Nokea
The clinic nurse is caring for a patient whose grandmother and sister have both had breast cancer. She requested a screening test to determine her risk of developing breast cancer and it has come back positive. The patient asks you what she can do to help prevent breast cancer from occurring. What would be your best response?
- A. Research has shown that eating a healthy diet can provide all the protection you need against breast cancer.
- B. Research has shown that taking the drug tamoxifen can reduce your chance of breast cancer.
- C. Research has shown that exercising at least 30 minutes every day can reduce your chance of breast cancer.
- D. Research has shown that there is little you can do to reduce your risk of breast cancer if you have a genetic predisposition.
Correct Answer: B
Rationale: Tamoxifen is a selective estrogen receptor modulator (SERM) that has been shown to significantly reduce the risk of developing breast cancer in women who are at high risk, particularly those with a family history of the disease or a positive genetic test for BRCA mutations. Large-scale studies have demonstrated that tamoxifen can reduce the incidence of breast cancer by up to 50% in high-risk women. It works by blocking estrogen receptors in breast tissue, which helps prevent the development of estrogen receptor-positive breast cancers.
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A client is receiving rituximab and asks how it works. What response by the nurse is best?
- A. It causes rapid lysis of the cancer cell membranes.
- B. It destroys the enzymes needed to create cancer cells.
- C. It prevents the start of cell division in the cancer cells.
- D. It sensitizes certain cancer cells to chemotherapy.
Correct Answer: C
Rationale: Rituximab is a monoclonal antibody that targets CD20, a protein found on the surface of certain B-cells, including some cancerous B-cells, such as in non-Hodgkin's lymphoma and chronic lymphocytic leukemia (CLL). Rituximab works by binding to the CD20 protein, which leads to the destruction of the cancerous B-cells through various mechanisms, including preventing the initiation of cell division. By blocking the division process, rituximab helps slow the growth and proliferation of cancer cells, allowing the immune system and additional treatments to clear them more effectively.
A nurse practitioner is assessing a patient who has a fever, malaise, and a white blood cell count that is elevated. Which of the following principles should guide the nurses management of the patients care?
- A. There is a need for the patient to be assessed for lymphoma.
- B. Infection is the most likely cause of the patients change in health status.
- C. The patient is exhibiting signs and symptoms of leukemia.
- D. The patient should undergo diagnostic testing for multiple myeloma.
Correct Answer: B
Rationale: An elevated white blood cell (WBC) count, also known as leukocytosis, is most commonly a response to infection. When the body detects an infection, the immune system responds by increasing the production of white blood cells to fight off the invading pathogens. The accompanying symptoms of fever and malaise are typical signs of infection, supporting the likelihood that this patient's health status is related to an infectious process rather than a more serious hematologic condition like lymphoma or leukemia.
A patient with acute myeloid leukemia (AML) is receiving induction therapy. What is the priority nursing intervention during this phase of treatment?
- A. Administering pain management
- B. Monitoring for signs of infection
- C. Providing emotional support
- D. Monitoring fluid balance
Correct Answer: B
Rationale: Induction therapy for acute myeloid leukemia (AML) involves intensive chemotherapy aimed at achieving remission by eliminating a large number of cancerous cells. However, this aggressive treatment also severely reduces the production of healthy blood cells, including neutrophils, which leads to neutropenia (a dangerously low number of neutrophils). This makes the patient highly susceptible to infections, which can be life-threatening. Monitoring for signs of infection is critical during this phase, as infections may occur quickly and progress rapidly due to the compromised immune system. Early detection and prompt treatment of infections are vital to improving patient outcomes during induction therapy.
A patient was admitted with gastric cancer. The patient asks the nurse about things to expect while receiving chemotherapy. Which of the following statements of the nurse shows incompetence?
- A. You can expect hair loss, but do not worry it will grow back immediately
- B. You may be infected easily, so avoid going to overpopulated places
- C. We may need to monitor your uric acid levels
- D. We may need to monitor your RBCs
Correct Answer: A
Rationale: While hair loss (alopecia) is a common side effect of chemotherapy due to the damage to rapidly dividing hair follicle cells, the statement that hair will grow back "immediately" is inaccurate and misleading. Hair regrowth after chemotherapy takes time, typically starting a few weeks to months after treatment ends. The new hair may also have a different texture or color initially. Therefore, this statement indicates a lack of understanding and could give the patient unrealistic expectations, which is why it shows incompetence.
Nurse Mandy is teaching a client about the side effects of radiation therapy. Which of the following should the nurse emphasize?
- A. Radiation therapy is painless.
- B. You may experience hair loss.
- C. Fatigue is a common side effect.
- D. You may experience nausea and vomiting.
Correct Answer: C
Rationale: Fatigue is one of the most frequent and profound side effects of radiation therapy. It often occurs because radiation can damage both cancerous and healthy cells, and the body requires energy to repair the damage caused by the treatment. Fatigue from radiation can be cumulative, meaning it may worsen as treatments progress, and can significantly affect the client's daily activities, requiring the nurse to educate the client on energy conservation techniques.