Prepared by : Vandie Magallanes Cancer Questions: 1.

The home health care nurse is caring for a client with cancer and the client is complaining of acute pain. The appropriate nursing assessment of the client's pain would include which of the following? a) the client's pain rating b) nonverbal cues from the client c) the nurse's impression of the client's pain d) pain relief after appropriate nursing intervention 2. The nurse is caring for a client who is a pelvic exenteration and the physician changes the client's diet from NPO status to clear liquids. The nurse makes which priority assessment before administering the diet? a) bowel sounds b) ability to ambulate c) incision appearance d) urine specific gravity

3. The client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment finding would the nurse expect to note specifically in the client? a) fatigue b) weakness c) weight gain d) enlarged lymph nodes 4. During the admission assessment of a client with advanced ovarian cancer, the nurse recognizes which symptom as typical of the disease? a) diarrhea b) hypermenorrhea

c) abnormal bleeding d) abdominal distention 5. The nurse is reviewing the complications of conization with a client who has microinvasive cervical cancer. Which complication, if identified by the client, indicates a need for further teaching? a) infection b) hemorrhage c) cervical stenosis d) ovarian perforation

ANSWERS AND RATIONALE 1) A - The 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 clients pain is not appropriate in determining the clients level of pain. Nonverbal cues from the client are important but are not the most appropriate pain assessment measure. Assessing pain relief is an important measure, but this option is not related to the subject of the question. 2) A - The client is kept NPO until peristalsis returns, usually in 4 to 6 days. When signs of bowel function return, clear fluids are given to the client. If no distention occurs, the diet is advanced as tolerated. The most important assessment is to assess bowel sounds before feeding the client. Options B, C, and D are unrelated to the subject of the question. 3) D - Hodgkins disease is a chronic progressive neoplastic disorder of lymphoid tissue characterized by the painless enlargement of lymph nodes with progression to extralymphatic sites, such as the spleen and liver. Weight loss is most likely to be noted. Fatigue and weakness may occur but are not related significantly to the disease.

4) D - Clinical manifestations of ovarian cancer include abdominal distention, urinary frequency and urgency, pleural effusion, malnutrition, pain from pressure caused by the growing tumor and the effects of urinary or bowel obstruction, constipation, ascites with dyspnea, and ultimately general severe pain. Abnormal bleeding, often resulting in hypermenorrhea, is associated with uterine cancer. 5) D - Conization procedure involves removal of a cone-shaped area of the cervix. Complications of the procedure include hemorrhage, infection, and cervical stenosis. Ovarian perforation is not a complication.