Understanding Pathophysiology 6th

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Chapter 10: Biology, Clinical Manifestations, and Treatment of Cancer
Huether & McCance: Understanding Pathophysiology, 6th Edition

MULTIPLE CHOICE

1. A patient has a tissue growth that was diagnosed as cancer. Which of the following terms best
describes this growth?
a. Malignant tumor
b. Lipoma
c. Meningioma
d. Hypertrophy
ANS: A
Some tumors initially described as benign can progress to cancer and then are referred to as
malignant tumors. Lipomas are benign growths, while a meningioma is a benign tumor.
Hypertrophy refers to tissue overgrowth, but not cancer.

REF: p. 234

2. Which information indicates a nurse understands characteristics of malignant tumors?

a. Grows slowly
b. Has a well-defined capsule
c. Cells vary in size and shape
d. Is well differentiated
ANS: C
Malignant tumors have cells that vary in both size and shape, and they grow rapidly. They are
poorly differentiated and not encapsulated.

REF: p. 234

3. A nurse is discussing preinvasive epithelial tumors of glandular or squamous cell origin. What
is the nurse describing?
a. Tumor in differentiation
b. Dysplastic
c. Cancer in situ
d. Cancer beyond (meta) situ
ANS: C
Early-stage growths that are localized to the epithelium and have not invaded are called cancer
in situ. Cancer in situ is early-stage growth and not a tumor in differentiation but is more
mature growth. Dysplastic cells do not define cancer in situ.

REF: p. 234

4. A 25-year-old male develops a tumor of the breast glandular tissue. What type of tumor will
be documented on the chart?
a. Carcinoma
b. Adenocarcinoma
c. Sarcoma
 d. Lymphoma
ANS: B
Tumors that arise from or form ductal or glandular structures are named adenocarcinomas.
Cancers arising in epithelial tissue are called carcinomas; mesenchymal tissue (including
connective tissue, muscle, and bone) usually have the suffix sarcoma; lymphatic tissue are
called lymphomas.

REF: p. 234

5. A 30-year-old female is diagnosed with cancer. Testing reveals that the cancer cells have
spread to local lymph nodes. A nurse realizes this cancer would be documented as stage:
a. 1.
b. 2.
c. 3.
d. 4.
ANS: C
Cancer that has spread to regional structures, such as lymph nodes, is stage 3. Cancer confined
to the organ of origin is stage 1. Cancer that is locally invasive is stage 2. Cancer that has
spread to distant sites, such as a liver cancer spreading to lung or a prostate cancer spreading
to bone, is stage 4.

REF: p. 259, Figure 10-22

6. An oncologist is discussing when a cancer cell loses differentiation. Which of the following is
the oncologist describing?
a. Autonomy
b. Anaplasia
c. Pleomorphic
d. Metastasis
ANS: B
Anaplasia, not autonomy, is the loss of differentiation. The term pleomorphic refers to a
marked variability of size and shape. A malignant tumor has the ability to spread far beyond
the tissue of origin by the process of metastasis.

REF: p. 234

7. A primary care provider is attempting to diagnose cancer and is looking for a tumor marker.
Which of the following could be a possible marker?
a. Red blood cells
b. Apoptotic cells
c. Enzymes
d. Neurotransmitters
ANS: C
Tumor markers include hormones, enzymes, genes, antigens, and antibodies, but not red blood
cells, apoptotic cells, or neurotransmitters.

REF: p. 258
 8. A 52-year-old male with hepatitis C recently developed hepatic cancer. Which of the
following markers should be increased?
a. Alpha-fetoprotein (AFP)
b. Catecholamines
c. Prostate-specific antigen
d. Homovanillic acid
ANS: A
Liver and germ cell tumors secrete a protein known as AFP, not catecholamines. Prostate
tumors secrete prostate-specific antigen. Homovanillic acid is a catecholamine marker.

REF: p. 259, Table 10-7

9. Which information should the nurse include when teaching about angiogenic factors? In
cancer, angiogenic factors stimulate:
a. release of growth factors.
b. tumor regression.
c. apoptosis.
d. new blood vessel growth.
ANS: D
Cancers can secrete multiple factors that stimulate new blood vessel growth called
angiogenesis, not release of growth factors or tumor regression. Apoptosis is cell death.

REF: pp. 245-246

10. What is the effect of telomere caps on cancer cells?

a. Repeated divisions
b. Clonal distinction
c. Limited mitosis
d. Mutation abilities
ANS: A
The presence of telomere caps gives cancer cells the ability to divide over and over again, thus
cancer cells have unlimited mitosis. Telomere caps do not give cells clonal distinction.
Mutation capability is a characteristic of cancer cells, but this property is not related to
telomeres.

