Chapter 37 My Nursing Test Banks

 

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E
Chapter 37

Question 1

Type: MCSA

The client has cancer. He asks the nurse where cancer comes from. What is the best explanation by the nurse?

1. Cancer is genetic; you inherited the predisposition for your cancer.

2. Cancer cells are your bodys cells that have lost the ability to control their growth.

3. Cancer is caused primarily by viruses in the environment.

4. Cigarette smoking and second-hand smoke are the primary causes of cancer.

Correct Answer: 2

Rationale 1: Cancer is thought to result from damage to the genes controlling cell growth. Some cancer is genetic, but this is not the best answer.

Rationale 2: Cancer is thought to result from damage to the genes controlling cell growth.

Rationale 3: Viruses are associated with only about 15% of all human cancers.

Rationale 4: Cigarette smoking and second-hand smoke are carcinogens that can lead to the development of cancer, but this is not the best answer.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 37-1

Question 2

Type: MCMA

The nurse teaches a support group about the causes of cancer for families of individuals with cancer. The nurse evaluates that learning has occurred when the clients make which statements?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Some cancers have a strong genetic component.

2. Cancer often results from an injury such as a bruise.

3. Cancers have a very strong environmental component.

4. Cancer can result from suppressed anger and rage.

5. Cancer can result from damaged tumor-suppressor genes.

Correct Answer: 1,3,5

Rationale 1: Some cancers have a strong genetic component.

Rationale 2: There is no evidence to support that injuries such as bruises result in cancer.

Rationale 3: Cancers have a very strong environmental component.

Rationale 4: There is no evidence to support that suppressed anger and rage will result in cancer.

Rationale 5: Cancer can result from damaged tumor-suppressor genes.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 37-2

Question 3

Type: MCMA

The client has recently been diagnosed with cancer. The nurse develops a plan to teach the client about the most effective treatments for cancer. What treatment options will the nurse include in this teaching?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Surgery

2. Chemotherapy

3. Nutrition therapy

4. Alternative medicine

5. Radiation therapy

Correct Answer: 1,2,5

Rationale 1: Surgery continues to be a primary treatment for cancer.

Rationale 2: Pharmacological controls for cancer, or chemotherapy, is one of the standard effective treatments for cancer.

Rationale 3: Support of nutrition is essential for the cancer client, but is, in itself, not a primary treatment.

Rationale 4: Alternative medicine is not considered a very effective treatment for cancer at this point.

Rationale 5: Radiation is one of the three primary treatments for cancer.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 37-4

Question 4

Type: MCSA

The nursing instructor teaches student nurses about chemotherapy for cancer. Which statement best explains why lung cancers are less sensitive to antineoplastic agents than other types of cancers?

1. Lung cancer cells have a very erratic cell cycle, and this is why there isnt much difference between the number of replicating and resting cells.

2. Lung cancer cells have been growing for a long time before detection, so they are less sensitive to antineoplastic agents.

3. Lung cancer cells have a low-growth fraction, which means there isnt much difference between the number of replicating and resting cells.

4. Lung cancer cells grow in a high-oxygen environment, so they are not very sensitive to antineoplastic agents.

Correct Answer: 3

Rationale 1: Lung cancer cells do not have a very erratic cell cycle.

Rationale 2: Lung cancer cells may grow for a long time before detection, but this is not the primary reason they are less susceptible to antineoplastic agents.

Rationale 3: Growth fraction is a ratio of the number of replicating cells to the number of resting cells. Antineoplastic drugs are much more toxic to tissues and tumors with high-growth fractions. Breast and lung cancers have low-growth fractions.

Rationale 4: A high-oxygen environment is not the reason why lung cancer cells are less sensitive to antineoplastic agents.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 37-5

Question 5

Type: MCSA

The client receives tamoxifen (Nolvadex) for treatment of breast cancer. She asks the nurse why the medicine works. What is the best response by the nurse?

1. Tamoxifen (Nolvadex) works by blocking estrogen receptors on breast tissue.

2. Tamoxifen (Nolvadex) works by inhibiting the cellular mitosis of breast cancer.

3. Tamoxifen (Nolvadex) works by inhibiting the metabolism of breast cancer cells.

4. Tamoxifen (Nolvadex) works by binding to the DNA of breast cancer cells.

Correct Answer: 1

Rationale 1: Breast cancer is dependent on estrogen for growth. Tamoxifen (Nolvadex) acts by blocking estrogen receptors; the tumor is deprived of estrogen.

