Chapter 16: Perspectives in Oncology Nursing School Test Banks

Black & Hawks: Medical-Surgical Nursing, 8th Edition

Test Bank

Chapter 16: Perspectives in Oncology

MULTIPLE CHOICE

1. In planning programs for cancer prevention, the nurse should provide information about cancer as the _____ leading cause of death

a.

major

b.

second

c.

third

d.

fourth

ANS: B

Each year, approximately 564,000 Americans die of cancer. Cancer remains the second leading cause of death in the United States.

DIF: Knowledge/Remembering REF: p. 250 OBJ: Intervention

MSC: Health Promotion and Maintenance Disease Prevention

2. After discussing the difference between benign and malignant tumors with a client, the nurse would know that the client understood the discussion when the client says

a.

A benign tumor does not invade other tissue.

b.

Malignant tissue is not found far from the original site of the tumor.

c.

Malignant tumors do not respond well to chemotherapy.

d.

The control of growth is impaired only in malignant tissue.

ANS: A

A benign neoplasm is a usually harmless growth that does not spread or invade other tissue. A malignant neoplasm is a harmful mass capable of invasion of other tissues and metastasis to distant organs.

DIF: Comprehension/Understanding REF: pp. 260, 250-251

OBJ: Intervention

MSC: Physiological Integrity Physiological Adaptation-Pathophysiology

3. The number of new cancer cases diagnosed has increased steadily since 1900. The nurse explains to a client that one of the reasons for this increase is that

a.

cancer is related to most birth defects.

b.

many false-positive cancer results are reported.

c.

people who live longer are less prone to cancer.

d.

statistical analysis and reporting are more accurate.

ANS: D

The apparent increase in the incidence of cancer may be somewhat misleading. It may simply reflect more precise diagnostic and statistical methods combined with the trend toward a longer life span.

DIF: Comprehension/Understanding REF: p. 252 OBJ: Intervention

MSC: Physiological Integrity Physiological Adaptation-Potential for Alteration in Body Systems

4. A nurse is conducting a smoking cessation clinic. What information about smoking does the nurse include in the teaching component of the program?

a.

A pack-year history is the length of time, in years, a person has smoked.

b.

Smokeless tobacco is harmless because the carcinogens have been removed.

c.

Smoking causes more cancer in the United States than do all other causes combined.

d.

The risk of cancer for someone who stops smoking does not improve.

ANS: C

There is a direct linear relationship between the amount and number of years a person has smoked and cancer risk. Tobacco is the most important known cause of cancer in the United States. A pack-year history is the number of cartons smoked a day multiplied by the number of years a person has smoked. While some carcinogens have been removed from smokeless tobacco, chew remains a leading cause of oral cancer. After a person quits smoking, the chances of getting lung cancer actually diminish.

DIF: Comprehension/Understanding REF: p. 253 OBJ: Intervention

MSC: Health Promotion and Maintenance Disease Prevention

5. A client is considering having genetic testing for cancer that runs in the family. Vital information for the nurse to include in the teaching plan before the client has the testing includes telling the client that

a.

Genetic testing is simple and inexpensive and the client does not need to seek out a specialist to interpret the results.

b.

If a genetic test comes back positive for a gene related to cancer, the client will develop the cancer.

c.

There are so many genetically-based cancers that even genetic testing cannot possibly cover them all.

d.

There are specific state and federal laws to protect people who undergo genetic testing from insurance and job discrimination.

ANS: D

Only about 5-10% of cancers are hereditary, but many more seem to be familial. Inherited cancers arise from a single gene mutation. This is a specialized area of oncology and the testing is quite expensive. There are specific, but limited, laws protecting those who undergo genetic testing against job and insurance discrimination and clients should understand these laws before having genetic testing done.

DIF: Application/Applying REF: p. 260 OBJ: Intervention

MSC: Safe, Effective Care Environment Management of Care-Legal Rights and Responsibilities

6. The nurse reviewing a research report recognizes that a discussion of oncogenes will address

a.

a chemotherapeutic agent that eradicates viruses that cause cancer.

b.

factors in the immune system protecting the client from malignant growths.

c.

risk factors in cancer development.

d.

segments of DNA that transform normal cells into malignant cells.

ANS: D

Oncogenes are small segments of cellular deoxyribonucleic acid (DNA) that can transform normal cells into malignant cells when appropriately activated.

DIF: Knowledge/Remembering REF: p. 255 OBJ: N/A

MSC: Physiological Integrity Physiological Adaptation-Pathophysiology

7. A nurse is conducting a wellness seminar in which the cancer-fighting actions of diet and physical activity are presented. A woman in the audience says, I thought diet and exercise were related to heart disease. The best response by the nurse is

a.

In people who dont smoke, diet and activity are the most important risk factors.

b.

They are important for both, but the diet to prevent cancer is totally different.

c.

They are important for heart disease too, but cancer is a bigger killer.

d.

Youre right; diet and activity are more important to prevent heart disease.

