A gastrectomy is performed on a client with gastric cancer. In the immediate postoperative period, the
nurse notes bloody drainage from the nasogastric tube. Which of the following is the appropriate nursing intervention?"
"a) notify the physician
b) me
d) continue to monitor the drainage (CORRECT)"Following gastrectomy, drainage from the nasogastric tube is normally bloody for 24 hours postoperatively, changes to brown-tinged, and is then to yellow or clear. Because bloody drainage is expected in the im
1. While being prepared for a biopsy, the patient asks the nurse what the difference is between a benign tumor and a malignant tumor. The nurse explains that a benign tumor differs from a malignant tumor in that benign tumors
"a. do not cause damage to a
b. do not spread to other tissues and organs. The major difference between benign and malignant tumors is that malignant tumors invade adjacent tissues and spread to distant tissues and benign tumors never metastasize. Both types of tumors may cause damag
11. The nurse is interviewing a male client about his past medical history. Which preexisting condition may lead the nurse to suspect that a client has colorectal cancer?
"a. Duodenal ulcers
b. Hemorrhoids
c. Weight gain
d. Polyps
Answer D. Colorectal polyps are common with colon cancer. Duodenal ulcers and hemorrhoids aren't preexisting conditions of colorectal cancer. Weight loss � not gain � is an indication of colorectal cancer.
74. The community nurse is conducting a health promotion program and the topic of the discussion relates to the risk factors for gastric cancer. Which risk factor, if identified by a client, indicates a need for further discussion?
"a) smoking
b) a high-
b) a high-fat diet - A high-fat diet plays a role in the development of cancer of the pancreas. Options A, C, and D are risk factorsrelated to gastric cancer.
75. A gastrectomy is performed on a client with gastric cancer. In the immediate postoperative period, the nurse notes bloody drainage from the nasogastric tube. Which of the following is the appropriate nursing intervention?
"a) notify the physician
b)
D)Following gastrectomy, drainage from the nasogastric tube is normally bloody for 24 hours postoperatively, changes to brown-tinged, and is then to yellow or clear. Because bloody drainage is expected in the immediate postoperative period, the nurse shou
A client has been diagnosed with colon cancer of the rectum. While
completing the preoperative checklist the client asks the nurse "Where
will my stoma be?" The nurse's best response is
A. right upper quadrant. B. left upper quadrant C. right lower quadr
D) LLQ"Rationale: A client with cancer of the rectum will
have an abdominoperineal resection. The anal canal will be closed and a
stoma will be formed from the proximal sigmoid colon in the left lower
quadrant of the abdomen. The other 3 answers are in co
A client undergoes a colonoscopy for colorectal cancer screening. During the procedure three small polyps were removed. Which nursing procedures are necessary when caring for the client immediately after the colonoscopy? "A. Monitor vital signs and inform
1. B - Rationale: After a colonoscopy the nurse should observe the patient closely for signs of bowel perforation (rectal bleeding, abdominal pain and distention, malaise, fever, and mucopurulent drainage). Vital signs should be monitored until stable. Du
A client with cancer of the colon who is receiving chemotherapy tells a nurse that some foods on the metal tray taste bitter. The nurse would try ti limit which of the following foods that is most likely to cause this taste for the client? "a) cantaloupe
beef: meat is perceived as bitter by clients with cancer
A female client with cancer is receiving chemotherapy and develops thrombocytopenia. The nurse identifies which intervention as the highest priority in nursing plan of care?
"a) Monitoring temperature
b) Ambulation three times daily
c) Monitoring the pla
Monitoring the PLT count"Answer: C
Thrombocytopenia indicates a decrease in the number of platelets in the circulating blood. A major concern is monitoring for the preventing bleeding. Option A elates to monitoring for infection, particularly if leukopeni
A female client with cancer is scheduled for radiation therapy. The nurse knows that radiation at any treatment site may cause a certain adverse effect. Therefore, the nurse should prepare the client to expect: "a. hair loss.
b. stomatitis.
c. fatigue.
d.
Answer C. Radiation therapy may cause fatigue, skin toxicities, and anorexia regardless of the treatment site. Hair loss, stomatitis, and vomiting are site-specific, not generalized, adverse effects of radiation therapy.
