Chapter 07: The Patient with Cancer
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. Which statement best defines concepts to be included in a teaching plan for a patient
with
cancer?
a. 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.
b. Cancer is the third leading cause of death in the United States. Many hospitals
have the highest number of patients with this diagnosis.
c. Americans who have a diagnosis of cancer die within 1 year or less.
d. When a person is genetically predisposed to a type of cancer, nothing can be done
to prevent its occurrence
.
ANS: A
Information about the disease and disease process is helpful to allay anxiety, as well as to
instruct about its pathophysiologic changes.
2. 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. A sore that will not heal
b. Alopecia
c. Abscess
d. Anorexia
ANS: A
The acronym is a change in bowel or bladder habits, a sore that will not heal, unusual
bleeding or discharge, a thickening or lump in the breast or elsewhere, indigestion or
difficulty swallowing, and a nagging cough or hoarseness.
3. 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?
a. 2
b. 3
c. 5
,d. 6
ANS: B
Cancer risks identified are obesity, smoker, and high-fat diet.
4. What phase is considered the latent period before the period of rapid growth of
tumors?
a. Initiation
b. Promotion
c. Progression
d. Metastasis
ANS: B
The stage of promotion is the latest period in which a cell is quiet, just before the rapid
growth and tumor production, which begins in the progression phase.
5. Which is true about both malignant tumors and benign tumors?
a. Both contain cells that closely resemble those in the tissue of origin.
b. Both travel quickly to invade and destroy other tissues and organs.
c. Both always grow and multiply very rapidly, competing for space and nutrients
and causing severe pain.
d. Both may press on nearby surrounding tissues, such as nerves and blood vessels,
causing pain.
ANS: D
Both benign and malignant tumors may create pressure on or obstruct an organ.
6. 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?
a. Avoidant
b. Problem solving
c. Approach oriented
d. Confrontational
,ANS: A
Persons who appraise their cancer diagnosis as harm or loss are more likely to use
avoidant coping strategies.
7. 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 M1 (0-1, presence of metastasis). He
has an as needed order of 4 mg of morphine intramuscularly every 4 hours. He requests
another pain injection approximately 3.5 hours after the last one. What is the most
appropriate nursing action?
a. Inform the patient that this narcotic may be given only every 4 hours to prevent
addiction.
b. Ignore the call bell for 20 minutes and then take at least 10 minutes to prepare and
administer the injection.
c. Give the morphine and evaluate the results of pain relief. Arrange for the physician
to evaluate for breakthrough pain.
d. Ask the family to assist in helping the patient accept waiting longer to receive an
addicting medication such as morphine.
ANS: C
Terminal care does not include concerns about morphine addiction. Medication may be
given slightly before the allotted time. The occurrence of breakthrough pain is a real
concern for this patient.
8. 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?
a. 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.
b. Listen attentively to any concerns that the patient expresses regarding the
treatment. Offer to hold his tray until after the treatment.
c. 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.
d. Suggest that the patient request a dose of strong analgesic instead of eating because
this treatment is very painful.
ANS: B
Chemotherapy causes nausea and vomiting. Holding the tray until later provides for better
intake and for holding the food in the stomach for digestion.
, 9. A nurse explains that drugs such as cannabinoids or Benadryl are frequently ordered
for patients with cancer who are taking chemotherapy. What do these types of drugs
accomplish?
a. Promote amnesia to dampen the fear.
b. Maintain fluid retention to prevent dehydration.
c. Control nausea, vomiting, and taste disorders caused by the therapy.
d. Control bouts of diarrhea or uncomfortable constipation.
ANS: C
Cannabinoids and antihistamines such as Benadryl are useful to help control nausea.
10. 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?
a. The patient must have fallen last night walking to the bathroom. Teach the patient
to use the call bell when assistance is needed.
b. The patient may have disseminated intravascular coagulation. The size, shape,
location, color, and tenderness must be reported and recorded fully.
c. An intravascular fluid overload is occurring because of the chemotherapy. Place
the patient on strict input/output (I/O) status and limit fluids.
d. 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
ANS: B
These signs of hemorrhage may indicate the oncologic emergency of disseminated
intravascular coagulation. Serious signs need to be reported in a timely manner and fully
described.
11. What manifestations might be assessed by a nurse when a patient is diagnosed with
the oncologic emergency hypercalcemia?
a. Hypertension and bradycardia
b. Fatigue, confusion, and weakness
c. Laboratory test results of potassium 3.5 mEq/L, sodium 143 mEq/L
d. Urine output less than 30 mL/hr
ANS: B
The indications for hypercalcemia are fatigue, confusion, weakness, and poor muscle tone.
