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Cancer Quiz, Pharma

1. Which of the following interventions will be most effective in improving Transcultural communications with oncology clients and their families?  a. Use touch to show concern and caring for the client  b. Focus attention on verbal communication skills only  c. Establish a rapport and listen to their concerns  d. Maintain eye contact at all times Establishing a rapport and listening to their concerns builds a universal trusting relationship necessary for the nursing care. Use of touch, verbal communication skills and eye contact varies from culture to culture and norms. 2. The nurse is assisting the physician with a thoracentesis for a client with suspected lung cancer. If the client has malignant effusion, the nurse would expect the fluid to be  a. Milky white  b. Straw colored  c. Turbid  d. Bloody An exudative pleural effusion which is bloody suggests malignant effusion. Parapneumoniceffusion have the following characteristic from turbid to milky white. Straw colored is seen mostly at the first hours of post-thoracentesis. 3. Which of the following has been associated with fatigue from cancer chemotherapy?  a. Decreased quality of life  b. Increase risk of infection  c. Improved disease prognosis  d. Pericardial effusion Cancer fatigue is manifested by weakness and verbalizations of decreased energy in performing the daily activities of living. Increased risk for infection, improved disease prognosis and pericardial effusion has no direct relationship with fatigue. 4. Which of the following would be considered an iatrogenic cause of cancer?  a. Ionizing radiation from radon  b. Ionizing radiation from uranium one  c. X-rays used to treat a tumor  d. Ultraviolet radiation from sun X-rays used to treat a tumor is considered iatrogenic cause of cancer since iatrogenic means doctor or hospital related cause of cancer. The other options pertains to environmental cause of cancer. 5. In addition to acetaminophen, which drugs are recommended from Step 1 of the World Health Organiztion (WHO) analgesic ladder for the treatment of mild to moderate cancer-related pain?  a. Oxycodone  b. NSAIDs  c. Codeine

d. Propoxyphene NSAIDs (non-steriodal anti-inflammatory drugs) is included in the Step 1 of the World Health organization analgesic ladder. Oxycodone belongs to the step 3, codeine is an example of opoids on step 2. Propoxyphene is in a group of drugs called narcotic pain relievers. It is used to relieve mild to moderate pain. 6. A terminally ill 82 year old client in hospice care is experiencing nausea and vomiting because of a partial bowel obstruction. Conservative management of the nausea and vomiting may be achieved with the use of.  a. A nasogastric suction tube  b. Intravenous antiemetics  c. Osmotic laxatives  d. A clear liquid diet A clear liquid diet for this patient is appropriate in order to lessen the episodes of nausea and vomiting. The three other options denotes invasive approaches. 7. Any biologic response modifiers (BRMs) have expected side effects of fever and chills or a flu like syndrome. These side effects typically:  a. Are controlled with antipyretics  b. Increased in intensity with continued therapy  c. Last 24 to 72 hours  d. Have a biphasic pattern It is actually self-limiting. Patients should be instructed on conserving energy and planning rest periods throughout the day. Emphasis should be placed on proper nutrition and hydration. Antipyretics are not used for management according to the recent research (source: http://www.msdlatinamerica.com/ebooks/LippincottsCancerChemotherapyHandbook/sid102736. html) It does not increased in intensity as well as it does not have a biphasic pattern. 8. Which of the following represents the most appropriate nursing intervention for a client with pruritus caused by cancer or the treatments?  a. Administration of antihistamines  b. Steroids  c. Medicated cool baths  d. Silk sheets Medicated cool baths denotes an independent nursing interventions which targets comfort of the patient. Administering antihistamines and steroids needs the order of physicians which means it is a dependent role of the nurse. Silk sheets does not provide relief from the pruritus. 9. The nurse caring for a client who is receiving external radiation therapy for treatment of lung cancer should anticipate that the client will have which of the following?  a. Diarrhea  b. Improved energy level  c. Dysphagia  d. Normal white blood cell count External radiation therapy is a treatment which uses radiation (x-ray energy) to kill cancer cells. It can be used to treat or prevent the spread of one or more cancer tumors. Side effects when external radiation therapy are applied includes problems in breathing, or have swelling and