A gastrectomy is performed on a client with gastric cancer. Int he immediate postoperative period, the nurse notes bloody drainage from the nasogastric tube. Which of the following is the appropriate nursing intervention.
"1. Notify the physician
2. Meas
4. Continue to monitor the drainage Following gastrectomy, drainage from the nasogastric tube is normally bloody for 24 hours postoperatively, changes to brown-tinged, and is then to yellow or clear. Because bloody drainage is expected in the immediate po
A nurse is reviewing the preoperative prescriptions for a client with colon tumor who is scheduled for abdominal perineal resection and notes that the physician has prescribed neomycin (Mycifradin) for the client. The nurse determines that this medication
CORRECT ANSWER: 3. To decrease the bacteria in the bowel. Rationale: To reduce the risk of contamination at the time of surgery, the bowel is emptied and cleansed. Laxatives and enemas are given to empty the bowel. Intestinal anti-infectives such as neomy
A nurse is teaching a client about the risk factors associated with colorectal cancer the nurse detemines that further teaching related to colorectal cancer is necessary if the client identifies which of the following as an associated risk factor? 1. Age
1 is correct. Correctal cancer risk factors include age older than 50, a family history of the disease, polyps, and chronic IBD
A patient who has been told by the health care provider that the cells in a bowel tumor are poorly differentiated asks the nurse what is meant by "poorly differentiated." Which response should the nurse make? "a. ""The cells in your tumor do not look very
C Rationale: An undifferentiated cell has an appearance more like a stem
cell or fetal cell and less like the normal cells of the organ or
tissue. The DNA in cancer cells is always different from normal cells,
whether the cancer cells are well differenti
A patient with metastatic colorectal cancer is scheduled for both
chemotherapy and radiation therapy. Patient teaching regarding these
therapies for this patient would include an explanation that:
"A. Chemotherapy can be used to cure colorectal cancer
B.
C is Correct. Rationale: Chemotherapy can be used to shrink the tumor before surgery,
as an adjuvant therapy after colon resection, and as palliative
treatment for nonresectable colorectal cancer. Radiation therapy may be
used postoperatively as an adjuv
An optimal teaching plan for an outpatient with stomach cancer receiving radiation therapy should include information about
"a. cancer support groups.
b. avitaminosis, ostomy care, and community resources.
c. prosthetic devices, skin conductance, and gri
d. wound and skin care, nutrition, drugs, and community resources "Radiation therapy is used as an adjuvant to surgery or for palliation in stomach cancer treatment. The nurse's role is to provide detailed instructions, to reassure the patient, and to ens
Chemotherapy is one of the therapeutic modalities for cancer. This treatment is contraindicated to which of the following conditions? "a. Recent surgery
b. Pregnancy
c. Bone marrow depression
d. All of the above
Answer: D. chemotherapy is contraindicated in cases of infection (chemotherapeutic agents are immunosuppressive), recent surgery (chemotherapeutic agent may retard the healing process), impaired renal and hepatic function (drugs are nephrotoxic and hepato
During a routine health examination, a 30-year-old patient tells the
nurse about a family history of colon cancer. The nurse will plan to:
"a. teach the patient about the need for a colonoscopy at age 50.
b. ask the patient to bring in a stool specimen t
d. have the patient ask the doctor about specific tests for colon cancer. "The patient is at increased risk and should talk with the health care
provider about needed tests, which will depend on factors such as the
exact type of family history and any cur
For a female client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client? "a) Client verbalizes feeling o
Answer: A
Verbalizing feelings is the client's first step in coping with the situational crisis. It also helps the health care team gain insight into the client's feelings, helping guide psychosocial care.
