Nokea
An oncology nurse educator is providing health education to a patient who has been diagnosed with skin cancer. The patient¢â‚¬â„¢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: Malignant (cancer) cells often express tumor-specific antigens (TSAs), which are proteins or markers on the surface of cancer cells that are not found on normal cells. These antigens are produced due to genetic mutations in cancer cells and can sometimes be used to help the immune system recognize and attack cancerous cells. Tumor-specific antigens play a key role in cancer diagnosis, monitoring, and targeted therapies.
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An oncology patient has just returned from the post-anesthesia care unit after an open hemicolectomy. This patient¢â‚¬â„¢s plan of nursing care should prioritize which of the following?
- A. Assess the patient hourly for signs of compartment syndrome.
- B. Assess the patient¢â‚¬â„¢s fine motor skills once per shift.
- C. Assess the patient¢â‚¬â„¢s wound for dehiscence every 4 hours.
- D. Maintain the patient¢â‚¬â„¢s head of bed at 45 degrees or more at all times.
Correct Answer: C
Rationale: After an open hemicolectomy (surgical removal of part of the colon), monitoring the surgical wound for signs of dehiscence (wound reopening) is a critical nursing priority. Dehiscence is a serious postoperative complication that can occur if the surgical site does not heal properly. Regular wound assessments every 4 hours allow the nurse to identify early signs of complications, such as redness, swelling, increased drainage, or separation of the wound edges. Early detection is key to preventing further complications, such as infection or evisceration (protrusion of abdominal organs through the wound).
A 60-year-old patient with chronic myeloid leukemia will be treated in the home setting and the nurse is preparing appropriate health education. What topic should the nurse emphasize?
- A. The importance of adhering to the prescribed drug regimen
- B. The need to ensure that vaccinations are up to date
- C. The importance of daily physical activity
- D. The need to avoid shellfish and raw foods
Correct Answer: A
Rationale: Chronic myeloid leukemia (CML) is typically treated with targeted therapies, such as tyrosine kinase inhibitors (TKIs), which can help control the disease and prolong survival. The effectiveness of these medications relies heavily on strict adherence to the prescribed drug regimen. Patients need to take their medication consistently and as directed to maintain therapeutic drug levels and effectively manage the disease. Non-adherence can lead to disease progression or resistance to treatment, which is why it is crucial for the nurse to emphasize this point during health education.
A client is admitted to the hospital with a suspected diagnosis of Hodgkin¢â‚¬â„¢s disease. Which assessment finding would the nurse expect to note specifically in the client?
- A. Fatigue
- B. Weakness
- C. Weight gain
- D. Enlarged lymph nodes
Correct Answer: D
Rationale: Hodgkin's disease (Hodgkin's lymphoma) is a type of cancer that originates in the lymphatic system, particularly affecting the lymph nodes. A hallmark sign of Hodgkin's disease is the painless enlargement of lymph nodes, often in the neck, armpit, or groin. These enlarged lymph nodes are typically firm and rubbery to the touch. This is one of the most distinctive and common early signs that healthcare providers look for when diagnosing the disease.
Nurse Joy is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which of the following principles?
- A. Limit the time with the client to 1 hour per shift
- B. Do not allow pregnant women into the client's room
- C. Remove the dosimeter badge when entering the client's room
- D. Individuals younger than 16 years old may be allowed to go in the room as long as they are 6 feet away from the client
Correct Answer: B
Rationale: Clients with internal radiation implants (also known as brachytherapy) emit a small amount of radiation, which can pose a risk to others. Pregnant women are particularly vulnerable to the harmful effects of radiation because it can affect both the mother and the developing fetus. Radiation exposure can lead to birth defects, miscarriage, or other developmental issues, so pregnant women should avoid any exposure by not entering the client's room.
The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient?
- A. These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and x-ray studies.
- B. These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer.
- C. Try not to be concerned about these symptoms. Every patient feels this way after having radiation therapy.
- D. Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying.
Correct Answer: A
Rationale: Fatigue and weakness are common side effects of radiation therapy, often due to the body's response to radiation damage and the energy required to repair both cancerous and healthy cells affected by the treatment. Reassuring the patient that these symptoms are expected while also emphasizing ongoing monitoring (through lab and x-ray studies) provides both comfort and a sense of proactive care. It ensures the patient that their symptoms are being addressed in a safe and medically appropriate way.