Chapter 57 My Nursing Test Banks

Osborn, Medical-Surgical Nursing, 2e
Chapter 57

Question 1

Type: MCSA

A patient shows the nurse a new sore on the forearm that has been increasing in size and will not heal. The nurse knows that which sign could also point to a diagnosis of malignant neoplasm?

1. The lesion is darker than the surrounding skin.

2. The shape of the lesion is asymmetric.

3. The lesion is raised.

4. The lesion is 4 mm in diameter.

Correct Answer: 2

Rationale 1: Many cutaneous lesions are a different color than surrounding skin. This finding is not specific to malignancy.

Rationale 2: An asymmetrical shape is an indicator of malignancy.

Rationale 3: Many benign cutaneous lesions are raised above skin level.

Rationale 4: Lesions that surpass 6 mm in diameter should raise concern about malignancy.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 57-1

Question 2

Type: MCSA

After learning that he has a benign tumor in his abdomen, a patient is overheard telling his wife that he has cancer. What should the nurse say to the patient and spouse?

1. You do have a growth in your abdomen, but it is encapsulated and, after being removed, will not come back.

2. This type of cancer is easily treated.

3. This type of cancer will not spread to other tissues.

4. Even though this growth has invaded other tissues, it can be contained.

Correct Answer: 1

Rationale 1: A benign tumor is encapsulated, slow-growing, and, once removed, does not recur.

Rationale 2: The patient does not have cancer but rather a benign tumor.

Rationale 3: Even though benign tumors do not spread to other tissues, the nurse should not refer to the growth as cancer.

Rationale 4: The growth has not invaded other tissues.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 57-2

Question 3

Type: MCSA

A patient tells the nurse that she has a benign tumor that has spread into her lymph glands and that surgery is planned. How should the nurse respond?

1. What did your doctor tell you about the tumor?

2. I hope the tumor can be removed before it spreads any further.

3. Thats a good thing that the tumor is benign.

4. If the tumor is benign, why are you going to have surgery to remove it?

Correct Answer: 1

Rationale 1: The patient believes that the tumor is benign; however, benign tumors do not spread; they are encapsulated and can be easily removed. As the patient seems to have conflicting information, the nurse should ask what the physician explained about the tumor.

Rationale 2: Benign tumors do not spread into other tissues. The nurse should not reinforce incorrect information.

Rationale 3: The nurse should not reinforce the patients belief that the tumor is benign.

Rationale 4: This response does not address the apparent confusion revealed by the patients statement.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 57-2

Question 4

Type: MCSA

A patient who was treated for colorectal cancer last year now has a malignant tumor in the lung. The nurse realizes that this patient is most likely experiencing which phenomenon?

1. Metastasis

2. Contact inhibition

3. Differentiation

4. Hypertrophy

Correct Answer: 1

Rationale 1: Malignant cells from the primary tumor may travel through the blood or lymph to invade other tissues and organs and form a secondary tumor. This process is called metastasis. Malignant neoplasms can recur after surgical removal of the primary and secondary tumors and after other treatments.

Rationale 2: Contact inhibition is a characteristic of benign neoplasms. It does not describe the phenomenon the patient is experiencing.

Rationale 3: Differentiation is the process whereby cells mature into their intended role. Differentiation is lost in malignant tumors.

Rationale 4: Hypertrophy refers to an increase in a cells size. There is no way the nurse can tell if this is a characteristic of this tumor.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 57-2

Question 5

Type: MCSA

A patient has been diagnosed with cancer. Which finding in the patients social history would the nurse evaluate as contributing to cancer development both in the initiation stage and the promotion stage?

1. The patient was exposed to radiation during an industrial accident 5 years ago.

2. The patient has taken vitamin C supplements for many years.

3. The patients menses began at age 10.

4. The patient reports drinking one or two glasses of wine each week.

Correct Answer: 1

Rationale 1: It is thought that radiation acts as both an initiator and a promoter in the development of cancer. Because of activity in both stages, radiation is considered a complete carcinogen.

Rationale 2: Vitamin C is considered an anticarcinogen.