ANS: A

For people who do not smoke, diet and exercise are the two most important modifiable cancer risks. The diets for both cancer and heart disease prevention are similar: low fat and high fiber. Heart disease is the number one killer in this country.

DIF: Comprehension/Understanding REF: pp. 254-255 OBJ: Intervention

MSC: Health Promotion and Maintenance Disease Prevention, Lifestyle Choices

8. A client has worked for 2 years installing insulation containing asbestos. The nurse will determine further assessment questions based on the understanding that occupational exposure to carcinogens represents _____% of all human cancers.

a.

<2

b.

2-8

c.

10-12

d.

>12

ANS: B

Occupational exposure to carcinogens causes about 2-8% of all known human cancers.

DIF: Comprehension/Understanding REF: pp. 253-254 OBJ: Assessment

MSC: Physiological Integrity Physiological Adaptation-Pathophysiology

9. A nurse is administering IV chemotherapy. What personal protective equipment (PPE) should the nurse use when doing this task?

a.

A gown and gloves

b.

Gloves and a mask

c.

No special PPE is needed

d.

Only gloves

ANS: A

Because chemotherapy presents a hazard to health care staff, the nurse should wear a gown and gloves when administering it.

DIF: Knowledge/Remembering REF: p. 254 OBJ: Intervention

MSC: Safe, Effective Care Environment Safety and Infection Control-Handling Hazardous and Infectious Materials

10. After explaining how malignant cells differ from normal cells to a client with breast cancer, the nurse knows the client understands the characteristics of malignant cells when the client says Malignant cells

a.

are larger than normal cells and have designated purposes.

b.

cannot grow if inflammation is present.

c.

develop chromosomal abnormalities as they mature.

d.

develop the same antigens as normal cells do.

ANS: C

Malignant cells may have an abnormal number of chromosomes or an abnormal arrangement. They also develop antigens that are completely different from those associated with normal cells. Malignant cells serve no useful purpose.

DIF: Comprehension/Understanding REF: p. 253 OBJ: Intervention

MSC: Physiological Integrity Physiological Adaptation-Pathophysiology

11. A client angrily tells the nurse that he cannot understand why he has liver cancer when he started out with bladder cancer. The nurse would recognize that the client misunderstands how a malignant tumor metastasizes when he states that cancer can spread by

a.

attaching to white blood cells.

b.

direct extension into the lymphatic system.

c.

invasion into the blood vessels.

d.

new growths into internal body cavities.

ANS: A

For the purposes of study, the metastatic cascade may be divided into three stages. Stage 1 involves invasion of neoplastic cells from the primary tumor into surrounding tissue and penetration of blood and lymph vessels. Metastatic spread to distant organs and tissues is almost always the result of cells moving through the bloodstream. Direct expansion of tumors in body cavities occurs as cells travel throughout the cavity to develop new growth on other serosal surfaces.

DIF: Comprehension/Understanding REF: pp. 257-258 OBJ: Assessment

MSC: Physiological Integrity Physiological Adaptation-Pathophysiology

12. The nurse assessing a clients risk of cancer from cigarette smoking notes that the client has smoked one-half pack per day for 10 years. The nurse calculates that this client has a history of

a.

2 pack-years.

b.

5 pack-years.

c.

10 pack-years.

d.

20 pack-years.

ANS: B

A pack-year refers to the number of packs of cigarettes smoked per day times the number of years the client has smoked .

DIF: Comprehension/Understanding REF: p. 253 OBJ: Assessment

MSC: Health Promotion and Maintenance Lifestyle Choices

13. A nurse preparing a teaching plan for a client recently diagnosed with cancer will include the fact about growth patterns of cancer that cancer cells

a.

exhibit contact inhibition.

b.

grow in adverse conditions, such as lack of nutrients.

c.

have a growth rate equal to or less than cell death rate.

d.

proliferate in response to specific stimuli.

ANS: B

Cancer cells grow in adverse conditions that contribute to a weakened immune system (e.g., lack of nutrients). The cells also proliferate in response to abnormal stimuli and do not exhibit contact inhibition, and the rate of cell formation exceeds that of cell death.

DIF: Comprehension/Understanding REF: p. 259 OBJ: Intervention

MSC: Physiological Adaptation Physiological Adaptation-Pathophysiology

14. A client has a benign tumor that has originated in adipose tissue. The nurse explains that this type of tumor is classified as a

a.

fibroma.

b.

lipoma.

c.

leiomyoma.

d.

carcinoma.

ANS: B

A lipoma arises in adipose tissue. A fibroma can arise anywhere but is usually found in the uterus. A leiomyoma arises from smooth muscle. A carcinoma is a cancer of epithelial cell origin.

DIF: Knowledge/Remembering REF: pp. 260-261 OBJ: Intervention

MSC: Physiological Adaptation-Pathophysiology

Elsevier items and derived items 2009 by Saunders, an imprint of Elsevier Inc.

Some material was previously published.

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