CHPN Chapter 3 Exam 72 Questions with Verified Answers
Breast cancer - CORRECT ANSWER Most frequently diagnosed and leading cause of death from
... [Show More] cancer in women
Lung cancer - CORRECT ANSWER Most frequently diagnosed and the leading cause of death from cancer in men
Lung cancer - CORRECT ANSWER The leading cause of death for men and women from cancer with a 16% survival rate for all stages combined
Breast cancer - CORRECT ANSWER Highest five-year survival rate of cancer with 89%
Liver and pancreas - CORRECT ANSWER Which two cancers have the lowest overall survival rate at 15% and 6%
Invasion - CORRECT ANSWER Process where cells continue to divide and with increased bulk, pressure, and secretion of enzymes, cancer spread locally or into surrounding structures.
Angiogenesis - CORRECT ANSWER Generation of blood vessels by the tumor site, which allows easier access for the tumor cells to enter the bloodstream; this increases risk of metastatic spread
metastasis - CORRECT ANSWER The spread of cancer cells from primary tumor site to distance sites in the body through one of several routes
Bone, liver, lungs - CORRECT ANSWER Where does bladder cancer spread to?
Bone, brain, liver, lungs - CORRECT ANSWER Where does breast cancer spread to?
Liver, lungs - CORRECT ANSWER Where does colon cancer spread to?
Adrenal gland, bone, brain, liver, other lung - CORRECT ANSWER Where does lung cancer spread to?
Adrenal gland, bone, liver, lungs - CORRECT ANSWER Where does prostate cancer spread to?
Curative - CORRECT ANSWER Type of cancer treatment- the intention of the treatment is elimination of the tumor and cure of the patient from cancer
Adjuvent - CORRECT ANSWER Types of cancer treatment - a type of treatment that is used in addition to her after the primary therapy in order to aid in the principal treatment regimen and to lower the risk of cancer returning ex. radiation after surgical resection.
Neoadjuvent - CORRECT ANSWER Types of cancer treatment- treatment given before the primary therapy such as chemo therapy prior to surgical resection
Palliative - CORRECT ANSWER Types of cancer treatment - a treatment that is intended to relieve or alleviate the symptoms or burden of the cancer and improve quality of life; not intended to cure.
Teletherapy - CORRECT ANSWER Delivery of radiation therapy from an External source
Brachytherapy - CORRECT ANSWER Radioactive source is placed inside of or directly on the body.
Skin reaction, fatigue, weight loss, Myelosuppression, alone is, nausea and vomiting, mucositis, xerostomia - CORRECT ANSWER Side effects of radiation
Stomatitis, alopecia , myelosuppression, nausea with or without vomiting, diarrhea, fatigue - CORRECT ANSWER Side effects of chemotherapy
Cardiotoxicity - CORRECT ANSWER Toxicity to the cardiac system induced by chemotherapy is similar in presentation to congestive heart failure with dyspnea, cough, pedal edema, poor response to diuretics or digitalis. Most common with anthrcyclines
Neurotoxicity - CORRECT ANSWER This causes chemotherapy associated Peripheral neuropathy and presentation starts where patient feels like they're wearing socks or gloves, also with distribution with report of burning, tingling, numbness, or vibration sensations.
Pulomomary toxicity - CORRECT ANSWER This side effect of chemotherapy is typically irreversible and progressive. It presented as a drug-induced pneumonitis or restrictive lung disease with dyspnea, Non-productive cough, basil or rails, tachypnea, and low-grade fever. Most common cause it to have agent is Bleomycin.
Nephrotoxicity - CORRECT ANSWER A dose limiting toxicity for some chemo therapy's, depending on severity of damage. Cisplatin is known for this and can occur 3 to 21 hours after dose given and can persist for several years and may be irreversible.
Hepatotoxicity - CORRECT ANSWER presentation of the side effect of chemotherapy includes elevated enzymes and can progress to jaundiced, hepato-megaly, and encephalopathy, and abdominal pain.
Decline in functional status, PPS - CORRECT ANSWER The most important prognostic indicator
Younger women have a poor prognosis related to hormonal shifts and obviously shouldn't cycles - CORRECT ANSWER Breast cancer prognosis statistics
Pancreatic Cancer - CORRECT ANSWER Type of cancer were less than 24% of patients survive longer than one year and five-year survival rate is 6%. Most common presentation includes weight loss and wasting. This is the fifth most common cause of cancer death in the US
Colon Cancer - CORRECT ANSWER The third leading cause of cancer death and men and women; five-year survival of those with distance spread is less than 10%. Symptoms include anemia, fatigue, partial or complete obstruction, pain, blood in the stool, fistula.
