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68 Cards in this Set
- Front
- Back
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What is the primary reason hematopoietic growth factors (HGFs) are used for neutropenia?
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The HGFs have been found to reduce the period of neutropenia, which is the highest period of risk for infection.
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Appropriate nursing measures to help stop a patient's nosebleed include which of the following?
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Cold compresses to the bridge of the nose, topical thrombin applied to the nares, and administration of platelets.
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Cancer patients' rehabilitation needs are legally best addressed by which of the following?
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Americans with Disabilities Act (1990)
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Initially, when a person learns he has cancer, what is the first psychological circumstance that happens?
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There is a sign of psychologic crisis.
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Cancer patients and families can have a more positive experience if which of the following occurs?
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Good psychosocial management is integrated into a patient's entire plan of care.
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Breaking the news that the patient has cancer should include which of the following?
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Simple, honest information and a discussion of treatment options.
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When the nurse is assessing the patient for acute anxiety, which of the following should she do?
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Assess for symptoms of chronic anxiety, which creates greater risk that the patient will experience acute anxiety.
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Why is it believed that serious illness is the most disruptive to family function in families who are in the prime of life (in their late thirties to forties)?
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They are in the phase of life that has the greatest responsibilities.
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Long-term survival for cancer patients entails which of the following?
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Concerns about physical sequelae and continued emotional distress.
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Nurses can best assist patients and families with open communication by doing what?
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Asking open-ended questions, which invites the sharing of feelings.
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What makes being a witness to the patient's story important?
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It helps inform the nurse about the patient's understanding of the illness
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Family members who are caregivers should be encouraged and reminded to do which of the following?
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Remember to value and be good to yourself, because your job is difficult.
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Once a woman is diagnosed with breast cancer, she may be concerned about several issues related to sexuality, including which of the following?
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Altered body image, self-esteem, impact on femininity and sexual function.
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When a woman is ill, she may began to doubt her sexual ability. Which of the following may affect this feeling?
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The effect the illness will have on her ability to respond sexually to arousal, vaginal lubrication, hot flashes and so on.
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Some women with breast cancer who have a mastectomy may choose to have reconstruction whether or not they have chemotherapy and/or radiation therapy. What is the most important issues to explain to her?
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She will be able to allow her partner to manipulate her breasts even though she has had reconstruction.
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What are some sexual concerns that potentially arise in connection with side effects from chemotherapy?
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Complete hair loss, which affects body image and sense of self esteem.
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Patients' sexuality concerns related to reproductive damage include which of the following?
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Damage to germ cells, childbearing, infertility and marriage likelihood.
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What interventions to promote sexual expression are suggested for women with a mastectomy who have had treatment for breast cancer?
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Use of fancy lingerie to camouflage surgical area, a change of positions during intercourse to decrease attention to surgical area and use of candles to subdue light
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Issues related to sexuality concerns can be of a physical nature; however, which of the following are questions related to the inner sense of femininity?
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Communication with partner related to their day, the relationship, their feelings and emotional availability.
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Assessment will always include the spouse or partner and whether or not the couple will cope with the diagnosis of breast cancer. What is the most important factor that influences the stability of their relationship after the cancer diagnosis?
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Whether the couple had a strong relationship before the cancer diagnosis.
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Mr. D. continued to have an aversion toward touching Mrs. D's reconstructed breast even after several conversations with her regarding her comfort. What should be an appropriate intervention for the CNS to do now that several months have lapsed?
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Refer Mr. & Mrs. D. to a sex therapist for in-depth therapy
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The CNS was able to address sexuality issues with Mrs. D. without hesitation. This type of assessment should always be included when caring for cancer patients. When is the best time to assess for sexuality concerns?
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Sexuality issues should be addressed at initial diagnosis, intermittently during treatment and post-treatment.
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Which of the following is an example of instrumental activity of daily living or IADL?
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Using the telephone
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Of the following, which would be the most important criterion to be considered when selecting a functional status measure for screening in clinical practice?