Rationale 3: Hormones have not been proven to have a direct carcinogenic effect. Rather, they support carcinogenesis by preparing target tissues so that they are ripe for the carcinogen insult.

Rationale 4: Alcohol intake of less than one drink per day is not considered carcinogenic.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 57-1

Question 6

Type: MCSA

A patients gynecologic examination reveals dysplasic changes of the cervix. Which historical information would the nurse interpret as indicating an increased risk that these changes are related to cervical cancer?

1. The patient was treated for human papillomavirus 2 years ago.

2. The patient reports getting drunk a few times a year.

3. The patient did not become sexually active until marriage at age 22.

4. The patient reports eating fast food several times a week.

Correct Answer: 1

Rationale 1: Human papillomavirus has been linked to the development of cervical cancer.

Rationale 2: Alcohol consumption is not directly related to the development of cervical cancer.

Rationale 3: The nurse cannot determine the risk associated with sexual activity as it is unclear how many sexual partners the patient has had since marriage. Virginity until marriage at age 22 does not predict future sexual activity.

Rationale 4: The normal fast food diet is high in fat and low in fiber and is not a healthy life choice, but it is not implicated in the development of cervical cancer.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 57-1

Question 7

Type: MCMA

A 20-year-old college student is diagnosed with Epstein-Barr virus. The student has a history of smoking and alcohol use and works part-time as a manual laborer for a floor refinishing company. Which factors increase the students risk of developing cancer?

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

Standard Text: Select all that apply.

1. Alcohol use

2. Occupation

3. Smoking

4. Viral infection

5. Age

Correct Answer: 1,2,3,4

Rationale 1: The consumption of alcohol is known to cause some cancers. The nurse should conduct additional assessment regarding the amount and frequency of consumption.

Rationale 2: Chemicals are implicated in the development of some cancers. Working in an industry that involves chemicals, as in this situation, may increase the risk.

Rationale 3: Tobacco use is linked to the development of cancer.

Rationale 4: Epstein-Barr virus has been implicated in the development of cancer.

Rationale 5: Aging is a risk factor in the development of cancer, but this patient is young.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 57-1

Question 8

Type: MCSA

After assessing several patients in the clinic, the nurse would be most concerned about which patients risk of developing cancer?

1. Patient age 51, spouse deceased, downsized from employment, history of back and leg pain

2. Patient age 52, plays tennis twice a week, no alcohol intake, smokes one or two cigarettes a month

3. Patient age 45, premenopausal, not planning to use hormone replacement therapy

4. Patient age 50, employed as a computer technician, uses the fitness center five times a week

Correct Answer: 1

Rationale 1: This patient is experiencing a great deal of stress. It has been suggested that multiple stressors may contribute to the development of cancer.

Rationale 2: This patient is physically active and does not drink alcohol. The role of very rare tobacco exposure in cancer development has not been established.

Rationale 3: This patient has few documented risks.

Rationale 4: This patient has few documented risks. The nurse would assess the amount of chemical exposure in the patients workplace.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 57-1

Question 9

Type: MCSA

A patient is diagnosed with metaplasia of esophageal tissue. The nurse understands that this patients first course of treatment will likely include which activity?

1. Identification and removal of the irritant causing the metaplasia

2. Surgical removal of the involved tissue

3. Chemotherapy

4. Radiation therapy

Correct Answer: 1

Rationale 1: Metaplasia occurs when one mature cell type is substituted for another type not typically found in the involved tissue. If the stimulus for this change is removed, the process is reversible.

Rationale 2: Surgical removal is not the likely first step in this patients therapy.

Rationale 3: If the changes continue and anaplasia occurs, chemotherapy may be indicated. It is not indicated at this point.

Rationale 4: If the changes continue and anaplasia occurs, radiation therapy may be indicated. It is not indicated at this point.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 57-2

Question 10

Type: MCSA

Biopsy of a skin lesion reveals anaplastic changes. The nurse would prepare this patient for which intervention?

1. Careful monitoring to ensure the cells do not develop into cancer

2. Chemotherapy for skin cancer

3. Removal of the anaplastic cells

4. Medication to reverse the anaplasia

Correct Answer: 3

Rationale 1: Anaplastic cells no longer have the ability to implement their unique functions and are chaotic in nature. This is the classic finding of cancer.

