Saherpath: Nursing Management: Chapter 8, Care of Patients with Cancer

Question 1 of 10

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Which statement, if made by the patient scheduled to receive external beam radiation for prostate cancer, indicates understanding of the procedure?

• • “A radioactive implant will be placed inside my prostate gland to kill the cancer cells.”Brachytherapy involves the use of implanted radioactive materials, not external beam radiation.
• • “I will only have to receive radiation one time as an outpatient procedure.”Radiation is delivered in several doses over the course of many days or weeks.
• • “I will need to be careful around family members after treatment because I do not want to contaminate them with radiation.”Patients receiving external beam radiation are not contaminated and do need to worry about exposing others to radiation.
• Correct
  • “The treatment area will be marked with semipermanent tattoos so the health care team will know where to deliver the radiation.”The treatment area is marked with semipermanent tattoos so that the provider and health care team will know the exact place to deliver the radiation.

Question 2 of 10

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Which statement, if made by the nurse, is important to include when teaching the patient about skin care after radiation?

• • “Limit showers to once per week during treatment.”Patients receiving radiation should shower or at least wash the radiated area once a day.
• • “Be sure to use sunscreen on the treated area if you will be outside.”Sunscreen should be avoided on the radiated area of skin.
• • “It is fine to shave the area as long as you use an electric razor.”Patients receiving radiation should not shave the area or use an electric razor without the radiologist’s permission.
• Correct
  • “Wear cotton clothing over the treatment site.”100% cotton clothing should be worn over the irradiated area.

Question 3 of 10

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While providing care for a patient receiving brachytherapy, which situation would require immediate intervention by the nurse?

• • The nurse is wearing a dosimeter badge.Anyone close to a radiation source should be wearing a radiation dosimeter badge to measure the amount of radiation dose that the individual received.
• • The patient has a temperature of 101°F (38°C).An elevated temperature is expected in patients receiving brachytherapy.
• • The unlicensed assistive personnel (UAP) wears gloves when changing the patient’s linens.Gloves should be worn when handling bedpans, linens, and other items that have come in contact with the patient undergoing brachytherapy.
• Correct
  • The patient informs the nurse that his granddaughter will be coming to visit later.The nurse should inquire immediately about the age of the grandchild because children should not visit patients receiving brachytherapy to limit their exposure to radiation.

Question 4 of 10

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Which statement, if made by the patient receiving chemotherapy with vincristine, demonstrates a common side effect associated with this medication?

• • “I constantly feel like I have to throw up.”Nausea is a common side effect of alkylating agents, not mitotic inhibitors.
• Correct
  • “I have not had a bowel movement in 3 days.”Constipation is a side effect of vincristine, which is a mitotic inhibitor.
• • “Every time I take a shower, I lose a ton of hair down the drain.”Alopecia is a common side effect of antitumor antibiotics, not mitotic inhibitors.
• • “I feel like I’m going through menopause again with all these hot flashes.”Hot flashes are a common side effect of hormone-related agents, not mitotic inhibitors.

Question 5 of 10

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The nurse would include which information in education for the patient newly prescribed chemotherapy treatment with cyclophosphamide?

• Correct
  • Skin discoloration may occur after treatment.Hyperpigmentation is a common side effect of cyclophosphamide.
• • Some hair loss is expected with this medication.Alopecia is not an expected side effect of cyclophosphamide.
• • It is normal to have some nerve pain after treatment.Peripheral neuropathy is a common side effect of mitotic inhibitors, not alkylating agents.
• • Ambulation is important to prevent clot formation, which is a complication of this medication.Deep venous thrombosis is a side effect of hormone-related agents, not alkylating agents.

Question 6 of 10

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Which action is the priority for the nurse who is caring for a patient receiving intravenous (IV) chemotherapy who reports redness and burning at the IV site?

• Correct
  • Stop the infusion.The patient is exhibiting signs of extravasation so the infusion should be stopped immediately.
• • Take the patient’s vital signs.The patient’s vital signs should be checked, but this is not the priority action.
• • Ask the pharmacy for an antidote.The nurse may ask the pharmacy for an antidote to inject, but this is not the priority action.
• • Apply a warm compress to the site.The nurse may apply a warm or cold compress to the site, but this is not the priority action.

Question 7 of 10

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The nurse would monitor which parameter when caring for a patient receiving chemotherapy with bleomycin?

• • Urine outputUrine output should be monitored for patients receiving alkylating agents because they are at risk for nephrotoxicity.
• • Hearing testsHearing tests should be monitored in patients receiving alkylating agents because they are at risk for ototoxicity and hearing loss.
• Correct
  • ElectrocardiogramThe electrocardiogram (ECG) should be monitored regularly in patients receiving bleomycin because they are at risk for cardiotoxicity.
• • Nerve conduction testsNerve conduction tests should be monitored for patients receiving mitotic inhibitors because they are at risk for peripheral neuropathy.

Question 8 of 10

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Which abnormal laboratory value would the nurse expect to see in a patient undergoing chemotherapy?

• • Hemoglobin 11.2 g/dLAlthough slightly low, this hemoglobin value does not indicate severe anemia, which would be expected in a patient receiving chemotherapy.
• Correct
  • Platelets 60,000 cells/uLThrombocytopenia is an expected side effect of chemotherapy.
• • Serum potassium 3.6 mEq/LThis is a normal serum potassium value.
• • White blood cell count 12,000 cells/uLFor a patient receiving chemotherapy, the nurse would expect to see a decrease in white blood cells, not an increase.

Question 9 of 10

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Which assessment finding would the nurse expect in a patient receiving estrogen hormone therapy for treatment of breast cancer?

• • Serum calcium 12.4 mg/dLHypercalcemia is a side effect of hormonal therapy with androgens or antiestrogen receptor drugs.
• Correct
  • Spotting between periodsIrregular menses is an expected side effect of hormonal therapy with estrogens.
• • Cessation of menstrual cycleStopping of menstrual periods is a side effect of hormonal therapy with androgens or antiestrogen receptor drugs.
• • Alanine aminotransferase (ALT) 150 U/LLiver dysfunction is a side effect of long-term hormonal therapy with androgens or antiestrogen receptor drugs.

Question 10 of 10

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Which statement, if made by the patient who will be receiving interleukin-2 for treatment of melanoma, indicates understanding of the treatment? Select all that apply. One, some, or all responses may be correct.

• Correct
  • “I will need to see what my insurance covers because I know this medication is expensive.”Interleukins are expensive to manufacture and are thus also expensive for the patient.
• • “I will need to be careful not to get injured because this drug increases my risk of bleeding.”Interleukins decrease bleeding tendencies.
• Correct
  • “After receiving this medication, I may feel like I am sick with the flu or a really bad cold.”Interleukins can cause flu-like symptoms as a side effect.
• • “This medication acts by making my cancer cells look more like healthy cells.”Interferons act by making cancer cells look more like healthy cells.
• Correct
  • “I need to be diligent about handwashing because this medication puts me at risk for infection.”Biologic response modifiers such as interleukins can suppress immune system function, which puts the patient at risk for infection.