Question

The nurse knows that the "CAUTION" mnemonic is used by the American Cancer Society to educate the public about warning signs of cancer. This include (Select ALL that apply)

Answer 1

Correct Answers:

a sore that does not heal
nagging cough or hoarseness
indigestion or difficulty in swallowing
change in bowel or bladder habits

Rationale :

A sore that does not heal

💎Nonhealing sores are a classic CAUTION warning sign and may reflect persistent malignant cell growth that impairs normal tissue repair.

💎 Any lesion that fails to close within ~2–3 weeks, enlarges, bleeds easily, or develops rolled/indurated edges warrants prompt evaluation.

💎Oral, cutaneous, and diabetic foot ulcers are high-risk sites where malignancy can be missed if assumed to be benign.

💎Early assessment (visual exam, biopsy if suspicious) is essential to stage disease and initiate timely treatment.

💎Emphasize patient teaching: document size/appearance, avoid self-treating chronic lesions, and report persistence or change quickly.

Nagging cough or hoarseness

💎A persistent cough or hoarseness (the N in CAUTION) can signal laryngeal or lung cancer, especially with smoking history or secondhand smoke exposure.

💎Red flags include >3 weeks duration, voice changes, hemoptysis, chest pain, or unexplained weight loss.

💎Pathology may involve airway or vocal cord irritation from tumor growth, causing progressive dysphonia.

💎Workup often includes CXR, laryngoscopy, or CT imaging, followed by tissue diagnosis when indicated.

💎 Nurses should coach clients to track duration/symptoms and not dismiss “lingering colds” that don’t improve.

Indigestion or difficulty swallowing (dysphagia)

💎 Persistent indigestion or dysphagia (the I in CAUTION) may reflect esophageal or gastric malignancy, especially when progressive or associated with odynophagia and regurgitation.

💎 Alarm features include unintentional weight loss, iron-deficiency anemia, GI bleeding, or early satiety.

💎 Tumor-related luminal narrowing and motility disruption can initially affect solids, then advance to liquids.

💎 Recommended evaluation: upper endoscopy with biopsy, and imaging for staging if cancer suspected.

💎 Early identification improves candidacy for curative therapies (endoscopic resection/surgery) and nutrition support.

Change in bowel or bladder habits

💎 A change in bowel/bladder habits (the C in CAUTION) can indicate colorectal or urothelial cancers—watch for new constipation/diarrhea, narrow (“pencil”) stools, urgency, frequency, or nocturia.

💎 Occult or visible blood in stool/urine, tenesmus, or incomplete emptying heighten concern and require prompt workup.

💎 Colorectal tumors may alter colonic transit and stool caliber; bladder tumors can cause irritative voiding and hematuria.

💎 Diagnostic pathways include FIT/FOBT, colonoscopy, or urinalysis + cystoscopy depending on symptom profile.

💎 Nurses reinforce screening adherence (e.g., colonoscopy as age/risks dictate) and immediate reporting of new pattern changes.

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Answer 2

Correct Answers:

Baked apricot chicken and steamed broccoli.

Rationale :

♦️Baked foods and vegetables high in antioxidants (broccoli, apricot, carrots) contain vitamins A, C, and E, which help neutralize free radicals that damage cellular DNA.

♦️Broccoli is rich in sulforaphane and indoles, known to have anti-carcinogenic properties, especially against colorectal and breast cancers.

♦️Apricots provide beta-carotene and flavonoids, supporting immune defense.

♦️Avoiding fried or smoked foods reduces intake of nitrosamines and polycyclic hydrocarbons, which increase cancer risk.

♦️Encouraging grilled or baked lean proteins aligns with cancer-preventive nutrition.

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Answer 3

Correct Answers:

Baked apricot chicken and steamed broccoli.

Rationale :

♦️Baked foods and vegetables high in antioxidants (broccoli, apricot, carrots) contain vitamins A, C, and E, which help neutralize free radicals that damage cellular DNA.