infections if a tumor is inside the lungs and difficulty in swallowing. Diarrhea, improved energy level and normal white blood cell count are not part of the side effects of it. 10. Carcinogenesis is irreversible in which of the following stages?  a. Progression stage  b. Promotion stage  c. Initiation stage  d. Regression stage Progression stage involves additional mutations happen and where carcinogenesis is irreversible. Promotion stage includes altered gene expression, suppressed immune response and enhanced cell division. Initiation stage involves detoxification of reactive molecules. There is no regression stage for carcinogenesis. 11. Cancer prevalence is defined as:  a. The number of new cancers in a year  b. All cancer cases more than 5 years  c. The like hood cancer will occur in a lifetime  d. The number of persons with cancer at a given point in time Cancer prevalence is the number of person with cancer at a given point in time. Crude rate is the number of new cancers in a year. Lifetime risk is the like hood cancer will occur at a given point in time. Cancer incidence is the number of persons with cancer at a given point in time. 12. A nurse us providing education in community setting about general measures to avoid excessive sun exposure. Which of the following recommendations is appropriate?  a. Apply sunscreen only after going to the water  b. Avoid peek exposure from 9am to 1pm  c. Wear a loosely woven clothing for added ventilation  d. Apply sunscreen with a sun protection factor of 15 or more before sun exposure This is the best recommendation that a nurse could say. Applying sunscreen only after going to the water makes the sunscreen ineffective. Wearing loosely woven clothing for added ventilation is not appropriate. Applying sunscreen with a sun protection factor of 15 or more before sun exposure is correct however it does not answer the question on how to avoid it. 13. Which of the following reasons explains why Meperidine (Demerol) is not recommended for chronic cancer-related pain?  a. It has a high potential for abuse  b. It has agonist-antagonist properties  c. It must be given intravascular to be effective  d. It contains a metabolite that causes seizures Meperidine (Demerol) contains a metabolite that causes seizures, it also results to sudden withdrawals. The rest of the choices does not describe meperidine. 14. Which of the following nursing interventions would be most helpful in making the respiratory effort of a client with metastatic lung cancer more efficient?  a. Teaching the client diaphragmatic breathing techniques  b. Administering cough suppressants as ordered  c. Teaching an encouraging pursed-lip breathing  d. Placing the client in a low semi-fowlers position

Pursed-lip breathing is one of the simplest ways to control shortness of breath. Diaphragmatic breathing is only effective for pain management. Administering cough suppressants is not therapeutic at this stage. While placing the client in a low semi-fowlers position makes it harder for the patient to breathe due to the incorrect angle. 15. A 58-year old client is receiving chemotherapy for lung cancer. He asks the nurse how the chemotherapeutic drugs will work. The most accurate explanation the nurse can give is which of the following?  a. Chemotherapy affects all rapidly dividing cells  b. the molecular structure of the DNA is altered  c. Cancer cell are susceptible to drug toxins  d. Chemotherapy encourages cancer cells to divide Chemotherapy affects all rapidly dividing cells is the appropriate answer. It does not only destroy the molecular structure of the DNA, not susceptible to toxins and it does not encourage cells to divide. 16. A 56-year old client is receiving chemotherapy that has the potential to cause pulmonary toxicity. Which of the following symptoms indicates a toxic response to the chemotherapy?  a. Decrease in appetite  b. Drowsiness  c. Spasms of the diaphragm  d. Cough and shortness of breath Spasms of the diaphragm indicates pulmonary toxicity in chemotherapy causing difficulty in breathing. While decrease in appetite, drowsiness and cough and shortness of breath are generalized form of symptoms that needs further investigation. 17. A 62-year old woman has had a left modified radical mastectomy with axillary node dissection. The nurse is aware that lymphedema is a common complication that can occur  a. With right-sided radical mastectomies  b. In older women  c. From 6 to 20 years after surgery  d. At any time after the procedure 7 to 10 days after surgery or not all Some cases may become evident later in life when a triggering event or worsening of the condition causes the lymphatic transport capacity to exceed the volume of interstitial fluid formation, causing the patient to be unable to maintain normal lymphatic flow. The rest of the choices does not describe the etiology of lypmhedema. 18. The nurse is assessing a 42- year old client with cancer. He has lost 1 pound in 4 weeks. He is taking ondansetron (Zofran) for nausea. He has a temperature of 38.3. the fever is indicative of  a. Inadequate nutrition  b. New resistance to current antiemetic therapy  c. Expected response to chemotherapy treatment  d. Infection Ondansetron hydrochloride (Zofran) is approved to prevent nausea and vomiting caused by chemotherapy, radiation, or surgery. This prescription medication is available in several forms, such as tablets, orally disintegrating tablets, a liquid, and an intravenous form. Although most people tolerate ondansetron well, this medication is not suitable for everyone. A few of the