A gastrectomy is performed on a client with gastric cancer. In the immediate postoperative period, the nurse notes bloody drainage from the nasogastric tube. Which of the following is the appropriate nursing intervention?
a) notify the physician
b) measur
D
- Following gastrectomy, drainage from the nasogastric tube is normally bloody for 24 hours postoperatively, changes to brown-tinged, and is then to yellow or clear. Because bloody drainage is expected in the immediate postoperative period, the nurse
Which one of the following expected outcomes about nutrition would be appropriate for a client who has had a total gastrectomy for gastric cancer? The client will:
"a.) Regain any weight lost within 4 weeks of the surgical procedure.
b.) Eat three full m
RATIONALE: An appropriate expected outcome is for the client to maintain nutrition either through oral or total parenteral feedings. Oral and total parenteral nutrition may also be used concurrently. It is not realistic to expect the client to regain weig
Teaching a client who has had recent bowel surgery how to facilitate the expulsion of feces may include the process of increasing intra-abdominal pressure. Which of the following best matches this process? "A.Crede's maneuver.B.Valsalva's maneuver.C.Heiml
B)valsalva"The Valsalva's maneuver facilitates the expulsion of feces by closing the
glottis and increasing the intra-abdominal pressure. Crede's maneuver is used to
manually expel urine from the bladder, Heimlich's maneuver is used to dislodge
food from
The 85-year-old male client diagnosed with cancer of the colon asks the nurse, "Why did I get this cancer?" Which statement is the nurse's best response?1.Cancer of the colon is associated with a lack of ?ber in the diet.2.Cancer of the colon has a greate
Answer 1: 1.A long history of low-?ber, high-fat, high-protein diets results in a prolonged transit time. This allows the carcinogenic agentsin the waste products to have a greater ex-posure to the lumen of the colon. 2.The older the client, the greater t
The client diagnosed with gastroesophageal re?ux disease (GERD) is at greater risk for which disease? 1.Hiatal hernia.2.Gastroenteritis.3.Esophageal cancer.4.Gastric cancer.
3) esophageal" cancer
1. A hiatal hernia places the client at risk forGERD; GERD does not predispose the clientfor developing a hiatal hernia.2.Gastroenteritis is an in?ammation of the stom-ach and intestine, usually caused by a virus.
3.
Barrett's esopha
The client diagnosed with stomach cancer has developed dissemenated intravascular coagulopathy (DIC). Which collaborative intervention would the nurse implement? A) Prepare to administer IV heparin. B) Assess for frank hemorrhage from venipuncture sites.
Correct A. Heparin interferes w/ the clotting cascade and may prevent further clotting factor consumption resulting in uncontrolled thromboses formation. B. Assessment is an independent intervention; not collaborative and doesn't require a HCP order. C. s
the client with a new colostomy is being discharged. which statement made by the client indicates the need for further teaching? 1. "if i notice any skin breakdown, i will call my HCP." 2 . "i should drink only liquids until the colostomy starts to work.
2 . "i should drink only liquids until the colostomy starts to work."1. if the tissue around the stoma becomes excoriated, the client will be unable to pouch the stoma adequately, resulting in discomfort and leakage. the client understands the teaching. 2
The client with polyps has watched a video on primary prevention of colon cancer. The nurse can evaluate teaching effectiveness when the client states "I should follow:
"1. low sodium low fat high fiber diet."
2. a low fat, low refined sugar and decrease
Correct Answer: a low fat, low refined sugar and decrease red meat while eating more fiber." Rationale: The dietary recommendations for the prevention of colon rectal cancer include decreasing the amount of fat, refined sugar, red meats while increasing
The community nurse is conducting a health promotion program and the topic of the discussion relates to the risk factors for gastric cancer. which risk factor, if identified by a client, indicates a need for further discussion?
"1. Smoking
2. A high-fat d
2) high-fat dieta high fat diet plays a role in the development of cancer of the pancreas. options 1,3,4 are risk factors related to gastric cancer.
The day after abdominal surgery, the nurse auscultates the client's abdomen and notes faint bowel sounds in all four quadrants. The client also reports experiencing flatus. The nurse interprets these findings as:
"a. imminent emesis.
b. intestinal blockag
Answer: C (return of peristalsis.)
Rationale: Auscultation of the abdomen following abdominal surgery is important to determine the return of bowel function. Bowel sounds caused by peristalsis usually return within 24 hrs. after surgery. Flatus, or the p
The home healthcare nurse is caring for a client with cancer and the client is complaining of acute pain. The most appropriate nursing assessment of the client's pain would include which of the following?
