Chapter 25

Which statement best defines concepts to be included in a teaching plan for a patient with cancer?

• Cancer is a group of diseases. The cancer cells are different from the cells in the tissue of its origin in both the growth and spreading of abnormal cells.

• Cancer is the third leading cause of death in the United States. Many hospitals have the highest number of patients with this diagnosis.

• Americans who have a diagnosis of cancer die within 1 year or less.

• When a person is genetically predisposed to a type of cancer, nothing can be done to prevent its occurrence.

A nurse explains that the seven warning signs of cancer written by the American Cancer Society (ACS) can be recalled by the acronym CAUTION. What should the nurse change to point out that the A in the acronym represents?

• A sore that will not heal

• Alopecia

• Abscess

• Anorexia

A home health nurse is compiling a patient profile on a 23-year-old obese woman who smokes one-half pack of cigarettes a day and drinks 1 beer a week. She works as a cook in a long-term care facility. She has two children and eats a diet high in fats. She exercises 30 minutes a day. Both parents are dead of heart disease. How many risk factors for cancer in this profile should the nurse identify?

• 2

• 3

• 5

• 6

What phase is considered the latent period before the period of rapid growth of tumors?

• Initiation

• Promotion

• Progression

• Metastasis

Which is true about both malignant tumors and benign tumors?

• Both contain cells that closely resemble those in the tissue of origin.

• Both travel quickly to invade and destroy other tissues and organs.

• Both always grow and multiply very rapidly, competing for space and nutrients and causing severe pain.

• Both may press on nearby surrounding tissues, such as nerves and blood vessels, causing pain.

A patient newly diagnosed with cancer says, “I feel like I’ve lost my future. I feel so much harm has been done to me that I’m overwhelmed.” To what type of coping strategies should the nurse recognize this attitude will most likely lead the patient?

• Avoidant

• Problem solving

• Approach oriented

• Confrontational

A patient has a cancer that has been TNM staged as T3 (1-4, size of primary tumor), N2 (0-3, degree of spread to regional lymph nodes), and M2 (0-1, presence of metastasis). He has an as needed order of 4 mg of morphine intramuscularly every 3 to 4 hours. He requests another pain injection approximately hours after the last one. What is the most appropriate nursing action?

• Inform the patient that this narcotic may be given only every 4 hours to prevent addiction.

• Ignore the call bell for 20 minutes and then take at least 10 minutes to prepare and administer the injection.

• Give the morphine and evaluate the results of pain relief. Arrange for the physician to evaluate for breakthrough pain.

• Ask the family to assist in helping the patient accept waiting longer to receive an addicting medication such as morphine.

A patient is scheduled for a chemotherapy treatment in approximately 30 minutes. Breakfast trays have arrived and are being served on the unit. What is the nurse’s best intervention?

• Encourage the patient to eat all his breakfast to keep up his strength to fight the cancer. Remind the patient that breakfast is about one third of his daily intake.

• Listen attentively to any concerns that the patient expresses regarding the treatment. Offer to hold his tray until after the treatment.

• Offer to call the family to come and be present after the treatment. Encourage the patient to drink at least all of the orange juice and coffee.

• Suggest that the patient request a dose of strong analgesic instead of eating because this treatment is very painful.

A nurse explains that drugs such as cannabinoids, Benadryl, and Vistaril are frequently ordered for patients with cancer who are taking chemotherapy. What do these types of drugs accomplish?

• Promote amnesia to dampen the fear.

• Maintain fluid retention to prevent dehydration.

• Control nausea, vomiting, and taste disorders caused by the therapy.

• Control bouts of diarrhea or uncomfortable constipation.

While bathing a patient with cancer, a nurse assessed several large new bruises on the patient’s upper arms and thighs. What is the best understanding of the possible causes and the correct nurse’s actions for these findings?

• The patient must have fallen last night walking to the bathroom. Teach the patient to use the call bell when assistance is needed.

• The patient may have disseminated intravascular coagulation. The size, shape, location, color, and tenderness must be reported and recorded fully.

• An intravascular fluid overload is occurring because of the chemotherapy. Place the patient on strict input/output (I/O) status and limit fluids.

• The patient must have had a drug-induced seizure, which caused arm and leg thrashing and the bruises. Report and record the findings, and pad the side rails.