conditions that should let healthcare providesr know about before taking the medication include liver problems, an irregular heart rhythm, and any allergies. Potential side effects include constipation, fatigue, and headaches. Fever is not included as an indication of side effect of the drug. 19. Which of the following variables is most important to asses when determining the impact of the cancer diagnosis and treatment modalities on a long term survivors quality of life  a. Occupation and employability  b. Functional status  c. Evidence of disease  d. Individual values and beliefs The patients will to survive matters a lot. Hope during the darkest part of cancer may have the key to successful treatment since the patient has the energy to cooperate and compliant with the regimen. Occupation and employability and functional status are similar in idea could be classified as factors that maybe affected by the diagnosis but not with the treatment of cancer. Evidence of the disease has varied impact to the patient. 20. A 57-year old woman has difficulty with mobility after her cancer treatment therapies and states, Why should I bother trying to get better? It doesnt seem to make any difference that I do the nurse response by helping the client establish reasonable activity goals, choose her own foods from the menu, and make choices about her daily activities. These interventions represent the nurses attempt to address which of the following nursing diagnoses?  a. Ineffective coping  b. Powerlessness  c. Impaired adjustment  d. Dysfunctional grieving Powerlessness according to NANDA is perception that ones own actions will not significantly affect an outcome; a perceived lack of control over a current situation or immediate happening. Ineffective coping is Inability to form a valid appraisal of the stressors, inadequate choices of practiced responses, and/or inability to use available resources. Impaired adjustment is inability to modify lifestyle or behavior in a manner consistent with a change in health status. Dysfunctional grieving is intellectual and emotional responses and behaviors by which individuals, families, communities work through the process of modifying self-concept based on the perception of potential loss. 21. Which of the following activities indicates that the client with cancer is adapting well to body image changes?  a. The client names his brother as the person to call if he is experiencing suicidal intention  b. The client discusses changes in body structure and function  c. The client discusses the date he has to return work  d. The client serves as a volunteer in a client-to-client visitation program Client to client visitation program allows each patient with similar cancer to interact and publicly denounce stigma due to alterations in the body. Suicidal intention denotes depression and desperation. If the client discusses changes in body structure and function, he is trying to rationalize which is a defense mechanism.

22. When a 62-year old client and his family receive the initial diagnosis of colon cancer, the nurse can act as an advocate:  a. Helping them maintain a sense of optimism and hopefulness  b. Determining their understanding of the results of the diagnostic testing  c. Listening carefully to their perceptions of what their needs are  d. Providing them with written materials about the cancer site and its treatment Listening carefully to their perception of what their needs are is acting in behalf of the patient and looking on the interest of the patient. Helping them maintain a sense of optimism and hopefulness means that the nurse functions as a counselor. Determining their understanding of the results of the diagnostic testing and giving them with written materials about the cancer site and its treatment are ways when a nurse functions as a teacher. 23. In an attempt to call public attention to the cancer survivors needs, a bill of rights was put forth by the:  a. American cancer society  b. National coalition of Cancer Survivors  c. National Cancer Institute  d. National Hospice Organization National Coalition for Cancer Survivorship: A survivor-led advocacy group that works on behalf of the millions of cancer survivors and the millions more touched by this disease. Founded in the US in 1986, NCCS issued the following 12 principles as Imperatives for Quality Cancer Care: Access, Advocacy, Action and Accountability. ACS (American Cancer Society) is a nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives and diminishing suffering from cancer through research, education, advocacy, and service. National Cancer Institute gives accurate, up-to-date, comprehensive cancer information from the US government's principal agency for cancer research. 24. A 72-year old woman with cancer needs assistance with her financial concerns. The nurse would suggest which of the following persons see the client?  a. Bank representative  b. Social worker  c. Oncology nurse  d. Representative of the hospital billing department A social worker could help the client in terms of financial matter, they are the once responsible in helping the patients access treatments provided by the government. A bank representative could not help her at this moment. An oncology nurse provides quality care in caring manifestations of cancer in her. A representative of the hospital billing department cant help her also since this person is just responsible in collecting payments. 25. The nurse is caring for a client with cancer who has intractable dyspnea. The nurse is aware that the physician may order which of the following types of drugs to relieve the dyspnea  a. Mucolytic agents  b. Antidepressants  c. Opiods  d. Diuretics

Opioids are very effective in relieving dyspnea, although the exact mechanism is not understood. Contrary to common belief, this effect does not result through inhibition of respiratory drive. Relief from the "work of breathing" is a function of steady-state opioid levels, much like steadystate opioid levels relieve pain. A mucolytic agent or expectorant is any agent which dissolves thick mucus and is usually used to help relieve respiratory difficulties. Antidepressants are medications prescribed for treating depression. A diuretic is any drug that elevates the rate of urination and thus provides a means of forced dieresis.