A client with metastatic cancer of the colon experiences severe vomiting following each administration of chemotherapy. Which action, if taken by the nurse, is most appropriate?
- A. Have the patient eat large meals when nausea is not present
- B. Offer dry crackers and carbonated fluids during chemotherapy
- C. Administer prescribed antiemetics 1 hour before the treatments
- D. Give the patient two ounces of a citrus fruit beverage during treatments
Correct Answer: C
Rationale: Chemo's gut punch severe vomiting bows to preemptive antiemetics, given 1 hour before, blunting nausea's peak, the most effective move per oncology standards. Big meals overload; crackers help post-, not during; citrus risks acid reflux. Nurses time antiemetics, syncing with chemo's onslaught, a proactive strike to ease this metastatic misery, trumping reactive nibbles or sips.
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The body has several mechanisms to increase the blood glucose level in case of hypoglycaemia. Question: Which of the following options best describes the role of glucagon and adrenaline in hypoglycaemia?
- A. Glucagon and adrenaline stimulate glycogenolysis in the liver
- B. Glucagon and adrenaline inhibit the insulin-stimulated glucose uptake in the muscles
- C. Glucagon stimulates glycogen synthase and adrenaline stimulates glycogenolysis in the liver
- D. Glucagon and adrenaline stimulate glycogen synthase en adrenaline stimulates glycogenolysis in the muscles
Correct Answer: A
Rationale: Hypo hits glucagon and adrenaline rip glycogen apart in liver, sugar surges. No muscle block, no synthase flip straight breakdown's the play nurses watch this, a chronic rescue duo.
An oncology nurse educator is providing health education to a patient who has been diagnosed with skin cancer. The patient's wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?
- A. Malignant cells contain more fibronectin than normal body cells
- B. Malignant cells contain proteins called tumor-specific antigens
- C. Chromosomes contained in cancer cells are more durable and stable than those of normal cells
- D. The nuclei of cancer cells are unusually large, but regularly shaped
Correct Answer: B
Rationale: Cancer cells sport tumor-specific antigens (e.g., CEA) proteins marking them as rogue, unlike normal cells. Fibronectin's less in malignant cells, aiding their slipperiness. Chromosomes are fragile and jumbled (aneuploidy), not stable. Nuclei are big and wonky (pleomorphic), not regular. Nurses in oncology education lean on this antigen trait it's why tests spot cancer and therapies target it, a clear line from normal to malignant.
Which statement about carcinogenesis is accurate?
- A. An initiated cell will always become clinical cancer.
- B. Cancer becomes a health problem once it is 1 cm in size.
- C. Normal hormones and proteins do not promote cancer growth.
- D. Tumor cells need to develop their own blood supply.
Correct Answer: D
Rationale: Carcinogenesis is the multi-step process by which normal cells transform into cancer cells, involving initiation, promotion, and progression. A key aspect of this process is angiogenesis, where tumor cells induce the formation of new blood vessels to supply nutrients and oxygen, enabling their growth beyond a minimal size. This is a critical step, as without a blood supply, tumors cannot sustain themselves or expand significantly. The statement that an initiated cell always becomes cancer is inaccurate because initiation alone is not sufficient; it requires promoters to progress. Similarly, the idea that cancer only becomes a problem at 1 cm oversimplifies the issue tumors can pose health risks earlier depending on location and type, though 1 cm is a detectable size. Normal hormones and proteins, like estrogen or growth factors, can indeed act as promoters in carcinogenesis, contradicting that option. Thus, the need for a tumor to develop its own blood supply is the most accurate statement, reflecting a fundamental biological requirement for cancer progression, which nurses must recognize when caring for oncology patients.
The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breathe and the nurse's rapid assessment reveals that the patient's jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct Answer: B
Rationale: Dyspnea plus distended jugulars scream SVCS breast cancer's mets can squeeze the vena cava, blocking venous return from the head and chest. It's an oncology emergency, fast-tracking to edema and airway issues if unchecked. Intracranial pressure needs brain involvement less likely here. Spinal compression hits legs and bladder, not breathing. Neck tumors might press locally, but SVCS fits this picture. Nurses jump on this, pushing for steroids or stenting, knowing seconds count.
A nurse is creating a plan of care for an oncology patient and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses the leading cause of infection-related death in oncology patients?
- A. Encourage several small meals daily
- B. Provide skin care to maintain skin integrity
- C. Assist the patient with hygiene, as needed
- D. Assess the integrity of the patient's oral mucosa regularly
Correct Answer: B
Rationale: Myelosuppression from chemo or cancer slashes white cells, making infection a top killer sepsis often starts at breached barriers like skin. Maintaining skin integrity via cleansing and protection stops bugs (e.g., Staph) from sneaking in, directly tackling this risk. Small meals fight malnutrition, a secondary factor, not the leading death driver. Hygiene helps, but it's broad, not specific to the prime entry point. Oral mucosa checks catch stomatitis, another risk, but skin's the bigger battlefield in oncology stats. Nurses prioritize this, knowing intact skin's the first defense against fatal infections in these fragile patients.
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