C. ALTERED BODY IMAGE

19. Most empirical studies dealing with the relationship of cancer to body image and quality of life have focused on:

1. The total self-appraisal of cancer patients, both men and women
2. The effects of various treatments on relationships of cancer patients with significant others
3. Women with gynecologic or breast cancer or males with testicular or prostate cancer
4. The interaction of variables such as age, depression, and activity status on the psychosocial aspects of sexual health

20. Albert is about to undergo chemotherapy with a regimen that includes cyclophosphamide, doxorubicin, vincristine, and prednisone, and is known to cause significant hair loss. Which of the following will be part of your patient education plan for Albert?

1. Chemotherapy-induced alopecia occurs slowly and may not occur for several months after the treatment.
2. Once chemotherapy is complete, regrowth is visible in 4–6 weeks.
3. Mild hair loss is associated with this regimen.
4. In situations involving very high doses of alkylating agents, it may take more than 2 years for regrowth.

21. Following four courses of chemotherapy, Albert shows you that his fingernails have developed transverse white lines or grooves. You explain to Albert that this symptom:

1. Is a response to cyclophosphamide because pigmentation has been deposited at the base of the nail
2. Indicates a reduction or cessation of nail growth in response to cytotoxic therapy
3. Reflects a cytotoxic reaction to cyclophosphamide
4. Is a partial separation of the nail plate called onycholysis and is a reaction to fluorouracil (5-FU) therapy

22. Because of the staging of her cancer, the size of the tumor, and a number of other factors, Marcia will undergo immediate breast reconstruction after her surgery. Her surgeon has explained that the procedure most likely to be used in her case is the transverse rectus abdominis (TRAM) flap. You explain to Marcia that this will involve removing tissue from her _________ and tunneling it to the mastectomy site.

1. Abdominal muscle
2. Latissimus dorsi muscle
3. Lower abdomen
4. Buttocks

23. Sally asks you if there is anything she can do to prevent hair loss with chemotherapy. Which of the following would be an appropriate response?

1. Use a hair dryer on a low setting after shampooing.
2. Use Minoxidil, an oral active vasodilator.
3. Use vitamin D to help prevent hair loss.
4. Use only protein-based shampoos and conditioners and avoid daily shampooing.

24. A woman with breast cancer is being treated with six courses of intravenous (IV) docetaxel, doxorubicin, and cyclophosphamide. She is very upset about the possibility of losing her hair. The most appropriate response to her concerns regarding hair loss would include which of the following?

1. Reassure her that although she will have significant hair loss, it will grow back.
2. Assure her that it is likely she will not lose any hair at all.
3. Inform her that hair loss is gradual over the next 2 months, and she will require a wig sooner rather than later.
4. Let her know that her hair will likely thin, but she will probably not require a wig.

25. A patient being treated with radiation to an abdominal field is concerned about hair loss that she expects to experience following radiotherapy. You can best reassure her by telling her that:

1. Hair follicles are relatively radioresistant due to their low rate of growth and mitotic activity.
2. Radiation response is seen mostly in tissues and organs that are within the treatment field.
3. Alopecia is permanent only when radiation is administered in low doses over an extended period of time.
4. Alopecia is more closely associated with brachytherapy than with teletherapy.