Rationale 2: Tamoxifen does not inhibit the cellular mitosis of breast cancer.

Rationale 3: Tamoxifen does not inhibit the metabolism of breast cancer cells.

Rationale 4: Tamoxifen does not bind to the DNA of breast cancer cells.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 37-9

Question 6

Type: MCSA

The nurse assesses several clients for their potential risk for developing cancer. Which client does the nurse assess to be at highest risk for developing cancer?

1. The client who drinks alcohol daily and eats red meat at most meals

2. The client who is 10 pounds overweight, but exercises regularly

3. The client who usually applies sunscreen when arriving at the beach

4. The client who frequently forgets self-breast exams, but has routine mammograms

Correct Answer: 1

Rationale 1: Alcoholism and consuming large amounts of red meat are lifestyle factors that put this client at risk for developing cancer.

Rationale 2: Being 10 pounds overweight is not a big risk, and regular exercise is protective against cancer.

Rationale 3: Application of sunscreen at the beach will help prevent skin cancer.

Rationale 4: A monthly self-breast exam is ideal, but routine mammograms will offset most of the risk from forgetting to do some monthly exams.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 37-3

Question 7

Type: MCSA

The client receives cyclophosphamide (Cytoxan) as treatment for cancer, and is experiencing oral irritation as an adverse effect. What does the best plan by the nurse include as it relates to providing oral comfort?

1. Teach the client to avoid extreme temperatures of food selections.

2. Teach good oral hygiene, including the use of an antiseptic mouthwash.

3. Administer megestrol (Megace ES) to the client.

4. Teach the client to use a firm toothbrush for brushing the teeth.

Correct Answer: 1

Rationale 1: Avoiding extreme temperatures of foods will help prevent further trauma and discomfort to the mouth.

Rationale 2: Most mouthwashes contain alcohol, which will make the problem worse.

Rationale 3: Megestrol (Megace ES) can be effective for appetite stimulation in cancer clients, but will not help oral irritation.

Rationale 4: The client should use a soft toothbrush.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 37-11

Question 8

Type: MCSA

The female client has lost her thick straight hair due to treatment with cyclophosphamide (Cytoxan). She is distraught and feels that no one will want to look at her. What will the best plan by the nurse include?

1. Plan to show the client photos of cancer survivors whose hair grew back better.

2. Plan to have a cancer survivor visit the client and discuss wearing a wig.

3. Tell the client that this is an opportunity to have curly hair.

4. Plan to discuss the clients feelings about the effects of her hair loss.

Correct Answer: 4

Rationale 1: Showing the client photos will not help, as her hair may not grow back better.

Rationale 2: Having a cancer survivor visit to talk about wigs is not the best intervention at the present time.

Rationale 3: Hair often does grow in differently such as curly instead of straight or a different color. However, this is not the best intervention at this time.

Rationale 4: The client needs to discuss and explore the meaning of her hair loss to deal with her feelings; this is the most therapeutic plan.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 37-11

Question 9

Type: MCSA

The client receives cisplatin (Platinol) as therapy for cancer. Which assessment finding would prompt the nurse to contact the clients physician immediately?

1. A temperature greater than 101F

2. An elevation in blood glucose

3. Nausea and projectile vomiting

4. A complaint of painful leg cramps

Correct Answer: 1

Rationale 1: A temperature greater than 101 F can indicate an infection, which can be life threatening because low WBCs are an adverse effect of cisplatin.

Rationale 2: An elevation in blood glucose could be related to pancreatitis, which is not an adverse effect of cisplatin.

Rationale 3: Nausea and vomiting are common side effects and are not life threatening.

Rationale 4: Painful leg cramps are not an adverse effect of cisplatin.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 37-6

Question 10

Type: MCSA

The client receives cyclophosphamide (Cytoxan). The nurse evaluates the clients laboratory work. Which laboratory finding would support canceling the clients next treatment with this drug?

1. Hemoglobin of 14 g/dl

2. Blood urea nitrogen of 12 mg/dl

3. WBC count of 8,000 cells/mcl

4. Platelet count of 8,000/mm

Correct Answer: 4

Rationale 1: A hemoglobin of 14 g/dl is a normal level; there is no need to cancel the treatment.

Rationale 2: A blood urea nitrogen of 12 mg/dl is within a normal range; there is no need to cancel the treatment.

