Download Nur 432 Adult Health 2 Exam 1 Questions and Answers 100%Correct/Verified Graded A+ Latest and more Exams Nursing in PDF only on Docsity!
100%Correct/Verified Graded A+ Latest Update 2022/
Chapters 15
1. Describe how cancer is a group of distinct illnesses with different causes,
manifestations, treatments, and prognoses. What is Cancer?
- Large grouping of different disorders
that have varied causes, manifestations, treatments, and prognoses
Pg. Cancer is a large group of disorders with different causes, manifestations, treatments, and prognoses. Because cancer can involve any organ system and treatment approaches have the potential for multisystem effects, cancer nursing practice overlaps with numerous nursing specialties. Cancer nursing practice covers all age groups and is carried out in various settings, including acute care institutions, outpatient centers, physician offices, rehabilitation facilities, the home, and long-term care facilities. The scope, responsibilities, and goals of cancer nursing, also called oncology nursing, are as diverse and complex as those of any nursing specialty. Nursing management of the patient with oncologic disorders includes care of patients
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
throughout the cancer trajectory from prevention through end-of-life care CDC Statistics 2020
- Estimated between 2010 and 2020, cancer cases in United States to increase 24% (
million cases per year) in males and 21% (900,000) for females
- Cancer types increase suspected in: Prostate, kidney, liver, and bladders in males.
Lung, breast, uterine, and thyroid in females. Melanoma in Caucasian females and males
- Cancer survivors to increase from 11.7 million in 2007 to 18 million in 2020 2. Explain the proliferative patterns of cancer cells and the
characteristics of malignant cells. Pg.
- Cancer is a disease process that begins when a cell is transformed by genetic
mutations (inherited or acquired of the cellular deoxyribonucleic acid (DNA).
- The initial genetically altered cell forms a clone and begins to proliferate abnormally,
evading normal intracellular and extracellular growth-regulating processes or signals as well as the immune system defense mechanisms of the body. Genetic mutations cause abnormalities in cell signaling transduction processes (signals from outside and within cells that turn cell activities either on or off) that can in turn lead to cancer development. Ultimately cells acquire a variety of capabilities that allow them to invade surrounding tissues and/or gain access to lymph and blood vessels, which carry the cells to other areas of the body resulting in metastasis or spread of the cancer.
- Proliferative Patterns: pg.
o During the lifespan, various body tissues normally undergo periods of rapid or
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
3. Differentiate between tissue invasion and metastasis. - Invasion: direct growth of the tumor into nearby or surrounding tissue - Metastasis : tumor cells are disseminated by the vascular and lymphatic system and
cancerous growth occurs in other areas of the body (often distant from the primary tumor site)
4. Differentiate between the characteristics of benign and malignant tumors.
Table 15-1 ( pg. 326) Characteristi cs Benign Malignant Cell Well-differentiated cells resemble Cells are undifferentiated and may bear little resemblance to the normal cells
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
normal cells of the tissue from which the tumor originated. of the tissue from which they arose. Mode of growth Tumor grows by expansion and does not infiltrate the surrounding tissues; usually encapsulated. Grows at the periphery and overcomes contact inhibition to invade and infiltrate surrounding tissues Rate of growth Rate of growth is usually slow. Rate of growth is variable and depends on level of differentiation; the more anaplastic the tumor, the faster its growth. Metastasis Does not spread by metastasis Gains access to the blood and lymphatic channels and metastasizes to other areas of the body or grows across body cavities such as the peritoneum General effects Is usually a localized phenomenon that does not cause generalized effects unless its location interferes with vital functions Often causes generalized effects, such as anemia, weakness, systemic inflammation, weight loss, and CACS cancer-related anorexia- cachexia syndrome Tissue destructio n Does not usually cause tissue damage unless its location interferes with blood flow Often causes extensive tissue damage as the tumor outgrows its blood supply or encroaches on blood flow to the area; may also produce substances that cause
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
5. Explain how lymph and blood are mechanisms by which cancer cells spread within
patients. Gains access to the blood and lymphatic channels and metastasizes to other areas of the body or grows across body cavities such as the peritoneum Pg. 326 Genetic mutations may lead to abnormalities in cell signaling transduction processes (signals from outside and within cells that turn cell activities either on or off) that can in turn lead to cancer development. Ultimately cells acquire a variety of capabilities that allow them to invade surrounding tissues and/or gain access to lymph and blood vessels, which carry the cells to other areas of the body resulting in metastasis or spread of the cancer
6. Determine how angiogenesis impacts the cancer patient. - Anaplasia (a pattern of growth in which cells lack normal characteristics and differ in
shape and organization with respect to their cells of origin) is associated with increased malignant potential. Pg.
- During progression, the altered cells exhibit increasingly malignant behavior. These cells
acquire the ability to stimulate
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
angiogenesis (growth of new blood vessels that allow cancer cells to grow), to invade adjacent tissues, and to metastasize.
7. Discuss the process of carcinogenesis and the effectiveness or ineffectiveness of
cancer treatment as it relates to the patient and this process. Carcinogenesis (Malignant Transformation) Carcinogens- Agents that promote or initiate malignancies, i.e. nitrates in foods (controversial, may or may not potentiate carcinogenesis), ultraviolet light, pesticides, viruses, bacteria, hormonal agents, genetics & family, alcohol use, tobacco, asbestos, paint, wood/cement dust, obesity, diet 3 Phases of Carcinogenesis
- Initiation - Substances that can cause cancer (i.e. chemicals)
- Promotion- Repeated exposure to promoting agents causes proliferation and expansion of
initiated cells
- Progression- The altered cells exhibit malignancy behaviors
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
CA and the Immune System
- Immune Surveillance: Altered (transformed) cells arise, but are intercepted by
surveillance cells of the immune system and destroyed
- In humans, transformed cells arise on a regular basis, but are recognized by
surveillance cells of the immune system that destroy them before cell growth becomes uncontrolled (immune surveillance).
- When the immune system fails to identify and stop the growth of transformed
cells, a tumor can develop and progress.
- Increased incidence of CA in immunocompromised patients (i.e. AIDS, transplant, recent CA
treatment)
- Patient treated for one cancer have increased risk for secondary cancer.
- Intact immune systems are able to recognize cancerous cells
- immune surveillance, an intact immune system usually has the ability to
recognize and combat cancer cells through multiple, interacting cells and actions of the innate, humoral, and cellular components of the immune system.
- Tumor-Associated Antigens (TAAs-attached to CA cells)- Foreign cells, T-cells
lymphocytes release cytokines to kill TAAs
- Tumor-associated antigens (TAAs; also called tumor cell antigens ) are found on
the membranes of many cancer cells. TAAs are processed by antigen-presenting cells (APCs) (e.g., macrophages and dentritic cells [very specialized cells of the immune system] that present antigens to both T- and B lymphocytes) and are presented to T lymphocytes that recognize the antigen-bearing cells as foreign. Multiple TAAs have been identified—some are found in many types of cancer,
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
some exist in the normal tissues of origin as well as the cancer cells, some exist in both normal and cancer cells but are overexpressed (exist in higher concentrations) in cancer cells, and others are very specific to certain cancer types.
- In response to recognizing TAAs as foreign, T-cell lymphocytes release several
cytokines that elicit various immune system actions, including (1) proliferation of cytotoxic (cell-killing) T lymphocytes capable of direct destruction of cancer cells, (2) induction of cancer cell apoptosis, and (3) recruitment of additional immune system cells (B-cell lymphocytes that produce antibodies, natural killer cells, and macrophages) that contribute to the destruction and degradation of cancer cells.
- Several theories postulate how malignant cells survive and proliferate, evading the
elaborate immune system defense mechanisms. If the body fails to recognize the TAAs on cancer cells or the function of the APCs is impaired, the immune response is not stimulated. Some cancer cells have been found to have altered cell membranes that interfere with APC binding and presentation to T lymphocytes. Tumors can also express molecules that induce T-lymphocyte anergy or tolerance such as PD-1 ligand. These molecules bind to PD-1 proteins on T lymphocytes and either block the killing of the tumor or induce cell death in the lymphocyte. In addition, cancer cells have been found to release cytokines that inhibit APCs as well as other cells of the immune system. When tumors do not possess TAAs that label them as foreign, the immune response is not alerted. This allows the tumor to grow too large to be managed by normal immune mechanisms.
9. Differentiate between primary, secondary, and tertiary prevention of cancer.
RN Role in Detection and Prevention of CA
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
Chart 15- American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention Individual Choices Achieve and Maintain a Healthy Weight Throughout Life o Be as lean as possible throughout life without being underweight. o Avoid excessive weight gain at all ages. For those who are currently overweight or obese, losing even a small amount of weight has health benefits and is a good place to start. o Engage in regular physical activity and limit consumption of high-calorie foods and beverages as key strategies for maintaining a healthy weight. o Adopt a Physically Active Lifestyle o Adults should engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity each week, or an equivalent combination, preferably spread throughout the week. o Children and adolescents should engage in at least 1 hour of moderate- or vigorous- intensity physical activity each day, with vigorous-intensity activity at least 3 days each week. o Limit sedentary behavior such as sitting, lying down and watching television, and other forms of screen-based entertainment. o Doing any intentional physical activity above usual activities, no matter what one’s level of activity, can have many health benefits. Consume a Healthy Diet, With an Emphasis on Plant Sources o Choose foods and beverages in amounts that help achieve and maintain a healthy weight.
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
o Limit consumption of processed meat and red meats. o Eat at least 21⁄ 2 cups of vegetables and fruits each day. o Choose whole grains in preference to processed (refined) grains. ▪ If You Drink Alcoholic Beverages, Limit Consumption o Drink no more than one drink per day for women or two per day for men. Community Action o Public, private, and community organizations should work collaboratively at national, state, and local levels to implement policy environmental changes that: o Increase access to affordable, healthy foods in communities, worksites, and schools, and decrease access to and marketing of foods and beverages of low nutritional value, particularly to youth. o Provide safe, enjoyable, and accessible environments for physical activity in schools and worksites, and for transportation and recreation in communities.