♦️Broccoli is rich in sulforaphane and indoles, known to have anti-carcinogenic properties, especially against colorectal and breast cancers.

♦️Apricots provide beta-carotene and flavonoids, supporting immune defense.

♦️Avoiding fried or smoked foods reduces intake of nitrosamines and polycyclic hydrocarbons, which increase cancer risk.

♦️Encouraging grilled or baked lean proteins aligns with cancer-preventive nutrition.

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Answer 4

Correct Answers:

the fact that chemotherapy acts on all rapidly growing cells, hence the lack of specificity.

Rationale :

🟣Chemotherapy agents target rapidly dividing cells, which include both malignant cells and normal tissues like bone marrow, GI tract, and hair follicles.

🟣This non-selective cytotoxicity explains common side effects—alopecia, mucositis, nausea, vomiting, and myelosuppression.

🟣Rapidly dividing hematopoietic cells lead to decreased WBCs, RBCs, and platelets, increasing infection and bleeding risk.

🟣Understanding this mechanism helps nurses provide anticipatory care and patient education.

🟣Supportive therapy includes antiemetics, growth factors, and infection prevention.

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Answer 5

Correct Answers:

informing the health care provider when the prescribed intervention is ineffective.

Rationale :

♦️Acting as a patient advocate involves communicating unrelieved pain to ensure the client receives timely and adequate analgesia.

♦️Cancer pain requires individualized management, and ineffective control should be escalated to the provider for reassessment or dose adjustment.

♦️This role supports the ethical principle of beneficence—promoting patient comfort and dignity.

♦️The nurse also ensures appropriate opioid titration while monitoring for side effects.

♦️Advocacy demonstrates collaboration and patient-centered care.

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Answer 6

Correct Answers:

protecting the client from infection and bleeding

Rationale :

✔️The nadir is the lowest point of bone marrow suppression, typically 7–14 days after chemotherapy, when WBCs and platelets are at their lowest.

✔️The client is highly susceptible to infection and bleeding, requiring neutropenic precautions.

✔️The nurse should monitor temperature, CBC, and signs of bleeding and maintain aseptic technique.

✔️Avoid invasive procedures, fresh flowers, and raw fruits/vegetables to reduce exposure risk.

✔️ Implementing these precautions helps prevent life-threatening sepsis or hemorrhage.

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Answer 7

Correct Answers:

safeguarding the client and others from unnecessary radiation exposure.

Rationale :

♦️During internal radiation (brachytherapy), the client is the source of radiation while the sealed device remains in place.

♦️The nurse’s top priority is radiation safety for the client, staff, and visitors.

♦️Principles: Time (limit exposure), Distance (maintain ≥6 ft), and Shielding (lead apron).

♦️Visitors should stay only 10–30 minutes daily, and pregnant women and children are restricted.

♦️Handling and disposal of radioactive materials must follow facility and radiation safety protocols.

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Answer 8

Correct Answers:

Most chemotherapy agents cause myelosuppression, monitor CBCs.
Bleomycin can lead to pulmonary fibrosis long-term, monitor for changes in pulmonary function.
Reproductive ability may return following chemotherapy but males should consider banking sperm prior to treatment.
Doxorubicin (Adriamycin) can cause dose-related cardiotoxicity, monitor the patient's ejection fraction (EF).

Rationale :

Most chemotherapy agents cause myelosuppression, monitor CBCs.

💎 Myelosuppression is one of the most common and serious toxicities of chemotherapy, resulting from the suppression of bone marrow activity.

💎 This leads to decreased production of WBCs, RBCs, and platelets, predisposing patients to infection, anemia, and bleeding tendencies.

💎 The nurse must monitor complete blood counts (CBCs) frequently to detect neutropenia, anemia, or thrombocytopenia early.

💎 Preventive interventions such as infection control measures, neutropenic precautions, and possible administration of colony-stimulating factors (e.g., filgrastim) are essential.

💎 Understanding this toxicity allows timely nursing interventions to maintain patient safety and reduce treatment complications.

