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WorksheetsBiology and Classification of Cancer
Total questions: 135
Worksheet time: 1hrs 8mins
Which statement best defines cancer as presented: Cancer encompasses a range of diseases that can arise in any cell capable of evading regulatory controls of which two processes?
Apoptosis and necrosis
Proliferation and differentiation
Transcription and translation
Inflammation and repair
According to the material, what are the two major dysfunctions in the process of cancer?
Defective cell proliferation and defective cell differentiation
Chromosomal nondisjunction and abnormal meiosis
Reduced apoptosis and increased angiogenesis
DNA repair failure and oxidative stress
Which statement about cancer cell proliferation is accurate?
Cancer cells always proliferate faster than normal cells of the tissue of origin
Cancer cells usually proliferate at the same rate as the tissue of origin but divide indiscriminately and may produce more than two cells at mitosis
Cancer cells proliferate slower than normal cells but evade apoptosis
Cancer cells divide only when growth factor levels are elevated
What is a key outcome of normal cellular differentiation described in the text?
Cells become capable of performing only specific functions
Cells acquire pluripotency
Cells increase their mitotic rate
Cells gain resistance to immune surveillance
Protooncogenes are best described as which of the following?
Mutated genes that induce tumors
Normal cell genes that regulate processes to keep cells in a mature, functioning state
Genes coding for immune checkpoints
Viral genes inserted into the human genome
When protooncogenes are mutated, what can they become?
Tumor suppressor genes
Oncogenes that induce tumors
Housekeeping genes
Apoptosis mediators
Which description correctly compares benign and malignant neoplasms as presented?
Both are undifferentiated
Benign neoplasms are well differentiated; malignant neoplasms range from well differentiated to undifferentiated
Benign neoplasms are invasive; malignant neoplasms are encapsulated
Benign neoplasms metastasize widely; malignant neoplasms do not
Arrange the stages of cancer development in order as defined in the text.
Progression → Initiation → Promotion
Initiation → Promotion → Progression
Promotion → Progression → Initiation
Initiation → Progression → Promotion
What characterizes the progression stage in the development of cancer, based on the text?
Stabilization of tumor growth and differentiation
Increased growth rate of the tumor, increased invasiveness, and spread to distant sites
Selective apoptosis of altered cells
Transformation back to benign behavior
Why may the immune response be inadequate to destroy cancer cells, according to the material?
Cancer cells arise from nonhuman pathogens, so they are not recognized
Cancer cells arise from normal human cells, making the mounted immune response potentially inadequate
The immune system does not recognize any antigens on cancer cells
All cancers lack antigen presentation capability
Tumor-associated antigens on cancer cells trigger which immune phenomenon described in the text?
Immunologic escape
Immunologic surveillance
Central tolerance
Molecular mimicry
The process by which cancer cells avoid destruction by the immune system is termed what?
Immunologic tolerance
Immunologic escape
Immune potentiation
Clonal deletion
Oncofetal antigens are useful clinically for which purpose stated in the text?
Curative treatment of primary tumors
Monitoring therapy effect and indicating tumor recurrence
Inducing differentiation of malignant cells
Blocking lymphatic spread
According to the classification section, tumors can be classified using which set of criteria?
Genetic polymorphisms alone
Anatomic site, histologic grading, and extent of disease (staging)
Patient age, sex, and ethnicity
Serum hormone levels and growth factor profiles
In anatomic classification of tumors, which elements are used to identify the tumor?
Tissue of origin, anatomic site, and tumor behavior such as benign or malignant
Gene expression profile and mutational burden only
Size of the primary tumor and number of metastatic nodes only
Presence of oncofetal antigens and tumor-associated antigens
A patient’s tumor shows increased invasiveness and distant spread after a period of reversible proliferation of altered cells. Which stage transition best explains this change?
Initiation to promotion
Promotion to progression
Progression to initiation
Promotion to initiation
Which statement aligns with the text about the common sites of metastasis?
Metastasis typically targets skin and skeletal muscle exclusively
Common sites include lungs, bone, brain, liver, and adrenal glands
Metastatic spread is confined to the lymph nodes
Only the liver is a common site for hematogenous spread
Which of the following most directly links to the concept of defective differentiation in cancer biology?
Cells remain capable of performing only specific functions after maturation
Cells lose mature functions and may become undifferentiated
Cells show controlled proliferation with normal mitotic figures
Cells undergo apoptosis after DNA damage
Which definition matches oncofetal antigens as presented?
