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An oncology nurse educator is speaking to a women's group about breast cancer. Questions and comments from the audience reveal a misunderstanding of some aspects of the disease. Various members of the audience have made all of the following statements. Which one is accurate?
- A. Mammography is the most reliable method for detecting breast cancer.
- B. Breast cancer is the leading killer of women of childbearing age.
- C. Breast cancer requires a mastectomy.
- D. Men can develop breast cancer.
Correct Answer: D
Rationale: While all the statements made by the audience members may have been common misconceptions, the only one that is accurate is that men can develop breast cancer. Although it is less common in men than in women, breast cancer can still affect males. It is important for everyone to be aware of the risks and symptoms of breast cancer, regardless of gender.
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A 39 y.o. homemaker sees her physician after she falls twice for seemingly no reason. Diagnostic tests are done, and she is diagnosed with multiple sclerosis. Which of the ff. explanations will help her understand her disease?
- A. "You have a build-up of myelin in your nervous system, causing congestion and muscle weakness."
- B. "You are missing a neurotransmitter that is important to muscle contraction."
- C. "The receptor sites on your muscles are damaged, so they can't contract correctly."
- D. "The insulation on your nerve cells is damaged, which slows the impulses to the muscles."
Correct Answer: D
Rationale: Option D, "The insulation on your nerve cells is damaged, which slows the impulses to the muscles," is the most accurate explanation for multiple sclerosis. Multiple sclerosis is a chronic autoimmune disorder where the body's immune system mistakenly attacks the myelin sheath, the protective covering of nerve fibers in the central nervous system. This damage disrupts the normal flow of electrical impulses along the nerves, leading to various symptoms such as muscle weakness, coordination problems, and balance issues. By understanding that the insulation on her nerve cells is damaged, the patient can better comprehend why she is experiencing symptoms like muscle weakness and falls.
For which of the following problems should the nurse monitor in the patient with multiple myeloma?
- A. Uncontrolled bleeding
- B. Liver engorgement
- C. Respiratory distress
- D. Pathological fractures
Correct Answer: A
Rationale: Patients with multiple myeloma are at an increased risk of bleeding due to low levels of platelets, which play a key role in blood clotting. Uncontrolled bleeding can occur in multiple myeloma patients, leading to serious complications such as hemorrhage and anemia. Therefore, the nurse should monitor for signs of bleeding, such as easy bruising, petechiae, or prolonged bleeding from minor cuts or procedures, and take appropriate interventions to manage and prevent further bleeding episodes in the patient with multiple myeloma. Monitoring for and addressing uncontrolled bleeding is crucial in ensuring the safety and well-being of the patient.
While examining a 2-year-old child, the nurse in charge sees that the anterior fontanel is open. The nurse should:
- A. Notify the doctor
- B. Look for other signs of abuse
- C. Recognize this as a normal finding
- D. Ask about a family history of Tay-Sachs disease
Correct Answer: C
Rationale: In infants and young children, it is normal for the anterior fontanel to remain open up to about 18-24 months of age. The fontanel serves an important function in allowing the skull to grow and expand as the brain grows rapidly during infancy. Therefore, the presence of an open fontanel in a 2-year-old child is a normal finding and does not warrant any immediate concern or action. It does not indicate abuse, the need to notify the doctor, or inquire about a family history of Tay-Sachs disease.
During starvation, the body slows metabolic processes and growth to minimize the need for nutrients. With the rapid reinstitution of feeding after starvation refeeding syndrome may occur. Of the following, the major changes that may occur with refeeding syndrome typically affect
- A. electrolytes
- B. serum proteins
- C. hormones
- D. liver enzymes
Correct Answer: A
Rationale: Refeeding syndrome primarily affects electrolytes, particularly phosphorus, potassium, and magnesium, which can become dangerously depleted due to rapid shifts in metabolism.
You are evaluating a 6-year-old child with ALL on interim maintenance phase who has frequent mucositis and myelosuppression that needs frequent discontinuation of his treatment. Of the following, the MOST valuable test for this child is
- A. complete blood count
- B. pharmacogenetic testing of the thiopurine S-methyltransferase (TPMT) gene
- C. renal function test
- D. bone marrow study
Correct Answer: B
Rationale: TPMT gene testing helps determine the child's ability to metabolize thiopurine drugs, which may explain the adverse effects.