula. A vesicovaginal fistula is an abnormal connection between the bladder and the vagina, which can cause urine to pass into the vagina. This can occur as a complication of radiation therapy for bladder cancer, as the radiation can damage the tissues and lead to the formation of a fistula. The other options (rupture of the bladder, extreme stress, altered perineal sensation) do not align with the client's symptoms and are less likely explanations.

Age younger than 50 years of age is not a risk factor for colorectal cancer. The risk for developing colorectal cancer increases with age, particularly after the age of 50. Therefore, if the client identifies age younger than 50 years as a risk factor, further teaching is necessary to correct this misconception.

Abdominal distention is a typical symptom of advanced ovarian cancer. As the tumor grows, it can cause fluid accumulation in the abdomen, leading to abdominal swelling and distention. This can be due to the presence of ascites, a condition where fluid accumulates in the peritoneal cavity. Abdominal distention can cause discomfort and a feeling of fullness. It is important for the nurse to recognize this symptom during the admission assessment to provide appropriate care and support to the client.

In multiple myeloma, there is an overproduction of abnormal plasma cells in the bone marrow. These abnormal cells release chemicals that cause bone destruction, leading to increased calcium levels in the blood. This condition is known as hypercalcemia. Therefore, an increased calcium level would be expected in a client diagnosed with multiple myeloma.

Encouraging fluids is the priority intervention in the plan of care for a client with multiple myeloma because this condition can lead to dehydration and kidney damage. Adequate hydration helps in preventing complications such as renal failure and promotes the elimination of toxins from the body. It also helps in maintaining normal blood volume and preventing hyperviscosity. Therefore, encouraging fluids is crucial in managing the client's condition and preventing further complications.

The appropriate nursing intervention in this situation is to continue to monitor the drainage. Bloody drainage from the nasogastric tube is expected in the immediate postoperative period after a gastrectomy. It is a normal occurrence due to surgical trauma and is not necessarily a cause for concern. The nurse should continue to monitor the drainage for any changes or signs of complications, but immediate intervention such as notifying the physician or irrigating the nasogastric tube is not necessary unless there are other accompanying symptoms or indications of a problem.

Periorbital edema is an early sign of superior vena cava syndrome, an oncological emergency. This condition occurs when the superior vena cava, a major vein that carries deoxygenated blood from the upper body to the heart, becomes partially or completely blocked. Periorbital edema refers to swelling around the eyes and is caused by the obstruction of blood flow. It is an early sign because it occurs before more severe symptoms, such as arm edema, cyanosis, or mental status changes, manifest. Therefore, periorbital edema is the correct answer.

In a client with syndrome of inappropriate antidiuretic hormone (SIADH) due to lung cancer, the nurse would anticipate that radiation and chemotherapy may be prescribed as treatments for the cancer. Serum sodium levels would need to be monitored closely because SIADH can cause hyponatremia (low sodium levels). Medications that are antagonistic to antidiuretic hormone, such as demeclocycline or tolvaptan, may be prescribed to counteract the effects of excessive antidiuretic hormone secretion. Increased fluid intake and decreased oral sodium intake may also be recommended to help correct the electrolyte imbalance.