Normal adult cell surface proteins used to suppress immunity
A type of tumor antigen used as tumor markers to monitor therapy effect and indicate tumor recurrence
Viral proteins that initiate the initiation stage
Cytokines that promote reversible proliferation
Which concise sequence correctly links a causal agent to the stage it most directly influences per the text?
Chemicals, radiation, or viruses → Initiation
Growth factor withdrawal → Progression
Angiogenesis → Initiation
Inherited mutation → Promotion
Which statement best defines the purpose of histologic grading of tumors as described: it evaluates the appearance of cells and the degree of differentiation to compare how closely abnormal cells resemble their tissue of origin, often using four grades for many tumor types.
It measures how far cancer has spread through the body by imaging findings.
It evaluates cell appearance and differentiation to gauge resemblance to the tissue of origin, often using four grades.
It assigns treatment protocols based solely on tumor size.
It determines whether cancer began in lymph nodes or distant organs.
According to the section, the staging classification system is primarily based on which feature?
Microscopic cell morphology and differentiation
Extent of the disease rather than cell appearance
Genetic mutations present in tumor DNA
Patient-reported symptom severity
The TNM classification system uses three parameters. Which option lists them correctly in order?
Tumor grade, nodal size, mitotic rate
Tumor size/invasiveness, regional lymph node involvement, distant metastasis
Tumor markers, nutritional status, metastatic burden
Tumor volume, vascularity, organ function
Which statement about clinical staging is consistent with the text?
It includes three stages that correspond to tumor grades I–III.
It uses five stages ranging from in situ to metastasis.
It is determined before any diagnostic workup is completed.
It replaces the TNM system for all solid tumors.
A patient is suspected of having cancer. Which set best represents components of an initial diagnostic plan as outlined: health history, identification of risk factors, physical examination, and specific diagnostic studies.
Physical exam only, followed by surgery if needed
Health history, risk factor identification, physical examination, and specific diagnostic studies
Blood tests and chemotherapy to see if the tumor shrinks
Genetic testing alone to establish diagnosis
Which statement accurately reflects the role of diagnostic studies after cancer is suspected?
They are used solely to confirm symptoms but not to guide treatment choices.
They determine disease extent, tissue of origin, and characteristics that may influence tumor behavior or treatment decisions (e.g., receptor status).
They are unnecessary if a biopsy is planned.
They only apply when the cancer is metastatic at presentation.
Which procedure is identified as the only definitive way to diagnose cancer, with the method depending on the suspected tumor’s location and size?
Computed tomography scan
Ultrasound-guided aspiration of lymph nodes
Biopsy procedure
Serum tumor marker assay
Which statement best defines the primary goals of cancer treatment as presented in the lesson?
Cure, control, or palliation
Eradication, remission, or surveillance
Prevention, detection, or rehabilitation
Induction, consolidation, or maintenance
When cure is the goal of treatment, which approach is most consistent with this aim?
Offering therapy expected to have the greatest chance of disease eradication, possibly combining local and systemic treatments
Using only palliative care to maintain comfort without attempting tumor reduction
Choosing watchful waiting to avoid treatment-related toxicity
Relying exclusively on hormone therapy regardless of tumor type
For cancers that cannot be completely eradicated but respond to therapy, what is the goal of treatment?
Control to maintain disease response over long periods
Cure to eliminate every cancer cell immediately
Palliation to relieve symptoms only
Surveillance to detect recurrence early
Which description aligns with palliation as a treatment goal?
Relief or control of symptoms while maintaining a satisfactory quality of life
Total elimination of cancer cells using aggressive multimodal therapy
Short-term observation without intervention
Preventing cancer in high-risk individuals by removing premalignant tissue
Which list correctly identifies common modalities for cancer treatment in this section?
Surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy, and hormone therapy
Antibiotics, antivirals, vaccines, and analgesics
Dialysis, plasmapheresis, phototherapy, and hyperbaric oxygen
Only surgery and radiation because systemic therapy is ineffective
In the context of primary prevention, which surgical action is provided as an example?
Removing premalignant colon polyps to reduce cancer risk
Debulking a large tumor to improve chemotherapy delivery
Amputating a limb after confirmed metastasis
Placing a central venous catheter for drug administration
Before recommending surgical intervention for cancer, which set of factors should be assessed?
Tumor stage and spread, technical feasibility of resection, co-morbidities, and expected postoperative function
Patient age alone, insurance status, and home support
Only genetic testing results and family history
Availability of experimental drugs regardless of tumor location
What is the stated goal of surgery in cancer care?
Remove all or as much resectable tumor as possible while sparing normal tissue
Deliver systemic therapy to micrometastases
Prevent nausea and vomiting associated with chemotherapy
Replace damaged organs with prosthetics
What is the primary goal of chemotherapy according to the text?