Stomach cancer - CORRECT ANSWER Significantly higher incident in males, caucasian to African-Americans it's a 2 to 1 ratio, overall incident has declined in the United States over the past 35 years. This is the third most common cause of cancer deaths globally. H. Pylori is #1 risk factor
Liver cancer - CORRECT ANSWER This is the most common solid tumor worldwide. Risk factors are chronic hepatitis, alcohol and smoking and diabetes mellitus. Death typically occurs from cachexia, Gastro intestinal or esophageal varices bleeding, liver failure and coma, fatal hemorrhage. Five year survival 15%.
Esophageal Cancer - CORRECT ANSWER This is the sixth the leading cause of death from cancer in occurs most frequently in those over the age of 50. The five-year survival rate in the United States is approximately 15%, with most people dying within the first year. Risk factors include smoking, high alcohol consumption, prior radiation to the chest, Gerd, and being male
Prostate cancer - CORRECT ANSWER The most common malignancy in males and the second leading cause of cancer death with a five-year survival rate approximately 99% in the United States
Bladder Cancer - CORRECT ANSWER Men have a three times higher incidence with this type of cancer in a five-year survival rate of approximately 77%. Smoking is the highest risk factor followed by occupational exposure and Gene mutations
Renal cancer - CORRECT ANSWER This is a localized cancer disease it is mostly curable and resectable; five year survival rate is 10% for those with stage 4 disease. risk factors are Smoking, obesity, hypertension, regular use NSAIDs and hepatitis C
Cervical cancer - CORRECT ANSWER The second most common cancer in women worldwide and HPV is the highest rest factors for developing this cancer.
Ovarian cancer - CORRECT ANSWER The fifth leading cause of cancer death in women and most lethal of all gynecological cancers, overall survival rate the United States is 45% if discovered early. Most women discover this cancer after metastasis.
Endometrial cancer - CORRECT ANSWER This is known as the most curable cancer when diagnosed early, overall five-year survival rate in the United States is greater than 80% if discovered early. Risk factors include post menopausal state, obesity, late menopause, diabetes, the polycystic ovarian syndrome.
Hodgkins Lymphoma - CORRECT ANSWER This is known as one of the most curable malignancies
The most aggressive in progression - CORRECT ANSWER Lymphomas with T cell origin are known to be
Multiple Myeloma - CORRECT ANSWER Hallmarks of the disease include serum or urine monoclonal immunoglobulin, monoclonal plasmacytosis, bony Lytic lesions. Risk is much greater in African Americans and Bone Pain is most common presenting symptoms.
Malignant melanoma - CORRECT ANSWER Worldwide incidences rising faster than any other malignancy. Tumor thickness is the most important factor to predict survival
Spinal cord compression - CORRECT ANSWER Caused by direct pressure from the tumor mass or by displacement of bone fragments and back pain is the most common presenting symptom
Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) - CORRECT ANSWER Inappropriate production of hormones causing hyponatremia, urine osmolality higher than plasma osmolality, and elevated urinary sodium and is primarily associated with small cell lung cancer. Treatment would be to free water restriction to correct hyponatremia, seizure precautions, hypertonic fluid administration
Cardiac Tamponade - CORRECT ANSWER Result of excess accumulation of fluid in the pericardial sac causing compression of the heart and diminish blood flow to the ventricles. Symptoms would include hypotension, symptoms of shock, dyspnea, cough, peripheral edema, jugular venous distention. Treatment would include oxygen, fluid volume resuscitation, pericardiocentesis.
Superior vena cava syndrome - CORRECT ANSWER A syndrome that develops from the obstruction or compression of the superior vena cava which is the vessel that carries blood from the heart to the chest arms head and neck, resulting in increased venous pressure and decreased cardiac output. Most common cause is a malignancy from small cell lung cancer. Symptoms would include facial and neck swelling.
Disseminated intravascular coagulation - CORRECT ANSWER Inappropriate and exaggerated overstimulation of normal coagulation when thrombosis, then bleeding occurs. Most commonly occurs in sepsis, acute leukemia, tumor lysis, mass of tissue injury. Symptoms would include gangrene, jaundice, widespread thrombosis or bleeding.Treatment would include anticoagulation therapy, oxygen, fluid or blood replacement.
Septic shock - CORRECT ANSWER Condition when overwhelming infection leads to hypotension, low blood flow, impaired coagulation, and impaired clot breakdown leading to poor tissue perfusion, cell ischemia, cell hypoxia, and organ failure. Symptoms include fever, shaking chills, hypotension, tachycardia, tachypnea, dyspnea, increased white blood cell count.
Tumor lysis syndrome - CORRECT ANSWER A metabolic response to tumor cells being killed rapidly from chemotherapy. Symptoms include fatigue and lethargy, increase in heart rate and blood pressure, muscle weakness, sudden mental incapacity, nausea or vomiting. Treatment is prevention 24 to 48 hours prior to treatment, frequent lab studies and aggressive hydration and diuresis.