Bleomycin can lead to pulmonary fibrosis long-term, monitor for changes in pulmonary function.

💎 Bleomycin is an antitumor antibiotic known for its dose-dependent pulmonary toxicity, particularly pulmonary fibrosis.

💎 The drug damages alveolar epithelial cells, leading to inflammation and scarring of lung tissue, which impairs gas exchange.

💎 Nurses should assess for symptoms such as cough, dyspnea, or crackles and monitor pulmonary function tests (PFTs) regularly during treatment.

💎 Early detection of pulmonary changes allows for modification or discontinuation of therapy to prevent irreversible lung damage.

💎 Patients should also be advised to avoid oxygen therapy unless essential, as it can potentiate toxicity.

Reproductive ability may return following chemotherapy but males should consider banking sperm prior to treatment.

💎 Chemotherapy can cause temporary or permanent gonadal dysfunction due to its cytotoxic effects on germ cells.

💎 Although fertility may return in some individuals, male patients are advised to bank sperm before starting treatment because recovery of fertility is unpredictable.

💎 This is particularly important with alkylating agents (e.g., cyclophosphamide) known to cause long-term infertility.

💎 Nurses must educate patients on fertility preservation options and provide emotional support when discussing reproductive health.

💎 Such counseling upholds the principle of informed decision-making and respects patients’ future family planning goals.

Doxorubicin (Adriamycin) can cause dose-related cardiotoxicity, monitor the patient's ejection fraction (EF).

💎 Doxorubicin, an anthracycline antibiotic, has a well-documented risk of cumulative dose-dependent cardiotoxicity leading to cardiomyopathy and heart failure.

💎 The mechanism involves free radical formation that damages cardiac myocytes, reducing the contractility of the heart.

💎 Nurses must monitor baseline and periodic ejection fraction (EF) using echocardiograms or MUGA scans during therapy.

💎 The risk increases when the lifetime cumulative dose exceeds 550 mg/m², making dose calculation essential.

💎 Prompt recognition of signs of heart failure, such as dyspnea or edema, allows early intervention to prevent permanent damage.

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Answer 9

Correct Answers:

the fluid level in the water seal chamber fluctuates

Rationale :

🔷Fluctuation (tidaling) in the water seal chamber occurs as the patient inhales and exhales, showing that the chest tube drainage system is patent and functioning properly.

🔷During inspiration, the water level rises, and during expiration, it falls, reflecting normal pressure changes in the pleural cavity.

🔷The absence of tidaling may indicate a blocked or kinked chest tube, or that the lung has fully re-expanded.

🔷Continuous bubbling would indicate an air leak, not normal function, so fluctuation is the expected finding.

🔷Nurses must regularly observe tidaling to ensure effective drainage and maintain appropriate negative pressure in the pleural space.

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Answer 10

Correct Answers:

Continue the present course of treatment.

Rationale :

🔶The arterial blood gas (ABG) values — pH 7.37, PaCO₂ 42 mmHg, PaO₂ 95 mmHg, HCO₃ 24 mEq/L — indicate normal acid-base balance and adequate oxygenation.

🔶The client’s mild pain during breathing exercises is expected following chest tube removal and should be managed conservatively with analgesics as prescribed.

🔶There are no signs of respiratory distress or hypoxemia that would warrant additional oxygen therapy or invasive procedures.

🔶Continuing the current treatment supports optimal recovery while maintaining effective pulmonary hygiene.

🔶The nurse should encourage deep breathing, coughing, and ambulation to prevent atelectasis and promote lung expansion.

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N210_Fall_2023_Exam_3_DAY-EVE_Fundamentals

No.

1 :
The nurse knows that the "CAUTION" mnemonic is used by the American Cancer Society to educate the public about warning signs of cancer. This include (Select ALL that apply)

2 :
The school nurse is teaching a nutrition class in the local high school. The lesson for the day focused on foods that can potentially reduce the risks of cancer. Which menu selection indicates that the students understood the instruction?

3 :
The school nurse is teaching a nutrition class in the local high school. The lesson for the day focused on foods that can potentially reduce the risks of cancer. Which menu selection indicates that the students understood the instruction?

4 :
The nurse is discussing chemotherapy with a client who was recently diagnosed with cancer and is scheduled to start treatment. The client demonstrates correct understanding if the client verbalizes that the side effects of chemotherapy is primarily due to:

5 :
The nurse can serve as a patient advocate in the management of pain related to cancer. Which action by the nurse exemplifies this role?

6 :
A client undergoing chemotherapy is at the nadir of treatment. The immediate nursing care should be directed toward:

7 :
A client with cervical cancer has a sealed source of internal radiation. Which nursing action has the highest priority for the patient during the period of time the device is in place?

8 :
Which of the following statements regarding chemotherapy toxicity indicate correct understanding by the nurse? Select all that apply:

9 :
A client who had a left lobectomy for lung carcinoma returns from surgery with a left lateral chest tube attached to water seal drainage with suction. Which of the following assessments would indicate that the drainage system is working properly?

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N210_Fall_2023_Exam_3_DAY-EVE_Fundamentals

No.

1 : The nurse knows that the "CAUTION" mnemonic is used by the American Cancer Society to educate the public about warning signs of cancer. This include (Select ALL that apply)

2 : The school nurse is teaching a nutrition class in the local high school. The lesson for the day focused on foods that can potentially reduce the risks of cancer. Which menu selection indicates that the students understood the instruction?

3 : The school nurse is teaching a nutrition class in the local high school. The lesson for the day focused on foods that can potentially reduce the risks of cancer. Which menu selection indicates that the students understood the instruction?

4 : The nurse is discussing chemotherapy with a client who was recently diagnosed with cancer and is scheduled to start treatment. The client demonstrates correct understanding if the client verbalizes that the side effects of chemotherapy is primarily due to:

5 : The nurse can serve as a patient advocate in the management of pain related to cancer. Which action by the nurse exemplifies this role?

6 : A client undergoing chemotherapy is at the nadir of treatment. The immediate nursing care should be directed toward:

7 : A client with cervical cancer has a sealed source of internal radiation. Which nursing action has the highest priority for the patient during the period of time the device is in place?

8 : Which of the following statements regarding chemotherapy toxicity indicate correct understanding by the nurse? Select all that apply:

9 : A client who had a left lobectomy for lung carcinoma returns from surgery with a left lateral chest tube attached to water seal drainage with suction. Which of the following assessments would indicate that the drainage system is working properly?

1 :
The nurse knows that the "CAUTION" mnemonic is used by the American Cancer Society to educate the public about warning signs of cancer. This include (Select ALL that apply)

2 :
The school nurse is teaching a nutrition class in the local high school. The lesson for the day focused on foods that can potentially reduce the risks of cancer. Which menu selection indicates that the students understood the instruction?

3 :
The school nurse is teaching a nutrition class in the local high school. The lesson for the day focused on foods that can potentially reduce the risks of cancer. Which menu selection indicates that the students understood the instruction?

4 :
The nurse is discussing chemotherapy with a client who was recently diagnosed with cancer and is scheduled to start treatment. The client demonstrates correct understanding if the client verbalizes that the side effects of chemotherapy is primarily due to:

5 :
The nurse can serve as a patient advocate in the management of pain related to cancer. Which action by the nurse exemplifies this role?

6 :
A client undergoing chemotherapy is at the nadir of treatment. The immediate nursing care should be directed toward:

7 :
A client with cervical cancer has a sealed source of internal radiation. Which nursing action has the highest priority for the patient during the period of time the device is in place?

8 :
Which of the following statements regarding chemotherapy toxicity indicate correct understanding by the nurse? Select all that apply:

9 :
A client who had a left lobectomy for lung carcinoma returns from surgery with a left lateral chest tube attached to water seal drainage with suction. Which of the following assessments would indicate that the drainage system is working properly?