Review Osteosarcoma

Pathophysiology of the Musculoskeletal System > Pathophysiology

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Osteosarcoma

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Total Questions : 15

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Question 1:

A nurse is educating a group of parents about the causes and risk factors associated with Osteosarcoma.
Which statement should the nurse include in the teaching?

A. "Genetic predisposition, such as Li-Fraumeni syndrome, can increase the risk of Osteosarcoma.” B. "Osteosarcoma primarily affects the short bones, such as the wrist and ankle bones.” C. "Exposure to low-dose radiation is a significant risk factor for Osteosarcoma.” D. "Individuals with Paget's disease have a decreased risk of developing Osteosarcoma.”

Answer and Explanation

Choice A:

Genetic predisposition, such as Li-Fraumeni syndrome, can increase the risk of Osteosarcoma. Rationale: Li-Fraumeni syndrome is a hereditary condition characterized by a mutation in the TP53 tumor suppressor gene. This gene normally helps regulate cell growth and prevent the formation of tumors. Individuals with Li-Fraumeni syndrome have an increased risk of developing various cancers, including Osteosarcoma. Therefore, the statement is accurate in identifying a genetic predisposition as a risk factor for Osteosarcoma.

Choice B:

Osteosarcoma primarily affects the short bones, such as the wrist and ankle bones. Rationale: This statement is not accurate. Osteosarcoma typically affects the long bones, such as the arms (humerus), legs (femur and tibia), and pelvis. It rarely occurs in short bones like the wrist and ankle bones.

Choice C:

Exposure to low-dose radiation is a significant risk factor for Osteosarcoma. Rationale: This statement is accurate. Exposure to ionizing radiation, even at low doses, is a known risk factor for the development of Osteosarcoma. It is particularly relevant in cases where individuals have received radiation therapy for other medical conditions.

Choice D:

Individuals with Paget's disease have a decreased risk of developing Osteosarcoma. Rationale: This statement is not accurate. Paget's disease of the bone is actually associated with an increased risk of Osteosarcoma. Paget's disease involves abnormal bone remodeling, which can create an environment conducive to the development of Osteosarcoma, although it is still a relatively rare complication.

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Question 2:

A client with Osteosarcoma asks the nurse about the pathophysiology of the disease.
Which response by the nurse is accurate?

A. "Osteosarcoma arises from mature bone-forming cells called osteocytes.” B. "Genetic mutations leading to uncontrolled proliferation of osteoblasts contribute to Osteosarcoma.” C. "Osteosarcoma typically starts in the epiphyseal region of long bones.” D. "The tumor primarily extends into the muscle tissues surrounding the bone.”

Answer and Explanation

Choice A:

Osteosarcoma arises from mature bone-forming cells called osteocytes. Rationale: This statement is not accurate. Osteosarcoma does not originate from osteocytes. Instead, it arises from osteoblasts, which are immature bone-forming cells. Genetic mutations can lead to uncontrolled proliferation of osteoblasts, contributing to the development of Osteosarcoma.

Choice B:

Genetic mutations leading to uncontrolled proliferation of osteoblasts contribute to Osteosarcoma. Rationale: This statement is accurate. Osteosarcoma is characterized by genetic mutations that cause osteoblasts to multiply uncontrollably, resulting in the formation of malignant bone tumors. This is a key aspect of the disease's pathophysiology.

Choice C:

Osteosarcoma typically starts in the epiphyseal region of long bones. Rationale: This statement is not accurate. Osteosarcoma usually begins in the metaphyseal region of long bones, not the epiphyseal region. The metaphysis is the area of the bone where growth occurs, making it more susceptible to malignant changes.

Choice D:

The tumor primarily extends into the muscle tissues surrounding the bone. Rationale: This statement is not accurate. Osteosarcoma primarily affects the bone itself, with the tumor originating within the bone tissue. While it can extend into nearby soft tissues, such as muscles, it does not primarily start in muscle tissues.

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Question 3:

A client recently diagnosed with Osteosarcoma is discussing treatment options with the healthcare team.
Which treatment modality is commonly used for Osteosarcoma management?

A. Radiation therapy. B. Chemotherapy. C. Hormone therapy. D. Physical therapy.

Answer and Explanation

Choice A:

Radiation therapy. Rationale: Radiation therapy is not commonly used as the primary treatment modality for Osteosarcoma. While it may be used in certain situations to shrink tumors or manage symptoms, the primary treatment approach for Osteosarcoma typically involves a combination of surgery and chemotherapy.