Eliminate or reduce the number of cancer cells in primary and metastatic sites
Shrink tumors only at the primary site
Prevent surgical complications by reducing bleeding
Stimulate the immune system without affecting tumor cells
Which pairing correctly matches chemotherapy drug category with its activity?
Cell cycle phase–nonspecific: act during all phases; Cell cycle phase–specific: act during specific phases
Cell cycle phase–nonspecific: only active in S phase; Cell cycle phase–specific: only active in G0
Cell cycle phase–nonspecific: require mitosis; Cell cycle phase–specific: inactive during the cell cycle
Cell cycle phase–nonspecific: targeted only; Cell cycle phase–specific: immunotherapy only
Which route is most commonly used for chemotherapy administration, and what measure reduces the risk of extravasation?
Intravenous administration through a central vascular access device
Oral administration with enteric-coated tablets
Subcutaneous injections given in alternating sites
Intramuscular injections administered in large muscles
An increasing trend in chemotherapy delivery is self-administration by patients. What nursing priority accompanies this trend?
Teaching proper medication handling and ensuring accurate dosing
Emphasizing that side effects are rare and usually ignored
Discouraging the use of written dosing schedules
Recommending patients avoid central lines at all costs
Which statement best describes regional chemotherapy as outlined in the material?
Delivery of the drug directly to the tumor site, commonly via intraarterial, intraperitoneal, intravesical bladder, intrathecal, or intraventricular methods
Systemic administration with dose adjustments for renal function only
Oral dosing timed to circadian rhythms to reduce toxicity
Topical application over the skin above the tumor to avoid systemic effects
Which statement best defines radiation in the context of cancer treatment?
The production of heat to destroy malignant tissue
The emission and distribution of energy through space or a material medium
The systemic delivery of cytotoxic drugs via the bloodstream
The surgical removal of a tumor and surrounding margins
In radiation treatment planning, what is the primary purpose of simulation?
To determine chemotherapy dosing based on body surface area
To accurately localize the tumor/target field and ensure set-up reproducibility
To decide whether a tumor is benign or malignant by imaging
To calibrate laboratory assays for myelosuppression
External beam radiation (EBRT) is characterized by which feature?
Implantation of radioactive sources directly into tissues
Delivery of ionizing radiation from a megavoltage treatment machine to the patient
Oral administration of radioactive capsules for systemic therapy
Use of ultrasound energy to heat the tumor core
Which description accurately differentiates brachytherapy from external beam radiation?
Brachytherapy uses high-energy photons generated outside the body, whereas EBRT uses implanted seeds
Brachytherapy inserts radioactive materials directly into or near the tumor; EBRT delivers radiation from a machine at a distance
Both techniques are identical in source placement but differ only in dose rate
EBRT requires catheters to place temporary seeds, whereas brachytherapy never uses catheters
Regarding radioactive implants used in brachytherapy, which is accurate?
All implants are permanent to maintain dose over a lifetime
Implants may be permanently placed or temporary depending on the plan
Temporary seeds are prohibited because the patient remains radioactive
Permanent implants are placed only intraluminally and never interstitially
What is the rationale for withdrawing temporary seeds after a specified time in brachytherapy?
To ensure the patient is not radioactive after the procedure
To reduce the risk of surgical site infection only
Because temporary seeds cause uncontrolled hemorrhage if left in place
To allow immediate combination with external beam radiation without imaging
Which safety principle is emphasized for health care professionals caring for a patient with a source of internal radiation?
Universal precautions and negative pressure rooms only
ALARA combined with time, distance, and shielding
Routine handwashing without any distance limitations
Avoidance of all metallic equipment in the room
Which nursing education priority helps decrease fear and anxiety for patients receiving chemotherapy or radiation?
Encouraging patients to skip premedications to minimize side effects
Teaching about the treatment plan, supportive care options, and what to expect
Advising patients to avoid all social support until therapy ends
Focusing only on surgical alternatives rather than current treatment
Which adverse effect is among the most common with chemotherapy and can result in life‑threatening complications such as infection and hemorrhage?
Dermatitis
Myelosuppression
Nephropathy
Pancreatitis
Which statement about fatigue in patients with cancer is most accurate?
It is rare and usually indicates disease remission
It is nearly universal and affects most patients with cancer
It occurs only after the final cycle of chemotherapy
It is unique to radiation and not seen with chemotherapy
Why is the intestinal mucosa particularly vulnerable during radiation and chemotherapy?