- Secondary Prevention- Early detection and screening, p. 332 Table 15-
o Secondary prevention involves screening and early detection activities that seek to identify precancerous lesions and early-stage cancer in individuals who lack signs and symptoms of cancer. ACS screening is advocated for many types of cancer. Detection of cancer at an early stage may reduce costs, use of resources, and the morbidity associated with advanced stages of cancer and their associated complex treatment approaches. Many screening and detection programs target people who do not regularly practice health-promoting behaviors or lack access to health care. Nurses continue to develop community-based screening and detection programs that address barriers to health care or reflect the socioeconomic and cultural beliefs of the target
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
- Explain how cancer is diagnosed, as well as tumor staging and grading. ( pg.333)
Diagnosis of Cancer: A cancer diagnosis is based on assessment of physiologic and functional changes and results of the diagnostic evaluation. Patients with suspected cancer undergo extensive testing to: (1) determine the presence and extent of cancer (2) identify possible disease metastasis (3) evaluate the function of involved and uninvolved body systems and organs (4) obtain tissue and cells for analysis, including evaluation of tumor stage and grade. The diagnostic evaluation includes a review of systems; physical examination; imaging studies; laboratory tests of blood, urine, and other body fluids; procedures; and pathologic analysis. TABLE 15.4 Selected Diagnostic Tests Used to Detect Cancer Test Description Examples of Diagnostic Uses Tumor marker identifica Analysis of substances found in tumor tissue, blood, or other body fluids that are indicative of cancer cells or specific Breast, colon, lung, ovarian, testicular, prostate cancers
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
tion characteristics of cancer cells. These substances may also be found in some normal body tissues Genetic tumor markers (Also called prognostic indicators) Analysis for the presence of mutations (alterations) in genes found in tumors or body tissues. Assists in diagnosis, selection of treatment, prediction of response to therapy, and risk of progression or recurrence Breast, lung, kidney, ovarian, brain cancers; leukemia; and lymphoma. Many uses of genetic profiling are considered investigational Mammography Use of x-ray images of the breast Breast cancer Magnetic resonance imaging
(MRI)
Use of magnetic fields and radiofrequency signals to create sectioned images of various body structures Neurologic, pelvic, abdominal, thoracic, breast cancers Computed tomography (CT) scan Use of narrow-beam x-ray to scan successive layers of tissue for a cross-sectional view Neurologic, pelvic, skeletal, abdominal, thoracic cancers Fluoroscopy Use of x-rays that identify contrasts in body tissue densities; may involve the use of contrast agents Skeletal, lung, gastrointestinal cancers Ultrasonogr aphy (ultrasou nd) High-frequency sound waves echoing off body tissues are converted electronically into images; used to assess tissues Abdominal and pelvic cancers
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
TABLE 15.4 Selected Diagnostic Tests Used to Detect Cancer rather than its structure. Used in detection of cancer or its response to treatment non-Hodgkin lymphoma and melanoma PET fusion Use of a PET scanner and a CT scanner in one machine to provide an image combining anatomic detail, spatial resolution, and functional metabolic abnormalities See PET Radioimmunoconj ugates Monoclonal antibodies are labeled with a radioisotope and injected IV into the patient; the antibodies that aggregate at the tumor site are visualized with scanners Colorectal, breast, ovarian, head and neck cancers; lymphoma and melanoma Vascular imaging Use of contrast agents that are injected into veins or arteries and monitored by fluoroscopy, CT, or MRI imaging in order to assess tumor vasculature. Used to assess tumor vascularity prior to surgical procedures. Use in assessing the efficacy of antiangiogenesis (preventing new blood vessel formation) Liver and brain cancers
Nur 432 Adult Health 2 Exam 1 Questions and Answers
100%Correct/Verified Graded A+ Latest Update 2022/
drugs is largely investigational Tumor Staging and Grading
- Staging provides a common language used by health care providers and scientists to
accurately communicate about cancer across clinical settings and in research. o These systems also provide a convenient shorthand notation that condenses lengthy descriptions into manageable terms for comparisons of treatments and prognoses. o Staging determines the size of the tumor, the existence of local invasion, lymph node involvement, and distant metastasis. Several systems exist for classifying the anatomic extent of disease. o The tumor, nodes, and metastasis (TNM) system is one system used to describe many solid tumors.
- Grading is the pathologic classification of tumor cells.
o Grading systems seek to define the type of tissue from which the tumor originated and the degree to which the tumor cells retain the functional and histologic characteristics of the tissue of origin (differentiation). o Samples of cells used to establish the tumor grade may be obtained from tissue scrapings, body fluids, secretions, washings, biopsy, or surgical excision. o This information helps providers predict the behavior and prognosis of various tumors. o The grade corresponds with a numeric value ranging from I to IV. o Grade I tumors, also known as well-differentiated tumors, closely resemble the tissue of origin in structure and function. o Tumors that do not clearly resemble the tissue of origin in structure or function are described as poorly differentiated or undifferentiated and are assigned grade IV.
Nur 432 Adult Health 2 Exam 1 Questions and Answers