Rationale 3: A WBC of 8,000 cells/mcl is within a normal range; there is no need to cancel the treatment.

Rationale 4: A normal platelet count is at least 150,000. The clients count is at a dangerous level, and the client is at risk for hemorrhage, so this client should not receive another treatment of cyclophosphamide until numbers have increased.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 37-9

Question 11

Type: MCSA

The client receives methotrexate (Rheumatrex). The nurse assesses for side effects of this drug. Which side effects are a primary concern for the nurse?

1. Hyperglycemia and fatigue

2. Nausea and vomiting

3. Hypertension and seizures

4. Ulcerative stomatitis and diarrhea

Correct Answer: 4

Rationale 1: Hyperglycemia is not an adverse effect of methotrexate.

Rationale 2: Nausea and vomiting are expected adverse effects and are not of primary concern.

Rationale 3: Hypertension and seizures are not adverse effects of this drug.

Rationale 4: Ulcerative stomatitis and diarrhea require suspension of therapy because they may lead to hemorrhagic enteritis and death from intestinal perforation.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 37-9

Question 12

Type: MCSA

The client experiences nausea and vomiting soon after chemotherapy treatments. What is the best action by the nurse?

1. Administer a sleeping medication during chemotherapy.

2. Increase fluid intake to flush the kidneys prior to chemotherapy.

3. Administer an antiemetic 12 hours before chemotherapy.

4. Restrict food on the day the client receives chemotherapy.

Correct Answer: 3

Rationale 1: A sleeping medication will not prevent nausea and vomiting.

Rationale 2: Increasing fluids will not prevent nausea and vomiting.

Rationale 3: Pharmacological intervention, such as administering an antiemetic, is usually necessary to control nausea and vomiting.

Rationale 4: It may help to withhold food 13 hours prior to chemotherapy, but the client can eat as desired; withholding food will not prevent nausea and vomiting.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 37-11

Question 13

Type: MCSA

The client receives several chemotherapeutic agents as treatments for cancer. The client asks the nurse why he needs so many drugs. What is the best response by the nurse?

1. Using multiple drugs means a shorter treatment time.

2. Using multiple drugs decreases the incidence of side effects.

3. Using multiple drugs will help kill more of the cancer.

4. Using multiple drugs is more cost-effective in treating cancer.

Correct Answer: 3

Rationale 1: Using multiple drugs does not shorten the time required for treatment.

Rationale 2: Using multiple drugs does not decrease the incidence of side effects.

Rationale 3: Using multiple drugs is the goal of combination treatment because more of the cancer cells will be killed with this approach.

Rationale 4: Using multiple drugs is not more cost-effective.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 37-7

Question 14

Type: MCSA

In understanding the difference between normal cells and cancer cells, the nurse knows that cancer is the result of

1. cell division occurring extensively in normal cells.

2. cell division occurring via controlled cell division.

3. suppressor genes stopping cell growth for cell division.

4. suppressor genes continuing cell growth for cell division.

Correct Answer: 3

Rationale 1: Extensive cell division does occur in normal cells.

Rationale 2: Cell division does occur via controlled cell division.

Rationale 3: Cancer is thought to result from damage to the suppressor genes controlling cell growth.

Rationale 4: Suppressor genes for cell growth must continue for cell division and replication.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 37-1

Question 15

Type: MCSA

In understanding the growth fraction as it pertains to the success of chemotherapy, the nurse knows that the growth fraction is a ratio of

1. the number of replicating cells to the number of active cells.

2. the number of non-replicating cells to the active cells.

3. the number of replicating cells to the number of resting cells.

4. The number of non-replicating cells to the number of resting cells.

Correct Answer: 3

Rationale 1: This is not the ratio as it relates to the growth fraction.

Rationale 2: This is not the ratio as it relates to the growth fraction.

Rationale 3: The growth fraction is a measure of the number of cells undergoing mitosis in a tissue. It is a ratio of the number of replicating cells to the number of resting cells.

Rationale 4: This is not the ratio as it relates to the growth fraction.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 37-5

Question 16

Type: MCSA

The most important nursing consideration for clients receiving alkylating agents is

1. monitoring nausea and vomiting.

2. monitoring nutritional intake.

3. monitoring skin integrity.

4. monitoring CBC with differential.

Correct Answer: 4

Rationale 1: Nausea and vomiting are common during use of many chemotherapy drugs and are not particular to alkylating agents, and this is not the most important nursing consideration.