It is among the most sensitive tissues to these therapies, leading to diarrhea, mucositis, anorexia, nausea, and vomiting
It is relatively radioresistant compared with bone marrow
It is protected by a thick keratin layer that prevents injury
It regenerates slowly, so acute effects are uncommon
Which statement about nausea and vomiting in cancer therapy is correct?
They are uncommon with chemotherapy agents
Some patients experience anticipatory or delayed nausea and vomiting
They occur only during the infusion and never afterward
They do not respond to premedication strategies
Both chemotherapy and radiation share which serious potential long‑term risk?
Irreversible and progressive pulmonary and cardiac toxicities
Permanent protection against future infections
Guaranteed cure of metastatic disease
Complete absence of late effects after two years
Which statement best defines immunotherapy as used in cancer treatment?
A therapy that directly damages DNA to kill rapidly dividing cells
A treatment that uses the body's immune system to fight cancer, sometimes called biologic therapy
A method that removes tumors surgically to prevent metastasis
A therapy that blocks hormone receptors to slow tumor growth
Targeted therapy primarily works by which mechanism?
Stimulating general immune activation without specificity
Targeting specific cell receptors and pathways important in tumor growth
Blocking endocrine feedback loops to reduce hormone levels
Replacing damaged hematopoietic stem cells with donor cells
According to the material, immunotherapy can enhance cancer control by which two approaches?
Boosting or manipulating the immune system, and attacking cancer cells directly
Reducing angiogenesis and starving tumors of nutrients
Delivering cytotoxic drugs more precisely via nanoparticles
Lowering hormone production to deprive tumors of growth signals
Which adverse effects are associated with immunotherapy and may require critical care if severe?
Capillary leak syndrome and pulmonary edema
Peripheral neuropathy and hand–foot syndrome
Ototoxicity and nephrotoxicity
Hyperglycemia and diabetic ketoacidosis
Bone marrow depression and fatigue are most directly associated with which cancer treatment modality mentioned?
Hormone therapy
Targeted therapy
Immunotherapy
Stem cell transplantation
Which statement about hormones in the context of cancer is accurate?
Hormones are produced by neurons and act only locally at synapses
Hormones are made in endocrine glands and act as chemical messengers in the body
Hormones are exogenous compounds given only as medications
Hormones function solely to suppress immune responses
When used as a cancer treatment, what is the primary goal of hormone therapy drugs?
To increase hormone receptor expression on cancer cells
To block the effects of the hormone and stop the growth of cancer cells
To induce general immune activation
To replace deficient hormones to improve patient well-being
Which statement best describes colony-stimulating factors within hematopoietic growth factors?
They inhibit bone marrow to reduce leukocytosis during chemotherapy
They stimulate production, maturation, regulation, and activation of hematologic cells
They replace stem cells destroyed by radiation
They block cytokine receptors on tumor cells to prevent proliferation
Under what specific condition should erythropoiesis-stimulating agents be used, according to the guidance?
Whenever a patient is anemic for any reason
Only when treating anemia specifically caused by chemotherapy, following the most recent administration guidelines
Only after a stem cell transplant has fully engrafted
Only in combination with colony-stimulating factors and corticosteroids
In allogeneic transplantation, what is the critical requirement for the donor’s cells?
They must be unmatched to induce graft-versus-tumor effect
They must be HLA-matched to the recipient
They must be derived from previously cryopreserved autologous cells
They must be harvested after the recipient’s conditioning regimen is complete
Which statement best defines syngeneic transplantation?
Transplanting stem cells from an HLA-matched unrelated donor
Obtaining stem cells from one identical twin and infusing them into the other
Reinfusing a patient’s own stem cells after high-dose chemotherapy
Transplanting cord blood stem cells from a sibling
Why is a conditioning regimen required prior to hematopoietic stem cell transplantation, and what key precaution follows?
To enhance tumor oxygenation; afterward, patients should increase physical activity to speed engraftment
To prepare the patient by reducing or eliminating marrow; afterward, patients must be protected from infectious agents while bone marrow indices are low
To amplify immune checkpoint activity; afterward, patients should avoid all transfusions
To expand donor stem cell counts; afterward, patients can discontinue antimicrobial prophylaxis
Which statement best defines gene therapy as described in the lesson?
An established surgical technique to remove tumor masses
An investigational treatment using genetic material to fight disease or replace missing genes
A standard chemotherapy regimen that targets rapidly dividing cells
A lifestyle program focused on diet and exercise to prevent relapse
According to the material, what is identified as the leading cause of death among patients with cancer?