Choice B:

Chemotherapy. Rationale: This statement is accurate. Chemotherapy is commonly used as a part of the multimodal treatment approach for Osteosarcoma. It is usually administered before surgery to shrink the tumor and after surgery to target any remaining cancer cells. Chemotherapy drugs like methotrexate and cisplatin are commonly used in Osteosarcoma treatment protocols.

Choice C:

Hormone therapy. Rationale: Hormone therapy is not a standard treatment for Osteosarcoma. Osteosarcoma is not a hormone-sensitive cancer, so hormone therapy is not effective in its management.

Choice D:

Physical therapy. Rationale: Physical therapy may be used as part of the comprehensive care plan for Osteosarcoma patients, especially after surgery or during the recovery phase. However, it is not a primary treatment modality for the disease itself.

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Question 4:

A nurse is providing education to a group of adolescents about prevention strategies for Osteosarcoma.
What information should the nurse include in the teaching?

A. "Regularly consume high doses of vitamin C to prevent Osteosarcoma.” B. "Engage in weight-bearing exercises to promote bone health.” C. "Avoid exposure to sunlight to reduce the risk of Osteosarcoma.” D. "Consume a diet rich in saturated fats to decrease the risk of Osteosarcoma.”

Answer and Explanation

Choice A:

Regularly consume high doses of vitamin C to prevent Osteosarcoma. Rationale: This statement is not accurate. There is no evidence to suggest that consuming high doses of vitamin C prevents Osteosarcoma. While vitamin C is important for overall health, especially for wound healing and immune function, it does not specifically prevent this type of bone cancer.

Choice B:

Engage in weight-bearing exercises to promote bone health. Rationale: This statement is accurate. Engaging in weight-bearing exercises, such as walking, running, or weightlifting, is beneficial for bone health. It helps maintain bone density and strength, potentially reducing the risk of Osteosarcoma.

Choice C:

Avoid exposure to sunlight to reduce the risk of Osteosarcoma. Rationale: This statement is not accurate. Sunlight exposure is primarily associated with skin cancers, such as melanoma and non-melanoma skin cancers. It is not a known risk factor for Osteosarcoma.

Choice D:

Consume a diet rich in saturated fats to decrease the risk of Osteosarcoma. Rationale: This statement is not accurate. A diet rich in saturated fats is not associated with a decreased risk of O . Questions

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Question 5:

A nurse is assessing a client with suspected Osteosarcoma.
Which clinical presentation is characteristic of this condition?

A. "I have been experiencing fatigue and weight loss.” B. "I noticed a palpable mass on my leg.” C. "I have difficulty moving my arm.” D. "My joint pain seems to worsen at night.”

Answer and Explanation

Choice A:

"I have been experiencing fatigue and weight loss." Fatigue and weight loss are non-specific symptoms and can be attributed to various medical conditions, but they are not characteristic of Osteosarcoma. Osteosarcoma typically presents with localized symptoms related to the tumor's location, such as a palpable mass, pain, and limited range of motion.

Choice C:

"I have difficulty moving my arm." Difficulty moving the arm is more indicative of a problem in the upper extremities and is not a characteristic presentation of Osteosarcoma, which primarily affects the long bones of the extremities, such as the legs.

Choice D:

"My joint pain seems to worsen at night." While joint pain can be a symptom of Osteosarcoma, it alone is not a characteristic presentation. The key characteristic of Osteosarcoma is the development of a palpable mass, often accompanied by localized pain and swelling. The mention of worsening pain at night is not specific enough to differentiate Osteosarcoma from other conditions.

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Question 6:

A client with Osteosarcoma is scheduled for surgery.
What is a common goal of surgical treatment for Osteosarcoma?

A. "Preserving the affected limb.” B. "Removing all cancer cells without surgery.” C. "Administering radiation therapy only.” D. "Performing amputation as the primary treatment.”

Answer and Explanation

Choice C:

"Administering radiation therapy only." While radiation therapy may be used as part of the treatment plan for Osteosarcoma, it is not the primary goal of surgical treatment. Surgical intervention, such as limb-sparing surgery or amputation, is the mainstay of therapy for Osteosarcoma.

Choice D:

"Performing amputation as the primary treatment." While amputation may be necessary in some cases of Osteosarcoma, the primary goal of surgical treatment is to preserve the affected limb whenever possible. Amputation is considered when limb preservation is not feasible or when the tumor is very large and invasive.

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Question 7:

A nurse is conducting a nursing assessment for a client with Osteosarcoma.
Which assessments should the nurse perform? Select all that apply.

A. "Assess for a history of radiation exposure.” B. "Examine the patient's liver function.” C. "Check for signs of metastatic spread.” D. "Monitor complete blood count.” E. "Perform a neurological examination.”

Answer and Explanation

Choice A:

Choice B:

While monitoring liver function is important in cancer patients, it is not a specific assessment related to Osteosarcoma. Osteosarcoma primarily affects the bones and may spread to the lungs or other distant sites rather than the liver.

Choice C:

Choice D:

Choice E:

"Perform a neurological examination." A neurological examination is not a standard assessment for Osteosarcoma. This cancer primarily involves the bones and surrounding tissues, and neurological symptoms are not typically associated with it.

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Question 8:

A client with Osteosarcoma is receiving chemotherapy as part of their treatment plan.
What is the purpose of administering chemotherapy in this case?

A. "To perform limb-sparing surgery.” B. "To shrink the tumor before surgery.” C. "To remove the palpable mass.” D. "To administer radiation therapy.”

Answer and Explanation

Choice A:

"To perform limb-sparing surgery." Chemotherapy is administered before surgery (neoadjuvant chemotherapy) to shrink the tumor and make limb-sparing surgery possible in cases of Osteosarcoma. The primary goal is to reduce the size of the tumor and improve the chances of successful surgical removal while preserving the affected limb.

Choice C:

"To remove the palpable mass." While surgery is intended to remove the palpable mass, chemotherapy is not given for the sole purpose of mass removal. Chemotherapy is used as part of a multimodal treatment approach to target cancer cells systemically and reduce the tumor's size before surgery.

Choice D:

"To administer radiation therapy." Chemotherapy is not the primary treatment for administering radiation therapy in Osteosarcoma cases. Radiation therapy is typically considered when there is residual disease after surgery or in cases where surgery is not possible.

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Question 9:

A nurse is caring for a client with Osteosarcoma who underwent surgery.
What is the primary goal of surgical treatment in Osteosarcoma cases?

A. "Administering neoadjuvant chemotherapy.” B. "Preserving limb function.” C. "Performing amputation as the primary treatment.” D. "Targeting residual tumor cells with radiation therapy.”

Answer and Explanation

Choice A:

"Administering neoadjuvant chemotherapy." Neoadjuvant chemotherapy is administered before surgery in Osteosarcoma cases to shrink the tumor and increase the likelihood of preserving limb function. The primary goal is not the administration of chemotherapy but rather limb preservation.

Choice C:

"Performing amputation as the primary treatment." Amputation is considered in cases where limb preservation is not feasible, but it is not the primary goal of surgical treatment in Osteosarcoma. The primary goal is to preserve limb function whenever possible.

Choice D:

"Targeting residual tumor cells with radiation therapy." While radiation therapy may be used postoperatively to target residual tumor cells, it is not the primary goal of surgical treatment. The primary goal of surgery in Osteosarcoma is to remove the tumor and preserve limb function. Questions

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Question 10:

A nurse is caring for a patient with Osteosarcoma who is experiencing significant pain.
What nursing intervention should the nurse prioritize to address the patient's pain?

A. Administer analgesics as prescribed. B. Offer emotional support to the patient. C. Monitor surgical incisions for signs of infection. D. Collaborate with physical therapists for rehabilitation.

Answer and Explanation

Choice A:

Administer analgesics as prescribed is the top priority nursing intervention for a patient with Osteosarcoma experiencing significant pain. Osteosarcoma is a type of bone cancer known for causing severe pain, and effective pain management is crucial for the patient's comfort and well-being. The nurse should follow the physician's orders and administer analgesics as prescribed to alleviate the pain. This not only helps in providing immediate relief to the patient but also ensures that the pain is controlled effectively, improving the patient's overall quality of life and ability to participate in necessary treatments and activities.

