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105 Cards in this Set
- Front
- Back
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As a cause of death in the US, cancer ranks:
a) first b) second c) third d) fourth |
b) second
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Cancer mortality in the United States is highest among:
a) African Americans b) American Indians c) Caucasians d) Hispanics |
a) African Americans
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The etiology of cancer can be associated with specific agents or factors such as:
a) dietary and genetic factors b) hormonal and chemical agents c) viruses d) all of the above |
d) all of the above
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David, age 67 years, is admitted for diagnostic studies to rule out cancer. He is white, has been employed as a landscaper for 40 years, and has a 36-year history of smoking one pack of cigarettes a day. David has three risk factors associated with the development of cancer. Choose the LEAST significant risk factor among the following:
a) age b) sex c) occupation d) race |
d) race
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Cancer cells affect the immune system by:
a) stimulating the release of T lymphocytes into the circulation b) suppressing the patient's natural defenses c) mobilizing macrophages d) all of the above |
d) all of the above
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To reduce nitrate intake because of possible carcinogenic action, the nurse suggests that a patient decrease his or her intake of:
a) eggs and milk b) fish and poultry c) ham and bacon d) green, leafy vegetables |
c) ham and bacon
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An endoscopic procedure can be used to remove an entire piece of suspicious tissue growth. The diagnostic biopsy method used for this procedure is known as:
a) excisional biopsy b) incisional biopsy c) needle biopsy d) staging |
a) excisional biopsy
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A patient is admitted for an excisional biopsy of a breast lesion. The nurse should do all of the following except:
a) clarify information provided by the physician b) provide aseptic care to the incision postoperatively c) provide time for the patient to discuss concerns d) counsel the patient about the possibility of losing her breast |
d) counsel the patient about the possibility of losing her breast
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Surgery done to remove lesions that are likely to develop into cancer are know as:
a) diagnostic b) palliative c) prophylactic d) reconstructive |
c) prophylactic
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An example of palliative surgery is a:
a) colectomy b) cordotomy c) mastectomy d) nephrectomy |
b) cordotomy
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The incorrect rationale for the effectiveness of radiation therapy is its ability to:
a) cause cell death b) breath the strands of the DNA helix c) disrupt mitosis by slowing dividing cells c) interrupt cellular growth when a nonsurgical approach is needed. |
c) disrupt mitosis by slowing dividing cells
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A patient with uterine cancer is being treated with internal radiation therapy. She should tell the patient that she will continue to omit radiation for how long after the implant is removed?
a) 30 minutes b) 1 hour c) 1 day d) 1 week |
d) 1 week!
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A major disadvantage of chemotherapy is that it:
a) attacks cancer cells during their vulnerable phase b) functions against disseminated disease c) is systemic d) targets normal body cells as well as cancer cells |
d) targets normal body cells as well as cancer cells
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When the patient takes vincristine, a plant alkaloid, the nurse should assess for symptoms of toxicity affecting the:
a) GI system b) nervous system c) pulmonary system d) urinary system |
b) nervous system
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Initial nursing action for extravasation of a chemotherapeutic agent(IE the iv catheter dislodged from the vein) includes all of the following except:
a) applying a warm compress to the phlebitic area b) immediately discontinuing the infusion c) injecting an antidote, if required d) placing ice over the site of infiltration |
a) applying warm compresses to the phlebitic area
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Allopurinol may be prescribed for a patient who is receiving chemotherapy to:
a) stimulate the immune system against the tumor cells b) treat drug-related anemia c) prevent alopecia d) lower serum and urine uric acid levels |
d) lower serum and urine uric acid levels
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BCG is a nonspecific biologic response modifier that is a standard form of the treatment for cancer of the:
a) bladder b) breast c) lungs d) skin |
a) bladder
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The most frequently occurring gram-positive cause of infection in cancer patients is:
a) Candid albicans b) Escherichio coli c) Pseudomonas aeruginosa d) staphylococcus |
d) staphylococcus
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The most common cause of bleeding in cancer patients is:
a) anemia b) coagulation disorders c) hypoxemia d) thrombocytopenia |
d) thrombocytopenia
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A malignant tumor:
a) grows by expansion b) is usually slow growing c) gains access to the blood and lymphatic channels d) demonstrates cells that are well differentiated |
c) gains access to the blood and lymphatic channels
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Which of the following is a growth-based classification of tumors?