"1. the clients pain rating
2. nonverbal cues from
1) client pain ratingthe clients self report is a critical component of pain assessment. the nurse should ask the client about the description of the pain and listen carefully to the clients words used to describe the pain. the nurses impression of the cl
The most effective treatment method for the nausea and vomiting that accompany chemotherapy is to:
"A. Administer an oral antiemetic when the client complains of nausea and vomiting.
B. Administer an antiemetic by intramuscular injection when the client
C. Before starting therapy with agents with high emetic potential, clients may be
pretreated with an antiemetic
The night before surgery for colon cancer, the client refuses the bowel preparation and angrily threatens to leave the hospital. Which of the following is the best response?
A. "A tranquilizer will help soothe your nerves and make the preparation less pa
Correct answer: Answer C is the only answer that supports the client and allows the client identify and discuss the issues causing the uncooperative behavior. The nurse understands that cancer surgery in the bowels can cause fears: loss of body function,
The nurse is caring for a patient one day after an abdominal-perineal resection for cancer of the rectum. The nurse should question which of the following orders?
"1. Discontinue the nasogastric tube.
2. Irrigate the colostomy.
3. Place petrolatum gauze
1. discontinued when peristalsis occurs
2. colostomy begins to function 3-6 days after surgery (correct)
3. done if no pouch in place, keeps stoma moist, cover with dry, sterile dressing
4. prevents post-op pain
The nurse is caring for a patient receiving an initial dose of chemotherapy to treat a rapidly growing metastatic colon cancer. The nurse is aware that this patient is at risk for tumor lysis syndrome (TLS) and will monitor the patient closely for which
Answer b: TLS is a metabolic complication characterized by rapid release of
intracellular components in response to chemotherapy. This can rapidly lead to acute renal failure. The hallmark signs of TLS are hyperuricemia, hyperphosphatemia, hyperkalemia,
The nurse is caring for a patient suffering from anorexia secondary to chemotherapy. Which of the following strategies would be most appropriate for the nurse to use to increase the patient's nutritional intake? "A. Increase intake of liquids at mealtime
D. Add items such as skim milk powder, cheese, honey, or peanut butter to selected foodsThe nurse can increase the nutritional density of foods by adding items high in protein and/or calories (such as peanut butter, skim milk powder, cheese, honey, or bro
The nurse is caring for clients in an outpatient clinic. Which information should the nurse teach regarding the American Cancer Society's recommendations for the early detection of colon cancer?
"1. Beginning at age 60, a digital rectal examination shoul
3. Have a colonoscopy at age 50 and then once every five to ten years. "1. A digital rectal examination is done to detect prostate cancer and should be started at age 40 years.
2. ""Middle age"" is a relative term; specific ages are used for recommendatio
The nurse is interviewing a male client about his past medical history.
Which preexisting condition may lead the nurse to suspect that a client
has colorectal cancer?
"a. Duodenal ulcers
b. Hemorrhoids
c. Weight gain
d. Polyps
Answer D. Colorectal polyps are common with colon cancer. Duodenal ulcers and hemorrhoids aren't preexisting conditions of colorectal cancer. Weight loss � not gain � is an indication of colorectal cancer.
The nurse is performing an admission assessment on a client diagnosed with a right colon tumor. The nurse asks the client about which characteristic symptom of this type of tumor?
"a) rectal bleeding
b) flat, ribbon-like stool
c) crampy, colicky abdomina
c) crampy, colicky abdominal pain)Vague abdominal discomfort or crampy, colicky abdominal pain is a characteristic symptom of a right colon tumor. Options A, B, and D are symptoms associated with left colon tumors.
The nurse is planning care for a 68-year-old patient with an abdominal
mass and suspected bowel obstruction. Which of the following factors in
the patient's history increases the patient's risk for colorectal
cancer?
"A. Osteoarthritis
B. History of rect
B. History of rectal polyps
rationale: A history of rectal polyps places this patient at risk for colorectal
cancer. This tissue can degenerate over time and become malignant. The
other factors identified do not pose additional risk to the patient.
