Chapter 17 Care of the Patient with Cancer

Chapter 17  Care of the Patient with Cancer

MULTIPLE CHOICE

1. A patient has developed stomatitis from chemotherapy. What should the appropriate intervention for this condition include?

1. Instruction in the following of a liquid diet
2. Using a commercial mouthwash after each meal
3. Cleaning teeth with a cotton swab dipped in hydrogen peroxide
4. Using a soft toothbrush

ANS: D
The use of a soft toothbrush to clean the teeth and rinsing with normal saline or soda will prevent added discomfort and bleeding.

DIF: Cognitive Level: Comprehension REF: Page 804 OBJ: 13 TOP: Stomatitis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

2. Which of the following men should be highest priority for referral for a prostate-specific antigen (PSA)?

1. 43-year-old Hispanic man
2. 45-year-old African American man
3. 49-year-old Korean man
4. 50-year-old Native American man

ANS: B
African American men are a high-risk population for prostate cancer. Orientals and Native Americans have a relatively low incidence of prostate cancer.

DIF: Cognitive Level: Analysis REF: Page 795 OBJ: 3 TOP: PSA testing 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). What should the next definitive diagnostic test be?

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

ANS: B
Men over the age of 50 should be advised to have a prostate-specific antigen (PSA) test and rectal examination 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: Page 800 OBJ: 11
TOP: Prostate cancer KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

4. How would the nurse explain to the patient who is taking cyclophosphamide (Cytoxan), an alkylating agent, about how the medication works?

1. It inhibits DNA and RNA synthesis
2. It interferes with DNA replication
3. It damages the cell in S phase of replication
4. It alters the hormonal environment that promotes cancer growth

ANS: B
Most chemotherapeutic agents work by interfering with the cell’s ability to multiply or reproduce. Cytoxan interferes with DNA replication.

DIF: Cognitive Level: Analysis REF: Page 803 OBJ: 13
TOP: Chemotherapy KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity

5. After an elevation of his PSA, the patient has blood drawn for a CA-19-9. When he asks the nurses the purpose of this new test, what is the most appropriate response?

1. It tests for hepatobiliary cancer
2. It tests for colorectal cancer
3. It tests for bladder cancer
4. It tests for lung cancer

ANS: A
The CA-19-9 is a tumor marker for tumors in the hepatobiliary system.

DIF: Cognitive Level: Comprehension REF: Page 800 OBJ: 11 TOP: CA-19-9 KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

6. A patient, age 39, receiving chemotherapy for treatment of her cancer has a white blood cell count of 1600/mm3. This finding requires nursing interventions to provide which of the following?

1. Adequate fluid intake
2. Protection from falls
3. Protection against infection
4. Frequent small nutritious snacks

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: Page 803 OBJ: 13 TOP: Leukopenia KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment