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An oncology nurse is contributing to the care of a patient who has failed to respond appreciably to conventional cancer treatments. As a result, the care team is considering the possible use of biologic response modifiers (BRMs). The nurse should know that these achieve a therapeutic effect by what means?
- A. Promoting the synthesis and release of leukocytes
- B. Focusing the patient's immune system exclusively on the tumor
- C. Potentiating the effects of chemotherapeutic agents and radiation therapy
- D. Altering the immunologic relationship between the tumor and the patient
Correct Answer: D
Rationale: BRMs (e.g., interferon, IL-2) tweak the immune-tumor dance revving up the body's attack or slowing cancer's evasion, not just pumping out leukocytes or boosting chemo/radiation. They don't laser-focus immunity but shift the balance, like marking tumors for T-cells. Nurses in oncology grasp this, knowing BRMs offer a Hail Mary when standard stuff flops, targeting that host-tumor interplay.
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Which of the following patients would probably not benefit from a >5-10% weight loss?
- A. A 28-year-old female with BMI 37 kg/m² and oligomenorrhea but planning for fertility in the future
- B. A 40-year-old man with BMI 26 kg/m², who has a strong family history of diabetes, recently diagnosed with prediabetes
- C. A 21-year-old man with BMI 42 kg/m² with no known medical problems and a family history of T2DM
- D. A 70-year-old female, BMI 26 kg/m², with well-controlled T2DM on two oral anti-diabetic medications and osteoporosis
Correct Answer: D
Rationale: A 5-10% weight loss benefits most with obesity-related conditions improving fertility (BMI 37), prediabetes (BMI 26), or T2DM risk (BMI 42). The 70-year-old with BMI 26, well-controlled T2DM, and osteoporosis may not benefit significantly; weight loss could worsen bone density, and her diabetes is managed, reducing urgency. Her age and comorbidities shift focus to stability, not weight reduction, guiding physicians in chronic care prioritization.
After receiving the hand-off report, which client should the oncology nurse see first?
- A. Client who is afebrile with a heart rate of 108 beats/min
- B. Older client on chemotherapy with mental status changes
- C. Client who is neutropenic and in protective isolation
- D. Client scheduled for radiation therapy today
Correct Answer: B
Rationale: In oncology nursing, prioritizing care is critical due to the complexity of cancer patients' conditions. An older client on chemotherapy with mental status changes is the priority because this could signal sepsis or infection, especially since chemotherapy-induced neutropenia often masks typical signs like fever in the elderly. Mental confusion might be the only early clue, and delayed assessment could lead to rapid deterioration or death. A heart rate of 108 beats/min without fever suggests tachycardia, possibly from dehydration or anxiety, but it's less urgent without other red flags. A neutropenic client in isolation needs monitoring, but no acute change is noted. The client scheduled for radiation has a planned treatment, not an immediate crisis. Assessing the older client first allows the nurse to rule out or address a life-threatening issue, aligning with the principle of prioritizing unstable patients in acute care settings.
Which is not associated with atypical pneumonia?
- A. abnormal LFTs
- B. hypernatremia
- C. hypophosphatemia
- D. bilateral patchy infiltrates on CXR
Correct Answer: B
Rationale: Atypical pneumonia LFTs wobble, phosphates drop, CXR patches, agglutinins rise; sodium stays. Nurses skip this chronic salt glitch.
Animal experiments have shown that destruction of the ventromedial nuclei of the hypothalamus leads to unrestrained eating, because a specific structure is lost. Question: Which structure is lost?
- A. The amygdala
- B. The vagus nerve
- C. The satiety centre
- D. The feeding centre
Correct Answer: C
Rationale: Ventromedial zap satiety centre dies, eating runs wild, not amygdala's fear, vagus' gut, or feeding's drive. Nurses link this, a chronic overeat switch.
The nurse is arriving at the beginning of her shift and has taken report on four clients on a medical-surgical unit. Which client should the nurse see first?
- A. A client with pain that is two days post-operative from a prostatectomy
- B. A client ready for discharge education after treatment of an acute kidney injury
- C. A client with hypertension with a blood pressure of 172/92 mm Hg
- D. A client with a history of asthma complaining of increased dyspnea
Correct Answer: D
Rationale: Asthma's increased dyspnea flags airway risk ABCs prioritize breathing, as bronchospasm could crash fast, needing nebulizers or oxygen. Post-op pain's manageable, discharge education waits, hypertension's high but stable. Nurses hit dyspnea first, ensuring airflow, a life-first call in this shift-start triage.