Causes and Treatments of Tumors - NCLEX-PN

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Question

What muscle pathology is often linked to small cell lung cancer?

Answer

Approximately 60% of patients diagnosed with Lambert-Eaton syndrome have an underlying cancer, most often small cell lung cancer. Lambert-Eaton syndrome is an autoimmune disorder in which the release of neurotransmitter is not permitted due to antibodies against the presynaptic calcium channels. This results in muscle weakness in the limbs. The other conditions listed are not associated with any respiratory cancers.

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Question

60% of cases of stomach cancer in the United States are associated with what infection?

Answer

Helicobacter pylori is present in the stomach of 60% of individuals with gastric cancer. Cancer in these cases may be caused by chronic inflammation at the site of infection, resulting in metaplasia.

Staphylococcus aureus, Salmonella enterica, and Escherichia coli are all common causes of gastroenteritis but are not associated with malignancy.

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Question

Which of the following is not a risk factor for renal cell carcinoma?

Answer

Smoking, obesity, and high blood pressure are among the most common risk factors for development of renal cell carcinoma. Other risk factors include genetic susceptibility, diuretic use, and male gender. Alcohol consumption has not been associated with increased rates of renal cell cancer.

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Question

Renal cell carcinoma can cause what paraneoplastic syndrome?

Answer

Renal cell carcinoma can cause hypercalcemia, due to secretion of PTHrP (parathyroid hormone-related protein).

SIADH and Lambert-Eaton myasthenic syndrome are both associated with small-cell lung cancer, while polymyositis is associated with non-Hodgkin lymphoma.

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Question

What cell line is metaplastic in multiple myeloma?

Answer

Multiple myeloma is caused by metaplasia of plasma cells. No other white blood cell type is typically metaplastic, though abnormal plasma cell accumulation in bone marrow does interfere with the synthesis of all other blood cell types.

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Question

Hepatocellular carcinoma is also associated with what toxin?

Answer

Hepatocellular carcinoma is associated with exposure to aflatoxin, from Aspergillus species, which can be found in many foods. Most commonly contaminated foods are corn, peanuts (and peanut butter), pistachios, brazil nuts, chillies, black pepper, dried fruit, and figs.

Asbestos is linked to mesothelioma, organophosphate exposure is linked to leukemia, and lead exposure has not been directly associated with any increase in malignancy, although current studies are pending further evidence.

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Question

Which of the following is a consequence of a carcinogen?

Answer

Carcinogens cause cancer by making changes to the host's DNA. They can be chemical (ex. pharmaceutical drugs), or viral (ex. Epstein-Barr). Additionally, exposure to radiation has also been known to damage DNA and is another form of a carcinogen.

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Question

A patient is suffering from alopecia secondary to chemotherapy. Which of the following is the correct course of action for the nurse?

Answer

Hair loss can be alarming if large amounts of hair are seen in linens. Shampooing, brushing, heat tools, and hair dyes can increase fallout. The nurse should welcome healthy discussion about self esteem if appropriate.

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Question

Which of the following would raise suspicion for thrombocytopenia?

Answer

Thrombocytopenia occurs when the blood does not have a high enough platelet count. Slow clotting blood, increased bruising, or petechiae can all point to thrombocytopenia.

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Question

Anemia, a side effect of many chemotherapeutic agents, involves which of the following?

Answer

Anemia is a condition caused the the deficiency of healthy red blood cells in the blood stream. This results in lack of sufficient oxygen delivery to tissues.

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Question

Which of the following is not a proven risk-factor for the development of oral cancer?

Answer

All of the above are proven risk factors with the exception of mouthwash use. Poor dental care, prolonged present irritation (such as excessive flossing), tobacco and alcohol use, infection with certain strains of HPV, and an unbalanced diet can increase the risk of oral cancer.

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Question

Suzie is a 42-year-old female and has recently visited a genetic counselor after referral by her primary care physician. She has a family history of breast cancer on her father's side. She was found to not have the cancer-linked BRCA 1 or 2 genetic mutations. The genetic counselor explained to her that __________.

Answer

The incidence of cancer-linked genes can increase an individual's risk of developing cancer. However, their absence does not guarantee that the individual will not develop cancers of any kind.

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Question

Alice is a 25-year-old female who is visiting her primary care physician for a routine physical. Which of the following may be conducted at the appointment?

Answer

A papanicolaou test (pap smear) may be preformed routinely on adult women as a screening for cervical cancer. A rapid antigen detection test (rapid strep test), urine analysis, cervical cerclage, or vaginal ultrasound would not be part of routine screening.

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Question

John is a 60-year-old man who has a first degree relative recently diagnosed with cancer. He asks his nurse what he can do to prevent himself from developing cancer. Which of the following is incorrect?

Answer

Green tea has not been proven to decrease the risk of developing cancer. All other precautions have been shown to decrease the risk of developing various cancers.

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Question

Ethel is an 80-year-old woman who is receiving chemotherapy for the treatment of a tumor. You are the nurse taking care of Ethel. While her chemotherapy is infusing __________.

Answer

Chemotherapeutic agents are often very irritating to the tissue if they unintentionally travel to areas outside the vein. They can cause severe tissue loss and degradation. Patients receiving chemotherapy need to be monitored closely for signs of infiltration.

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Question

Nathan received chemotherapy 24 hours ago. You instruct Nathan to __________.

Answer

People receiving chemotherapy should flush the toilet twice after use for at least 48 hours to avoid exposing anybody else to the byproducts of the chemotherapy drugs. Wearing gloves when preparing foods, throwing away linens, using excessive bleach, and drinking bottled water are not necessary and do not significantly reduce risk to others.

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Question

Identify the chemotherapeutic agent.

Answer

Methotrexate is a chemotherapeutic agent. Levofloxacin is an antibiotic, lamotrigine is a mood stabilizer, gabapentin is an anti-epileptic agent, and furosemide is a diuretic.

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Question

Your patient is experiencing diarrhea after receiving chemotherapy. Which of the following is an appropriate nursing intervention?

Answer

A diet high in soluble fiber will help to decrease the effects of diarrhea. Note that soluble fiber also provides relief from constipation. Senokot-S is a stool softener that will cause increased diarrhea. Remaining sedentary and not eating are not necessary and will not help a patient recovering from chemotherapy.

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Question

The oncology nurse cares for a patient receiving internal radiation treatment for cancer. Which of the following scenarios most concerns the nurse?

Answer

When caring for a patient receiving internal radiation, the length of exposure to the radiation is a high priority for the nurse. It is important to rotate staff who care for the patient, limiting close contact to 30 minutes per 8 hour shift. Additionally, it is important to organize tasks so limited time is spent in the client’s room. Visitors must also be limited. Pregnant women should not be assigned to work with this client. The patient must be on bedrest while sealed sources of radiation are placed. It is also important not to stand close to the radioactive source.

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Question

What muscle pathology is often linked to small cell lung cancer?

Answer

Approximately 60% of patients diagnosed with Lambert-Eaton syndrome have an underlying cancer, most often small cell lung cancer. Lambert-Eaton syndrome is an autoimmune disorder in which the release of neurotransmitter is not permitted due to antibodies against the presynaptic calcium channels. This results in muscle weakness in the limbs. The other conditions listed are not associated with any respiratory cancers.

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