Rationale 2: It is not clear that chemotherapy is indicated at this time.

Rationale 3: Removal of anaplastic cells can result in a cure for many cancers.

Rationale 4: Anaplastic cells cannot be reversed.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 57-2

Question 11

Type: MCSA

A patient diagnosed with cancer is admitted with a weight loss of 25 lbs. over the last month as well as progressive anorexia and muscle wasting. The nurse would plan care around which condition?

1. Anorexia-cachexia syndrome

2. Syndrome of inappropriate antidiuretic hormone (SIADH)

3. Superior vena cava syndrome (SVC)

4. Sepsis

Correct Answer: 1

Rationale 1: The nurse can recognize the syndrome of cancer cachexia by the presence of anorexia, weight loss, muscle and adipose tissue wasting, and hyperlipidemia.

Rationale 2: SIADH is a paraneoplastic syndrome causing water imbalance.

Rationale 3: SVC presents with dyspnea, cough, and a feeling of fullness in the head.

Rationale 4: The information presented does not suggest sepsis.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 57-5

Question 12

Type: MCMA

A patient diagnosed with cancer tells the nurse that he does not want to experience any more pain. What information should the nurse consider when formulating a response?

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

Standard Text: Select all that apply.

1. Up to 50% of cancer patients with pain do not get adequate relief.

2. The presence of pain and fatigue makes other cancer symptoms more difficult to manage.

3. The nurse can provide only the pain relief measures that are ordered.

4. The majority of cancer pain comes from tissue destruction by tumor cells.

5. The nurse should adhere to evidence-based guidelines as the plan of care for this patients pain.

Correct Answer: 1,2

Rationale 1: Statistics show that pain management in cancer patients fails to provide adequate relief in up to 50% of cases.

Rationale 2: Pain and fatigue make other cancer symptoms more severe and harder to manage.

Rationale 3: Many nonpharmacologic pain relief measures are useful for cancer pain and can be implemented without prescription.

Rationale 4: Cancer pain comes from diagnostic procedures and treatments as well as from the action of the cancer itself.

Rationale 5: There are evidence-based guidelines for the treatment of cancer pain, but they should be individualized for the specific patient.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 57-4

Question 13

Type: MCSA

A patient diagnosed with cancer has been receiving radiation treatments to shrink the tumor. After several weeks, the patient tells the nurse that she has not needed as much pain medication. What should the nurse consider when responding to this report?

1. The radiation treatments have probably reduced the pressure of the tumor on adjacent tissues.

2. The tumor is secreting pain-control chemicals initiated by the radiation.

3. The patient may be developing tolerance to the pain.

4. The patient is probably continuing to have pain but is benefiting from the placebo effect of taking action against the tumor.

Correct Answer: 1

Rationale 1: Radiation treatments can help to reduce the symptoms of cancer by shrinking tumor size.

Rationale 2: Pain control chemicals are not secreted by the tumor or initiated by the radiation.

Rationale 3: The patient is not getting used to having pain.

Rationale 4: Radiation has physical effects that can reduce pain from the tumor.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 57-5

Question 14

Type: MCSA

A patients carcinoembryonic antigen (CEA) level was initially16 ng/mL. The current level is 6 ng/mL. How would the nurse evaluate this change?

1. The patients treatment for cancer is effective.

2. The patients treatment regimen should be more aggressive.

3. The patient has a new cancer site.

4. The patients cancer is gone.

Correct Answer: 1

Rationale 1: CEA levels can be used to assess response to treatment. The decline in CEA level means the treatment is working.

Rationale 2: The value does not indicate the need for more aggressive treatment.

Rationale 3: This laboratory test cannot determine new cancer sites.

Rationale 4: The test result is still elevated, so the cancer is probably still present. It would require more than one test to determine it has been eliminated.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 57-4

Question 15

Type: MCMA

A patient will be receiving busulfan (Myleran) as treatment for leukemia. Which interventions should the nurse include in the patients plan of care?

