Chapter 19: Concepts of Cancer Development Ignatavicius: Medical-Surgical Nursing, 10th Edition

1. The nurse learning about cellular regulation understands that which process occurs during the

S phase of the cell cycle?

a.

Actual division (mitosis)

b.

Doubling of DNA

c.

Growing extra membrane

d.

No reproductive activity

ANS: B

During the S phase, the cell must double its DNA content through DNA synthesis. Actual

division, or mitosis, occurs during the M phase. Growing extra membrane occurs in the G1

phase. During the G0 phase, the cell is working but is not involved in any reproductive

activity

A nurse asks the staff development nurse what "apoptosis" means. What response best?

a.

Growth by cells enlarging

b.

Having the normal number of chromosomes

c.

Inhibition of cell growth

d.

Programmed cell death

ANS: D

Apoptosis is programmed cell death. With this characteristic, organs and tissues function with

cells that are at their peak of performance. Growth by cells enlarging is hyperplasia. Having

the normal number of chromosomes is euploidy. Inhibition of cell growth is contact

inhibition.

A nurse is learning the difference between normal cells and benign tumor cells. What

information does this include?

a.

Benign tumors grow through invasion of other tissue.

b.

Benign tumors have lost their cellular regulation from contact inhibition.

c.

Growing in the wrong place or time is typical of benign tumors.

d.

The loss of characteristics of the parent cells is called anaplasia

ANS: C

Benign tumors are basically normal cells growing in the wrong place or at the wrong time.

Benign cells grow through hyperplasia, not invasion. Benign tumor cells retain contact

inhibition. Anaplasia is a characteristic of cancer cells

A nurse learns that which of the following is the single biggest risk factor for developing

cancer?

a.

Exposure to tobacco

b.

Advancing age

c.

Occupational chemicals

d.

Oncovirus infection

ANS: B

The single biggest risk factor for developing cancer is advancing age. As one ages, immunity

decreases and exposures increase. Tobacco use is the single most preventable cause of cancer.

Exposure to chemicals and oncoviruses cause fewer cancers.

Which statement about carcinogenesis is accurate?

a.

An initiated cell will always become clinical cancer.

b.

Cancer becomes a health problem once it is 1 cm in size.

c.

Normal hormones and proteins do not promote cancer growth.

d.

Tumor cells need to develop their own blood supply.

ANS: D

Tumors need to develop their own blood supply through a process called angiogenesis. An

initiated cell needs a promoter to continue its malignant path. Normal hormones and proteins

in the body can act as promoters. A 1-cm tumor is a detectable size, but other events have to

occur for it to become a health problem.

The nurse caring for oncology clients knows that which form of metastasis is the most

common?

a.

Bloodborne

b.

Direct invasion

c.

Lymphatic spread

d.

Via bone marrow

ANS: A

Bloodborne metastasis is the most common way for cancer to metastasize. Direct invasion and

lymphatic spread are other methods. Bone marrow is not a medium in which cancer spreads,

although cancer can occur in the bone marrow.

A nurse is assessing a client with glioblastoma. What assessment is most important?

a.

Abdominal palpation

b.

Abdominal percussion

c.

Lung auscultation

d.

Neurologic examination

ANS: D

A glioblastoma arises in the brain. The most important assessment for this client is the

neurologic examination.

A nurse has taught a client about dietary changes that can reduce the chances of developing

cancer. What statement by the client indicates the nurse needs to provide additional teaching?

a.

"Foods high in vitamin A and vitamin C are important."

b.

"I'll have to cut down on the amount of bacon I eat."

c.

"I'm so glad I don't have to give up my juicy steaks."

d.

"Vegetables, fruit, and high-fiber grains are important."

ANS: C

To decrease the risk of developing cancer, one should cut down on the consumption of red

meats and animal fat. The other statements are correct

A client is in the oncology clinic for a first visit since being diagnosed with cancer. The nurse

reads in the client's chart that the cancer classification is TISN0M0. What does the nurse

conclude about this client's cancer?

a.

The primary site of the cancer cannot be determined.

b.

Regional lymph nodes could not be assessed.

c.

There are multiple lymph nodes involved already.

d.

There are no distant metastases noted in the report.

ANS: D

TIS stands for carcinoma in situ; N0 stands for no regional lymph node metastasis; and M0

stands for no distant metastasis.

A client asks the nurse if eating only preservative- and dye-free foods will decrease cancer

risk. What response by the nurse is best?

a.

"Maybe; preservatives, dyes, and preparation methods may be risk factors."

b.

"No; research studies have never shown those things to cause cancer."

c.

"There are other things you can do that will more effectively lower your risk."

d.

"Yes; preservatives and dyes are well known to be carcinogens."

ANS: A

Dietary factors related to cancer development are poorly understood, although dietary

practices are suspected to alter cancer risk. Suspected dietary risk factors include low-fiber

intake and a high intake of red meat or animal fat. Preservatives, preparation methods, and

additives (dyes, flavorings, sweeteners) may have cancer-promoting effects. It is correct to say

that other things can lower risk more effectively, but this does not give the client concrete

information about how to do so, and also does not answer the client's question.

The nurse learning about cancer development remembers characteristics of normal cells.

Which characteristics does this include? (Select all that apply.)

a.

Differentiated function

b.

Large nucleus-to-cytoplasm ratio

c.

Loose adherence

d.

Nonmigratory

e.

Specific morphology

f.

Orderly and specific growth

ANS: A, D, E, F

Normal cells have the characteristics of differentiated function, nonmigratory, specific

morphology, a smaller nucleus-to-cytoplasm ratio, tight adherence, and orderly and

well-regulated growth.

The nurse working with oncology clients understands that interacting factors affect cancer

development. Which factors does this include? (Select all that apply.)

a.

Exposure to carcinogens

b.

Genetic predisposition

c.

Immune function

d.

Normal doubling time

e.

State of euploidy

ANS: A, B, C

The three interacting factors needed for cancer development are exposure to carcinogens,

genetic predisposition, and immune function.

A nurse is participating in primary prevention efforts directed against cancer. In which

activities is this nurse most likely to engage? (Select all that apply.)

a.

Demonstrating breast self-examination methods to women

b.

Instructing people on the use of chemoprevention

c.

Providing vaccinations against certain cancers

d.

Screening teenage girls for cervical cancer

e.

Teaching teens the dangers of tanning booths

f.

Educating adults about healthy eating habits

ANS: B, C, E, F

Primary prevention aims to prevent the occurrence of a disease or disorder, in this case cancer.

Secondary prevention includes screening and early diagnosis. Primary prevention activities

include teaching people about chemoprevention, providing approved vaccinations to prevent

cancer, teaching teens the dangers of tanning beds, and educating adults on eating habits to

reduce the risk of getting cancer. Breast examinations and screening for cervical cancer are

secondary prevention methods.

A nurse is providing community education on the seven warning signs of cancer. Which signs

are included? (Select all that apply.)

a.

A sore that does not heal

b.

Changes in menstrual patterns

c.

Indigestion or trouble swallowing

d.

Near-daily abdominal pain

e.

Obvious change in a mole

f.

Frequent indigestion

ANS: A, B, C, E, F

The seven warning signs for cancer can be remembered with the acronym CAUTION:

changes in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge,

thickening or lump in the breast or elsewhere, indigestion or difficulty swallowing, obvious

change in a wart or mole, and nagging cough or hoarseness. Abdominal pain is not a warning

sign