Choice B:

Offering emotional support to the patient is indeed an essential aspect of holistic care, but in this case, pain management takes precedence. While emotional support is important, it should not be prioritized over addressing the patient's immediate physical discomfort. Once the pain is managed, emotional support should be provided as part of comprehensive care.

Choice C:

Monitoring surgical incisions for signs of infection is an important nursing responsibility, especially for post-surgery patients. However, in this scenario, addressing the patient's significant pain should be the priority. Infection monitoring should still be done but should not take precedence over pain management.

Choice D:

Collaborating with physical therapists for rehabilitation is a valuable part of the patient's overall care plan, but it is not the immediate priority when the patient is experiencing significant pain. Rehabilitation and physical therapy can be considered once the pain is under control and the patient's condition stabilizes.

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Question 11:

A client newly diagnosed with Osteosarcoma asks the nurse about the purpose of chemotherapy.
Which nursing response is appropriate to provide education on the rationale behind chemotherapy?

A. "Chemotherapy helps reduce emotional distress.” B. "Chemotherapy helps prevent metastasis.” C. "Chemotherapy targets osteosarcoma cells directly.” D. "Chemotherapy is used to manage pain.”

Answer and Explanation

Choice A:

"Chemotherapy helps reduce emotional distress" is an inaccurate statement. While chemotherapy can be emotionally distressing due to its side effects, its primary purpose is to treat cancer by targeting and destroying cancer cells. Managing emotional distress may be a part of supportive care but is not the main rationale behind chemotherapy.

Choice C:

"Chemotherapy targets osteosarcoma cells directly" is not entirely accurate. While chemotherapy does target cancer cells, it does not specifically target only Osteosarcoma cells. It affects rapidly dividing cells, which includes both cancerous and some healthy cells, leading to various side effects. The primary purpose of chemotherapy in Osteosarcoma is to prevent metastasis and shrink or eliminate the tumor.

Choice D:

"Chemotherapy is used to manage pain" is not the main purpose of chemotherapy in Osteosarcoma. Pain management is typically achieved through analgesics and other pain-relieving measures. Chemotherapy may indirectly help with pain by shrinking the tumor and reducing pressure on surrounding tissues, but pain management is not its primary rationale.

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Question 12:

A client is concerned about the potential complications of Osteosarcoma and asks the nurse what to watch out for.
Which complication should the nurse mention as a significant concern for Osteosarcoma patients?

A. Gastrointestinal bleeding. B. Metastasis to the lungs and other bones. C. Allergic reactions to chemotherapy. D. Development of autoimmune disorders.

Answer and Explanation

Choice A:

Gastrointestinal bleeding is not a common complication of Osteosarcoma. While Osteosarcoma primarily affects the bones, it can potentially invade nearby soft tissues, but gastrointestinal bleeding is not a characteristic complication associated with this cancer.

Choice B:

Metastasis to the lungs and other bones is a significant concern for Osteosarcoma patients. Osteosarcoma has a high propensity to metastasize, and the lungs are one of the most common sites for metastatic spread. Additionally, metastasis to other bones can occur, further complicating the patient's condition. Monitoring for metastasis and early detection are essential to guide treatment decisions and improve outcomes.

Choice C:

Allergic reactions to chemotherapy are a concern but not a specific complication of Osteosarcoma itself. Allergic reactions can occur with various medications, including chemotherapy drugs, but they are not unique to Osteosarcoma patients.

Choice D:

Development of autoimmune disorders is not a known complication of Osteosarcoma. Osteosarcoma primarily involves the growth of malignant bone tissue and is not typically associated with autoimmune-related issues.

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Question 13:

A nurse is educating a group of high-risk individuals about Osteosarcoma prevention.
What advice should the nurse provide to these individuals regarding prevention strategies?

A. Avoid physical therapy. B. Undergo regular medical surveillance. C. Increase exposure to radiation. D. Consume a diet high in calcium. E. Use over-the-counter pain relievers regularly.

Answer and Explanation

Choice A:

Avoiding physical therapy is not a relevant or appropriate prevention strategy for Osteosarcoma.
Physical therapy is a valuable component of rehabilitation and may be beneficial for patients with Osteosarcoma to regain function and mobility after treatment.