If left untreated, renal failure and death may occur.
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. Which statement best defines concepts to be included in a teaching plan for a patient
with
cancer?
a. 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.
b. Cancer is the third leading cause of death in the United States. Many hospitals
have the highest number of patients with this diagnosis.
c. Americans who have a diagnosis of cancer die within 1 year or less.
d. When a person is genetically predisposed to a type of cancer, nothing can be done
to prevent its occurrence
.
ANS: A
Information about the disease and disease process is helpful to allay anxiety, as well as to
instruct about its pathophysiologic changes.
2. 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. A sore that will not heal
b. Alopecia
c. Abscess
d. Anorexia
ANS: A
The acronym is a change in bowel or bladder habits, a sore that will not heal, unusual
bleeding or discharge, a thickening or lump in the breast or elsewhere, indigestion or
difficulty swallowing, and a nagging cough or hoarseness.
3. 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?
a. 2
b. 3
c. 5
,d. 6
ANS: B
Cancer risks identified are obesity, smoker, and high-fat diet.
4. What phase is considered the latent period before the period of rapid growth of
tumors?
a. Initiation
b. Promotion
c. Progression
d. Metastasis
ANS: B
The stage of promotion is the latest period in which a cell is quiet, just before the rapid
growth and tumor production, which begins in the progression phase.
5. Which is true about both malignant tumors and benign tumors?
a. Both contain cells that closely resemble those in the tissue of origin.
b. Both travel quickly to invade and destroy other tissues and organs.
c. Both always grow and multiply very rapidly, competing for space and nutrients
and causing severe pain.
d. Both may press on nearby surrounding tissues, such as nerves and blood vessels,
causing pain.
ANS: D
Both benign and malignant tumors may create pressure on or obstruct an organ.
6. 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?
a. Avoidant
b. Problem solving
c. Approach oriented
d. Confrontational
,ANS: A
Persons who appraise their cancer diagnosis as harm or loss are more likely to use
avoidant coping strategies.
7. 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 M1 (0-1, presence of metastasis). He
has an as needed order of 4 mg of morphine intramuscularly every 4 hours. He requests
another pain injection approximately 3.5 hours after the last one. What is the most
appropriate nursing action?
a. Inform the patient that this narcotic may be given only every 4 hours to prevent
addiction.
b. Ignore the call bell for 20 minutes and then take at least 10 minutes to prepare and
administer the injection.
c. Give the morphine and evaluate the results of pain relief. Arrange for the physician
to evaluate for breakthrough pain.
d. Ask the family to assist in helping the patient accept waiting longer to receive an
addicting medication such as morphine.
ANS: C
Terminal care does not include concerns about morphine addiction. Medication may be
given slightly before the allotted time. The occurrence of breakthrough pain is a real
concern for this patient.
8. 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?
a. 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.
b. Listen attentively to any concerns that the patient expresses regarding the
treatment. Offer to hold his tray until after the treatment.
c. 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.
d. Suggest that the patient request a dose of strong analgesic instead of eating because
this treatment is very painful.
ANS: B
Chemotherapy causes nausea and vomiting. Holding the tray until later provides for better
intake and for holding the food in the stomach for digestion.
, 9. A nurse explains that drugs such as cannabinoids or Benadryl are frequently ordered
for patients with cancer who are taking chemotherapy. What do these types of drugs
accomplish?
a. Promote amnesia to dampen the fear.
b. Maintain fluid retention to prevent dehydration.
c. Control nausea, vomiting, and taste disorders caused by the therapy.
d. Control bouts of diarrhea or uncomfortable constipation.
ANS: C
Cannabinoids and antihistamines such as Benadryl are useful to help control nausea.
10. 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?
a. The patient must have fallen last night walking to the bathroom. Teach the patient
to use the call bell when assistance is needed.
b. The patient may have disseminated intravascular coagulation. The size, shape,
location, color, and tenderness must be reported and recorded fully.
c. An intravascular fluid overload is occurring because of the chemotherapy. Place
the patient on strict input/output (I/O) status and limit fluids.
d. 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
ANS: B
These signs of hemorrhage may indicate the oncologic emergency of disseminated
intravascular coagulation. Serious signs need to be reported in a timely manner and fully
described.
11. What manifestations might be assessed by a nurse when a patient is diagnosed with
the oncologic emergency hypercalcemia?
a. Hypertension and bradycardia
b. Fatigue, confusion, and weakness
c. Laboratory test results of potassium 3.5 mEq/L, sodium 143 mEq/L
d. Urine output less than 30 mL/hr
ANS: B
The indications for hypercalcemia are fatigue, confusion, weakness, and poor muscle tone.
If left untreated, renal failure and death may occur.
