Nokea
A patient with a large stomach tumor attached to the liver is scheduled for a debulking procedure. Which information should the nurse teach the patient about the outcome of this procedure?
- A. Pain will be relieved by cutting sensory nerves in the stomach.
- B. Relief of pressure in the stomach will promote better nutrition.
- C. Decreasing the tumor size will improve the effects of other therapy.
- D. Tumor growth will be controlled by the removal of malignant tissue.
Correct Answer: C
Rationale: Debulking shrinks a stomach tumor stuck to the liver, boosting chemo and radiation's punch smaller targets respond better. Pain relief isn't the goal nerves aren't cut. Pressure relief might help eating, but it's secondary. Growth control fails it's not curative; tumor regrows. Nurses in oncology pitch this: it's a team play, enhancing other treatments' odds, vital for patients facing inoperable masses.
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A 45 year old man, BMI 35 but otherwise healthy and normotensive has an urinary albumin excretion of 30 mg in 24 hours. Which is the correct action to take?
- A. Reduce weight
- B. It can be observed over 3 months for improvement
- C. Refer him to a nephrologist
- D. Treatment is required
Correct Answer: A
Rationale: Albumin 30 microalbuminuria's dawn, weight loss curbs it; watch, refer, treat, ignore lag. Nurses nudge this chronic kidney shield.
There are several different transmembranous glucose transporters (Gluts). Question: Which Gluts occur most frequently in the liver and which in the pancreas?
- A. Glut 1 in the liver and Glut 2 in the pancreas
- B. Glut 2 in the liver and Glut 2 in the pancreas
- C. Glut 2 in the liver and Glut 1 in the pancreas
- D. Glut 4 in the liver and Glut 2 in the pancreas
Correct Answer: B
Rationale: Liver slurps glucose with Glut 2, pancreas senses it the same both lean on this transporter's flow. Glut 1's elsewhere, Glut 4's muscle-fat turf nurses know this, a chronic glucose gate map.
Which of the following procedures are performed for a client with a pericardial effusion?
- A. Thoracotomy
- B. Pericardiocentesis
- C. Coronary artery bypass graft
- D. Thoracentesis
Correct Answer: B
Rationale: Pericardial effusion fluid around the heart threatens tamponade, compressing cardiac output. Pericardiocentesis drains this via needle or catheter, relieving pressure, a targeted fix for this diagnosis. Thoracotomy, an open chest surgery, is overkill unless complications escalate. Coronary bypass addresses arterial blockages, unrelated to effusion. Thoracentesis taps pleural fluid, not pericardial. Nurses prep for pericardiocentesis, anticipating its urgency in restoring function, a procedure matching the condition's anatomy and risk, critical for stabilizing clients in this cardiac emergency.
Which of the following findings would be most indicative of retinoblastoma for an 18-month old child?
- A. Orbital inflammation of the right eye and head tilt when standing.
- B. Cat's eye reflex and yellow discharge from the left eye.
- C. Leukokoria and hyphema noted for the right eye.
- D. Strabismus in the left eye and light sensitivity in the opposite eye.
Correct Answer: C
Rationale: Retinoblastoma, a retinal cancer in young children, commonly presents with leukokoria (white pupil reflection) and hyphema (blood in the anterior eye chamber), making these findings most indicative due to tumor effects on retinal light reflection and vascular fragility. Orbital inflammation and head tilt suggest brain tumors or orbital cellulitis, not retinoblastoma's typical intraocular focus. Cat's eye reflex (leukokoria) fits, but yellow discharge points to infection (e.g., conjunctivitis), not cancer. Strabismus and light sensitivity may occur in retinoblastoma but are less specific strabismus from muscle imbalance and sensitivity from inflammation lacking hyphema's diagnostic weight. Nurses spotting leukokoria and hyphema trigger urgent ophthalmology referral, critical in pediatric oncology for early detection and vision-saving or life-saving intervention in this age group.
The nurse understands that the physician would need to be notified regarding a chemotherapy dose if the client experiences:
- A. Fatigue
- B. Nausea and vomiting
- C. Stomatitis
- D. Bone marrow suppression
Correct Answer: D
Rationale: Chemotherapy's marrow hit bone marrow suppression drops counts like neutrophils or platelets, risking infection or bleeding, a dose-limiting toxicity needing physician review to adjust or pause treatment. Fatigue, nausea, and stomatitis are common, manageable with nursing care rest, antiemetics, mouth rinses unless extreme. Suppression's severity, tied to labs (e.g., ANC <500), halts therapy to protect the client, a critical threshold nurses monitor, distinguishing it from routine side effects, ensuring safety in this marrow-bashing regimen.