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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In which ethnic group are people over 35 years advised to have their blood glucose levels checked because of the risk of type 2 diabetes?
- A. Creoles
- B. Hindu
- C. Moroccans
- D. Turks
Correct Answer: B
Rationale: Hindus over 35 South Asian risk rockets type 2, outpacing others' odds. Nurses screen this, a chronic ethnic flag.
For a patient with osteogenic sarcoma, you would be particularly vigilant for elevations in which laboratory value?
- A. Sodium
- B. Calcium
- C. Potassium
- D. Hematocrit
Correct Answer: B
Rationale: Osteogenic sarcoma, a bone cancer, often triggers hypercalcemia bone destruction releases calcium into blood, risking arrhythmias or kidney damage, a life-threatening shift demanding close watch. Sodium and potassium imbalances aren't bone-specific, more tied to general metabolism or treatment side effects. Hematocrit reflects anemia, common in cancer but not osteogenic sarcoma's hallmark. Calcium's spike, linked to osteolysis, makes it the nurse's focus elevations signal tumor activity or progression, prompting urgent interventions like fluids or bisphosphonates, a vigilance rooted in this cancer's skeletal impact and metabolic havoc.
A nurse has taught a client about dietary changes that can reduce the chances of developing cancer. What statement by the client indicates the nurse needs to provide additional teaching?
- A. Foods high in vitamin A and vitamin C are important.
- B. I'll have to cut down on the amount of bacon I eat.
- C. I'm so glad I don't have to give up my juicy steaks.
- D. Vegetables, fruit, and high-fiber grains are important.
Correct Answer: C
Rationale: Diet plays a significant role in cancer prevention, and nurses often educate clients on evidence-based dietary adjustments. Foods rich in vitamins A and C, such as carrots and citrus fruits, are known to have antioxidant properties that may reduce cancer risk by neutralizing free radicals. Reducing processed meats like bacon is advised due to their association with colorectal cancer, linked to nitrates and high fat content. Similarly, high vegetable, fruit, and fiber intake is recommended for their protective effects against various cancers, including colon cancer. However, excessive red meat consumption, such as steaks, is a known risk factor for cancers like colorectal and prostate cancer due to saturated fats and carcinogenic compounds formed during cooking. The client's statement about not giving up steaks suggests a misunderstanding, indicating the nurse must clarify that limiting red meat, not just processed meat, is part of a cancer-preventive diet. This additional teaching is essential to ensure the client adopts a comprehensive approach to reducing cancer risk.
The nurse is caring for a client with type 2 diabetes who has been hospitalized with severe hyperglycemia. Which of the following topics will be most important to include in discharge teaching?
- A. Effect of endogenous insulin on transportation of glucose into cells
- B. Function of the liver in formation of glycogen and gluconeogenesis
- C. Impact of the client's family history on likelihood of developing diabetes
- D. Symptoms indicating that the client should contact the health care provider
Correct Answer: D
Rationale: Discharge teaching for type 2 diabetes post-hyperglycemia hinges on crisis prevention knowing when symptoms like thirst or confusion scream for help beats insulin mechanics, liver roles, or family odds. Clients need actionable cues to self-manage, not just theory; recognizing trouble and calling in keeps them out of the ER. Physiology's useful, genetics informative, but spotting escalation's life-saving, a chronic care must nurses drill into patients for real-world control.
The nurse is assessing a 14-year-old girl with a tumor. Which of the following findings would indicate Ewing sarcoma?
- A. Child complains of dull bone pain just above the knee.
- B. Palpation reveals non-tender swelling on the right ribs.
- C. Parents report a mass on the abdomen that crosses the midline.
- D. Palpation reveals asymptomatic mass on the upper back.
Correct Answer: B
Rationale: Ewing sarcoma is a rare bone cancer primarily affecting children and adolescents, typically arising in flat bones like the pelvis, chest wall (e.g., ribs), or vertebrae, and the diaphysis of long bones. A hallmark is a palpable, non-tender mass, making non-tender swelling on the ribs a strong indicator, as it aligns with the tumor's common chest wall location and lack of initial pain sensitivity. Dull bone pain above the knee suggests a long bone issue, possibly osteosarcoma, which favors the metaphysis, not Ewing's typical diaphysis site. An abdominal mass crossing the midline is more characteristic of Wilms tumor or neuroblastoma, not Ewing sarcoma. An asymptomatic upper back mass could suggest various tumors, but lacks specificity for Ewing's flat bone preference. Nurses must recognize this presentation to facilitate prompt imaging and biopsy, critical for early diagnosis and treatment planning in pediatric oncology.