An oncology patient will begin a course of chemotherapy and radiation therapy for the treatment of bone metastases. What is one means by which malignant disease processes transfer cells from one place to another?
- A. Adhering to primary tumor cells
- B. Inducing mutation of cells of another organ
- C. Phag projecting healthy cells
- D. Invading healthy host tissues
Correct Answer: D
Rationale: Bone mets mean cancer's invaded malignant cells burrow into nearby tissues, breaking barriers to spread, a hallmark of metastasis. They don't just stick to the primary (adhesion's weak), mutate distant cells (that's not how it rolls), or eat healthy ones (phagocytosis is immune, not cancer). Invasion's the ticket cells chew through matrix, hit lymph or blood, and land in bones. Nurses in oncology spotlight this, tying it to why radiation's aimed at those hotspots, slowing the creep.
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Which enzyme is activated by oxidative stress in endothelial cells and plays a key role in the development of complications?
- A. GAPDH
- B. Glyoxalase-1
- C. PARP
- D. Transketolase
Correct Answer: C
Rationale: PARP wakes to oxidative hits repairs DNA, drives damage in diabetes vessels, not GAPDH's stall, glyoxalase's detox, or transketolase's shunt. Nurses clock this, a chronic complication cog.
Regarding oxygen consumption by the adult human body:
- A. It is approximately 3 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ at rest in the awake adult patient.
- B. It rises to approximately 11 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ at peak exercise in healthy young adults.
- C. Increases by approximately 5-fold after major surgery.
- D. Peak oxygen consumption is likely to be quantified accurately by cardiopulmonary exercise testing.
Correct Answer: A
Rationale: Oxygen consumption (VOâ‚‚) reflects metabolic demand. At rest, VOâ‚‚ is approximately 3-4 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ in awake adults, aligning with basal energy needs (250-300 ml/min total). During peak exercise, healthy young adults can reach 30-40 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹, far exceeding 11 ml, depending on fitness. Post-major surgery, VOâ‚‚ increases 50-100% (1.5-2-fold), not 5-fold, due to stress and healing, though critical illness may spike higher briefly. Cardiopulmonary exercise testing (CPET) accurately measures peak VOâ‚‚, unlike the Duke Activity Status Index, which estimates it via questionnaire. The resting value of 3 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ is a physiological constant, foundational to understanding perioperative oxygen delivery and demand.
A nurse is caring for a client diagnosed with atherosclerosis. Which of the following is considered a risk factor for the development of this disorder?
- A. Diet high in vitamin K
- B. Low HDL-C/High LDL-C
- C. High HDL-C/Low LDL-C
- D. Vegan diet
Correct Answer: B
Rationale: Atherosclerosis loves lipids low HDL (good cholesterol) and high LDL (bad cholesterol) pile plaque, a prime risk factor driving vessel narrowing. Vitamin K aids clotting, not plaque. High HDL/low LDL protects. Vegan diets cut fats, lowering risk. Nurses flag lipid imbalance, pushing statins or diet shifts, a cholesterol-fueled root of this vascular scourge.
A nurse is caring for four clients with leukemia. After hand-off report, which client should the nurse see first?
- A. Client who had two bloody diarrhea stools this morning
- B. Client who has been premedicated for nausea prior to chemotherapy
- C. Client who is crying and feeling lonely
- D. Client with an unchanged lesion to the lower right lateral malleolus
Correct Answer: A
Rationale: Leukemia's marrow suppression risks bleeding two bloody stools signal GI hemorrhage, a potential emergency needing urgent assessment for stability, trumping others per ABCs. Premedicated nausea's managed, loneliness needs support but waits, and an unchanged lesion's stable. Nurses prioritize bleeding, anticipating labs or fluids, a life-saving call in this fragile hematologic lineup.
In which illness can hydrophobia be seen?
- A. tetanus
- B. malaria
- C. rabies
- D. EBV
Correct Answer: C
Rationale: Hydrophobia rabies' brain hates water, not tetanus' clench, malaria's sweat, EBV's glands, or HSV's sores. Nurses clock this chronic rabies red flag.