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

Standard Text: Select all that apply.

1. Assess for infection.

2. Monitor for hearing loss.

3. Monitor for a decrease in BUN level.

4. Institute fall precautions.

5. Reduce the amount of sodium in the patients diet.

Correct Answer: 1,2,4

Rationale 1: Busulfan will likely cause suppression of immunity, so the patient should be monitored for the development of infection.

Rationale 2: Busulfan is otoxic and may cause hearing loss.

Rationale 3: Busulfan may cause dehydration, which will result in an increased BUN level.

Rationale 4: The patient taking busulfan may develop peripheral neuropathy as well as anemia, so fall precautions are indicated.

Rationale 5: There is no specific reason to alter the patients diet unless electrolyte measurements indicate a need.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 57-6

Question 16

Type: MCMA

A patient diagnosed with breast cancer is receiving 5-fluorouracil (5-FU). Based on anticipated adverse effects or side effects of this medication, which interventions should the nurse perform?

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

Standard Text: Select all that apply.

1. Test stool for occult blood.

2. Monitor for electrocardiogram changes.

3. Administer antiemetics as needed.

4. Instruct the patient to drink extra fluids prior to treatment.

5. Encourage the patient to wear sunscreen.

Correct Answer: 1,3,4,5

Rationale 1: The nurse should monitor this patient for signs of bleeding. Testing stools for blood is one method.

Rationale 2: Electrocardiogram changes are not an expected effect of this regimen.

Rationale 3: This regimen may cause nausea and vomiting, so early use of antiemetics is indicated.

Rationale 4: This regimen may be dehydrating, so the patient should be encouraged to increase fluid intake.

Rationale 5: This regimen may make the patient sensitive to the sun, so sunscreen should be applied whenever the patient is outside.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 57-6

Question 17

Type: MCMA

Which assessment findings would indicate to the nurse that a patient receiving vincristine is experiencing a toxic reaction?

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

Standard Text: Select all that apply.

1. The patient reports being too weak to get out of bed much of last week.

2. The patient has lost her hair.

3. The patient reports constipation.

4. The patient reports that she cannot feel her feet.

5. The patient has a high fever and shaking chills this morning.

Correct Answer: 1,4,5

Rationale 1: Neurologic changes such as motor weakness are a sign of toxicity.

Rationale 2: Alopecia is an expected effect of this regimen. The nurse should provide information about the use of wigs, hats, or caps.

Rationale 3: Constipation is a common effect of this regimen. The nurse should provide information about laxatives and stool softeners.

Rationale 4: Paresthesias are an effect of toxicity.

Rationale 5: A high fever and shaking chills indicate infection, which may be related to toxicity from this regimen.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 57-6

Question 18

Type: MCMA

The nurse is providing care to a patient undergoing brachytherapy. Which actions should the nurse take for personal protection?

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

Standard Text: Select all that apply.

1. Wear a lead apron from the radiology department.

2. Encourage the patient to provide as much self-care as possible.

3. Rotate care of the patient with other nurses.

4. Conduct assessment from the doorway.

5. Limit time in the room to 30 minutes per shift per nurse.

Correct Answer: 2,3,5

Rationale 1: Wearing lead aprons used in X-ray departments is not recommended.

Rationale 2: If the patient provides self-care, the amount of time the nurse is exposed to radiation is reduced.

Rationale 3: Rotating the care of the patient will reduce each nurses radiation exposure.

Rationale 4: The nurse must come into contact with the patient to conduct certain assessments, such as auscultating the lungs.

Rationale 5: The time in this patients room should be limited to 30 minutes per shift.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 57-6

Question 19

Type: MCMA

The patient undergoing radiation treatment has developed dry desquamation of the skin over the treatment area. How should the nurse care for this damaged skin?

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

Standard Text: Select all that apply.

1. Shave the area carefully to remove irritating hair or stubble.

2. Tape a light, absorbent bandage over the area to collect drainage.

3. Have the patient expose the area to 20 minutes of sunlight each day.

4. Cover the area with a hydrophilic moisturizing lotion.

5. Wash the area with lukewarm water only.

Correct Answer: 4,5

Rationale 1: The area should not be shaved.

