NUR 402 FINAL EXAM 4 Actual Real
Study Questions with Correct and Well
Explained Answers
1. While the patient is waiting for diagnostic study results, you should be
available to actively listen to the patient's concerns, and you should be
skilled in techniques that can engage the patient and the family members or
significant others in a discussion about their cancer-related fears.
The goals of cancer treatment are based on the principle that
A) surgery is the single most effective treatment for cancer.
B) initial treatment is always directed toward cure of the cancer.
C) a combination of treatment modalities is effective for controlling
many cancers.
D) although cancer cure is rare, quality of life can be increased with
treatment modalities. - ANSWER C) a combination of treatment
modalities is effective for controlling many cancers.
The goals of cancer treatment are cure, control, and palliation. When cure is
the goal, treatment is offered that is expected to have the greatest chance of
disease eradication. Curative cancer therapy depends on the particular cancer
being treated and may involve local therapies (i.e., surgery or irradiation)
alone or in combination, with or without periods of adjunctive systemic
therapy (i.e., chemotherapy).
2. The most effective method of administering a chemotherapy agent that is a
vesicant is to
, A) give it orally.
B) give it intraarterially.
C) use an Ommaya reservoir.
D) use a central venous access device. - ANSWER D) use a central
venous access device.
If vesicants are inadvertently infiltrated into the skin, severe local tissue
breakdown and necrosis may result. It is extremely important to monitor for and
promptly recognize symptoms associated with extravasation of a vesicant and
to take immediate action if it occurs. The infusion should be immediately turned
off, and protocols for drug-specific extravasation procedures should be
followed to minimize further tissue damage. Infusion with central venous
access devices can reduce the risk of infiltration of chemotherapy agents that
are vesicants.
3. The nurse explains to a patient undergoing brachytherapy of the cervix that
she
A) must undergo simulation to locate the treatment area.
B) requires the use of radioactive precautions during nursing care.
C) may experience desquamation of the skin on the abdomen and upper
legs.
D) requires shielding of the ovaries during treatment to prevent ovarian
damage. - ANSWER B) requires the use of radioactive precautions
during nursing care.
Brachytherapy consists of the implantation or insertion of radioactive materials
directly into the tumor or adjacent to the tumor. Caring for the person
undergoing brachytherapy or receiving radiopharmaceuticals requires the nurse
to take special precautions. The principles of ALARA (as low as reasonably
achievable) and of time, distance, and shielding are vital to health care
professional safety in caring for the person with an internal radiation source.
,4. A patient on chemotherapy and radiation for head and neck cancer has a
WBC count of 1.9 × 103/µL, hemoglobin of 10.8 g/dL, and a platelet count
of 99 × 103/µL. Based on the CBC results, what is the most serious clinical
finding?
A) Cough, rhinitis, and sore throat
B) Fatigue, nausea, and skin redness at site of radiation
C) Temperature of 101.9° F, fatigue, and shortness of breath
D) Skin redness at site of radiation, headache, and constipation -
ANSWER C) Temperature of 101.9° F, fatigue, and shortness of
breath
Neutropenia is more common in patients receiving chemotherapy than in those
receiving radiation, and it can seriously increase the risk for life-threatening
infection and sepsis. Any sign of infection should be treated promptly because
fever in the setting of neutropenia is a medical emergency.
5. To prevent fever and shivering during an infusion of rituximab (Rituxan),
the nurse should premedicate the patient with
A) aspirin.
B) acetaminophen.
C) sodium bicarbonate.
D) meperidine (Demerol). - ANSWER B) acetaminophen.
Common side effects of rituximab include constitutional flu-like symptoms,
including headache, fever, chills, myalgias, fatigue, malaise, weakness,
anorexia, and nausea. The patient is commonly premedicated with
acetaminophen in an attempt to prevent or decrease the intensity of these
symptoms, and large amounts of fluids help decrease symptoms.
6. The nurse counsels the patient receiving radiation therapy or chemotherapy
that
A. effective birth control methods should be used for the rest of the patient's
life.
, B. if nausea and vomiting occur during treatment, the treatment plan will be
modified.
C. after successful treatment, a return to the person's previous functional level
can be expected.
D. the cycle of fatigue-depression-fatigue that may occur during treatment can
be reduced by restricting activity.
- ANSWER C) after successful treatment, a return to the person's previous
functional level can be expected.
Some cancer survivors may continue to experience symptoms or functional
impairment related to treatment for years after treatment. Others who have
successful treatment may not have any functional limitations. A cancer
diagnosis can affect many aspects of a patients' life; cancer survivors commonly
report financial, vocational, marital, and emotional concerns long after
treatment is over. Resources for survivors are listed in Table 16-20.
7. A patient on chemotherapy for 10 weeks started at a weight of 121 lb. She
now weighs 118 lb and has no sense of taste. Which nursing intervention
would be a priority?
A) Advise the patient to eat foods that are fatty, fried, or high in calories.
B) Discuss with the physician the need for parenteral or enteral feedings.
C) Advise the patient to drink a nutritional supplement beverage at least
three times a day.
D) Advise the patient to experiment with spices and seasonings to
enhance the flavor of food. - ANSWER D) Advise the patient to
experiment with spices and seasonings to enhance the flavor of food.
8. When caring for the patient with cancer, what does the nurse understand as
the response of the immune system to antigens of the malignant cells?