Hemorrhage due to thrombocytopenia
Infection
Pulmonary embolism
Chemotherapy-induced cardiomyopathy
Which list includes examples of oncologic emergencies classified in the text?
Hyperkalemia, febrile neutropenia, and sepsis
Spinal cord compression, tumor lysis syndrome, and cardiac tamponade
Myocardial infarction, stroke, and ketoacidosis
Ascites, pleural effusion, and peripheral neuropathy
A patient undergoing cancer treatment presents with hyponatremia due to inappropriate antidiuretic hormone activity. Based on the text, this condition is best categorized as which type of event?
A routine adverse effect without urgent concern
An obstructive emergency limited to the gastrointestinal tract
A metabolic oncologic emergency (syndrome of inappropriate antidiuretic hormone secretion)
An infiltrative emergency always caused by metastasis to the liver
What proportion of patients receiving active cancer treatment experience moderate to severe pain, according to the lesson?
About 10%
Around 25%
Around 50%
About 95%
The content emphasizes that an effective cancer pain plan should be based on which foundational action?
Administering high-dose opioids to all patients preemptively
Performing comprehensive and ongoing pain assessments addressing both components of pain
Relying solely on patient self-reported pain diaries
Scheduling fixed-dose nonsteroidal anti-inflammatory drugs for every patient
Which factor set from the text can influence adaptation and coping after a cancer diagnosis?
Body mass index and vision acuity only
Demographic characteristics, prior coping strategies, social support, and religious or spiritual beliefs
Type of health insurance and zip code only
Hemoglobin level and serum creatinine concentration
From a nursing perspective highlighted in the material, which action best supports positive coping for patients and caregivers?
Avoid discussing emotions to prevent distress
Assess responses and support development of a hopeful attitude throughout cancer stages
Delegate all psychosocial concerns to non-clinical staff
Focus solely on medication teaching without addressing coping
Which statement about cancer survivorship aligns with the text?
Survivors rarely experience late effects once treatment ends
Long-term and late effects can include functional impairment, non–cancer-related death, and co-morbidities like heart disease, diabetes, and osteoporosis
Psychosocial effects are uncommon and brief after treatment
Financial and vocational concerns typically resolve within weeks after therapy
What psychosocial theme is common in life after cancer, as described in the lesson?
Certainty about prognosis and rapid role normalization
Issues related to living with uncertainty
Complete absence of marital or emotional concerns
Universal improvement in social support without intervention
Which statement reflects culturally competent care needs cited in the content?
Late-stage diagnosis risk is highest in over-served populations
Nurses should assess cultural differences, identify barriers to care, and adapt care to meet specific cultural needs
Standardized care plans are sufficient regardless of cultural context
Cultural assessment should be deferred until after all treatments are completed
According to the introduction provided, which statement about lung cancer is accurate?
Lung cancer is a rare cause of death globally
Lung cancer is one of the top ten leading causes of death worldwide
Lung cancer causes more deaths only in pediatric populations
Lung cancer mortality is limited to countries with low healthcare spending
Which factor is identified as the most important risk factor for developing lung cancer, accounting for 80% to 90% of cases?
Exposure to radon gas at home
Cigarette smoking
Occupational asbestos exposure
Secondhand smoke during childhood
Primary lung cancers are categorized into two broad subtypes. Which pairing correctly lists them with their approximate proportions?
NSCLC (~84%) and SCLC (~13%)
Adenocarcinoma (~50%) and squamous cell carcinoma (~30%)
Small cell lung cancer (~84%) and non–small cell lung cancer (~13%)
Metastatic lung cancer (~60%) and primary lung cancer (~40%)
What is the single most effective noninvasive technique for evaluating lung cancer, while recognizing that biopsy is required for a definitive diagnosis?
MRI of the chest
Chest radiography
CT scanning
Positron emission tomography (PET) only
According to the material, which statement about staging is accurate?
Both NSCLC and SCLC are staged using the TNM system with equal usefulness
NSCLC is staged using TNM, while TNM staging has not been useful for SCLC
SCLC is staged only by tumor size using TNM
Neither NSCLC nor SCLC uses the TNM system
For NSCLC stages I to IIIa, which treatment is described as the treatment of choice because the disease is potentially curable with resection?
Chemotherapy alone
Targeted therapy alone
Surgical resection
Radiation therapy alone
In NSCLC, when might chemotherapy and targeted therapy be used according to the material?
Only after recurrence, never with surgery
For nonresectable tumors or as adjuvant therapy to surgery
Exclusively before radiation therapy as neoadjuvant treatment
Only in stage IV disease with palliative intent
Which nursing management goals are emphasized for patients with lung cancer?
