Cancer Exemplars

A routine complete blood count for an active older man indicates possible myelodysplastic syndrome. Which procedure would the nurse plan to explain to the patient?

Bone marrow biopsy

Which action would the admitting nurse include in the plan of care for a patient who has neutropenia?

Check temperature every 4 hours

Which laboratory test will the nurse use to determine whether a prescribed myeloid growth factor is effective for a patient with acute lymphocytic leukemia who is receiving chemotherapy?

Absolute neutrophil count

A patient who has acute myelogenous leukemia (AML) is considering treatment with a hematopoietic stem cell transplant (HSCT). Which approach would the nurse take?

Inquire whether there are questions or concerns about HSCT.

Which action would the nurse include in the plan of care for a patient admitted with multiple myeloma?

Monitor fluid intake and output.

Which intervention would the nurse plan for a patient with non-Hodgkin‘s lymphoma whose platelet count drops to 18,000/uL during chemotherapy?

Test all stools for occult blood

A patient receiving outpatient chemotherapy for myelogenous leukemia develops an absolute neutrophil count of 850/uL. Which collaborative action would the nurse anticipate?

Teach the patient to administer myeloid growth factor injections.

Which action for a patient with neutropenia is appropriate for the registered nurse (RN) to delegate to a licensed practical/vocational nurse (LPN/VN)?

Administering injections of myeloid growth factor

Several patients call the outpatient clinic and ask to make an appointment as soon as possible. Which patient would the nurse schedule to be seen first?

A 23-yr-old with no previous health problems who has a nontender axillary lump

After receiving change-of-shift report for several patients with neutropenia, which patient would the nurse assess first?

A 33-yr-old with a fever of 100.8F (38.2C)

Following successful treatment of Hodgkin‘s lymphoma for a 55-yr-old woman, which topic would the nurse include in patient teaching?

Need for follow-up appointments to screen for malignancy

A patient who has non-Hodgkin‘s lymphoma is receiving combination treatment with rituximab (Rituxan) and chemotherapy. Which patient assessment finding requires the most rapid action by the nurse?

Lip swelling

Which information about a patient admitted with multiple myeloma is most important for the nurse to report to the health care provider?

Serum calcium level is 15 mg/dL.

Which information would the nurse include when teaching patients about decreasing the risk for sun damage to the skin?

Try to stay out of the direct sun between the hours of 10 AM and 2 PM.

Which information would the nurse include in the teaching plan for a patient diagnosed with basal cell carcinoma (BCC)?

Minimizing sun exposure reduces risk for future BCC.

A patient in the dermatology clinic has a thin, scaly erythematous plaque on the right cheek. Which action would the nurse take?

Prepare the patient for a skin biopsy.

Which patient risk factor would the nurse assign as the priority focus of patient teaching?

Using a tanning booth weekly

The health care provider prescribes topical 5-FU for a patient with actinic keratosis on the left cheek. Which statement would the nurse include in the patient‘s instructions?

“Your cheek area will erode and take several weeks to heal.”

A patient with an enlarging, irregular mole that is 7 mm in diameter is scheduled for outpatient treatment. The nurse would plan to prepare the patient for which procedure?

Surgical excision

An older adult patient with a squamous cell carcinoma (SCC) on the lower arm has a Mohs procedure in the dermatology clinic. Which nursing action will be included in thepostoperative plan of care?

Teach the use of cold packs to reduce bruising and swelling.

There is one opening in the schedule at the dermatology clinic, and four patients are seeking appointments today. Which patient will the nurse schedule for the available opening?

38-year-old with a 7-mm nevus on the face that has recently become darker

Which screening test would the nurse plan to teach a 45-yr-old male about during an annual wellness exam?

Colonoscopy

A patient who recently had a colon resection for cancer of the colon asks about the purpose of the carcinoembryonic antigen (CEA) test. Which explanation would the nurse provide?

Monitor for tumor growth after surgery.

A patient had an abdominal-perineal resection for colon cancer. Which action is most important for the nurse to include in the plan of care for the day after surgery?

Assess the drainage and incision.

Which information obtained by the nurse interviewing a patient is most important to communicate to the health care provider?

Blood in the stool

A 19-yr-old patient has familial adenomatous polyposis (FAP). Which action will the nurse in the gastrointestinal clinic include in the plan of care?

Schedule the patient for yearly colonoscopy.

After change-of-shift report, which patient would the nurse assess first?

A 64-yr-old with lung cancer and tracheal deviation after subclavian catheter

insertion

A lobectomy is scheduled for a patient with stage I non–small cell lung cancer. The patient tells the nurse, “I would rather have chemotherapy than surgery.” Which initial response would the nurse provide?

“Tell me what you know about the treatments available.”

A patient with newly diagnosed lung cancer tells the nurse, “I don‘t think I‘m going to live to see my next birthday.” Which initial response would the nurse provide?

“Can you tell me what makes you think you will die so soon?”