Sherpath: Common Problems Related to Cancer or Cancer Treatment: Chapter 8, Care of Patients with Cancer

Question 1 of 9

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Which common problem related to cancer and cancer treatment would the nurse discuss with a patient who asks what to expect in the upcoming months? Select all that apply. One, some, or all responses may be correct.

• Correct
  • Nausea and stomatitisNausea and stomatitis are common problems related to cancer and cancer treatment.
• • Fatigue and hair growthFatigue and alopecia (not hair growth) are common problems related to cancer and cancer treatment.
• • Anorexia and weight gainAnorexia and weight loss (not weight gain) are common problems related to cancer and cancer treatment.
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  • Anemia and increased risk of infectionAnemia and infection are common problems related to cancer and cancer treatment.
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  • Bladder infections and constipationBladder infections and constipation are common problems related to cancer and cancer treatment.

Question 2 of 9

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Which statement, if made by the patient scheduled for mouth cancer treatment with radiation, indicates an understanding of preventive measures the patient can take to prevent side effects of the treatment?

• • “I will eat three large meals each day.”The nurse should educate the patient to eat smaller, more frequent meals with calorie-dense items to prevent anorexia and weight loss, which can occur as a side effect of radiation.
• • “Drinking alcohol is fine as long as I do it in moderation.”Alcohol should be avoided to prevent mucositis and stomatitis, which are common side effects of radiation therapy.
• • “I need to use an alcohol-based mouthwash to prevent sores.”Alcohol-based mouthwashes should be avoided to prevent mucositis and stomatitis, which are common side effects of radiation therapy.
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  • “I have to cut down on eating the spicy foods that I like so much.”Spicy food should be avoided to prevent mucositis and stomatitis, which are common side effects of radiation therapy of the head and neck.

Question 3 of 9

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Which nursing intervention is appropriate for the patient with chemotherapy-induced peripheral neuropathy? Select all that apply. One, some, or all responses may be correct.

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  • Administer laxatives as prescribed.Constipation often occurs with chemotherapy-induced peripheral neuropathy so the nurse should administer laxatives as prescribed.
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  • Put the patient in a room close to the nurse’s station.The patient with chemotherapy-induced peripheral neuropathy is at high risk for falls so they should be placed in a room close to the nurse’s station for closer monitoring.
• • Reassure the patient that this condition is not permanent.Chemotherapy-induced peripheral neuropathy may be permanent.
• • Reassure the patient that this condition will not affect their sex life.Chemotherapy-induced peripheral neuropathy can cause erectile dysfunction, so it is important for the nurse to educate the patient and discuss this possibility.
• • Teach the patient to take blood pressure daily and report elevations.Orthostatic hypotension can result from chemotherapy-induced peripheral neuropathy, so the patient needs to be educated about reporting low blood pressure to the provider and changing positions slowly.

Question 4 of 9

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Which laboratory value would the nurse expect to see in the patient with bone marrow suppression?

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  • Hemoglobin 6.3 g/dLThis hemoglobin value indicates anemia, which is a common finding in patients with bone marrow suppression.
• • Platelet count 165,000/uLAlthough on the lower side, this platelet count is within the normal range. Thrombocytopenia would be expected in a patient with bone marrow suppression.
• • Red blood cell count 5.2 x10⁶/uLThis red blood cell count value falls within the normal range. The nurse would expect this count to be decreased in a patient with bone marrow suppression.
• • White blood cell count 12,000/mm³This is an elevated white blood cell count. The nurse would expect a decreased white blood cell count in a patient with bone marrow suppression.

Question 5 of 9

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Which intervention would the nurse expect to implement for the cancer patient in the emergency department who is found to be in atrial fibrillation with a serum creatinine of 1.7 mg/dL and serum calcium of 6.2 mg/dL?