a) carcinoma b) leukemia c) malignant d) sarcoma |
Tumors classified on the basis of growth are benign or malignant
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Which of the following does a nurse thoroughly evaluate before a bone marrow transplantation (BMT).
a) complete drug history b) complete blood studies c) complete family history d) complete allergy history |
b) complete blood studies
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Which of the following does a nurse have to assess during the BMT procedure?
a) patient's urine gravity status b) patient's psychological status c) patient's electrolyte levels d) patient's blood pressure status |
b) patient's psychological status- during the BMT procedure, the nurse assesses the patient's psychological status. Patients experience many mood swings and need emotionally support and help throughout this process. Assessing the patient's blood pressure, urine gravity, and electrolyte levels is important for patients undergoing chemotherapy
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What are the nursing interventions for clients receiving any form of BMT?
a) closely monitor patient for at least 3 months b) closely monitor patient for at least 4 weeks c) closely monitor patient for at least 5 months d) closely monitor patient for at least 3 days |
a) closely monitor patient for at lest 3 months after a BMT; the nurse closely monitors the patient for at least 3 months because complications related to the transplant are still possible, and infections are very common.
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The drug interleukin-2 is an example of which type of biologic response modifier?
a) monoclonal antibodies b) retinoids c) cytokine d) antimetabolites |
c) cytokine
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Which of the following classes of antineoplastic agents is cell cycle specific?
a) antitumor antibiotics b) antimetabolites c) nitrosoureas d) alkylating agents |
b) antimetabolites
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To treat cervical cancer, a client has had an applicator of radioactive material placed in the vagina. Which observation by the nurse indicates a radiation hazard?
a) the client is maintained on strict bed rest b) the head of the bed is at a 30 degree angle c) the client receives a complete bed bath each morning d) the nurse checks the applicator's position every 4 hours |
c) the client receives a complete bed bath every morning- the client shouldn't receive a complete bed bath while the applicator is in place, she shouldn't be bathed below the waist because of the risk of radiation exposure to the nurse; the client should remain on strict bed rest with the head raised to a 30-45 degree angle; the nurse should check the applicator's positions every 4 hours to ensure that it remains in the proper place
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The nurse administers chemotherapeutic drugs to a client with cancer. What adverse effects are most common?
a) painful mouth sores b) frequent diarrhea c) nausea and vomiting d) constipation |
c) nausea and vomiting
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A patient reports finding a small lump in the left breast near the nipple. What should the nurse tell the client to do?
a) inform the physician immediately b) squeeze the nipple to check for drainage c) check the area after the next menstrual period d) put a heating pad on the area to reduce inflammation |
a) inform the physician immediately-a breast lump may be a sign of cancer; the client shouldn't squeeze the nipple to check for drainage until the physician examines the area
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Another word for dry mouth is:
a) xerostomia b) stomatitis c) thrombocytopenia d) crystitis |
a) xerostomia
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Another word for diminished sense of taste is:
a) xerostomia b) stomatitis c) dysgeusia d) crystitis |
c) dysgeusia
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Another word for oral mucous membrane irritation is:
a) xerostomia b) stomatitis c) thrombocytopenia d) crystitis |
b) stomatitis
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A nurse is caring for a client who has a history of COPD and is admitted with a diagnosis of viral pneumonia. Which of the following findings should indicate to the nurse a need to contact the primary care provider?