The Nurse is reviewing the preop orders of a client w/ a colon tumor who is scheduled for abdominal perineal resection and notes that the physician prescribed neomycin (Mycifradin) for the client. The nurse determines that this medication has been prescri
3. To decrease the bacteria in the bowel To reduce the risk of contamination at the time of surgery, the bowel is emptied and cleansed. Laxatives and enemas are given to empty the bowel. intestinal anti-infectives such as neomycin or kanamycin (Kantrex) a
The nurse is teaching a client about the modifiable risk factors than can reduce the risk for colorectal cancer. The nurse places the highest priority on discussing which risk factor with this client?
"A. Age older than 30 years
B. High fat and low fiber
Correct Answer: B
Rationale: Common risk factors for colorectal cancer that cannot be changed include age older than 40, first-degree relative with colorectal caner, and history of bowel problems such as ulcerative colitis or familial polyposis. Clients
The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary if the client identifies which of the following as an associated risk factor? 1. a history of inflammatory bow
3. Colorectal cancer most often occurs in populations with diets low in fiber and high in refined carbohydrates, fats, and meats.
The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching related to colorectal cancer is necessary if the client identifies which of the following as an associated risk factor?
"a)
Colorectal cancer risk factors include age older than 50 years, a family history of the disease, colorectal polyps, and chronic inflammatory bowel disease.
The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching related to colorectal cancer is necessary if the client identifies which of the following as an associated risk factor?
"a
a) age younger than 50 years- Colorectal cancer risk factors include age older than 50 years, a family history of the disease, colorectal polyps, and chronic inflammatory bowel disease.
The nurse planning care for the client who
has had an abdominal-perineal resection
for cancer of the colon. Which interventions
should the nurse implement? Select all that
apply.
"1. Provide meticulous skin care to stoma
2. Asess the flank incision
3. Ma
Answer: 1,3,5.
There are midline and perineal incisions not flank
Jackson Pratt drains are emptied every shift but they
are not irrigated.
The nurse understands that cancerous lesions found in the stomach are the second most common cancer in the world. Which of the following is a risk factor for these malignant lesions?
"A. Excessive alcohol consumption
B. Being female under 40 years of age
Answer: C. Exposure to leaded gasoline
Cancerous lesions found in the stomach are the second most common cancer in the world. Gastric cancer affects people over the age of 40 and is seen more often in men than in women. Risk factors for the development o
The occupational health nurse if preparing a presentation to a group of factory workers about preventing colon cancer. Which information should be included in the presentation? "1. Wear a high-filtration mask when around chemicals.
2. Eat several servings
Correct Answer: 2
1. Some cancers have a higher risk of developing when the client is occupationaly exposed to chemicals, but cancer of the colon is not one of them.
2. Cruciferous vegetables, such as broccoli, cauliflower, and cabbage, are high in fiber
The teaching plan for an outpatient with stomach cancer receiving radiation therapy should include information about:
"a. cancer support groups, alopecia, and stomatitis
b. avitaminosis, ostomy care, and community resources
c. prosthetic devices, skin co
d. wound and skin care, nutrition, drugs, and community resourcesRationale: Radiation therapy is used as an adjuvant to surgery or for palliation in stomach cancer treatment. The nurse's role is to provide detailed instructions, to reassure the patient, a
What is the best test to diagnose stomach cancer?
"A. Upper endoscopic examination
B. Barium enema
C. Endoscopic retrograde cholangiopancreatogram (ERCP)
D. Magnetic resonance imaging (MRI)
Upper endoscopic examination is the best diagnostic test for stomach cancer. It allows direct visualization and biopsy. Barium enema is for lower gastrointestinal problems and does not allow direct visualization. ERCP is an endoscopic procedure used to ex
Which symptom, if reported by a client, would lead the nurse to suspect colon cancer? 1) abdominal cramping 2) constant hunger 3) feeling of fullness, 4) weight gain
3)feeling of fullnessthe client with gastric cancer may report a feeling of fullness in the stomach, but not enough to cause him to seek medical care. Abdominal cramping isn't associated with gastric cancer and weight loss (not increased hunger or weight