Rationale 2: Due to adverse effects such as nausea, vomiting, and anorexia, nutritional intake is decreased in clients taking many kinds of chemotherapeutic drugs. This issue is not particular to alkylating agents and is not the most important nursing consideration.

Rationale 3: Impaired skin integrity is an issue with clients taking many forms of chemotherapy. It is not particular to alkylating agents and is not the most important nursing consideration.

Rationale 4: Blood cells are particularly sensitive to alkylating agents. Bone marrow suppression is the primary dose-limiting toxicity of the drugs in this class. If the absolute neutrophil count (ANC) obtained by reading CBC with differential falls below 500/mm, the risk for infection increases.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 37-6

Question 17

Type: MCSA

The client is prescribed tamoxifen for the treatment of breast cancer. The nurse should advise the client to monitor for which adverse effect?

1. Fatigue

2. Cough

3. Vaginal discharge

4. Signs of dehydration

Correct Answer: 3

Rationale 1: Fatigue may occur with many types of chemotherapy, but is not a particular adverse effect with tamoxifen.

Rationale 2: Cough is not an expected adverse effect of tamoxifen.

Rationale 3: Vaginal discharge is an expected adverse effect of tamoxifen and should be reported to the health care team.

Rationale 4: Rather than dehydration, the client should be monitored for water retention and concentrated urine.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 37-9

Question 18

Type: MCSA

The main mechanism of action of alkylating agents is

1. they stimulate the bodys immune system.

2. unknown.

3. they change the shape of the DNA double helix and prevent nucleic acid from completing normal cell division.

4. they disrupt metabolic pathways.

Correct Answer: 3

Rationale 1: This is representative of pharmacotherapy with biologic response modifiers, immune therapies, and miscellaneous antineoplastics.

Rationale 2: The mechanism of hormonal antineoplastic activity is largely unknown.

Rationale 3: Alkylation changes the shape of the DNA double helix and prevents the nucleic acid from completing normal cell division.

Rationale 4: This is representative of the antimetabolites.

Global Rationale:

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts:

Learning Outcome: 37-10

Question 19

Type: MCSA

A client states, I get so sick to my stomach after chemotherapy. Why cant they just put it directly into my tumor? Which nursing response is indicated?

1. There is no technology available to directly place chemotherapy in a tumor.

2. These are such strong medications that they would eat up your tissues.

3. That type of therapy does exist, but it does not work for your particular type of cancer.

4. I know you get sick, but the nausea and vomiting is not severe and passes quickly.

Correct Answer: 3

Rationale 1: Some antineoplastics are given locally or through direct instillation into a tumor site. This treatment is not available for all tumors.

Rationale 2: Although this statement is somewhat accurate, it is not therapeutic and is not the best answer to this question.

Rationale 3: This is a straightforward and accurate statement of fact.

Rationale 4: Many clients experience severe nausea and vomiting that lasts several hours up to days.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO #8

Question 20

Type: MCSA

A nurse suspects that the IV line through which doxorubicin (Adriamycin) is infusing has infiltrated. The nurse has discontinued the IV site. What additional action should be taken?

1. No special action is necessary.

2. A warm wet compress should be placed on the site.

3. Wash the area thoroughly with soap and water.

4. Apply ice packs to the area immediately.

Correct Answer: 4

Rationale 1: Special actions are indicated.

Rationale 2: This is not the recommended treatment.

Rationale 3: Washing the surface will not treat the extravasation.

Rationale 4: Ice packs will help to reduce the absorption of the drug.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO #9

Question 21

Type: MCMA

A nurse suspects that the IV line infusing vincristine (Oncovin) has infiltrated. The nurse discontinued the line. Which other actions are indicated?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Apply local ice packs.

2. Inject hyaluronidase per protocol.

3. Place a tourniquet on the clients arm above the IV site.

4. Place warm compresses on the site.

5. Administer prednisone per protocol.

Correct Answer: 2,4

Rationale 1: Cold compresses will significantly increase the toxicity of vinca alkaloids.

Rationale 2: Hyaluronidase is used as treatment for vincristine extravasation.

Rationale 3: There is no need to place a tourniquet on the clients arm.

Rationale 4: Warm compresses are recommended as treatment.