a) consolidation in lower lobes by chest-x-ray b) left shift seen in WBC differential c) oxygen saturation of 91% d) orthostatic hypotension |
b) left shift seen if WBC differential
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A nurse is performing a breast examination on a client. Which of the following findings by the nurse supports a suspicion of breast cancer?
a) asymmetrical size of breasts b) breast tissue with an orange-peel appearance c) presence of montgomery's tubercles on the areola d) movable mass in the left-lower breast quadrant |
b) breast tissue with an orange-peel appearance
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A nurse is providing teaching to a client diagnosed with Hodgkin's lymphoma who is undergoing external radiation treatment. Which of the following should the nurse include in the care plan for the irradiated area?
a) use an antibacterial soap to cleanse the skin b) use lotion to moisturize irradiated skin c) avoid patting the skin when drying d) avoid direct sun exposure to the skin |
d) avoid direct sun exposure to the skin
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A client is diagnosed with non-Hodgkin's lymphoma and is receiving chemotherapy. Which of the following is a priority assessment finding?
a) loss of body hair b) report of anorexia c) mucositis or the oral cavity d) erythema at the IV insertion site |
d) erythema at the IV insertion site
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A nurse is providing care to a client who has leukemia. The nurse reviews the client's lab data and finds the platelet count to be 48,000. The nurse anticipates implementing which of the following nursing interventions?
a) provide a diet low in vitamin k b) place the client on contact precautions c) administer subcutaneous epoetin alfa d) test urine and stool for occult blood |
d) test the urine and stool for occult blood
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A nurse is reviewing the daily laboratory work for a female client with acute leukemia. Which of the following is an expected finding?
a) aPTT 90 seconds b) Hemoglobin 14 c) HCT 40 d) platelet count of 170,000 |
a) aPTT 90 seconds
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A nurse is caring for a client in an outpatient clinic who is receiving chemotherapy and has lab data revealing bone marrow suppression. The nurse should plan to instruct the client to do which of the following?
a) take aspirin for minor aches and pains b) rinse toothbrush after each use with warm water c) avoid eating fresh fruit and vegetables d) wear clothing that will minimize sun exposure |
c) avoid eating fresh fruit and vegetables
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A nurse is caring for a client with Hodgkin's lymphoma. Which of the following findings should the nurse expect?
a) overgrowth of B-lymphocyte plasma cells b) Reed-Sternberg cells c) Epstein-Barr virus d) HIV virus |
b) Reed-Sternberg cells
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What does the term metastasis refer to?
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Cancer spreading to other parts of the body
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What are the 3 steps in order of carcinogenesis?
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Initiation, promotion, progression
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During what stage is the genetic structure of cellular DNA altered?
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initiation
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During what stage of carcinogenesis are cellular changes exhibiting malignant behavior?
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progression
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During what stage of carcinogenesis does repeated exposure to promoting agents cause the expression of abnormal or mutant genetic information even after long periods of latency.
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Promotion
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What do the following foods have in common: alcohol, fats, salt-cured or smoked meats, nitrate and nitritie-containing foods, and high calorie diets?
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Foods that appear to increased the risk of cancer.
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Do increased number of pregnancies have an increased or decreased incidence of breast, enometrial and ovarian cancers?
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Decreased
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What cells are responsible for recognizing tumor associated antigens?
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T lymphocytes
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What does the TNM stand for in the tumor grading system?
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T=extent of primary tumor
N=lymph node involement M=extent of metastasis |
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What does palliation refer to?
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symptom relief
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What is a radical excision?
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Removal of tumor, lymph nodes and nearby structures and surrounding tissues
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What do the following tissues have in common in reference to cancer; bone marrow, lymphatic tissue, epithelium of the GI tract, hair cells, and gonads?
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They all undergo frequent cell division and are most sensitive to radiation therapy.
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What is brachytherapy?
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internal radiation
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What is the normal prescribed activity level for a patient with an intracavitary radioisotope?
a) ambulation only b) bedrest c) bedrest with bathroom privileges d) no activity restriction |
b) bedrest-with log rolling to prevent dislodging implant
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What diet and medication is prescribed for a person with an intracavitary radioisotope, to prevent bowel movements during therapy to prevent displacement of the radioisotope?
