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The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breath and the nurses rapid assessment reveals that the patients jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct Answer: B
Rationale: Superior vena cava syndrome (SVCS) is a medical emergency that can occur in patients with advanced cancer, such as breast cancer with metastasis. SVCS is caused by the obstruction or compression of the superior vena cava, a large vein that carries blood from the upper body back to the heart. When the superior vena cava is obstructed or compressed, it can lead to symptoms such as difficulty breathing (dyspnea) and distended jugular veins.
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A female patient tells the nurse that she thinks she has a vaginal infection because she has noted inflammation of her vulva and the presence of a frothy, yellow-green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infection?
- A. Trichomonas vaginalis
- B. Candidiasis
- C. Gardnerella
- D. Gonorrhea
Correct Answer: A
Rationale: The clinical manifestations of inflammation of the vulva and the presence of frothy, yellow-green discharge are indicative of a vaginal infection caused by Trichomonas vaginalis. Trichomoniasis is a sexually transmitted infection caused by a protozoan parasite. It commonly presents with symptoms such as frothy, yellow-green vaginal discharge, vaginal itching, inflammation of the vulva, and sometimes a foul odor. Testing for Trichomonas vaginalis can be done through microscopic examination of the vaginal discharge or through nucleic acid amplification tests. Treatment usually involves the use of antibiotics such as metronidazole or tinidazole. It is important to promptly diagnose and treat trichomoniasis to prevent complications and further transmission.
The nurse is monitoring a patient with severe preeclampsia who is on IV magnesium sulfate. Which signs of magnesium toxicity should the nurse monitor for? (Select all that apply.)
- A. Cool, clammy skin
- B. Altered sensorium
- C. Pulse oximeter reading of 95%
- D. Respiratory rate of less than 12 breaths per minute
Correct Answer: B
Rationale: The signs of magnesium toxicity that the nurse should monitor for in a patient with severe preeclampsia on IV magnesium sulfate include an altered sensorium (confusion, lethargy, slurred speech) and a respiratory rate of less than 12 breaths per minute. Altered sensorium is a common symptom of magnesium toxicity, reflecting the drug's central nervous system depressant effects. A decreased respiratory rate can indicate respiratory depression, a potentially serious complication of magnesium toxicity. Monitoring for these signs is crucial to promptly identifying and managing magnesium toxicity in patients on magnesium sulfate therapy. Signs such as cool, clammy skin and a pulse oximeter reading of 95% would not be indicative of magnesium toxicity.
A male patient with a metastatic brain tumor is having a generalized seizure and begins vomiting. What should the nurse do first?
- A. Perform oral suctioning.
- B. Page the physician.
- C. Insert a tongue depressor into the patients mouth.
- D. Turn the patient on his side.
Correct Answer: D
Rationale: When a patient is experiencing a seizure and begins vomiting, the priority action for the nurse is to turn the patient onto their side. This position helps to prevent aspiration, which can occur when the patient inhales vomit into their lungs. Turning the patient on their side allows for the vomit to drain out of the mouth, reducing the risk of aspiration and maintaining a clear airway. Performing oral suctioning would be necessary after turning the patient on their side, but it is not the initial priority in this situation. Paging the physician and inserting a tongue depressor are not appropriate actions during a seizure and vomiting episode.
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. Phagocytizing healthy cells
- D. Invading healthy host tissues
Correct Answer: D
Rationale: Malignant disease processes transfer cells from one place to another primarily through the invasion of healthy host tissues. Cancer cells have the ability to break away from the primary tumor site and invade nearby healthy tissues. Once invasive cancer cells find their way into blood vessels or lymphatics, they can be carried to distant sites in the body where they can form new tumors, establish metastases, and spread the disease. This invasive property of cancer cells underlies the ability of cancer to spread throughout the body, a process known as metastasis. Commanding the cells to appear to adhere to primary tumor cells, inducing mutation of cells of another organ, or phagocytizing healthy cells are not mechanisms by which malignant disease processes transfer cells from one place to another.
A physician explains to the patient that he has an inflammation of the Cowper glands. Where are the Cowper glands located?
- A. Within the epididymis
- B. Below the prostate, within the posterior aspect of the urethra
- C. On the inner epithelium lining the scrotum, lateral to the testes
- D. Medial to the vas deferens
Correct Answer: B
Rationale: The Cowper glands, also known as bulbourethral glands, are a pair of small exocrine glands located below the prostate gland, within the posterior aspect of the male urethra. These glands are responsible for producing a clear, viscous fluid that helps lubricate the urethra, neutralize acidic urine remnants, and provide a conducive environment for sperm to survive in the urethra. Inflammation of the Cowper glands can result in conditions such as urethritis or other discomfort related to the male reproductive system.