Nokea
A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician prescribes mitomycin (Mutamycin) with other chemotherapeutic agents for palliative treatment. How mitomycin does exert its cytotoxic effects?
- A. It inhibits deoxyribonucleic acid (DNA) synthesis
- B. It's cell cycle-phase specific
- C. It inhibits ribonucleic acid (RNA) synthesis
- D. It inhibits protein synthesis
Correct Answer: A
Rationale: Mitomycin exerts its cytotoxic effects by forming cross-links between adjacent guanine residues in DNA, leading to inhibition of DNA synthesis. This mechanism disrupts the replication of cancer cells, ultimately inducing cell death. Mitomycin is an alkylating agent that primarily targets DNA, making it an effective treatment for certain types of cancers, such as adenocarcinoma of the stomach.
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Which combination of signs is commonly associated with glomerulonephritis?
- A. Mild proteinuria, hematuria, decreased urine output, and lethargy.
- B. Massive proteinuria, hematuria, increased output, and lethargy.
- C. Mild proteinuria, increased output, and lethargy.
- D. Massive proteinuria, decreased output, and hypotension.
Correct Answer: A
Rationale: Glomerulonephritis typically presents with mild to moderate proteinuria, hematuria, decreased urine output, and lethargy.
You asked to obtain a measurement of serum sodium level in the hospital lab; you obtain a value of 125 mmol/L by repeating the test 5 times. The reference value of serum sodium at that lab is between 135-155 mmol/L. Your measurement is termed
- A. accurate but not precise
- B. precise but not accurate
- C. neither accurate nor precise
- D. both accurate and precise
Correct Answer: C
Rationale: The measurement is consistently low, indicating it is neither close to the true value (inaccurate) nor consistent with the reference range.
The spouse of a client with gastric cancer expresses concern that the couple's children may develop this type of cancer when they're older. When reviewing risk factors for gastric cancer with the client and family, the nurse explains that a certain blood type increases the risk by 10%. The nurse is referring to:
- A. Type A
- B. Type AB
- C. Type B
- D. Type O
Correct Answer: A
Rationale: Among the different blood types, individuals with blood type A have been found to have a slightly higher risk of developing gastric cancer. Research has shown that individuals with blood type A are associated with a 10% increased risk of gastric cancer compared to other blood types. This information is important to consider when discussing potential risk factors for gastric cancer with clients and their families.
The MOST appropriate advice for a 4-year-old child visiting the outpatient department with excessive crying is
- A. reassures her that this is a normal phenomenon
- B. seek more history regarding other skills and developmental domains
- C. refer her to pediatric psychiatry
- D. investigate for child abuse
Correct Answer: B
Rationale: Further history may help differentiate normal behavior from developmental concerns.
The beta subunit of human chorionic gonadotropin (HCG) is a useful surface marker in some malignant germ cell tumors (GCTs); it is secreted by syncytiotrophoblasts. In which of the following GCTs this surface marker is characteristically elevated?
- A. teratoma
- B. germinoma
- C. endodermal sinus tumor
- D. embryonal carcinoma
Correct Answer: D
Rationale: Embryonal carcinoma is strongly associated with elevated beta-HCG levels.