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a low residue diet and an anti-diarrheal agent such as Lomotil
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A patient receiving brachytherapy requires: Check all that apply:
a) posting radiation therapy signs b) a private room c) staff members wear dosimeter badges |
All of the above!
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What are the limitation with visitors that a patient on brachytherapy will have?
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No children or pregnant visitors, and others can only visit for 30 minutes a day and keep a 6 food distance form the patient
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True or False: Patients undergoing brachytherapy with seed implants are not able to return home until the radioactive seed it removed.
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False: they are able to return home as radiation exposure to others is minimal
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What is the lethal tumor dose?
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The radiation dosage that will eradicate 95% of the tumor yet preserve normal tissue
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What effects on the mouth can radiation have?
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dryness, loss of taste and decreased salivation
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What is amifostine(Ethyol) used for?
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It helps prevent damage to DNA by acting as a scavenger of free radicals-it is given during radiation to help protect normal tissue from radiation damage
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True or false: Chemotherapy will eventually eradicate 100% of the tumor.
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False: eradication of 100% of the tumor is almost impossible, instead the goal of treatment is eradication of enough of the tumor so that the remaining tumor cells can be destroyed by the body's immune system
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Chemotherapy agents may classified by:
a) the location they are applied to b) the strength of the chemical c) the cost of the chemo d) their relationship to the cell cycle |
d) their relationship to the cell cycle- certain chemotherapeutic agents are specific to certain phases of the cell cycle
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What are vesicants?
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chemo chemical that will cause tissue death if it comes in contact with the subcutaneous tissue
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What steps will be taken if a chemo iv site becomes infiltrated?
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The infusion is stopped,Ice is applied, the doctor may aspirate any remaining chemo in the tissue, and may inject a neutralizing agent into the affected tissue
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What is the most common side effect of chemotherapy and how long can it last for following therapy?
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nausea and vomiting; it can last for 34-48 hours after chemo
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Most chemotherapy cause a (increase/decrease) in bone marrow function.
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Decrease-myelosuppression
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Why must chemotherapy be limited, why not run it continuously until the cancer is gone?
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Because bone marrow function is suppressed, WBC RBC and platelets will not be formed to maintain adequate blood levels. You have to allow time between treatments to allow the other cells produced by the bone marrow to raise to normal levels.
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What happens to the levels of potassium, phosphate and calcium during chemotherapy?
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hyperkalemia, hyperphosphatemia and hypocalcemia
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True or false: Allopurinol is frequently indicated to prevent damage to the kidneys during chemotherapy.
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True
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Concerning chemotoxicity, what are possible heart complications?
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reduces ejection fraction and heart failure
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Concerning chemotoxicity, what are possible renal complication?
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Increased urinary excretion of uric acid which causes renal damage
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What is recommended for MEN prior to initiating chemotherapy due to possible chemotoxicity effects?
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sperm banking because of possible sterility
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True or false: Gloves are not necessary when handling chemotherapeutic agents unless you are injecting medication into the chemotherapy iv bag.
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False: nausea, vomiting, dizziness, alopecia and nasal mucosa ulcerations have been reported in health care personnel who have handled chemotherapeutic agents. You must wear protective equipment!
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A patient with cancer is placed in a private room if their absolute WBC count is less than:
a) 5000 b) 3000 c) 1000 d) 500 |
c) 1000
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Standing water in a patient with cancer's room should be changed how often?
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Every day
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Cancer patient's skin should be cleansed with what prior to inserting an IV.
a) alcohol b) iodine c) chlorohexadine d) saline |
b) iodine
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What should you apply to irritated skin areas(from radiation)?
a) a mild soap b) lotion c) powder d) vitamin A&D ointment |
d) vitamin A&D ointment: all other will cause more irritation
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Flossing is ill advised if your platelet count is below___.
a) 100,000 b) 80,000 c) 40,000 d) 20,000 |
c) 40,000
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True or False: It is recommended that you cut long hair before chemotherapy.