Systolic Dysfunction (left ventricle) heart failure - CORRECT ANSWER Inability to maintain adequate cardiac output, which leads to failure to oxygenate or perfuse organs and tissues and he decreased ejection fraction. It can initially cause lung congestion as blood is not able to enter the left atrium and ventricle. Signs and symptoms include dyspnea, cough, fatigue, anxiety, tachycardia.
Diastolic function right heart failure - CORRECT ANSWER This is characterized by a preserved ejection fraction. This leads to the inability to fill the ventricle appropriately. This can cause generalize system and congestion with Edema of extremities and hepatic system. Symptoms include weight gain, Dependent edema and ascites, weakness, anorexia, nausea
Ischemic Stroke - CORRECT ANSWER The result of an occlusion that inhibits circulation to parts of the brain and is cause of approximately 87% of strokes. The most common symptom is one sided weakness or paralysis that will occur on the opposite side of the body from where the damage to the brain occurred. It can because by atrial fibrillation; septic embolus; embolism from the heart, aorta, or intracranial arteries.
Hemorrhagic stroke - CORRECT ANSWER Usually occur suddenly due to rupture of a blood vessel causing an intracranial bleed. Alterations in consciousness, headache, and nausea and vomiting or typical symptoms
hypertension, though atrial fibrillation is also a significant risk for elderly - CORRECT ANSWER Strongest risk factor for a stroke
ALS - CORRECT ANSWER Typical life expectancy overall for this disease is approximately three years after symptom onset is diseases incurable and is managed with supportive therapies. respiratory failure is the usual cause of death
Multiple sclerosis - CORRECT ANSWER Areas of destruction of the Myelin sheath in the brain and spinal cord determine the path of this disease. Muscle weakness, numbness, incontinence, and mental and visual difficulties will develop. This disease is incurable. Prognosis is variable and many patients with this disease have a lifespan that is no shorter than otherwise expected.
These diseases often have a significant symptoms burden and caregiving needs which may be difficult for families - CORRECT ANSWER Family concerns with neurodegenerative diseases in regards to hospice and palliative care
Emphysema - CORRECT ANSWER Causes distention of air spaces with destruction of alveolar walls. The use of accessory muscles for adequate breathing, barrel chest, diminished breath sounds, decreased ability to cough and expectorate, and weight loss are commonly associated findings. This is the type A COPD
Chronic bronchitis - CORRECT ANSWER Causes increased mucus secretion and a productive cough. Adventitious breath sounds with resonance on percussion, central cyanosis are common exam findings and often patients may be overweight. This is the type B copd.
Opioids - CORRECT ANSWER The gold standard for management of dyspnea
Multi-organ involvement - CORRECT ANSWER What increases the incidence of death from end-stage renal disease?
Chronic renal failure, stage five chronic kidney disease - CORRECT ANSWER This is most commonly caused by diabetes and hypertension. Clinical factors include fluid balance, electrolyte management, acidosis, and anemia must be monitored and treated as guided by the patients goals
Fentanyl and methadone. Avoid morphine and codeine, Hydromorphone and oxycodone are used with caution - CORRECT ANSWER Opioid medication considered safe for CKD
Likely only days. - CORRECT ANSWER How long does the patient have if they discontinue dialysis?
Diabetes - CORRECT ANSWER Seventh leading cause of death in the United States. This is been linked to an increased risk for cancer.
Hyperglycemia - CORRECT ANSWER Symptoms of this include Dry skin, drowsiness, blurred vision, nausea, polydipsia, and polyphagia.
Hypoglycemia - CORRECT ANSWER Symptoms of this include tremors and shakiness, palpitations and tachycardia, diaphoresis, anxiety, nervousness, dizziness, weakness, headache, irritability, confusion and/or decrease consciousness, with seizures in extreme situations
Liver failure - CORRECT ANSWER 12 leading cause of death in the United States. Signs and symptoms include hepatic enephalopathy, ascites, infections, jaundice, portal vein thrombosis, portal hypertension, pruritus, anorexia, nausea, esophageal varices
Active an amino acid, carbohydrate and fat metabolism, bile production, and detoxification of medications, alcohol, and other substances. The liver assist in keeping the body well by removing bacteria and other pathogens from the blood. It's stores fat soluble vitamins, minerals, and manufactures clotting factors. - CORRECT ANSWER Functions of the liver
Weight and fluid balance, avoiding aspirin and other NSAIDs, abstain from alcohol, fluid in sodium restriction, paracentesis for Ascites, monitor for bleeding, prevention of bleeding. Sometimes diuretics and Spironolacalone are use for Edema and ascites and Fentanyl is considered the opioid of choice in end-stage liver failure. - CORRECT ANSWER Treatments for liver failure and symptoms
HIV - CORRECT ANSWER Has progressed from a terminal illness to a chronic illness over the last few years, following the development of antiretrovirals therapy. This specifically attacks CD4 cells within the immune system through it RNA, which is converted to DNA within the whole cell. Primary infection is characterized by flu like symptoms that occur in a month or two after infection. [Show Less]