Rationale 2: The use of tape should be avoided in this area.

Rationale 3: Sunlight should be avoided.

Rationale 4: A hydrophilic moisturizing lotion or ointment such as vitamin A and D ointment should be applied two or three times daily.

Rationale 5: Soaps should be avoided.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 57-6

Question 20

Type: MCSA

A patient diagnosed with cancer and scheduled to begin biotherapy asks the nurse how the therapy will treat the cancer. How should the nurse respond?

1. It changes the body processes that caused the cancer by enhancing your own immunity.

2. It uses radiation implanted into the cancerous organ.

3. It uses laser therapy to remove the cancer.

4. It causes the blood flow to the tumor to be interrupted.

Correct Answer: 1

Rationale 1: Biotherapy modifies the biologic processes that result in malignant cells, primarily through enhancing the persons own immune responses.

Rationale 2: Brachytherapy is the implantation of radiation into the organ with the cancer.

Rationale 3: Photodynamic therapy uses medication that is activated by a laser to treat the cancer.

Rationale 4: Interrupting blood flow to the tumor is not the purpose of biotherapy.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 57-6

Question 21

Type: MCSA

Which patient would the nurse prioritize as needing information about lifestyle modifications to prevent cancer?

1. A 65-year-old woman whose body weight is within the normal range and who exercises twice a week, eats a variety of vegetables and fruits, eats red meat three times a week, and does not smoke

2. A 35-year-old Caucasian male who is overweight, has a family history of heart disease, and is a vegetarian

3. A 44-year-old African American woman whose mother had breast cancer at age 50 and who is overweight, smokes one or two cigarettes a week, and drinks three cups of coffee daily

4. A 47-year-old Hispanic female whose mother and father have a history of type 2 diabetes and who is overweight by 30 lbs., walks three times weekly, and is a nonsmoker

Correct Answer: 3

Rationale 1: Other than age, this patient has no strong risk factors for the development of cancer. Age cannot be modified. Exercise frequency should be increased, but other patients have a greater need for lifestyle modifications.

Rationale 2: This patients weight may increase his risk for cancer, but there are no other strong risks. He does not have the greatest need for lifestyle modifications.

Rationale 3: The patient who needs the most education is the one with the most risk factors. This woman is overweight, has some exposure to tobacco, and has a family history of cancer; her risk is the highest among these patients.

Rationale 4: This patient is overweight but has no other significant risks.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 57-1

Question 22

Type: MCSA

The nurse is providing discharge instructions to a patient newly diagnosed with leukemia. The patient says, My physician mentioned that her survival rates for this type of cancer are good, so I guess my chances of beating this are good, too. How should the nurse respond?

1. That means that your physician also had this type of leukemia and is a survivor.

2. It means that your chances are better than if you were being treated by a different physician.

3. Survival rates are a way of showing how well treatments work generally. They are not specific to an individual patient.

4. Do not put too much faith in statistics. They seem to change all the time.

Correct Answer: 3

Rationale 1: The physician is not discussing personal survival.

Rationale 2: The nurse should not assume that other physicians have not been as successful at treating this cancer.

Rationale 3: Survival rates provide useful measures for the end result of treatment and may reflect improvements in cancer treatment. Each patient is different, so statistics may or may not be valid for individuals.

Rationale 4: The nurse should explain the implications of these statistics rather than dismiss them as invalid.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 57-1

Question 23

Type: FIB

The TNM classification system is being used to stage a patients cancer. The nurse would plan to care for a patient with an advanced lesion spreading into adjacent organs if the primary tumor size (T) classification is T_____.

Standard Text:

Correct Answer: 4

Rationale : TNM is a standardized classification system that describes tumor size (T), regional lymph node involvement (N), and extent of metastasis (M). An advanced lesion that is spreading into adjacent organs is characterized as T4.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 57-2

Question 24

Type: MCMA

The nurse is participating in a community education event on cancer and is planning a display describing the difference between malignant and benign tumors. Which information would the nurse include as characteristic of malignancy?

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

Standard Text: Select all that apply.