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Measure should differentiate individuals with and without functional compromise, be brief and be easy to score and interpret
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Which of the following is true about the risk factors for functional loss during and following cancer and its treatment?
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The relative contributions of polypharmacy, malnutrition, inactivity and comorbidity to functional loss during and following treatment are unknown.
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Which of the following is true of exercise and/or activity and functional status in patients with cancer?
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Benefits of regular exercise include improvements in cardiopulmonary capacity and muscle strength and endurance, a reduction in fatigue and depression and an improved sense of well-being.
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An individual who is coping with decline in functional status is assessed to be setting unrealistic plans, demonstrating nonadherence to recommendations and at the same time endlessly searching for a solution that offers a more optimistic outlook. These would all be most characteristic of which of the following emotional reactions?
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Denial and minimization
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Let's return to the case discussed above, involving a patient with Stage IIIA multiple myeloma with multiple osteolytic bone lesions who is receiving outpatient chemotherapy. The patient's daughter asks to meet with you. She is concerned because her father is not using his wheeled walker at home. You meet with the patient and his daughter to discuss their respective viewpoints on this situation. The daughter notes that her father is frail and lives alone, and she fears that he is a significant risk to fall and sustain fracture. After all he has been through with chemotherapy treatment, she feels that a fracture will just set him back further and that it is unnecessary for him to take the risk...etc. Resolving this case requires the nurse primarily consider which of the following ethical constructs?
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Autonomy
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You are a nurse on an inpatient oncology unit, and you are considering a measure of functional status that you will administer upon admission to your unit and 3 days before discharge to evaluate the outcome of rehabilitative and supportive care interventions delivered on your unit. Your unit cares mostly for patients admitted with febrile neutropenia, those with complications of radiotherapy such as dehydration, and patients with pain, intractable nausea and vomiting or other distressing symptoms at the end of life. Your average length of stay is 5 to 8 days, and patients are primarily discharged to home, although some are transferred to hospice. Which of the following types of functional status measures might be the most appropriate selection to measure this outcome?
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A measure of independence in basic ADLs and IADLs and performance and/or participation limitations such as ability to fulfill roles as worker, spouse or parent
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If a patient does not want to learn, what is the first thing a nurse should do?
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Explain why the topic is important.
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A nurse might use the behavioral learning theory to accomplish which of the following?
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Help prepare a patient for a painful procedure.
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Which of the following describes likely characteristics of adult learners?
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Are self-directed and problem oriented
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Which of the following is used in the best approach to teaching patients with limited English proficiency?
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A culturally competent professional translator who understands oncologic terminology.
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A person with basic literacy skills can read which of the following?
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Simple prose text.
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Which of the following is true of patients who do not read well?
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They often say they have left their glasses at home.
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What should the nurse always do when beginning a teaching lesson?
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First review the learning needs and assessment.
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When teaching older adults, what should the nurse do?
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Make sure the patient understands the goals of teaching.
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According to most surveys, the majority of Americans state they would prefer to die at home. Where do most Americans die, in fact?
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In a hospital.
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Which of the following is true regarding palliative care?
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Palliative care should be initiated at the time of dianosis of serious, life-threatening illness
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Which of the following statements is true regarding patients who are most appropriate for palliative team referral?
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Any patient with stage IV cancer should have a palliative care referral
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Which of the following puts persons who have been on high doses of oral opioids and who have some dysfunction at risk of neurotoxicity?
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Accumulation of the 3-gluceronide metabolites of opiods
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If myoclonus develops and opioid neurotoxicity is suspected, what is usually the first intervention?
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Rotation to a different opioid at 50% of the equianalgesic dose.
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Mrs. White has lost 85 pounds over the past year. She has no appetite. Here daughter states, "She just won't eat. You need to get her some tube or intravenous feedings, or something. We can't just let her starve to death." What would be the most appropriate response?
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"Your mother is not dying from starvation. Her disease has changed both her appetite and how her body uses food. Artificial foods and fluid may actually make her feel worse."
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The following laxative should be avoided in end-of-life care.
