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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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Which of these pulmonary conditions is most likely to be seen with a CD4 count between 200 and 500 ?
- A. pulmonary TB
- B. CMV
- C. PCP
- D. Kaposi sarcoma
Correct Answer: A
Rationale: CD4 200-500 TB sneaks in, lungs ripe before deeper drops. CMV, PCP crave <200; Kaposi's skin-first; cryptococcus hits brains more. Nurses clock TB's early strike, a chronic lung foe at this immune ledge.
A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective?
- A. The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale).
- B. The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness.
- C. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.
- D. The patient states that nonopioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief.
Correct Answer: C
Rationale: Terminal pancreatic cancer pain's relentless around-the-clock opioids with breakthrough doses keep it tamed, per hospice norms. Waiting for 5/10 lags; IV isn't inherently better oral's fine. Nonopioids at max opioid miss the mark escalation's the play. Nurses in oncology teach this steady dosing plus rescues nails chronic cancer pain, a win if families get it.
A primary nursing responsibility is the prevention of lung cancer by assisting patients in smoking/tobacco cessation. Which tasks would be appropriate to delegate to the LPN/LVN?
- A. Develop a quit plan
- B. Explain the application of a nicotine patch
- C. Discuss strategies to avoid relapse
- D. Suggest ways to deal with urges for a tobacco
Correct Answer: B
Rationale: LPN/LVNs shine in standardized teaching like explaining nicotine patch application, a medication-focused task within their scope, detailing placement and timing to aid cessation. Developing a quit plan requires RN-level planning and assessment of individual needs. Discussing relapse strategies involves behavioral counseling, an RN forte. Suggesting urge-coping methods needs tailored insight, beyond LPN/LVN training. Patch explanation leverages their skills, supporting lung cancer prevention through practical cessation aid, a delegated task enhancing team efforts while keeping complex planning with RNs.
In order to delay the progression of CKD, the single most important intervention is:
- A. Prescription of an ACE or ARB
- B. Reducing dietary sodium
- C. Increasing physical activity
- D. Achieving good blood pressure control
Correct Answer: D
Rationale: CKD's brake BP control tops ACEs, salt cuts, or workouts, slashing glomeruli strain, a chronic slowdown king. Nurses prioritize this, a pressure-driven win.
Traditionally, nurses have been involved with tertiary cancer prevention. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention?
- A. Yearly Pap tests
- B. Testicular self-examination
- C. Teaching patients to wear sunscreen
- D. Screening mammograms
Correct Answer: C
Rationale: Primary prevention stops cancer before it starts by reducing risk factors in healthy folks. Teaching sunscreen use blocks UV radiation a prime cause of skin cancer like melanoma fitting this category perfectly. Pap tests and mammograms are secondary prevention, detecting cervical and breast cancer early for treatment. Testicular self-exams also fall under secondary, aiming to catch testicular cancer sooner. The shift to primary efforts, like sun protection, reflects a proactive stance, cutting UV-induced DNA damage that kicks off carcinogenesis. Nurses pushing this can slash skin cancer rates, especially in fair-skinned populations, by fostering habits that shield against environmental triggers, unlike reactive screening or post-diagnosis care.