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For which type of malignancy should the nurse expect the use of the intravesical route of regional chemotherapy delivery?
- A. Bladder
- B. Leukemia
- C. Osteogenic sarcoma
- D. Metastasis to the brain
Correct Answer: A
Rationale: Intravesical chemotherapy is used for bladder cancer to deliver drugs directly into the bladder.
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Autoimmune diseases are associated with several susceptibility factors. Environmental factors associated with increased risk of autoimmune disease include:
- A. Infections
- B. Level of exposure to the sun
- C. Imbalance of microbiota composition
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D, "All of the above." Autoimmune diseases have complex causes, involving genetic predisposition and environmental factors. Infections can trigger autoimmune responses, sunlight exposure can influence immune function, and an imbalance in microbiota composition can lead to dysregulated immune responses. Therefore, all three factors can contribute to an increased risk of autoimmune diseases. Choices A, B, and C individually are all associated with autoimmune diseases, making option D the correct choice.
An allogenic hematopoietic stem cell transplant is considered as treatment for a patient with acute myelogenous leukemia. What information should the nurse include when teaching the patient about this procedure?
- A. There is no risk for graft-versus-host disease because the donated marrow is treated to remove cancer cells
- B. The patient’s bone marrow will be removed,treated stored and then reinfused after intensive chemotherapy
- C. Peripheral stem cells are obtained from a donor who has a human leukocyte antigen (HLA) match with the patient
- D. There is no need for posttransplant protective isolation because the stem cells are infused directly into the blood
Correct Answer: C
Rationale: Peripheral stem cells from an HLA-matched donor are used in allogenic transplants.
You give an intradermal injection of allergen to a patient who is undergoing skin testing for allergies. A few minutes later,the patient complains about feeling anxious short of breath and dizzy. You notice that the patient has reddened blotches on the face and arms. All of these therapies are available on your emergency cart. Which action should you take first?
- A. Start oxygen at 4 L/min using a nasal cannula.
- B. Obtain IV access with a large-bore IV catheter.
- C. Administer epinephrine (Adrenalin) 0.3 mL subcutaneously.
- D. Give albuterol (Proventil) with a nebulizer.
Correct Answer: C
Rationale: The patient is showing signs of anaphylaxis,a life-threatening allergic reaction. The first priority is to administer epinephrine which acts quickly to reverse the symptoms by constricting blood vessels relaxing airway muscles and increasing heart rate. Oxygen and IV access are important but secondary to the immediate administration of epinephrine. Albuterol may be used for bronchospasm but is not the first-line treatment for anaphylaxis.
What is the normal pH range of the blood and what ratio of base to acid does this reflect?
- A. 7.32 to 7.42; 25 to 2
- B. 7.32 to 7.42; 28 to 2
- C. 7.35 to 7.45; 20 to 1
- D. 7.35 to 7.45; 30 to 1
Correct Answer: C
Rationale: The normal blood pH range is 7.35–7.45, reflecting a bicarbonate-to-carbonic acid ratio of approximately 20:1.
Prophylactic measures that are routinely used as early as possible in HIV infection to prevent opportunistic and debilitating secondary problems include administration of
- A. isoniazid (INH) to prevent tuberculosis
- B. trimethoprim/sulfamethoxazole (TMP/SMX) for toxoplasmosis
- C. vaccines for pneumococcal pneumonia, influenza, and hepatitis A and B
- D. varicella-zoster immune globulin (VZIG) to prevent chickenpox or shingles
Correct Answer: C
Rationale: Vaccination protects against preventable infections that can become severe in immunocompromised individuals.