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Psyllium (Metamucil)
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How does the mechanism operate by which medication and electrolyte disturbances lead to stimulation of the vomiting center of the brain?
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Via the chemoreceptive trigger zone (CTZ)
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Which of the following is an effective intervention for dyspnea in the palliative care setting?
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A fan at the bedside flowing cool air on the face
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The widow of one of your recently deceased patients states, "Last night I thought I heard him say 'Goodnight, honey' just like he always had. Do you think I'm going crazy?" The best response would be to say:
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"Many persons have similar experiences of seeing or hearing the one who has died. You must miss him saying good night."
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What should the hospital-based oncology nurse understand to be one factor influencing increased emphasis on home care and alternative care settings?
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Demographic changes such as steady growth of the elderly ill population.
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What are some of the patient characteristics associated with the need for home care or extended care?
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New cancer diagnosis, new diabetes diagnosis, educational level below 12
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In the US, family members and friend provide approximately what percentage of in-home care?
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83% to 89%
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What is the primary reason more people do not have an advance directive?
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Belief that advance directives are for elderly and terminally ill patients.
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The Medicare definition regarding "homebound status" includes which of the following?
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Confined to home because of illness and injury except with the use of supportive devices or special transportation.
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The oncology nurse determines that patient and family education about hospice is successful when the patient states that which of the following is a major goal of hospice?
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Hospice provides a setting for care that is supportive of both the terminally ill individual and their family.
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What is an external factor that influences patient and family or caregiver ability to learn?
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Timing of the instruction
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During a discussion with a patient's family regarding evaluation of Internet-based health care information, the oncology nurse understands that the family needs further teaching when they make the following statement:
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"I don't worry about who sponsors the website; I just like to look at a lot of different information."
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What is included among the basic elements for the standards of practice for transitional planning?
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Client identification and selection, problem identification, planning, monitoring, evaluating, and outcomes development
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An 82 year old woman with multiple myeloma is preparing to go home with supervised care from her daughters. Which of the following reflects a possible drawback of home care for this patient and family?
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Out-of-pocket costs and lost wages for caregivers
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Once patients are diagnosed with cancer, they may be concerned about several issues related to sexuality including which of the following?
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Altered body image, self-esteem, impact on femininity or masculinity and sexual function.
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When people are ill, they begin to doubt their sexual identity. All of the following may impact this feeling except:
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Disinterest in sex because it is not important to our society.
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The person who has experienced limb amputation as a result of cancer may face several sexual problems that inhibit a sexual relationship including:
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Amputee Fetishism
Body position during intercourse Phantom pain sensation "ALL OF THE ABOVE" |
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Potential sexual concerns with long-term side effects for the patient with hematologic malignancy include:
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Ovarian dysfunction, testicular dysfunction and potential infertility
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Patients' sexual concerns related to reproductive damage include:
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Damage to germ cells, childbearing, infertility and marriage likelihood
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Older couples are often still sexually active and require the following discussion about sexuality regarding:
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Longer precoital stimulation and various different positions for intercourse may need to be tried due to slowed physical response and musculoskeletal changes.
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Appropriate interventions for sexuality concerns of patients with head and neck cancer include:
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Use of artificial saliva or sugarless mints to freshen stale breath and prevent tooth decay
Use scented candles, perfumes and aftershaves to enhance sexual intimacy Use of a fancy nightgown with a high neck or a dickey to cover the tracheotomy site "ALL OF THE ABOVE" |
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Alternate methods to sexual intercourse may need to be tried after surgery for many of the female patients with genital cancer during and after the area has healed. All of teh following may be included except:
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The best solution is to give up a sexual relationship with a partner and to masturbate if becoming sexually frustrated.
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Men who experience pelvic genital concerns often feel demasculinated and unlovable. Potential intervention(s) to enhance the man's perspective on his masculinity include:
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Encourage aspects of arousal, intimacy and foreplay
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Nursing diagnosis categories related to sexuality include:
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Relating, valuing, moving and perceiving
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Breaking the news that the patient has cancer should include all of the following steps except:
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A message delivered with professional detachment.
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