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  • Administer allopurinol as prescribed.The patient is exhibiting signs and symptoms of tumor lysis syndrome so the nurse would anticipate administering allopurinol.
• • Schedule the patient for hemodialysis.Hemodialysis is not indicated for this patient. A patient presenting with signs and symptoms of hypercalcemia of malignancy would likely be scheduled for hemodialysis.
• • Administer high-dose steroids as prescribed.High-dose steroids are indicated for the treatment of spinal cord compression, not tumor lysis syndrome.
• • Administer packed red blood cells (PRBCs).PRBCs are not indicated for this patient. PRBC administration would be an expected intervention for the patient with disseminated intravascular coagulation (DIC).

Question 6 of 9

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Which clinical manifestation would indicate to the nurse that a serious complication is occurring in the patient with an aggressive lung tumor?

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  • DysphagiaDysphagia is a clinical manifestation of superior vena cava syndrome, which often occurs because of compression from an expanding tumor (usually lung cancer) near the superior vena cava.
• • Bleeding gumsBleeding gums are a clinical manifestation of disseminated intravascular coagulation (DIC), which occurs because of abnormal activation of clotting factors.
• • Severe back painSevere back pain is a clinical manifestation of spinal cord compression, which results from a rapidly growing tumor that metastasizes to the bone.
• • Ventricular tachycardiaCardiac dysrhythmias are a clinical manifestation of tumor lysis syndrome, which results from destruction of tumor cells and release of their contents into the bloodstream.

Question 7 of 9

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Which statement is important for the nurse to include in the teaching for the patient with disseminated intravascular coagulation (DIC)? Select all that apply. One, some, or all responses may be correct.

• • “Do not forget to floss your teeth daily.”Patients at a high risk for bleeding should avoid flossing to prevent further blood loss.
• Correct
  • “You must take care not to fall or otherwise injure yourself.”Patients at a high risk for bleeding should avoid falls or other injury that can result in bleeding.
• • “This condition is caused because your platelet level is way too high.”DIC involves thrombocytopenia, which is a low platelet count.
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  • “We will be monitoring your blood counts regularly and giving you transfusions as needed.”Blood levels will be monitored regularly for patients with DIC, and packed red blood cells (PRBCs) and platelet transfusions administered as needed.
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  • “Let your provider or nurse know right away if you have any one-sided weakness or other signs of stroke.”Because patients with DIC are at high risk for clotting, stroke symptoms should be reported right away.

Question 8 of 9

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Which information about the dying process would the nurse provide to the family members of a patient diagnosed with stage four pancreatic cancer who is receiving hospice care?

• • Be sure to encourage fluids and prevent dehydration.Patients at the end of life tend to stop drinking fluids gradually, and this is normal. The family should not force the hospice patient to eat or drink.
• • Speak loudly so you will know that they can hear you.The family should speak quietly and calmly when talking to their loved one on hospice.
• • Avoid giving medications at the end of life to keep them lucid.Medications for comfort and pain should be provided at the end of life.
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  • Breathing may become labored toward the end of the dying process.It is normal for breathing to become loud and labored at the end of life because the patient cannot adequately clear their secretions.

Question 9 of 9

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Which statement made by the patient with stage four liver cancer indicates that the patient is in the bargaining stage?

• • “Well, if it’s my time to go, I can accept that.”This statement reflects the acceptance stage of Elisabeth Kübler-Ross’s five stages of grief and dying. This stage is characterized by statements like, “I’m ready…” The patient accepts death.
• • “There’s nothing that I can do about it, I guess.”This statement reflects the depression stage of Elisabeth Kübler-Ross’s five stages of grief and dying. This stage is characterized by statements like, “It is me, I give up…” The patient stops trying to fight the diagnosis.
• • “But my grandfather drank his whole life and never got cancer.”This statement reflects the denial stage of Elisabeth Kübler-Ross’s five stages of grief and dying. This stage is characterized by statements like, “This can’t happen to me!” The patient denies that cancer is even a possibility.
• Correct
  • “If I get through this, I swear I’ll never touch alcohol again.”This statement reflects the bargaining stage of Elisabeth Kübler-Ross’s five stages of grief and dying. This stage is characterized by statements like, “Yes me, but…” The patient acknowledges that they are indeed dying but still attempts to bargain their way out of it.