Choice B:

The most appropriate advice for Osteosarcoma prevention strategies is to undergo regular medical surveillance.
Osteosarcoma is primarily a genetic condition, and there are no specific lifestyle changes or dietary modifications that can prevent its development.
Regular medical check-ups and surveillance can help in early detection and intervention if there are any signs or symptoms of the disease.

Choice C:

Increasing exposure to radiation is not a recommended prevention strategy for Osteosarcoma or any other condition.
Radiation exposure can increase the risk of cancer, and unnecessary radiation should be avoided.

Choice D:

Consuming a diet high in calcium is not a specific prevention strategy for Osteosarcoma.
While calcium is important for bone health, Osteosarcoma is primarily a genetic condition, and dietary factors are not known to be a significant risk factor.

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Question 14:

A nurse is performing a comprehensive assessment on a patient suspected of having Osteosarcoma.
Select all the nursing assessment techniques that are relevant for this condition.

A. Palpating the lymph nodes. B. Measuring blood pressure. C. Assessing range of motion of the affected limb. D. Inspecting the skin for changes in color or texture. E. Evaluating the patient's cognitive function.

Answer and Explanation

Choice A:

Palpating the lymph nodes.
Rationale: Palpating the lymph nodes is relevant because it helps assess for potential metastasis.
Osteosarcoma can spread to nearby lymph nodes, and checking for enlarged or palpable lymph nodes is important in assessing the extent of the disease.

Choice B:

Measuring blood pressure.
Rationale: Measuring blood pressure is generally not directly relevant to assessing Osteosarcoma.
While hypertension can be a side effect of some cancer treatments, it is not a primary assessment for Osteosarcoma itself.

Choice C:

Assessing range of motion of the affected limb.
Rationale: Assessing range of motion of the affected limb is relevant because Osteosarcoma can cause pain, swelling, and limitations in joint mobility.
Evaluating the range of motion helps in assessing the impact of the tumor on the patient's functional status.

Choice D:

Inspecting the skin for changes in color or texture.
Rationale: Inspecting the skin for changes in color or texture is relevant because skin changes, such as erythema (redness), warmth, or ulceration, can be indicative of advanced disease or tumor extension into the soft tissues surrounding the bone.

Choice E:

Evaluating the patient's cognitive function.

Rationale: Evaluating the patient's cognitive function is generally not directly relevant to assessing Osteosarcoma.

It may be important for other conditions or as part of a comprehensive patient assessment but is not specific to Osteosarcoma.

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Question 15:

(Select all that apply): A nurse is caring for a patient with Osteosarcoma.
What are appropriate nursing interventions for this patient? Select all that apply.

A. Administering chemotherapy as prescribed. B. Providing emotional support to the family. C. Monitoring for signs of infection in surgical incisions. D. Offering cold therapy for pain relief. E. Collaborating with occupational therapists for rehabilitation.

Answer and Explanation

Choice A:

Administering chemotherapy as prescribed is an appropriate nursing intervention for a patient with Osteosarcoma.
Chemotherapy is a standard treatment modality for Osteosarcoma, aimed at reducing the size of the tumor, preventing metastasis, and improving the overall prognosis.
The nurse should ensure that chemotherapy is administered according to the physician's orders and monitor the patient for any adverse effects.

Choice B:

Providing emotional support to the family is an important aspect of holistic care, but it is not a specific nursing intervention for Osteosarcoma patients.
Emotional support is valuable but should be provided in conjunction with other nursing interventions that directly address the patient's physical and emotional needs.

Choice C:

Monitoring for signs of infection in surgical incisions is essential in the care of Osteosarcoma patients who have undergone surgery.
Surgical incisions can be a potential source of infection, and early detection and management of infections are crucial for the patient's recovery.
This nursing intervention helps prevent complications and ensures the patient's safety.

Choice D:

Offering cold therapy for pain relief is not a standard nursing intervention for Osteosarcoma patients.
Pain relief in Osteosarcoma is primarily achieved through the administration of analgesics and other pain management strategies.
Cold therapy may be used in some cases for localized pain relief, but it is not a universal intervention for all Osteosarcoma patients.

Choice E:

Collaborating with occupational therapists for rehabilitation is a valuable nursing intervention for patients with Osteosarcoma.

Occupational therapy can help patients regain functional independence and improve their quality of life after surgery or treatment.

It focuses on activities of daily living and enhancing the patient's physical and emotional well-being.

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Osteosarcoma

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