Chapter 21 - Principles of Cancer Development
A 72-year-old client recovering from lung cancer surgery asks the nurse to explain how she developed cancer when she has never smoked. Which factor may explain the possible cause?
- A diagnosis of diabetes treated with insulin and diet
- An exercise regimen of jogging 3 miles four times a week
- A history of cardiac disease
- Advancing age
D. Advancing age
The nurse includes which factors in teaching regarding the typical warning signs of cancer? Select all that apply.
- Persistent constipation
- Scab present for 6 months
- Curdlike vaginal discharge
- Axillary swelling
A. Persistent constipation
B. Scab present for 6 months
D. Axillary swelling
Which information must the organ transplant nurse emphasize before a client is discharged?
- “Taking immunosuppressant medications increases your risk for cancer and the need for screenings.”
- “You are at increased risk for cancer when you reach 60 years of age.”
- “Immunosuppressant medications will decrease your risk for developing cancers.”
- “After 6 months, you may stop immunosuppressant medications, and your risk for cancer will be the same as that of the general population.”
A. “Taking immunosuppressant medications increases your risk for cancer and the need for screenings.”
A nurse is counseling a 60-year-old African-American male client about risk factors for lung cancer. Teaching should focus most on what risk factor?
- Tobacco use
- Increased age
A. Tobacco use
The nurse manager in a long-term care facility is developing a plan for primary and secondary prevention of colorectal cancer. Which tasks associated with the screening plan will be delegated to nursing assistants within the facility?
- Testing of stool specimens for occult blood
- Teaching about the importance of dietary fiber
- Referring clients for colonoscopy procedures
- Giving vitamin and mineral supplements
A. Testing of stool specimens for occult blood
Which type of cancer has been associated with Down syndrome?
- Breast cancer
- Colorectal cancer
- Malignant melanoma
What are the common cancers related to tobacco use? Select all that apply.
- Cardiac cancer
- Lung cancer
- Cancer of the tongue
- Skin cancer
- Cancer of the larynx
B. Lung cancer
C. Cancer of the tongue
E. Cancer of the larynx
A client has a glioblastoma. The nurse begins to plan care for this client with which type of cancer?
- Smooth muscle
- Fatty tissue
The nurse is giving a group presentation on cancer prevention and recognition. Which statement by an older adult male client indicates understanding of the nurse’s instructions?
- “Cigarette smoking always causes lung cancer.”
- “Taking multivitamins will prevent me from developing cancer.”
- “If I have only one shot of whiskey a day, I probably will not develop cancer.”
- “I need to report the pain going down my legs to my health care provider.”
D. “I need to report the pain going down my legs to my health care provider.”
The home health nurse is caring for a client who has a history of a kidney transplant and takes cyclosporine (Sandimmune) and prednisone (Deltasone) to prevent rejection. Which assessment finding is most important to communicate to the transplant team?
- Temperature of 96.6°F (35.9°C)
- Reports of joint pain
- Pink and dry oral mucosa
- Palpable lump in the client’s axilla
D. Palpable lump in the client’s axilla
A client has a diagnosis of lung cancer. To which areas does the nurse anticipate that this client’s tumor may metastasize? Select all that apply.
- Lymph nodes
C. Lymph nodes
The nurse explains to a client that which risk factor of those listed most likely contributed to the client’s primary liver carcinoma?
- Infection with hepatitis B virus
- Consuming a diet high in animal fat
- Exposure to radon
- Familial polyposis
A. Infection with hepatitis B virus
The nurse is conducting a community health education class on diet and cancer risk reduction. What should be included in the discussion? Select all that apply.
- Limit sodium intake.
- Avoid beef and processed meats.
- Increase consumption of whole grains.
- Eat “colorful fruits and vegetables,” including greens.
- Avoid gas-producing vegetables such as cabbage.
B. Avoid beef and processed meats.
C. Increase consumption of whole grains.
D. Eat “colorful fruits and vegetables,” including greens.
Which statement about the process of malignant transformation is correct?
- Mutation of genes is an irreversible event that always leads to cancer development in the initiation phase.
- Insulin and estrogen enhance the division of an initiated cell during the promotion phase.
- Tumors form when carcinogens invade the gene structure of the cell in the latency phase.
- Nutrition of cancer cells is provided by tumor angiogenesis factor (TAF) in the promotion stage.
D. Nutrition of cancer cells is provided by tumor angiogenesis factor (TAF) in the promotion stage.
The nurse is teaching a 47-year-old woman about recommended screening practices for breast cancer. Which statement by the client indicates understanding of the nurse’s instructions?
- “My mother and grandmother had breast cancer, so I am at risk.”
- “I get a mammogram every 2 years since I turned 30.”
- “A clinical breast examination is performed every month since I turned 40.”
- “A computed tomography (CT) scan will be done every year after I turn 50.”
A. “My mother and grandmother had breast cancer, so I am at risk.”
A client who is scheduled to undergo radiation for prostate cancer is admitted to the hospital by the nurse. Which statement by the client is most important to communicate to the health care provider?
- “I am allergic to iodine.”
- “My urinary stream is very weak.”
- “My legs are numb and weak.”
- “I am incontinent when I cough.”
C. “My legs are numb and weak.”
The nurse reviews the chart of a client admitted with a diagnosis of glioblastoma with a T1NXM0 classification. Which explanation does the nurse offer when the client asks what the terminology means?
- “Two lymph nodes are involved in this tumor of the glial cells, and another tumor is present.”
- “The brain tumor measures about 1 to 2 cm and shows no regional lymph nodes and no distant metastasis.”
- “This type of tumor in the brain is small with some lymph node involvement; another tumor is present somewhere else in your body.”
- “Glioma means this tumor is benign, so I will have to ask your health care provider the reason for the chemotherapy and radiation.”
B. “The brain tumor measures about 1 to 2 cm and shows no regional lymph nodes and no distant metastasis.”
The nurse suspects metastasis from left breast cancer to the thoracic spine when the client has which symptom?
- Back pain
- Frequent urination
- Cyanosis of the toes
B. Back pain
The nurse presents a cancer prevention program to teens. Which instruction will have the greatest impact in cancer prevention?
- Avoid asbestos.
- Wear sunscreen.
- Get the human papilloma virus (HPV) vaccine.
- Do not smoke cigarettes.
D. Do not smoke cigarettes.
A 52-year-old client tells the nurse that she has never had a mammogram because she is terrified that she will have cancer. Which response by the nurse is therapeutic?
- “Don’t worry, most lumps are discovered by women during breast self-examination.”
- “Does anyone in your family have breast cancer?”
- “Finding a cancer in the early stages increases the chance for cure.”
- “Have you noticed a lump or thickening in your breast?”
C. “Finding a cancer in the early stages increases the chance for cure.”
The nurse is assessing a client with lung cancer. Which symptom does the nurse anticipate finding?
- Easy bruising
- Night sweats
- Chest wound
Which activity performed by the community health nurse best reflects primary prevention of cancer?
- Assisting women to obtain free mammograms
- Teaching a class on cancer prevention
- Encouraging long-term smokers to get a chest x-ray
- Encouraging sexually active women to get annual Papanicolaou (Pap) smears
B. Teaching a class on cancer prevention