Chapter 17 Care of the Patient with Cancer

Chapter 17  Care of the Patient with Cancer

MULTIPLE CHOICE

1. A patient, age 62, has been receiving external radiation and chemotherapy for oropharyngeal carcinoma. His oral mucosa is denuded and edematous. He has ulcerations over his bucca and tongue, and his saliva is thick and ropey. Which intervention does the nurse teach to this patient?

1. Use a soft diet until the acute reaction subsides.
2. Gargle and rinse his mouth several times a day with a commercial mouthwash.
3. Use cotton-tipped swabs dipped in hydrogen peroxide to clean his teeth.
4. Avoid hot beverages.

ANS: D
Nursing interventions, including avoiding hot beverages, are important for prevention of trauma to oral mucosa.

DIF: Cognitive Level: Analysis REF: Page 798, Nursing Diagnoses box
OBJ: 14 TOP: Oropharyngeal carcinoma
KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

2. Which is a type of biopsy? a. Syringe

b. Aspiration
c. Polypectomy d. Puncture

ANS: B
Types of biopsy include aspiration, excision, needle, and incision.

DIF: Cognitive Level: Knowledge REF: Page 787, Figure 17-3 OBJ: 3 TOP: Biopsy KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

3. A patient, age 56, has been advised that his prostate-specific antigen (PSA) level is elevated. The physician then performed a digital rectal examination (DRE). Which procedure is indicated next?

1. CA-125 test
2. Transrectal ultrasound
3. Needle biopsy of the prostate
4. MRI

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 17-2

ANS: B
Men over the age of 50 should be advised to have a prostate-specific antigen (PSA) test and rectal exam once a year. Two other screening methods—DRE and transrectal ultrasonography (TRUS)—are used alone and in combination in the early detection of prostate cancer.

DIF: Cognitive Level: Analysis REF: Pages 788-789
OBJ: 13 TOP: Prostate cancer
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

4. A patient, age 72, is receiving chemotherapy for treatment of malignant lymphoma. Chemotherapeutic agents work by

1. destroying only cancer cells.
2. interfering with the cells’ ability to reproduce.
3. reducing the production of hydrochloric acid.
4. interfering with the movement of cells from one part of the body to another.

ANS: B
Most chemotherapeutic agents work by interfering with the cells’ ability to multiply or reproduce.

DIF: Cognitive Level: Analysis REF: Page 791 OBJ: 8 TOP: Chemotherapy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

5. The patient, age 63, has a diagnosis of cancer of the prostate gland with metastasis and is experiencing cachexia. This state is best described by the characteristics of:

1. Poor health, malnutrition, and wasting
2. Increased appetite and nervousness
3. Irritability and anger
4. Depression, fear, and anxiety

ANS: A
The patient with advanced cancer often experiences cachexia, a profound state of ill health, malnutrition, and wasting.

DIF: Cognitive Level: Knowledge box
OBJ: 9 TOP: Terms Assessment

MSC: NCLEX: Physiological Integrity

REF: Page 799, Nursing Diagnoses KEY: Nursing Process Step:

6. A patient, age 39, has been receiving chemotherapy for treatment of her cancer of the breast. She has a white blood cell count of 1,600/mm3. A person who has leukopenia has a special need for which nursing intervention?

1. Provision of adequate fluid intake
2. Protection from falls
   Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 17-3

c. Protection against infection d. Limitation of activities

ANS: C
The nurse needs to protect the patient against pathogens, monitor the patient for signs of infections, and respond aggressively if an infection occurs.

DIF: Cognitive Level: Analysis REF: Pages 792, 794 OBJ: 14 TOP: Chemotherapy
KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment