Tumors and Cancer - NCLEX-PN
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You are the nurse taking care of a patient in an oncology clinic who was treated with chemotherapy and radiation therapy for anal cancer. The patient finished treatment two weeks ago. Which of the following treatment side effects would you expect to see?
You are the nurse taking care of a patient in an oncology clinic who was treated with chemotherapy and radiation therapy for anal cancer. The patient finished treatment two weeks ago. Which of the following treatment side effects would you expect to see?
The correct answer is "rectal bleeding." This answer is correct, as the patient is being treated with chemotherapy and radiation therapy for anal cancer, and is multiple weeks removed from treatment. Rectal bleeding is a very common side effect in patients who recently received radiation therapy to the anus, as numerous blood vessels are treated by the radiation therapy, and the body's immunologic response to radiation therapy also promotes vascular permeability. Rectal bleeding, unless profuse and uncontrolled is often a self-limiting phenomenon in the setting of radiation and while troublesome for the patient, does not pose much of an acute threat to the patient's stability.
Fever is something that should be taken seriously in any cancer patient, especially one receiving chemotherapy. However, it should not necessarily be expected. It should always be assessed for.
Headache is a common side effect in patients actively receiving chemotherapy, often either directly due to the chemotherapy drug itself, or to dehydration as a side effect of treatment/lack of appetite. This patient is multiple weeks removed from chemotherapy though, so headache would not be expected as a treatment side effect at this time.
Pupil dilation and eye redness are not typical side effects of chemotherapy or radiation therapy for anal cancer.
The correct answer is "rectal bleeding." This answer is correct, as the patient is being treated with chemotherapy and radiation therapy for anal cancer, and is multiple weeks removed from treatment. Rectal bleeding is a very common side effect in patients who recently received radiation therapy to the anus, as numerous blood vessels are treated by the radiation therapy, and the body's immunologic response to radiation therapy also promotes vascular permeability. Rectal bleeding, unless profuse and uncontrolled is often a self-limiting phenomenon in the setting of radiation and while troublesome for the patient, does not pose much of an acute threat to the patient's stability.
Fever is something that should be taken seriously in any cancer patient, especially one receiving chemotherapy. However, it should not necessarily be expected. It should always be assessed for.
Headache is a common side effect in patients actively receiving chemotherapy, often either directly due to the chemotherapy drug itself, or to dehydration as a side effect of treatment/lack of appetite. This patient is multiple weeks removed from chemotherapy though, so headache would not be expected as a treatment side effect at this time.
Pupil dilation and eye redness are not typical side effects of chemotherapy or radiation therapy for anal cancer.
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You are the nurse at an oncology practice taking care of an otherwise healthy 22-year old male being treated with chemotherapy and radiation for Hodgkin's lymphoma. His chemotherapy regimen consists of doxorubicin, bleomycin, vinblastine, and dacarbazine. He is not receiving any other medications. He reports feeling well aside from fatigue, and numbness and tingling of his hands and feet. Which of the following is the most likely cause of the hand and foot numbness and tingling?
You are the nurse at an oncology practice taking care of an otherwise healthy 22-year old male being treated with chemotherapy and radiation for Hodgkin's lymphoma. His chemotherapy regimen consists of doxorubicin, bleomycin, vinblastine, and dacarbazine. He is not receiving any other medications. He reports feeling well aside from fatigue, and numbness and tingling of his hands and feet. Which of the following is the most likely cause of the hand and foot numbness and tingling?
The correct answer is "Vinblastine-induced neuropathy."
This is the most likely explanation for this patient's peripheral neuropathy, as the patient is described as being healthy aside from Hodgkin's lymphoma, and on no medications aside from his chemotherapy regimen. As a result, diabetic neuropathy and selective serotonin reuptake inhibitor discontinuation syndrome can each be ruled out as etiologies. Similarly, given that he is otherwise healthy and not complaining of any additional neurological symptoms (and given that he is young and actively receiving chemotherapy) it is unlikely that he is experiencing posterior spinal cord degeneration.
Thus, in a young patient with lymphoma who is receiving chemotherapy and experiencing peripheral neuropathy, the most likely etiology is one of the chemotherapy medications that he is receiving. In this patient's case, he is receiving doxorubicin, bleomycin, vinblastine, and dacarbazine. Of these medications, vinblastine is the most strongly associated with peripheral neuropathy, as this is a fairly common side effect of vinblastine and other agents in the same class (vinca alkaloids). As such, vinblastine-induced neuropathy is the most likely etiology.
The correct answer is "Vinblastine-induced neuropathy."
This is the most likely explanation for this patient's peripheral neuropathy, as the patient is described as being healthy aside from Hodgkin's lymphoma, and on no medications aside from his chemotherapy regimen. As a result, diabetic neuropathy and selective serotonin reuptake inhibitor discontinuation syndrome can each be ruled out as etiologies. Similarly, given that he is otherwise healthy and not complaining of any additional neurological symptoms (and given that he is young and actively receiving chemotherapy) it is unlikely that he is experiencing posterior spinal cord degeneration.
Thus, in a young patient with lymphoma who is receiving chemotherapy and experiencing peripheral neuropathy, the most likely etiology is one of the chemotherapy medications that he is receiving. In this patient's case, he is receiving doxorubicin, bleomycin, vinblastine, and dacarbazine. Of these medications, vinblastine is the most strongly associated with peripheral neuropathy, as this is a fairly common side effect of vinblastine and other agents in the same class (vinca alkaloids). As such, vinblastine-induced neuropathy is the most likely etiology.
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You are a nurse at an oncology clinic taking care of a 65-year old male with stage one non-small cell lung cancer (NSCLC) who is one year removed from a wedge resection and chemotherapy. Which of the following tests would be best to assess treatment response in this patient?
You are a nurse at an oncology clinic taking care of a 65-year old male with stage one non-small cell lung cancer (NSCLC) who is one year removed from a wedge resection and chemotherapy. Which of the following tests would be best to assess treatment response in this patient?
The correct answer is "PET-CT." This is the correct answer because a PET-CT shows not only spatial information from the serial slices taken on CT imaging, which would include the size and location of any potential tumor, scarring, or nodal involvement, but also the FDG-avidity or uptake of the contents of the image, which would help correlate the spatial findings with possible disease activity. Nodules observed on a CT scan can be non-descript, ranging from malignant, to indeterminate, to benign (which may still be infectious or inflammatory). The addition of PET to a CT allows the observer to see which nodules, nodes, or lesions are more likely to be indicative of disease burden, as tumors and infections will have greater FDG uptake since they are more metabolically active than surrounding tissues.
MRI is not typically used to assess treatment in lung cancer as CT coupled with PET is more commonly used. X-ray does not provide enough resolution to adequately assess response to cancer treatment. Pulmonary function tests, while a useful measure of lung functionality, do not give a specific picture of the lung cancer burden and as such are not the best treatment response assessment tool.
The correct answer is "PET-CT." This is the correct answer because a PET-CT shows not only spatial information from the serial slices taken on CT imaging, which would include the size and location of any potential tumor, scarring, or nodal involvement, but also the FDG-avidity or uptake of the contents of the image, which would help correlate the spatial findings with possible disease activity. Nodules observed on a CT scan can be non-descript, ranging from malignant, to indeterminate, to benign (which may still be infectious or inflammatory). The addition of PET to a CT allows the observer to see which nodules, nodes, or lesions are more likely to be indicative of disease burden, as tumors and infections will have greater FDG uptake since they are more metabolically active than surrounding tissues.
MRI is not typically used to assess treatment in lung cancer as CT coupled with PET is more commonly used. X-ray does not provide enough resolution to adequately assess response to cancer treatment. Pulmonary function tests, while a useful measure of lung functionality, do not give a specific picture of the lung cancer burden and as such are not the best treatment response assessment tool.
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You are the nurse in an oncology clinic taking care of a patient with a glioblastoma who has been receiving chemotherapy and radiation therapy. You want to assess response to treatment. Which of the following images should would best assess treatment response?
You are the nurse in an oncology clinic taking care of a patient with a glioblastoma who has been receiving chemotherapy and radiation therapy. You want to assess response to treatment. Which of the following images should would best assess treatment response?
The correct answer is "MRI Head." This is the correct answer because in evaluating brain parenchyma, which is relatively soft tissue, MRI provides the greatest degree of spatial resolution, which would best allow assessment of any residual, recurrent, or new tumor burden within the brain. CT imaging is commonly used to assess the brain when evaluating for bleeds or fractures, among other conditions, as it is far more expedient than MRI. However, it does not visualize the soft tissue of the brain parenchyma as well as MRI, and treatment response MRI scans are often not emergent, and therefore MRI would be preferred. PET-CT, while often highly useful in oncologic assessments is of limited value in evaluating the brain for cancer response, because the entire brain is highly metabolically active in nearly all patients, and therefore the entire brain typically has a great deal of FDG uptake uniformly, limiting the value of the scan.
The correct answer is "MRI Head." This is the correct answer because in evaluating brain parenchyma, which is relatively soft tissue, MRI provides the greatest degree of spatial resolution, which would best allow assessment of any residual, recurrent, or new tumor burden within the brain. CT imaging is commonly used to assess the brain when evaluating for bleeds or fractures, among other conditions, as it is far more expedient than MRI. However, it does not visualize the soft tissue of the brain parenchyma as well as MRI, and treatment response MRI scans are often not emergent, and therefore MRI would be preferred. PET-CT, while often highly useful in oncologic assessments is of limited value in evaluating the brain for cancer response, because the entire brain is highly metabolically active in nearly all patients, and therefore the entire brain typically has a great deal of FDG uptake uniformly, limiting the value of the scan.
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With what co-infection is Burkitt lymphoma associated?
With what co-infection is Burkitt lymphoma associated?
EBV infection is common in Burkitt lymphoma. In malaria-endemic areas, it is thought that the cancer is actually caused by chronic malarial infection increasing a person's susceptibility to chronic EBV infection. The same is assumed about HIV co-infection with EBV in the United States.
None of the other infections listed are associated with Burkitt lymphoma.
EBV infection is common in Burkitt lymphoma. In malaria-endemic areas, it is thought that the cancer is actually caused by chronic malarial infection increasing a person's susceptibility to chronic EBV infection. The same is assumed about HIV co-infection with EBV in the United States.
None of the other infections listed are associated with Burkitt lymphoma.
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What is the most common malignant brain tumor in children?
What is the most common malignant brain tumor in children?
90% of medulloblastomas are in pediatric patients. It is the tumor type in 14.5% of primary brain malignancies of childhood and adolescence. Glioblastoma is the most common type of brain tumor in adults and accounts for 52% of all primary brain tumors. Meningiomas are also fairly common in adult populations, accounting for 34% of primary brain tumors. Juvenile pilocytic astrocytoma is a brain tumor of childhood but only accounts for 2% of cases.
90% of medulloblastomas are in pediatric patients. It is the tumor type in 14.5% of primary brain malignancies of childhood and adolescence. Glioblastoma is the most common type of brain tumor in adults and accounts for 52% of all primary brain tumors. Meningiomas are also fairly common in adult populations, accounting for 34% of primary brain tumors. Juvenile pilocytic astrocytoma is a brain tumor of childhood but only accounts for 2% of cases.
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Actinic keratosis occasionally develops into which skin cancer?
Actinic keratosis occasionally develops into which skin cancer?
Actinic keratosis occasionally develops into squamous cell carcinoma and is generally removed prophylactically. Actinic keratosis is not associated with development of any of the other skin cancer types listed.
Actinic keratosis occasionally develops into squamous cell carcinoma and is generally removed prophylactically. Actinic keratosis is not associated with development of any of the other skin cancer types listed.
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Which of the following types of lung cancer is most linked to cigarette smoking?
Which of the following types of lung cancer is most linked to cigarette smoking?
Small cell carcinoma (also called oat cell cancer) makes up 15% of lung cancers and almost always presents in patients with a history of cigarette smoking.
Adenocarcinoma is the most common type of lung cancer in patients who have never smoked. Mesothelioma is most commonly caused by asbestos exposure, while bronchial carcinoids are often of unknown etiology.
Small cell carcinoma (also called oat cell cancer) makes up 15% of lung cancers and almost always presents in patients with a history of cigarette smoking.
Adenocarcinoma is the most common type of lung cancer in patients who have never smoked. Mesothelioma is most commonly caused by asbestos exposure, while bronchial carcinoids are often of unknown etiology.
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What condition may look like eczema around the nipple but is actually a malignant skin change?
What condition may look like eczema around the nipple but is actually a malignant skin change?
Paget's disease of the breast will often present as itchy, scaling, cracked, red lesions around the nipple. The other conditions mentioned are all forms of breast cancer, but all of them originate in tissues deeper to the breast and will generally present without a visible rash, though some skin changes such as redness or dimpling may occur.
Paget's disease of the breast will often present as itchy, scaling, cracked, red lesions around the nipple. The other conditions mentioned are all forms of breast cancer, but all of them originate in tissues deeper to the breast and will generally present without a visible rash, though some skin changes such as redness or dimpling may occur.
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Which of the following is a benign tumor?
Which of the following is a benign tumor?
A fibroma is considered a benign fibrous tissue tumor. The other tumor types are all malignant.
A fibroma is considered a benign fibrous tissue tumor. The other tumor types are all malignant.
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What is the most common soft tissue tumor in children?
What is the most common soft tissue tumor in children?
The most common soft tissue tumor in children is rhabdomyosarcoma. This generally presents on the face, neck, or extremities, with nearly one-third of cases presenting with orbital involvement. 90% of all cases of rhabdomyosarcoma are seen in children, most often seen in children under 10 years of age. Leiomyosarcoma, epithelioid sarcoma, and desmoid tumors are all relatively rare soft tissue tumors of childhood.
The most common soft tissue tumor in children is rhabdomyosarcoma. This generally presents on the face, neck, or extremities, with nearly one-third of cases presenting with orbital involvement. 90% of all cases of rhabdomyosarcoma are seen in children, most often seen in children under 10 years of age. Leiomyosarcoma, epithelioid sarcoma, and desmoid tumors are all relatively rare soft tissue tumors of childhood.
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What is the most common type of thyroid cancer?
What is the most common type of thyroid cancer?
Papillary carcinoma is the most common thyroid cancer (60-70% of all thyroid cancers). Follicular carcinoma is the second most common thyroid cancer type (10-20% of cases), followed by medullary thyroid cancer (5%), then anaplastic carcinoma (under 5% of cases).
Papillary carcinoma is the most common thyroid cancer (60-70% of all thyroid cancers). Follicular carcinoma is the second most common thyroid cancer type (10-20% of cases), followed by medullary thyroid cancer (5%), then anaplastic carcinoma (under 5% of cases).
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Which thyroid cancer will present with a proliferation of parafollicular cells (c cells) that produce excess calcitonin?
Which thyroid cancer will present with a proliferation of parafollicular cells (c cells) that produce excess calcitonin?
Medullary carcinoma of the thyroid originates from the parafollicular cells (c cells). Elevated levels of calcitonin in these patients cause diarrhea, which is the most common clinical symptom. Papillary carcinoma, follicular carcinoma, and anaplastic carcinoma are not associated with any significant elevation in calcitonin levels.
Medullary carcinoma of the thyroid originates from the parafollicular cells (c cells). Elevated levels of calcitonin in these patients cause diarrhea, which is the most common clinical symptom. Papillary carcinoma, follicular carcinoma, and anaplastic carcinoma are not associated with any significant elevation in calcitonin levels.
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What cancer presents with the following triad: hematuria, flank pain, and an abdominal mass?
What cancer presents with the following triad: hematuria, flank pain, and an abdominal mass?
Hematuria, flank pain, and an abdominal mass are all signs of renal cell carcinoma, an adenocarcinoma originating in the proximal proximal tubule of the kidney.
Mesothelioma is a form of lung cancer associated with asbestos exposure, Ewing's sarcoma is a type of bone cancer common in children and adolescents, and Hodgkin's lymphoma is a cancer that originates in the lymphocytes of the blood.
Hematuria, flank pain, and an abdominal mass are all signs of renal cell carcinoma, an adenocarcinoma originating in the proximal proximal tubule of the kidney.
Mesothelioma is a form of lung cancer associated with asbestos exposure, Ewing's sarcoma is a type of bone cancer common in children and adolescents, and Hodgkin's lymphoma is a cancer that originates in the lymphocytes of the blood.
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What is the most common type of liver cancer?
What is the most common type of liver cancer?
Hepatocellular carcinoma accounts for approximately 75% of all primary liver cancers.
Cholangiocarcinoma and hepatoblastoma are rare forms of liver cancer, and a teratoma is a tumor that contains normal-appearing tissues from multiple germ layers, which can appear in multiple locations in the body.
Hepatocellular carcinoma accounts for approximately 75% of all primary liver cancers.
Cholangiocarcinoma and hepatoblastoma are rare forms of liver cancer, and a teratoma is a tumor that contains normal-appearing tissues from multiple germ layers, which can appear in multiple locations in the body.
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All of the following cancers frequently metastasize to bone except                     .
All of the following cancers frequently metastasize to bone except                     .
Breast, lung, kidney, and prostate cancers make up approximately 80% of metastases to bone. Stomach cancer can metastasize to bone, but it does so only rarely.
Breast, lung, kidney, and prostate cancers make up approximately 80% of metastases to bone. Stomach cancer can metastasize to bone, but it does so only rarely.
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The appearance of red, purple, brown, or black papular lesions on the extremities, back, face, mouth, and genitalia is a typical presentation for what malignancy?
The appearance of red, purple, brown, or black papular lesions on the extremities, back, face, mouth, and genitalia is a typical presentation for what malignancy?
Kaposi sarcoma presents with red, purple, brown, or black papular lesions on the extremities, back, face, mouth, and genitalia. It is caused by human herpes virus 8 (HHV8) and is typically seen in immunocompromised patients.
Neither Burkitt lymphoma nor pancreatic cancer typically present with any associated skin lesions, while melanomas tend to be singular lesions.
Kaposi sarcoma presents with red, purple, brown, or black papular lesions on the extremities, back, face, mouth, and genitalia. It is caused by human herpes virus 8 (HHV8) and is typically seen in immunocompromised patients.
Neither Burkitt lymphoma nor pancreatic cancer typically present with any associated skin lesions, while melanomas tend to be singular lesions.
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What type of cancer generally presents with elevated calcium, renal failure, anemia, and lytic bone lesions?
What type of cancer generally presents with elevated calcium, renal failure, anemia, and lytic bone lesions?
Multiple myeloma, also known as plasma cell myeloma or Kahler's disease, presents with lytic bone lesions, blood count abnormalities, elevated blood calcium, and an abnormal paraprotein antibodies which can cause damage to kidneys.
Osteosarcoma, while located in the bone, tends to present with a mass visible on imaging. Gastric and ovarian cancer are not associated with any changes in bone (unless due to metastasis).
Multiple myeloma, also known as plasma cell myeloma or Kahler's disease, presents with lytic bone lesions, blood count abnormalities, elevated blood calcium, and an abnormal paraprotein antibodies which can cause damage to kidneys.
Osteosarcoma, while located in the bone, tends to present with a mass visible on imaging. Gastric and ovarian cancer are not associated with any changes in bone (unless due to metastasis).
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The nursing student prepares a report on acute versus chronic leukemia. Which of the following assessments is correct?
The nursing student prepares a report on acute versus chronic leukemia. Which of the following assessments is correct?
To answer this question, it is essential to 1) identify the correct definition of acute conditions versus chronic conditions and 2) identify the age groups that experience acute leukemia versus chronic leukemia. Acute conditions such as acute leukemias have rapid onsets, while chronic conditions such as chronic leukemias have gradual onsets. Acute leukemias are more common among children and young adults, while chronic conditions are more common among adults aged 25 to 60.
To answer this question, it is essential to 1) identify the correct definition of acute conditions versus chronic conditions and 2) identify the age groups that experience acute leukemia versus chronic leukemia. Acute conditions such as acute leukemias have rapid onsets, while chronic conditions such as chronic leukemias have gradual onsets. Acute leukemias are more common among children and young adults, while chronic conditions are more common among adults aged 25 to 60.
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Which of the following types of kidney tumors occurs most frequently in children?
Which of the following types of kidney tumors occurs most frequently in children?
Wilm's tumor, also known as nephroblastoma, is a rare type of malignant tumor that occurs primarily in children. These tumors tend to be unilateral, and will present as an abdominal mass with abdominal pain or tenderness, nausea and vomiting, and fever. 20% of cases will also present with hematuria.
Wilm's tumor, also known as nephroblastoma, is a rare type of malignant tumor that occurs primarily in children. These tumors tend to be unilateral, and will present as an abdominal mass with abdominal pain or tenderness, nausea and vomiting, and fever. 20% of cases will also present with hematuria.
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