Strict bedrest, fluid restriction, and high-flow oxygen at all times
Patent airway, effective breathing patterns, adequate tissue oxygenation, minimal discomfort, patient understanding, and realistic outlook
Daily chest physiotherapy, high-protein diet, and complete isolation
Elimination of all pain medications to assess respiratory drive
Head and neck cancers typically arise from which anatomical sites?
Thyroid gland and parathyroid glands
Mucosal surfaces of paranasal sinuses, oral cavity, nasopharynx, oropharynx, or larynx
Middle ear and mastoid cells
Salivary gland ducts only
Which are typical late symptoms of head and neck cancer according to the material?
Hoarseness and ear pain
Unintentional weight loss and pain
Nasal congestion and rhinorrhea
Early difficulty in chewing and swallowing
Which statement best summarizes treatment selection principles for head and neck cancer?
Treatment is standardized and based only on tumor size
Choice depends on tumor location, stage, patient age and health, cosmetic and functional considerations, urgency, and patient preference
Radiation is avoided in all early-stage cases due to toxicity
Surgery is always first-line regardless of site and function
How do early-stage (I–II) and advanced-stage (III–IV) head and neck cancers typically differ in treatment approach?
Stages I–II usually require combination chemoradiation; stages III–IV are managed with observation
Stages I–II are potentially curable with single-modality radiation or larynx-sparing surgery; stages III–IV often need combinations of surgery, radiation, chemotherapy, and targeted therapy
Stages I–II are treated only with targeted therapy; stages III–IV with radiation alone
There is no distinction; both require total laryngectomy with permanent tracheostomy
Which surgical procedure is typically involved in advanced head and neck cancer management and results in a permanent tracheostomy?
Partial glossectomy
Neck dissection without airway change
Total laryngectomy
Endoscopic sinus surgery
For early-stage oral cancer, which treatment is stated as most effective?
Surgery
Immunotherapy alone
Long-term antibiotic therapy
Observation with lifestyle modification
After radical neck surgery, patients may require an alternative nutrition route due to swelling or suture placement. Which supportive measure is described?
Enteral feeding to maintain adequate nutrition
Total parenteral nutrition for all patients
Clear-liquid diet until edema resolves
No nutritional support unless weight loss occurs
Which nursing goal is emphasized for patients with oral cavity cancer?
Maintain a patent airway and promote effective communication
Restrict fluids to reduce edema
Avoid all analgesics to prevent sedation
Delay nutrition until after radiation is complete
Which is listed as a key risk factor for esophageal cancer?
Smoking
High calcium intake
Cholelithiasis
Viral hepatitis
Most patients with esophageal cancer present with which progressive symptom, often accompanied by pain and weight loss?
Dysphagia
Hematemesis
Persistent hiccups
Early satiety
Treatment selection for esophageal cancer primarily depends on which consideration stated in the material?
Tumor location and stage at diagnosis
Patient age over 65 years
Serum carotene levels
Presence of gallstones
Palliative care priorities for esophageal cancer include which action?
Restoring swallowing function and maintaining nutrition and hydration
Aggressive weight loss to reduce tumor size
Routine prophylactic splenectomy
Limiting oral intake to prevent aspiration
Which statement about stomach cancer etiology is supported by the text?
It likely begins with nonspecific mucosal injury from factors such as H. pylori, autoimmune inflammation, or irritant exposure
It is primarily caused by acute viral gastroenteritis
It results exclusively from genetic syndromes with no environmental influence
It always starts after peptic ulcer perforation
Which manifestation is commonly associated with stomach cancer before many distressing symptoms appear?
Weight loss with lack of appetite and abdominal pain
Sudden onset of jaundice without pain
Painless hematuria
Pruritus without gastrointestinal complaints
In early detection of stomach cancer, nursing assessment should prioritize identifying patients at risk due to which conditions?
Pernicious anemia and achlorhydria
Hyperthyroidism and nephrolithiasis
Cystic fibrosis and pancreatitis
Migraine and seasonal allergies
Which surgical procedures are commonly used to treat gastric cancer?
Partial or complete gastrectomy, vagotomy, and/or pyloroplasty
Colectomy with ileostomy formation only
Pancreaticoduodenectomy and splenectomy exclusively
Appendectomy with lymph node sampling
Which set lists long-term postoperative complications specifically associated with gastric surgery?
Dumping syndrome, postprandial hypoglycemia, and bile reflux gastritis
Acute pancreatitis, cholecystitis, and hepatitis
Small bowel obstruction, peritonitis, and appendicitis
Urinary retention, nephrolithiasis, and pyelonephritis
In immediate postoperative care after gastric surgery, which priority best reflects standard care?
Maintain fluid and electrolyte balance while preventing respiratory complications, discomfort, and infection
Advance to regular diet on postoperative day one to stimulate gastric motility
Remove the NG tube if output is minimal to reduce patient discomfort
Allow patient to self-adjust nasogastric tube position for comfort
A patient has a nasogastric (NG) tube after gastrectomy. Which action is correct?
Observe the gastric aspirate for color, amount, and odor and avoid replacing or repositioning the tube
Flush the NG tube every hour with water to prevent clogging
Reposition the NG tube if coughing increases to minimize irritation
Clamp the NG tube during ambulation to reduce drainage
Why might postoperative wound healing be impaired after gastric surgery?
Poor nutritional intake, requiring potassium and vitamin supplements and possibly enteral feedings
Excessive ambulation in the early postoperative period causing tissue strain
High-dose opioid use suppressing the immune response
Cold ambient temperatures leading to peripheral vasoconstriction
Which statement about pernicious anemia in relation to gastric surgery is accurate?
It is a long-term complication of total gastrectomy and may also occur after partial gastrectomy
It only occurs after partial gastrectomy due to limited resection
It develops acutely within days of surgery and resolves spontaneously
It results from excessive iron absorption following vagotomy
Which goal of care is appropriate for a patient with stomach cancer?
Minimal discomfort, optimal nutritional status, and well-being appropriate to disease stage
Rapid weight loss to decrease tumor burden and reduce nausea
Strict bedrest to conserve energy until chemotherapy begins
Elimination of all oral intake to reduce gastric secretions indefinitely
Which is a major risk factor category for colorectal cancer (CRC)?
Increasing age and a family or personal history of CRC, colorectal polyps, or IBD
High intake of vitamin C and routine colon cleansing
Prior appendectomy and lactose intolerance
Regular physical activity and high-fiber diet
Which symptoms most commonly appear only in advanced stages of colorectal cancer?
Rectal bleeding, abdominal pain, and/or changes in bowel habits
Jaundice, pruritus, and dark urine
Hemoptysis, pleuritic chest pain, and wheezing
Polyuria, polydipsia, and weight loss
What is the primary origin of most colorectal cancers, and how can many cases be prevented?
They arise from adenomatous polyps; early detection and removal of precancerous polyps can prevent most CRC
They originate from chronic fissures; routine sitz baths can prevent most CRC
They begin as viral lesions; antiviral therapy can prevent most CRC
They develop from diverticula; avoiding nuts and seeds can prevent most CRC
At what age should men and women at average risk begin screening to detect colorectal polyps and cancer?
45 years of age
35 years of age
50 years of age
60 years of age
Which statement best reflects current screening and treatment principles for CRC?
Colonoscopy is the gold standard for screening; treatment options depend on stage and may include tumor removal alone or with chemotherapy, targeted therapy, radiation, or palliative chemotherapy for nonresectable disease
Fecal occult blood testing is sufficient for all patients; chemotherapy alone cures most early-stage disease
Sigmoidoscopy replaces colonoscopy for complete screening; radiation is avoided in all cases
Screening is unnecessary before symptoms; surgery is deferred until metastases develop
Which is NOT a listed indication for surgical resection of the bowel?
Remove cancer
Repair a perforation, fistula, or traumatic injury
Relieve an obstruction or stricture
Treat chronic kidney disease
Proctocolectomy with ileal pouch/anal anastomosis (IPAA) is described as which sequence?
Single operation with colectomy and permanent ileostomy
Two surgeries 8–12 weeks apart: first colectomy, rectal mucosectomy, ileal pouch construction, ileoanal anastomosis, and temporary ileostomy; second closure of the ileostomy to direct stool to the new pouch
Three staged operations ending in permanent colostomy
Laparoscopic resection without temporary diversion
A proctocolectomy with a permanent ileostomy most accurately involves which outcome?
Removal of the colon only with ileocolic anastomosis
Removal of the colon, rectum, and anus with closure of the anal opening
Removal of the rectum only with J‑pouch formation
Temporary ileostomy followed by reversal at 12 weeks
Which resection removes the ascending colon and hepatic flexure with the ileum anastomosed to the transverse colon?
Right hemicolectomy
Left hemicolectomy
Anterior rectosigmoid resection
Abdominal‑perineal resection (APR)
Which operation removes the splenic flexure, descending colon, and sigmoid colon?
