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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.
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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.
What is the cut-off of blood pressure for the diagnosis of hypertension that is recommended by MOH Clinical Practice Guideline?
- A. 120/70 mmHg
- B. 125/75 mmHg
- C. 130/70 mmHg
- D. 140/90 mmHg
Correct Answer: D
Rationale: MOH guidelines hold hypertension at 140/90 mmHg, a conventional cutoff balancing sensitivity and specificity for diagnosis in primary care, aligning with global norms like WHO. Lower thresholds 120/70, 125/75, 130/70, 135/80 catch prehypertension or align with newer AHA standards, but MOH sticks to 140/90 for actionable clarity, triggering treatment to curb stroke or heart risks. This higher bar avoids overdiagnosis in resource-stretched settings, ensuring focus on clear disease, a practical call for managing chronic vascular load.
A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. The nurse teaches the patient about the management of the skin reaction. Which statement, if made by the patient, indicates the teaching was effective?
- A. I can use ice packs to relieve itching.
- B. I will scrub the area with warm water.
- C. I can buy aloe vera gel to use on my skin.
- D. I will expose my skin to a sun lamp each day.
Correct Answer: C
Rationale: Dry desquamation flaky, itchy radiated skin loves aloe vera; it soothes without gunking up or infecting. Ice burns it; scrubbing rips it; sun lamps torch it worse. Nurses in oncology teach this gentle, natural relief keeps skin sane through radiation's rough ride, a patient win if they get it.
Which agent is the usually choice for moderate to severe travelers diarrhea?
- A. metronidazole
- B. doxycycline
- C. norfloxacin
- D. penicillin
Correct Answer: C
Rationale: Norfloxacin fluoroquinolone zaps travelers' E. coli, not metro, doxy, pen, or cotrim's fade. Nurses pick this chronic gut punch.
While performing an admission assessment for a client, the nurse notes that the client has varicose veins with ulcerations and lower extremity edema with a report of a feeling of heaviness. Which of the following nursing diagnoses should the nurse identify as the priority in the client's care?
- A. Ineffective peripheral tissue perfusion
- B. Alteration in body image
- C. Impaired skin integrity
- D. Alteration in activity tolerance
Correct Answer: C
Rationale: Varicose veins with ulcerations, edema, and heaviness scream venous stasis impaired skin integrity tops the list as open sores risk infection, a pressing threat needing immediate wound care. Ineffective perfusion drives the issue, but skin breakdown's acuity trumps. Body image matters emotionally, less urgently. Activity tolerance lags behind active complications. Nurses prioritize skin integrity, addressing ulcers' vulnerability, a direct care focus to halt deterioration in this chronic venous picture, aligning with safety and healing goals.