Eliopoulos — CH. 26 — Cancer

1. Which of the following statements most accurately captures an aspect of the relationship between cancer and aging?

a. The incidence and prevalence of cancer in older adults is approximately equal to that of younger adults.

b. Cancer is the leading cause of death among persons age 65 and older.

c. Age is the most significant risk factor for cancer.

d. The prevalence of cancer in older adults is expected to decrease in coming decades.

ANS: C

2. A nurse is conducting a workshop for a group at a senior center. Which member of the group has the highest statistical risk of developing cancer within the next year?

a. An obese 75-year-old woman.

b. An 85-year-old Swedish woman.

c. An 85-year-old Italian man.

d. A 75-year-old man with a poor diet.

ANS: B

3. The diagnosis and treatment of cancer in older adults is accompanied by complexities that do not exist in younger populations. Which of the following phenomena contribute to the additional complexity of cancer diagnosis and treatment among the elderly? (Select all that apply.)

a. Detection often occurs at later stage in the course of the disease.

b. Older adults tend to have atypical presentations of many types of cancer.

c. The presence of other chronic health problems makes detection more difficult.

d. The potentially harmful effects of many treatment options make treatment more challenging.

e. Decreased survival rates in older adults mean that treatment is often not cost-effective.

ANS: A, C, D

4. Mammograms (at various intervals) for detecting breast cancer are generally recommended for all women. Which group is least likely to take advantage of having them?

a. Elderly women of all ethnicities

b. Middle-aged black women

c. Middle-aged Latinas

d. Young Latinas

ANS: A

5. The family of a 78-year-old male patient is shocked by his recent diagnosis of pancreatic cancer, citing his lifelong commitment to a healthy diet, consistent exercise, and avoidance of environmental risk factors. Which of the following factors most likely contributed to the man's diagnosis?

a. Age-related changes to his immune system may have compromised his body's ability to recognize cancerous cells.

b. The interplay of existing chronic conditions may have contributed to the etiology of his cancer.

c. His cancer may have been a consequence of a bacterial or viral infection earlier in life.

d. Autoimmune processes associated with the aging process may have initiated abnormal cell division.

ANS: A

6. Recognizing the high incidence of breast cancer among older adult women, a public health nurse has included the topic in a health promotion teaching session at a senior's center. What should the nurse tell the assembled women about their risk of developing breast cancer?

a. "Stopping your hormone replacement therapy can greatly reduce your chance of developing breast cancer."

b. "The substances that you were exposed to during your childbearing years will largely determine your future risks of breast cancer."

c. "Breast cancer appears to be heavily influenced by heredity."

d. "Women who had their children very early in life appear to have an increased risk of breast cancer."

ANS: C

7. When counseling patients, which strategy should a nurse identify as most likely to help elderly men avoid prostate cancer?

a. Cooking meat at high temperatures.

b. Avoiding food additives.

c. Maintaining weight within an ideal range.

d. Avoiding tobacco smoke.

ANS: C

8. Cancer is not a disease of only the elderly. Some cancers, however, are more prevalent in old age. What factor may explain one of the relationships between cancer and age?

a. Prolonged exposure to carcinogens.

b. Age-related weight differences.

c. Increased T-cell activity with age.

d. Alterations in BRCA1 and BRCA2 genes.

ANS: A

9. When the nursing student identifies which of the following as a risk factor for developing breast cancer does the nurse educator know that the student will need additional instruction?

a. Women who had their first menstrual period before age 12.

b. Women who experienced menopause after age 55.

c. Women who have a first-degree relative with breast cancer.

d. Women who do not use hormonal replacement therapy with menopause.

ANS: D

10. The incidence of cancer in a remote rural area was found to be higher than expected. Of the following possible reasons for the finding, which is the most likely?

a. Fluoridated drinking water.

b. Industrial waste in the drinking water.

c. Nitrate-contaminated drinking water.

d. Nitrate-contaminated vegetables such as spinach and beets.

ANS: C

11. A nurse is taking the medical history of an elderly patient who has thyroid cancer. What is an especially important question the nurse should ask?

a. Have you ever smoked cigarettes?

b. Did you have acne as a teenager?

c. Have you ever experienced stress?

d. Have you ever used artificial sweeteners?

ANS: B

12. Which of the following are interventions that gerontological nurses can implement to prevent and diagnose cancer in older adults? (Select all that apply.)

a. Encouraging healthy lifestyles.

b. Educating patients about cancer screening.

c. Facilitating patient efforts to obtain appropriate screening tests.

d. Providing creative, holistic, and skillful nursing interventions to patients diagnosed with cancer.

e. Supporting the physical, emotional, and spiritual health of individuals.