A) Metastasis
B) Tumor angiogenesis
C) Immunologic escape
D) Immunologic surveillance - ANSWER D) Immunologic surveillance
Study Questions with Correct and Well
Explained Answers
1. While the patient is waiting for diagnostic study results, you should be
available to actively listen to the patient's concerns, and you should be
skilled in techniques that can engage the patient and the family members or
significant others in a discussion about their cancer-related fears.
The goals of cancer treatment are based on the principle that
A) surgery is the single most effective treatment for cancer.
B) initial treatment is always directed toward cure of the cancer.
C) a combination of treatment modalities is effective for controlling
many cancers.
D) although cancer cure is rare, quality of life can be increased with
treatment modalities. - ANSWER C) a combination of treatment
modalities is effective for controlling many cancers.
The goals of cancer treatment are cure, control, and palliation. When cure is
the goal, treatment is offered that is expected to have the greatest chance of
disease eradication. Curative cancer therapy depends on the particular cancer
being treated and may involve local therapies (i.e., surgery or irradiation)
alone or in combination, with or without periods of adjunctive systemic
therapy (i.e., chemotherapy).
2. The most effective method of administering a chemotherapy agent that is a
vesicant is to
, A) give it orally.
B) give it intraarterially.
C) use an Ommaya reservoir.
D) use a central venous access device. - ANSWER D) use a central
venous access device.
If vesicants are inadvertently infiltrated into the skin, severe local tissue
breakdown and necrosis may result. It is extremely important to monitor for and
promptly recognize symptoms associated with extravasation of a vesicant and
to take immediate action if it occurs. The infusion should be immediately turned
off, and protocols for drug-specific extravasation procedures should be
followed to minimize further tissue damage. Infusion with central venous
access devices can reduce the risk of infiltration of chemotherapy agents that
are vesicants.
3. The nurse explains to a patient undergoing brachytherapy of the cervix that
she
A) must undergo simulation to locate the treatment area.
B) requires the use of radioactive precautions during nursing care.
C) may experience desquamation of the skin on the abdomen and upper
legs.
D) requires shielding of the ovaries during treatment to prevent ovarian
damage. - ANSWER B) requires the use of radioactive precautions
during nursing care.
Brachytherapy consists of the implantation or insertion of radioactive materials
directly into the tumor or adjacent to the tumor. Caring for the person
undergoing brachytherapy or receiving radiopharmaceuticals requires the nurse
to take special precautions. The principles of ALARA (as low as reasonably
achievable) and of time, distance, and shielding are vital to health care
professional safety in caring for the person with an internal radiation source.
,4. A patient on chemotherapy and radiation for head and neck cancer has a
WBC count of 1.9 × 103/µL, hemoglobin of 10.8 g/dL, and a platelet count
of 99 × 103/µL. Based on the CBC results, what is the most serious clinical
finding?
A) Cough, rhinitis, and sore throat
B) Fatigue, nausea, and skin redness at site of radiation
C) Temperature of 101.9° F, fatigue, and shortness of breath
D) Skin redness at site of radiation, headache, and constipation -
ANSWER C) Temperature of 101.9° F, fatigue, and shortness of
breath
Neutropenia is more common in patients receiving chemotherapy than in those
receiving radiation, and it can seriously increase the risk for life-threatening
infection and sepsis. Any sign of infection should be treated promptly because
fever in the setting of neutropenia is a medical emergency.
5. To prevent fever and shivering during an infusion of rituximab (Rituxan),
the nurse should premedicate the patient with
A) aspirin.
B) acetaminophen.
C) sodium bicarbonate.
D) meperidine (Demerol). - ANSWER B) acetaminophen.
Common side effects of rituximab include constitutional flu-like symptoms,
including headache, fever, chills, myalgias, fatigue, malaise, weakness,
anorexia, and nausea. The patient is commonly premedicated with
acetaminophen in an attempt to prevent or decrease the intensity of these
symptoms, and large amounts of fluids help decrease symptoms.
6. The nurse counsels the patient receiving radiation therapy or chemotherapy
that
A. effective birth control methods should be used for the rest of the patient's
life.
, B. if nausea and vomiting occur during treatment, the treatment plan will be
modified.
C. after successful treatment, a return to the person's previous functional level
can be expected.
D. the cycle of fatigue-depression-fatigue that may occur during treatment can
be reduced by restricting activity.
- ANSWER C) after successful treatment, a return to the person's previous
functional level can be expected.
Some cancer survivors may continue to experience symptoms or functional
impairment related to treatment for years after treatment. Others who have
successful treatment may not have any functional limitations. A cancer
diagnosis can affect many aspects of a patients' life; cancer survivors commonly
report financial, vocational, marital, and emotional concerns long after
treatment is over. Resources for survivors are listed in Table 16-20.
7. A patient on chemotherapy for 10 weeks started at a weight of 121 lb. She
now weighs 118 lb and has no sense of taste. Which nursing intervention
would be a priority?
A) Advise the patient to eat foods that are fatty, fried, or high in calories.
B) Discuss with the physician the need for parenteral or enteral feedings.
C) Advise the patient to drink a nutritional supplement beverage at least
three times a day.
D) Advise the patient to experiment with spices and seasonings to
enhance the flavor of food. - ANSWER D) Advise the patient to
experiment with spices and seasonings to enhance the flavor of food.
8. When caring for the patient with cancer, what does the nurse understand as
the response of the immune system to antigens of the malignant cells?
A) Metastasis
B) Tumor angiogenesis
C) Immunologic escape
D) Immunologic surveillance - ANSWER D) Immunologic surveillance
