Nokea
The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer. Which information about the patient alerts the nurse to discuss a possible change in therapy with the health care provider?
- A. Poor oral intake
- B. Frequent loose stools
- C. Complaints of nausea and vomiting
- D. Increase in carcinoembryonic antigen (CEA)
Correct Answer: D
Rationale: Colorectal cancer's chemo tracks via CEA rising levels signal progression or resistance, a red flag for therapy tweak, needing provider input. Poor intake, diarrhea, and nausea are side effects, manageable with nursing care diet, fluids, antiemetics unless extreme. CEA's uptick, a tumor marker, trumps symptoms, hinting at disease outpacing treatment. Nurses flag this, pushing for scans or regimen shifts, a critical catch in this cancer's chemo dance.
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For a patient on the chemotherapeutic drug vincristine (Oncovin), which of the following side effects should be reported to the physician?
- A. Fatigue
- B. Nausea and vomiting
- C. Paresthesia
- D. Anorexia
Correct Answer: C
Rationale: Vincristine, a vinca alkaloid, disrupts nerve function, making paresthesia tingling or numbness a critical side effect signaling neurotoxicity, warranting physician review for dose adjustment or cessation. Fatigue, nausea, and anorexia, while common in chemotherapy, are manageable with nursing interventions rest, antiemetics, small meals unless severe. Paresthesia's specificity to vincristine's mechanism, targeting microtubules, elevates its urgency; unchecked, it risks permanent nerve damage, impacting mobility and quality of life. Reporting it ensures timely intervention, distinguishing it from routine effects, a key nursing responsibility in monitoring chemotherapy's narrow therapeutic window.
An oncology nurse is caring for a patient who has developed erythema following radiation therapy. What should the nurse instruct the patient to do?
- A. Periodically apply ice to the area
- B. Keep the area cleanly shaven
- C. Apply petroleum jelly to the affected area
- D. Avoid using soap on the treatment area
Correct Answer: D
Rationale: Radiation erythema red, raw skin needs gentle care to dodge worsening. Soap dries and irritates, stripping fragile skin and upping infection risk, so skipping it's key. Ice or heat can burn or blister radiated tissue, already thin and sensitive. Shaving scrapes it raw; petroleum jelly traps moisture, breeding bacteria. Nurses teach this to protect the site, pushing mild cleansers (if needed) and air exposure, standard in oncology to heal radiation burns without sparking new problems.
Which ONE of the following is NOT a diagnostic criterion for Kawasaki's disease?
- A. fever for 5 days
- B. bilateral non purulent conjunctivitis
- C. generalised lymphadenopathy
- D. polymorphous rash
Correct Answer: C
Rationale: Kawasaki fever, eyes, rash, hands fit; lymph's one node, not general. Nurses count this chronic five, not six.
Physical exertion improves the glucose uptake in patients with type 2 diabetes. Question: Which intracellular process is the most likely explanation of this increase in glucose uptake?
- A. Increase of the tyrosine phosphorylation of IRS-1, which improves the insulin signal transduction
- B. Increase of the tyrosine phosphorylation of GLUT4-transporters which indices its translocation
- C. Increase of AMPK, which induces GLUT4 translocation
- D. Increase of AMPK, which induces IRS-1 phosphorylation
Correct Answer: C
Rationale: Exercise boosts glucose AMPK flips GLUT4 out, no insulin needed, not IRS-1 or direct GLUT4 hits. Nurses see this, a chronic muscle mover.
A 10-year-old boy is being prepared for a bone marrow transplant. The nurse can determine that the child understands this treatment when he says:
- A. I'll be much better after this blood goes to my bones.
- B. I won't feel too good until my body makes healthy cells.
- C. This will help all of the medicine they give me to work better.
- D. You won't have to wear a mask and gown after my transplant.
Correct Answer: B
Rationale: A bone marrow transplant (BMT) replaces diseased marrow (e.g., in leukemia) with healthy stem cells, but recovery is slow new, functional blood cells take weeks to months to regenerate, during which the child may feel unwell due to immunosuppression and engraftment challenges. The statement I won't feel too good until my body makes healthy cells' shows the boy grasps this delay, reflecting realistic understanding critical for coping and consent in pediatric care. Feeling better immediately after infusion is inaccurate initial post-BMT phases often worsen symptoms. Enhancing medicine efficacy isn't the goal; BMT is the therapy. Masks and gowns persist post-transplant due to infection risk until immunity recovers. The nurse's validation of this insight ensures the child is prepared, aligning with oncology's focus on patient education and emotional support during complex treatments.