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A patient with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location precludes the use of enteral feeding. What intervention should the nurse identify as best meeting this patient's nutritional needs?
- A. Administration of parenteral feeds via a peripheral IV
- B. TPN administered via a peripherally inserted central catheter
- C. Insertion of an NG tube for administration of feeds
- D. Maintaining NPO status and IV hydration until treatment completion
Correct Answer: B
Rationale: Gastric cancer blocking oral and enteral routes needs TPN via a PICC delivering calories and protein centrally, bypassing the gut. Peripheral IV can't handle TPN's osmolarity veins fry. NG's out with tumor placement. NPO with just fluids starves her long-term. Nurses in oncology peg TPN as the lifeline, keeping strength up when cancer chokes other options.
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Why are endothelial cells in particular sensitive to the damage caused by high plasma glucose levels?
- A. Endothelial cells have a high metabolic activity
- B. Endothelial cells cannot regulate the glucose uptake
- C. Endothelial cells have a low level of antioxidants
- D. All statements provided above are correct
Correct Answer: B
Rationale: Endothelial cells drown in glucose no uptake brakes, high sugar slams them, not just metabolism or low shields. A chronic vessel weak spot nurses watch this sugar soak.
Which of the following is NOT part of the histology of non-alcoholic steatohepatitis?
- A. Fatty infiltration in liver
- B. Fibrosis of liver
- C. Inflammatory infiltrates in lobules
- D. Cirrhosis
Correct Answer: D
Rationale: NASH histology includes steatosis (fatty infiltration), lobular inflammation, and fibrosis, per pathology definitions. Mallory bodies (intracellular inclusions) are classic but not universal. Cirrhosis is an advanced NAFLD outcome, not a defining NASH feature progression, not initial histology. This distinction aids physicians in staging chronic liver disease accurately.
Tetanus:
- A. is caused by clostridium tetani endotoxin
- B. is associated with a better prognosis if the incubation period is short
- C. can be manifest by rigidity of muscles in close proximity to the area of the initial injury
- D. usually presents with weakness in the extremities which then progresses to the facial muscles
Correct Answer: C
Rationale: Tetanus exotoxin, not endo, long incubation's better, local rigidity fits, not weakness march, autonomic storms. Nurses lock this chronic spasm tale.
The nurse assesses a patient with non-Hodgkin's lymphoma who is receiving an infusion of rituximab (Rituxan). Which assessment finding would require the most rapid action by the nurse?
- A. Shortness of breath
- B. Shivering and chills
- C. Muscle aches and pains
- D. Temperature of 100.2°F (37.9°C)
Correct Answer: A
Rationale: Rituximab, a monoclonal antibody, can trigger anaphylaxis shortness of breath yells airway trouble, needing stat infusion halt over chills , aches , or mild fever . Nurses in oncology jump breathing trumps flu-like norms, a life-or-death call.
A client with cancer is admitted to a short-term rehabilitation facility. The nurse prepares to administer the client's oral chemotherapy medications. What action by the nurse is most appropriate?
- A. Crush the medications if the client cannot swallow them.
- B. Give one medication at a time with a full glass of water.
- C. No special precautions are needed for these medications.
- D. Wear personal protective equipment when handling the medications.
Correct Answer: D
Rationale: Oral chemotherapy drugs, like their IV counterparts, are hazardous due to their cytotoxic properties, posing risks to healthcare workers through skin contact or inhalation during handling. The most appropriate action is for the nurse to wear personal protective equipment (PPE), such as gloves, to minimize exposure, aligning with oncology safety standards. Crushing these medications is contraindicated, as it increases the risk of aerosolizing toxic particles, endangering both nurse and client many are labeled do not crush.' Giving one at a time with water isn't necessary unless specified and doesn't address safety. Assuming no precautions are needed ignores the drugs' hazardous nature, risking occupational exposure. Using PPE ensures safe administration, protects the nurse's health, and maintains the medication's integrity, reflecting best practices in cancer care where handling precautions are non-negotiable.