After reviewing the history of a group of clients, which client should the nurse identify as having the greatest risk for cancer?

A 40-year-old client who smoked cigarettes as a teen.

A 50-year-old woman with a maternal history of breast cancer.

A woman who had a total hysterectomy 5 years ago for a grade 4 Pap smear.

A man with no tumor marker elevation 3 years after prostate cancer treatment.

Answer and Explanation

The Correct Answer is B

A. A 40-year-old client who smoked cigarettes as a teen. While smoking is a known risk factor for several cancers, a brief history of smoking in adolescence does not pose as high a risk as a strong family history of breast cancer. Long-term smoking exposure is more strongly linked to lung and other cancers.
B. A 50-year-old woman with a maternal history of breast cancer. A family history of breast cancer, especially in a first-degree relative (mother, sister, or daughter), significantly increases the risk of developing breast cancer. This client may also carry genetic mutations such as BRCA1 or BRCA2, further elevating the risk.
C. A woman who had a total hysterectomy 5 years ago for a grade 4 Pap smear. A grade 4 Pap smear indicates severe cervical dysplasia or carcinoma in situ, but a total hysterectomy removes the uterus and cervix, significantly reducing the risk of cervical cancer recurrence.
D. A man with no tumor marker elevation 3 years after prostate cancer treatment. This client is in remission with no current signs of active cancer. While prostate cancer survivors require monitoring, his risk is lower compared to someone with an active familial predisposition to cancer.

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Correct Answer is D

Explanation

A. Has hyperemia at the site of an acute local infection. Hyperemia (increased blood flow) is a sign of the body's normal immune response to infection. While the client has an infection, their immune system is still active, making them less vulnerable to new healthcare-associated infections (HAIs) compared to an immunosuppressed individual.
B. Recently received a series of adult immunizations. Vaccinations enhance the immune system and help protect against infections. This does not increase the risk of developing an HAI.
C. Lost ten pounds adhering to a low carbohydrate diet. Dietary changes alone do not significantly impact infection risk unless they lead to malnutrition. A 10-pound weight loss does not necessarily indicate a compromised immune system.
D. Receiving immune suppressant therapy for cancer. Immunosuppressive therapy weakens the immune system, making the client highly susceptible to HAIs. Cancer treatments, such as chemotherapy, radiation, or corticosteroids, reduce the body's ability to fight infections, increasing the risk of hospital-acquired infections like pneumonia, bloodstream infections, and surgical site infections.

A. Remove the ink marks of the portal after each radiation treatment. B. Apply moisture lotions daily to the radiation portal site. C. Protect the skin of the radiation portal site from sunlight exposure. D. Avoid washing the skin inside the radiation portal site.

Correct Answer is C

Explanation

A. Remove the ink marks of the portal after each radiation treatment. Ink marks should not be removed, as they help ensure precise radiation targeting during each session. The marks should remain visible until the treatment plan is complete.
B. Apply moisture lotions daily to the radiation portal site. Many lotions and creams contain ingredients that can irritate the skin or interfere with radiation therapy. Only approved, non-irritating, fragrance-free moisturizers should be used, and typically only after consulting the oncology provider.
C. Protect the skin of the radiation portal site from sunlight exposure. Radiation therapy increases skin sensitivity, making it more vulnerable to sunburn and damage. Clients should cover the treated area with loose clothing or use sunscreen (SPF 30 or higher) if sun exposure is unavoidable.
D. Avoid washing the skin inside the radiation portal site. Gentle washing with mild soap and lukewarm water is recommended to keep the area clean and reduce irritation. Harsh scrubbing, hot water, and scented soaps should be avoided.

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After reviewing the history of a group of clients, which client should the nurse identify as having the greatest risk for cancer?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse identifies the hospitalized client in which situation as being at highest risk for the development of a healthcare associated infection (HAI)?

Correct Answer is D

Explanation

The nurse is caring for a client who is receiving teletherapy radiation for a malignant tumor. Which instructions regarding skin care of the portal site should the nurse provide?

Correct Answer is C

Explanation

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Which test for HIV is used primarily as a confirmatory test rather than a generalized screening test?

Exhibits The nurse reviews the client's data. Which factor(s) place the client at greatest risk for skin injuries? Select all that apply.

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