Nokea
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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The Pulmonary rehabilitation program consists of several specific components. Which of the following are not a part of the program?
- A. Education and self-management
- B. Exercise training
- C. Coping measures to relieve anxiety, depression and changes in behaviour
- D. Spirometry
Correct Answer: D
Rationale: Pulmonary rehab builds COPD strength education, exercise, coping tools for mind and mood, all in. Spirometry's a test, not therapy diagnoses, doesn't train. Nurses skip it here, a chronic fix's focus.
Cardiac catheterisation (angiography) is performed to assess blood flow through the coronary arteries through use of a contrast agent and radiographic imaging. The nursing responsibilities in caring for the patient post angiography do not include:
- A. Applying pressure and observing the insertion site for bleeding or haematoma formation
- B. Informing the patient of the findings of the angiogram to allay fear and provide reassurance
- C. Monitor for arrhythmias by both cardiac monitoring and assessing apical or peripheral pulses
- D. Encourage fluids to increase urinary output and flush out the dye
Correct Answer: B
Rationale: Post-angio, nurses press sites, watch rhythms, flush dye hands-on musts. Telling results? Docs' turf nurses soothe, don't spill, a chronic care line.
Risk factors for developing COPD do not include:
- A. Smoking - passive or active
- B. Age
- C. High fat diet
- D. Indoor and outdoor air pollution
Correct Answer: C
Rationale: COPD's lung wreckers smoking, age, pollution scar airways, no dodge. High fat diet fattens, not chokes lungs; it's metabolic, not respiratory. Nurses target smoke and smog, not butter, a chronic breath stealer's true culprits.
A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). The nurse will include which information in the patient's teaching plan?
- A. Donor bone marrow is transplanted through a sternal or hip incision.
- B. Hospitalization is required for several weeks after the stem cell transplant.
- C. The transplant procedure takes place in a sterile operating room to minimize the risk for infection.
- D. Transplant of the donated cells can be very painful because of the nerves in the tissue lining the bone.
Correct Answer: B
Rationale: HSCT for leukemia means 2-4 weeks in hospital engraftment's slow, and infection risk's sky-high in isolation. No incision it's IV. No OR it's bedside. Pain's minimal no bone nerves hit. Nurses in oncology stress this long haul, sterile stay, not surgical drama, prepping patients for the real grind.
Caution should be exercised in the initiation of an ARNI in all of the following clinical scenarios except:
- A. Significant hyperkalaemia
- B. Significant renal dysfunction (eGFR <30 ml/min)
- C. Patient on a maximal dose ACE-inhibitor
- D. Non-alcoholic fatty liver disease (NAFLD)
Correct Answer: D
Rationale: ARNI (sacubitril/valsartan) risks spike with hyperkalemia, renal flop (eGFR <30), ACE-I overlap, or low BP potassium, filtration, washout, and perfusion all teeter. NAFLD? No biggie liver fat doesn't sway ARNI's game. Clinicians greenlight this, dodging chronic cautions elsewhere.