Which of the following is not routinely included as part of a diagnostic
work-up for colorectal cancer?
a. barium enema
b. colonoscopy
c. bone marrow biopsy
d. carcinoembryonic antigen (CEA) - Precise Answer ✔✔c. bone
marrow biopsy
A bone marrow biopsy is not routinely performed as part of a diagnostic
work-up for colorectal cancer. Barium enemas provide a clear picture of
the large intestine and are useful in detection of smaller tumors.
Colonoscopy provides increased visualization and the ability to biopsy
lesions. CEA is elevated in later stages of colorectal cancer and may
have prognostic value at diagnosis or disease recurrence.
You are a registered nurse working in an outpatient infusion center and
have begun administration of paclitaxel on a newly-diagnosed breast
cancer patient. The patient mentions that she is feeling flushed and
shows you a small hive on her left cheek. Your next course of action is
to:
a. reassure the patient that this is a normal side effect of paclitaxel
b. give the patient 50mg of IV Benadryl
c. immediately stop the infusion and notify the oncologist
,d. decrease the rate of paclitaxel by 50% - Precise Answer ✔✔c.
immediately stop the infusion and notify the oncologist
The patient is experiencing signs of an infusion reaction with the
potential for anaphylaxis. The nurse must be alert to recognize signs and
symptoms of an early infusion reaction to avoid an anaphylactic
response. The first step in addressing an infusion reaction is to
immediately stop the infusion and notify the physician.
A 62-year-old male patient diagnosed with stage 3 SCLC is admitted to
the oncology unit with somnolence, weakness, nausea, vomiting, and
diffuse abdominal pain. His wife reports that he has become increasingly
weak over the past three days and has exhibited a change in mental
status. She reports that he has not had a bowel movement in five days.
Which of the following oncologic complications is a likely explanation
for the patient's clinical presentation?
a. superior vena cava syndrome
b. septic shock
c. liver metastasis
d. hypercalcemia - Precise Answer ✔✔d. hypercalcemia
Hypercalcemia is the oncologic complication that presents with
symptoms of mental status change, weakness, nausea, vomiting,
constipation and abdominal pain. Small cell lung cancer is a malignancy
commonly associated with hypercalcemia. Superior vena cava syndrome
presents as edema of the face, neck, and upper extremities; respiratory
compromise, chest pain, headache, dizziness and a feeling of facial
fullness. The clinical features of septic shock include tachypnea, nausea,
diarrhea, confusion, and ultimately oliguria and metabolic acidosis. The
patient may experience some of these same symptoms with liver
metastasis as well.
,Which of the following chemotherapeutic agents is classified as a Vinca
alkaloid?
a. docetaxel
b. topotecan
c. oxaliplatin
d. vinblastine - Precise Answer ✔✔d. vinblastine
Vinca alkaloids are a subset of chemotherapeutic drugs derived from the
Madagascar periwinkle plant that exert their cytotoxic effects by halting
cell division and causing cell death. Vinblastine is a plant alkaloid, and
more specifically, a vinca alkaloid. Docetaxel is also a plant alkaloid,
derived from Taxanes. Topotecan is also plant alkaloid but is more
specifically classified as a Camptothecin analog. Oxaliplatin is not a
plant alkaloid, it is an alkylating agent known as a 'metal salt'.
Which of the following treatment examples best describes adjuvant
therapy?
a. a 53-year-old patient receives chemotherapy and radiation for a
diagnosis of stage 3 breast cancer
b. a 64-year-old patient diagnosed with stage 3 ovarian cancer receives
chemotherapy after undergoing a total abdominal hysterectomy and
bilateral salpingo-oophorectomy
c. a 42-year-old patient diagnosed with stage 1 breast cancer undergoes a
lumpectomy with lymph node biopsy
d. an 80-year-old patient diagnosed with chronic leukemia receives oral
chemotherapy with regular monitoring by her oncologist - Precise
Answer ✔✔b. chemotherapy following surgery
, Adjuvant therapy is an additional cancer treatement given after the
primary treatment to minimize the risk of cancer recurrence. In example
B, they patient underwent surgery as a primary treatment with
chemotherapy given as adjuvant therapy. Primary treatment is defined as
the first treatment given and is also referred to as first line treatment,
induction treatment, or primary therapy.
A 60-year-old male patient newly diagnosed with small cell carcinoma
of the right lung is admitted to the oncology unit with a chief complaint
of facial and neck swelling as well as a cough. A diagnosis of superior
vena cava syndrome is made. Which of the following treatment options
would you expect to see ordered for this patient?
a. thoracentesis under local anesthesia
b. chemotherapy with adjuvant radiation therapy
c. transfusion of two units of PRBCs
d. surgical consultation to place a chest tube - Precise Answer ✔✔b.
chemotherapy with adjuvant radiation therapy
The correct answer is chemotherapy with adjuvant radiation therapy to
shrink the tumor and to elevate the obstruction that is causing the
syndrome. Thoracentesis and chest tube p[placement would be viable
treatment options for a pleural effusion. Transfusion of packed red blood
cells would not be suitable treatment option for superior vena cava
syndrome.
Which of the following would you include as part of discharge
instructions for a patient diagnosed with head and neck cancer and who
has received radiation therapy?
a. apply soothing ointments to the lips for dryness and cracking
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