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True! To minimize hair loss.
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What type of diet would be recommended for a patient with a sore and painful mouth?
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liquid or puree
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What is recommended timing wise, for wearing a wig?
a) wear it before hair loss begins b) wear when hair loss begins c) wear it when hair loss is noticeable |
a) wear it before hair loss begins
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True or False: Cancer patients who are experiencing nausea should avoid drinking fluids with meals.
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True: Increased fluids with meals can lead to early satiety and contribute to malnutrition.
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True or False: Cancer patients who experience a lot of nausea are recommended to drink wine with meals.
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True: Wine stimulates the appetite and adds calories
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A platelet count of 20,000-50,000 is considered:
a) Mild risk b) Moderate risk c) Severe risk |
b) moderate risk
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A platelet count of less than 20,000 is considered:
a) Mild risk b) Moderate risk c) Severe risk |
c) severe risk
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A platelet count of 50,000-100,000 is considered:
a) Mild risk b) Moderate risk c) Severe risk |
a) mild risk
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How long should you apply direct pressure to injection and venipuncture site; for the patient with a low platelet count?
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5 minutes
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What should the activity level be for a patient with a platelet count of 20,000 be?
a) ambulate with assistance b) out of bed to chair c) bathroom privileges d) bed rest |
d) bed rest with padded side rails to reduces the risk of injury
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If a patient has to get out of bed, what additional precaution should be used:
a) a helmet b) elbow pads c) throw rugs d) supervision |
d) supervision
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What is an allogenic bone marrow transplant?
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a BMT from a donor other than the patient
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What is a syngeneic BMT?
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a BMT from an identical twin
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What is ablative allogeneic BMT?
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When the recipient undergoes massive doses of chemo to kill all their bone marrow prior to the transplant of doner marrow
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Why would a person receive chemotherapy after getting donor BM in non-ablative allogeneic BMT?
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The chemotherapy doses are lower and are aimed at suppressing the recipient's immune system to allow engraftment of donor bone morrow.
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What is graft-versus-host-disease(GVHD)?
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When the implanted T cells from the donors bone marrow mounts an immune response against the patients own tissues.
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What eye condition may develop after total body irradiation?
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cataracts
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Why does hyperthermia, or a temperature of 106 degrees kill tumors?
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Because malignant cells lack the mechanisms necessary to repair damage caused by elevated temperatures.
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Is hyperthermia most effective when used alone or in conjunction with chemo or radiation.
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It is most effective when used in conjunction with chemo or radiation.
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What are autologous vaccines?
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They are vaccines made from your own cancer cells: cells are removed, killed and re injected to teach your immune system to teach your body to recognize the cancer as a foreign body.
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How does phototherapy work?
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Photosensitizing agents are injected and they accumulate in in malignant tissue and are then activated by a light that kills them.
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What is the leading cause of death in cancer patients?
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infection
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A patient with hair loss from chemo asks how long it will take for the hair to start growing back. What do you tell them?
a) immediately after treatment stops b) it will never grow back c) 2 weeks after last treatment d) 8 weeks after last treatment |
d) 8 weeks after last treatment
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What is recommended for cancer patient as far as oral hygiene?
a) mouth care right after meals b) mouth care before meals c) glycerin mouth washes d) medium-hard bristle tooth brushes |
b) mouth care before meals to make the meals more pleasant
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What is the most common sign of infection in cancer patients with suppressed immune systems?
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fever!
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True or False: Analgesic medication should be given on a PRN basis rather then at set intervals to prevent over medication and unnecessary medication side effects.
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False: Set intervals give better pain control and break the cycle of tension and anxiety associated with waiting until pain becomes so severe that pain relief is inadequate once the analgesic is given
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