ANS: A, B, C

13. Which of the following would reduce the risk of lung cancer? (Select all that apply.)

a. Avoiding the use of and exposure to tobacco products.

b. Limiting exposure to the sun.

c. Eating a diet rich in fiber, fruits, and vegetables.

d. Ensuring that there is adequate ventilation in the home.

e. Maintaining weight within an ideal range.

ANS: A, D

14. A 77-year-old male patient who has been diagnosed with lung cancer is discussing treatment options with his oncologist. Which of the following factors is most likely to make the patient's treatment more complicated than that of a younger patient?

a. Radiation treatment is not an option for most patients over age 70.

b. Age-related decline in kidney function can affect drug therapy.

c. The client is unlikely to be a candidate for surgery.

d. Fewer pharmacologic treatment options exist for older adult clients.

ANS: B

15. Older adults undergoing radiation and chemotherapy require close monitoring for which of the following reasons?

a. They are more vulnerable than younger patients to dehydration and infections.

b. Older adults are more likely than younger patients to suffer pain.

c. They are more sensitive to radiation than are younger patients.

d. They are more likely to become suicidal than are younger patients.

ANS: A

16. An elderly patient scheduled for cancer treatments may require age-related adjustments in dosages for some procedures. Which kind of treatment can be administered without any age-related adjustment?

a. Surgery

b. Radiation

c. Chemotherapy

d. Biologic therapy

ANS: B

17. Which one of the following statements about conventional treatment for cancer and the elderly is most accurate?

a. The risk of mortality and complications after surgery is no greater for older adults than it is for younger adults.

b. Advanced age can affect the pharmacokinetic process of excretion with cytotoxic drugs because of decreased glomerular filtration rate.

c. Older adults are usually not able to tolerate radiation therapy.

d. Older adults require more basic care when undergoing conventional treatment for cancer.

ANS: B

18. Which one of the following statements about the patients' choice to use complementary and alternative medicine (CAM) is most accurate?

a. CAM therapies are used by 80% of all Americans.

b. CAM therapies are not popular in the United States.

c. CAM practitioners tend to focus mostly on treating the disease.

d. CAM practitioners usually focus on the whole person.

ANS: D

19. A 72-year-old woman who has been diagnosed with breast cancer has declared her intention to seek an alternative treatment abroad that is claimed to eradicate cancer in nearly all cases. How can the nurse best respond to the woman's statement?

a. "Alternative and complementary therapies have been shown to have a valuable role in the holistic treatment of cancer."

b. "It would be a good idea to investigate whether your American insurer will reimburse for treatment in another country."

c. "It's likely in your best interests to limit your treatment to what your oncologist performs."

d. "You might want to investigate why this treatment is not available in the United States."

ANS: D

20. A nurse who works in an oncologist's office is talking with a patient with cancer who has exhausted all conventional treatments. The patient says she has heard that she can be cured by a healer who uses massage therapy. What is the most helpful response the nurse can give?

a. "Let's consult the National Cancer Institute website to find out if there are any risks in this treatment and whether the benefits will outweigh them."

b. "It won't work, and you will waste your money."

c. "Massage isn't useful for cancer."

d. "This will give you something else to think about other than your illness."

ANS: A

21. Which of the following patient signs and symptoms should the nurse recognize as a warning sign of cancer?

a. Dyspnea on exertion.

b. Joint pain.

c. A sore that does not heal.

d. Increasing forgetfulness.

ANS: C

22. A 71-year-old man has been diagnosed with colon cancer after a recent colonoscopy. How can the nurse best address the man's anxiety surrounding his diagnosis?

a. "Try to remember that nearly everyone who is diagnosed with cancer these days survives."

b. "I don't think you will have a great deal of trouble with pain."

c. "This must be very stressful for you. Who are the people that you can rely on for support at this time?"

d. "I'd encourage you to explore alternative and complementary therapies."

ANS: C

23. A nurse is conducting a class in recognizing the danger signals for cancer and lowering risks. Which of the following is a possible danger signal, as publicized by the American Cancer Society?

a. Abdominal or chest pain.

b. Indigestion or difficulty in swallowing.

c. Unusual vision problems.

d. Reddening or blanching of the skin.

ANS: B

24. Elderly patients may need more support when facing a diagnosis of cancer than younger patients, because elders:

a. Have a more pessimistic outlook on life.

b. Have less faith in medicine.

c. May only know about persons who were diagnosed with cancer years ago when treatment options were more limited.

d. May not realize that a cancer diagnosis is often mistaken.

ANS: C

25. Which one of the following statements about providing support to patients and families is most accurate?

a. It is selfish of family members to have additional concerns of their own.

b. An example of a worry of a family member might be that the cost of treatment may impoverish them.

c. It is not useful for the patient to express his or her feelings.

d. It is best to keep the patient and family from knowing of the cancer diagnosis and prognosis.

ANS: B