Nurse Joy is caring for a client with cancer who has been receiving cisplatin (Platinol-AQ). Which laboratory result requires an intervention by the nurse?
- A. White blood cell count of 6000 cells/microL
- B. Serum potassium level of 3.5 mEq/L
- C. Blood urea nitrogen (BUN) of 18 mg/dL
- D. Platelet count of 150,000 cells/microL
Correct Answer: C
Rationale: The correct answer is C. A BUN level of 18 mg/dL is within the normal range; however, since cisplatin is nephrotoxic, it requires close monitoring. Elevated BUN levels can indicate impaired kidney function. Choices A, B, and D are within normal ranges and do not directly relate to cisplatin therapy or require immediate intervention.
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A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The patient states, 'They tell me my cancer is malignant, while my coworker's breast tumor was benign. I just don't understand at all.' When preparing a response to this patient, the nurse should be cognizant of what characteristic that distinguishes malignant cells from benign cells of the same tissue type?
- A. Slow rate of mitosis of cancer cells
- B. Different proteins in the cell membrane
- C. Differing size of the cells
- D. Different molecular structure in the cells
Correct Answer: B
Rationale: The correct answer is B. Malignant cells have different proteins in their membranes, such as tumor-specific antigens, which distinguish them from benign cells. Choice A is incorrect as cancer cells typically have a rapid and uncontrolled rate of mitosis. Choice C is incorrect as the size of cells alone does not distinguish between malignant and benign cells. Choice D is incorrect as the molecular structure is not the primary characteristic that distinguishes between malignant and benign cells.
A healthcare professional is assessing a female client who is taking hormone therapy for breast cancer. What assessment finding requires the healthcare professional to notify the primary health care provider immediately?
- A. Irregular menses.
- B. Edema in the lower extremities.
- C. Ongoing breast tenderness.
- D. Red, warm, swollen calf.
Correct Answer: D
Rationale: The correct answer is D. A red, warm, swollen calf may indicate a deep vein thrombosis, which is a medical emergency. This finding requires immediate notification of the primary health care provider to prevent potential complications such as pulmonary embolism. Choices A, B, and C are not indicative of life-threatening conditions and should be monitored but do not require immediate notification like a suspected deep vein thrombosis.
A patient has been found to have an indolent neoplasm. The nurse should recognize what implication of this condition?
- A. The patient faces a significant risk of malignancy.
- B. The patient has a myeloid form of leukemia.
- C. The patient has a lymphocytic form of leukemia.
- D. The patient has a major risk factor for hemophilia.
Correct Answer: A
Rationale: The correct answer is A: 'The patient faces a significant risk of malignancy.' Indolent neoplasms are characterized by their slow growth and relatively low malignancy potential; however, they do have the capability to progress to malignancy over time. Choices B, C, and D are incorrect because they make assumptions about specific types of leukemia and hemophilia, which are not necessarily related to the presence of an indolent neoplasm.
A patient with non-Hodgkin lymphoma (NHL) is receiving treatment. What is the most important assessment for the nurse to make in this patient?
- A. Skin integrity
- B. Nutritional status
- C. Respiratory function
- D. Cognitive function
Correct Answer: C
Rationale: The correct answer is C: Respiratory function. In a patient with non-Hodgkin lymphoma (NHL), monitoring respiratory function is crucial due to the potential for complications such as pleural effusion or pneumonia. Assessing skin integrity (choice A) is important but not as critical as monitoring respiratory function in this case. Nutritional status (choice B) and cognitive function (choice D) are also important aspects of care but do not take precedence over assessing respiratory function in a patient with NHL undergoing treatment.
A nurse is caring for a patient who has a diagnosis of acute leukemia. What assessment most directly addresses the most common cause of death among patients with leukemia?
- A. Monitoring for infection
- B. Monitoring nutritional status
- C. Monitoring electrolyte levels
- D. Monitoring liver function
Correct Answer: A
Rationale: The correct answer is monitoring for infection. In patients with acute leukemia, the most common cause of death is usually infection or bleeding. By closely monitoring for signs of infection, such as fever, altered mental status, or elevated white blood cell count, healthcare providers can intervene promptly. Monitoring nutritional status (choice B) is important but does not directly address the most common cause of death among leukemia patients. Monitoring electrolyte levels (choice C) and liver function (choice D) are also important assessments in cancer patients; however, they are not the most direct assessment to address the leading cause of death in patients with leukemia.