Rationale 5: Prednisone is not given concurrently with vincristine due to increased bone marrow toxicity.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:

Question 22

Type: MCMA

A client is prescribed methotrexate (Rheumatrex) for treatment of osteogenic sarcoma. The client says, My friend took methotrexate, but she has never had cancer. How should the nurse respond to this statement?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Does your friend have rheumatoid arthritis?

2. She must have had cancer and not told you.

3. Methotrexate is used to treat some autoimmune disorders as well.

4. You must have misinterpreted what your friend said.

5. Methotrexate is used to treat some forms of liver disease.

Correct Answer: 1,3

Rationale 1: Methotrexate has powerful immunosuppressant properties and is used to treat rheumatoid arthritis, ulcerative colitis, lupus, and psoriasis.

Rationale 2: There are other reasons to take methotrexate.

Rationale 3: Methotrexate is a powerful immunosuppressant.

Rationale 4: It is very possible that the friend did not have cancer and was being treated with methotrexate.

Rationale 5: Methotrexate is hepatotoxic and would not be used to treat liver diseases.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO #9

Question 23

Type: MCMA

A clients dosage schedule includes chemotherapy for each of 5 days and then no chemotherapy for 5 days. The client says, Why dont they just keep giving me the chemo? I want to kill this cancer and get on with my life. How should the nurse respond?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. This chemotherapy is so strong that you cannot physically stand to take it for more than 5 days.

2. We need to give your normal cells time to recover from the medication before you get more chemotherapy.

3. You should let the doctors worry about that.

4. We need to let some of the cancer cells develop into the stage where the chemotherapy can kill them.

5. The chemotherapy is not always immediately available, so pauses are taken to allow for more stock to arrive.

Correct Answer: 2,4

Rationale 1: This is not a completely accurate statement and is not therapeutic. The client may become concerned that the chemotherapy will be fatal.

Rationale 2: The goal of chemotherapy is to destroy malignant cells with as little damage to normal cells as possible. In some cases, a pause in chemotherapy treatment is necessary to allow this recovery.

Rationale 3: This is a dismissive and nontherapeutic statement.

Rationale 4: Some chemotherapies are cell-cycle specific and kill cells only in a specific window of development. Pauses in chemotherapy are necessary to allow cells to mature into this window.

Rationale 5: While recent developments have indicated that the supply of some chemotherapy drugs is not reliable, this is not a therapeutic statement.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO #7

Question 24

Type: MCMA

A client is diagnosed with a small lipoma on his arm and is being discharged from the clinic. The client says, I have a tumor, but I am not being treated with anything. I dont understand. How should the nurse respond?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. I am supposed to make an appointment for you to see the oncologist who will recommend treatment.

2. Lipomas are benign and usually do not require treatment.

3. Lipomas grow slowly and are not cancerous.

4. Lipomas do not metastasize and are not cancer.

5. The physician will consult with a surgeon and will contact you later.

Correct Answer: 2,3,4

Rationale 1: There is no indication for seeing an oncologist.

Rationale 2: A lipoma is a fatty tumor and is benign. They do not require treatment unless they are positioned where they are easily irritated or injured. If so, simple removal generally suffices.

Rationale 3: Lipomas are benign and grow slowly.

Rationale 4: Lipomas are benign and therefore do not metastasize.

Rationale 5: There is no reason for a surgical consultation.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO #1

Question 25

Type: MCMA

A client with pancreatic cancer is receiving chemotherapy even though prognosis is grim. How does the nurse explain the rationale for this treatment?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. It is a long shot, but maybe the chemotherapy will cure him.

2. Sometimes the chemotherapy can reduce the size of the tumor.

3. We just hate to give up on him. He is such a nice man.

4. Chemotherapy can sometimes reduce the pain.

5. Hopefully the chemotherapy will improve his quality of life.

Correct Answer: 2,4,5

Rationale 1: If the client has a grim prognosis related to pancreatic cancer, it is not ethical to give the family false hope.

Rationale 2: Chemotherapy is sometimes given to reduce tumor size and help to reduce problems associated with the pressure the tumor is exerting on adjacent structures.

Rationale 3: Use of the term give up on him is not therapeutic. It may confuse the family when it comes time to discontinue the chemotherapy.

Rationale 4: Pain reduction is a common reason for administering chemotherapy to a client with a poor prognosis.

Rationale 5: The reason palliative chemotherapy is administered is to improve the clients quality of life.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO #6

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E

Copyright 2014 by Pearson Education, Inc.

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