Right hemicolectomy
Left hemicolectomy
Anterior rectosigmoid resection
Proctocolectomy with IPAA
In an abdominal‑perineal resection (APR), what is the definitive result regarding bowel elimination?
Creation of a permanent colostomy after removal of the entire rectum
Temporary ileostomy with later reversal
No stoma; primary anastomosis of rectum to anus
Continent ileal pouch with natural evacuation
Which statement best defines an ostomy and a stoma?
Ostomy is a temporary wound closure; stoma is scar tissue over the incision
Ostomy is the surgical creation of an opening; stoma is the opening that allows intestinal contents to pass through the abdominal skin
Ostomy is natural anal continence; stoma is a rectal reservoir
Ostomy is perineal drain placement; stoma is the internal anastomosis
For a patient undergoing ostomy surgery, which nursing care priority is highlighted as essential early on?
High‑intensity exercise training
Emotional support and patient teaching about stoma care and the ostomy
Routine discontinuation of all laxatives
Avoidance of any discussion about body image
Postoperative nursing care after ostomy surgery should include which set of actions?
Wound care, monitoring for complications, promoting nutrition, assessing the stoma, and selecting an appropriate pouching system
Bedrest only until first flatus, then discharge
Antibiotics only if the stoma appears red
Daily rectal digital examination to assess tone
Which electrolyte disturbances require close observation in a patient with an ileostomy?
Calcium and magnesium excess
Potassium, sodium, and fluid deficits indicating possible electrolyte imbalance
Phosphate accumulation with hyperkalemia
Chloride alkalosis with low sodium only
Which description correctly characterizes a fistula?
A benign mucosal polyp within the colon lumen
An abnormal tract between two hollow organs or between a hollow organ and the skin, named by the track it takes
A postoperative seroma within subcutaneous tissue
A congenital absence of the anal canal
Which combination reflects priority nursing management for patients with fistulas?
Early ambulation and incentive spirometry only
Maintaining fluid and electrolyte balance, controlling infection, protecting surrounding skin, managing output, and providing nutritional support
Withholding oral intake indefinitely and avoiding antibiotics
Daily rectal suppositories to stimulate peristalsis
Which viral infection is associated with about 90% of anal cancer cases?
Human papillomavirus (HPV)
Hepatitis B virus (HBV)
Hepatitis C virus (HCV)
Epstein–Barr virus (EBV)
According to the material, which group is specifically listed as being at high risk for anal cancer?
HIV-positive homosexual men
Postmenopausal women without prior cancer
Young adults with appendicitis
Non-smokers with asthma
What is most often the first symptom of anal cancer?
Rectal bleeding
Jaundice
Unintentional weight gain
Persistent hiccups
Which combination best describes treatment options for anal cancer based on lesion size and depth?
Chemotherapy and radiation, and surgical resection
Antibiotics and probiotics
Insulin therapy and diet alone
Antiviral therapy for 6 months
Hepatocellular carcinoma (HCC) is described as:
The most common type of primary liver cancer
A benign lesion with no risk of spread
Primarily a metastatic tumor from the colon
A pediatric-only liver tumor
Why is early-stage hepatocellular carcinoma difficult to diagnose?
Its manifestations are similar to cirrhosis
It always presents with severe pain
It is detected by routine skin examination
It causes early neurological deficits
Liver cancer prevention efforts in the material focus primarily on which actions?
Identifying and treating chronic viral hepatitis B and C; addressing chronic alcohol ingestion
Screening all adults with annual abdominal CT scans
Avoiding high-fat foods and increasing fiber alone
Exercising daily for 60 minutes
Which factor is NOT listed as influencing treatment decisions for liver cancer in the material?
Patient’s eye color
Tumor size, location, and number
Invasion of blood vessels and spread beyond the liver
Overall age, health, and liver function
According to the material, most pancreatic cancers at diagnosis have:
Metastasized
Resolved spontaneously
Presented as benign cysts
Caused hypoglycemia only
The signs and symptoms of pancreatic cancer are described as most similar to which condition?
Chronic pancreatitis
Acute appendicitis
Gallstones without inflammation
Peptic ulcer disease
Which symptom set most closely aligns with anal cancer as presented in the material?
Rectal pain, itching, pressure, or a full feeling
Severe right upper quadrant pain after fatty meals
Diffuse bone pain and fractures
Night sweats with cervical lymphadenopathy
Which prevention or risk-reduction measure is specifically mentioned for lowering liver cancer risk?
Treatment of chronic alcohol ingestion
Daily multivitamin supplementation
Routine colon cleansing
High-dose vitamin C infusions