REF: p. 245

11. Which of the following indicates a nurse understands a proto-oncogene? A proto-oncogene is

best defined as a(n) _____ gene.
a. normal
b. altered
c. inactive
d. tumor-suppressor
ANS: A
In its normal, nonmutant state, an oncogene is referred to as a proto-oncogene.
A proto-oncogene is not an altered gene, an inactive gene, or a tumor-suppressor gene.

REF: p. 240
12. Which genetic change causes alterations in only one or a few nucleotide bases?
a. Insertions
b. Deletions
c. Point mutations
d. Amplification mutations
ANS: C
Genetic changes may occur by both mutational and epigenetic mechanisms. Mutation
generally means an alteration in the DNA sequence affecting expression or function of a gene.
Mutations include small-scale changes in DNA, such as point mutations, which are the
alteration of one or a few nucleotide base pairs. The process involved with insertions,
deletions, or amplification mutations is different.

REF: p. 237

13. A 45-year-old female was recently diagnosed with cervical cancer. Which of the following is
the most likely cause of her cancer?
a. Herpes virus
b. Rubella virus
c. Human papillomavirus (HPV)
d. Hepatitis B virus
ANS: C
The presence of HPV is a factor in cervical cancer. The presence of herpes virus, rubella
virus, or hepatitis B virus is not a factor in cervical cancer.

REF: p. 250

14. A 30-year-old male with HIV is diagnosed with Epstein-Barr virus. After 2 months, the virus
is still active. Based upon the Epstein-Barr virus, which of the following cancers is most likely
to develop in this patient?
a. B-cell lymphoma
b. Kaposi sarcoma
c. T-cell leukemia
d. T-cell lipoma
ANS: A
Epstein-Barr virus is associated with B-cell lymphoma. Kaposi sarcoma is associated with
HIV. Retroviruses are associated with leukemia. Lipomas are not associated with HIV.

REF: p. 250

15. A 45-year-old male presents with persistent, severe stomach pain. Testing reveals a peptic
ulcer. Further laboratory tests reveal the presence of Helicobacter pylori. Which of the
following is of concern for this patient?
a. Gastric cancer
b. Leukemia
c. Lung cancer
d. Adenocarcinoma of the colon
ANS: A
 The presence of Helicobacter pylori is associated with gastric cancer, not leukemia, lung
cancer, or colon cancer.

REF: p. 249

16. Which statement indicates the patient has a correct understanding of metastasis? The most
common route of metastasis is through the blood vessels and:
a. lung tissue.
b. body cavities.
c. lymphatics.
d. connective tissues.
ANS: C
The most common route of metastasis is through the lymphatics, not lung tissue, body
cavities, or connective tissues.

REF: p. 253

17. A nurse is giving an example of inflammation as an etiology for cancer development. What is
the best example the nurse should give?
a. Pneumonia and lung cancer
b. Ulcerative colitis and colon cancer
c. Prostatic hypertrophy and prostate cancer
d. Hypercholesterolemia and leukemia
ANS: B
Individuals with a 10+ year history of ulcerative colitis have a 30-fold increase in developing
colon cancer. There is no relationship between pneumonia and lung cancer; between prostatic
hypertrophy and cancer of the prostate; and between hypercholesterolemia and leukemia.

REF: pp. 248-249

18. A patient asks when adjuvant chemotherapy is used. How should the nurse respond? Adjuvant
chemotherapy treatment is used:
a. as the primary treatment.
b. before radiation therapy.
c. after surgical removal of a tumor.
d. in cancer with little risk of metastasis.
ANS: C
Adjuvant chemotherapy is given after surgical excision of a cancer with the goal of
eliminating micrometastases. Adjuvant chemotherapy is not given as the primary treatment or
before radiation therapy. Adjuvant chemotherapy is indicated in the treatment of individuals
with metastasis.

REF: p. 261

MULTIPLE RESPONSE

1. Brachytherapy is being used to treat cancer in a patient. What types of cancers respond well to
brachytherapy? (select all that apply)
a. Prostate
b. Cervix
c. Head
d. Neck
e. Lung
ANS: A, B, C, D
Radiation sources can be temporarily placed into body cavities through a delivery method
termed brachytherapy. Brachytherapy is useful in the treatment of cervical, prostate, and head
and neck cancers. It is not used in the treatment of lung cancer.

REF: p. 260