1. Malignant tumors grow in an infiltrative pattern.

2. Malignant tumors grow rapidly.

3. Malignant tumors grow within a fibrous capsule.

4. Malignant tumors are poorly differentiated.

5. Malignant tumors have a good blood supply.

Correct Answer: 1,4,5

Rationale 1: Malignant masses infiltrate the surrounding tissues. Benign tumors grow expansively.

Rationale 2: Rate of growth is not a determining factor.

Rationale 3: Benign tumors are encapsulated. Malignant tumors are not.

Rationale 4: Malignant tumors are composed of cells that lose differentiation.

Rationale 5: Malignant tumors tend to have better vascularity than benign tumors.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 57-2

Question 25

Type: MCMA

The nurse is teaching a group of middle-school children about avoiding carcinogens. The nurse would divide the carcinogens into which categories?

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

Standard Text: Select all that apply.

1. Vascular factors

2. Biologic factors

3. Chemical factors

4. Psychological factors

5. Environmental factors

Correct Answer: 2,3,5

Rationale 1: Vascular factors impact blood vessels and blood flow. They do not cause cancer.

Rationale 2: Carcinogens include biologic agents that have the potential for changing the molecular structure of the genetic component of a cell.

Rationale 3: Tobacco and asbestos are examples of chemical carcinogens.

Rationale 4: Psychological factors do not specifically cause cancer although they may affect the immune system and allow other factors to come into play.

Rationale 5: Examples of environmental factors that are associated with cancer include sunlight and radon.

Global Rationale:

Cognitive Level: Creating

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 57-2

Question 26

Type: MCMA

The nurse is on a team charged with developing techniques to reduce the occurrence of serosal seeding during cancer therapy. Which procedures and interventions should be the focus of this teams work?

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

Standard Text: Select all that apply.

1. Biopsies

2. Tumor manipulation during surgery

3. External beam radiation

4. Brachytherapy

5. Use of pressure bandages postoperatively

Correct Answer: 1,2

Rationale 1: Biopsies can cause serosal seeding as needles are withdrawn through tissues.

Rationale 2: Seeding may occur when a tumor is manipulated during surgery.

Rationale 3: There is no indication that external beam radiation treatments increase the incidence of serosal seeding.

Rationale 4: There is no evidence that brachytherapy increases the incidence of serosal seeding.

Rationale 5: There is no evidence that the use of pressure bandages postoperatively increases the incidence of serosal seeding.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 57-2

Question 27

Type: MCMA

A patient newly diagnosed with prostate cancer says, I know this kind of cancer spreads to other organs. Which places should I worry about getting it? The nurse would include which anatomical locations in the response to this question?

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

Standard Text: Select all that apply.

1. Bowel

2. Lung

3. Liver

4. Bone

5. Brain

Correct Answer: 1,2,3,4

Rationale 1: The bowel is among the most common sites of prostate cancer metastasis.

Rationale 2: Lungs are among the most common sites of prostate cancer metastasis.

Rationale 3: The liver is among the most common sites of prostate cancer metastasis.

Rationale 4: Bones are among the most common sites of prostate cancer metastasis.

Rationale 5: Prostate cancer does not commonly metastasize to the brain.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 57-3

Question 28

Type: MCSA

The nurse is teaching a group of high school students about risk factors for the development of cancer. The nurse explains that alcohol is the leading etiologic factor in cancer of the oral cavity, larynx, and esophagus. The nurse goes on to explain that the risk is even higher if alcohol is combined with which substance?

1. Spicy foods

2. Soda

3. Tobacco

4. Sweet foods

Correct Answer: 3

Rationale 1: The combination of spicy foods and alcohol does not increase the risk for these cancers.

Rationale 2: The combination of soda and alcohol does not increase the risk of these cancers.

Rationale 3: When combined with tobacco use, alcohol is the leading etiologic factor in squamous cell carcinoma of the oral cavity, larynx, and esophagus. Alcohol may behave like a cocarcinogen or have a synergistic effect with tobacco, which is the most deadly carcinogen.

Rationale 4: The combination of sweet foods and alcohol does not increase the risk for these cancers.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

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