The serum alpha-fetoprotein (AFP) level is elevated with some malignant germ cell tumors (GCTs) especially endodermal sinus tumors; it can be used as a measure of treatment response and during follow-up after completion of chemotherapy. However, it is normally elevated during infancy. At which age does AFP physiologically fall to normal adult level?
- A. three month
- B. eight month
- C. one year
- D. three year
Correct Answer: C
Rationale: AFP levels typically normalize by around one year of age.
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A 12-year-old male adolescent, recently diagnosed with Hodgkin lymphoma, shows left cervical and supraclavicular lymph node involvement and drenching night sweats. Based on Ann Arbor Classification, the patient is classified as
- A. stage IA
- B. stage IB
- C. stage IIA
- D. stage IIB
Correct Answer: D
Rationale: Involvement of two lymph node regions above the diaphragm with systemic symptoms corresponds to stage IIB.
An oncology nurse educator is speaking to a women's group about breast cancer. Questions and comments from the audience reveal a misunderstanding of some aspects of the disease. Various members of the audience have made all of the following statements. Which one is accurate?
- A. Mammography is the most reliable method for detecting breast cancer.
- B. Breast cancer is the leading killer of women of childbearing age.
- C. Breast cancer requires a mastectomy.
- D. Men can develop breast cancer.
Correct Answer: D
Rationale: While all the statements made by the audience members may have been common misconceptions, the only one that is accurate is that men can develop breast cancer. Although it is less common in men than in women, breast cancer can still affect males. It is important for everyone to be aware of the risks and symptoms of breast cancer, regardless of gender.
You are evaluating a 6-year-old child with ALL on interim maintenance phase who has frequent mucositis and myelosuppression that needs frequent discontinuation of his treatment. Of the following, the MOST valuable test for this child is
- A. complete blood count
- B. pharmacogenetic testing of the thiopurine S-methyltransferase (TPMT) gene
- C. renal function test
- D. bone marrow study
Correct Answer: B
Rationale: TPMT gene testing helps determine the child's ability to metabolize thiopurine drugs, which may explain the adverse effects.
Mrs. Diwa has been diagnosed with systemic lupus erythematosus, the nurse upon assessment can expect to find which of the following?
- A. dysphagia
- B. dryness or itching of genitalia
- C. decreased visual acuity or blindness
- D. abnormal lung sounds
Correct Answer: D
Rationale: Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple organs in the body, including the lungs. Patients with SLE are at risk for developing various respiratory complications, which can result in abnormal lung sounds on auscultation. Common respiratory manifestations of SLE include pleurisy, pleural effusion, interstitial lung disease, and pulmonary hypertension. Therefore, the nurse assessing Mrs. Diwa can expect to find abnormal lung sounds indicative of these respiratory complications. However, it is important to note that SLE can also present with a wide range of other symptoms affecting different organ systems.
Which of the following elements shows that the client does not understand the cause of exacerbation of system lupus erythematosus (SLE)?
- A. "I don't have to worry about changing my
- B. "I don't have to worry if I get a strep. throat diet."
- C. I need to work on managing stress in life."
Correct Answer: B
Rationale: Option B, "I don't have to worry if I get a strep throat," shows that the client does not understand the cause of exacerbation of systemic lupus erythematosus (SLE). Strep throat can trigger SLE exacerbations as infections are known to worsen autoimmune diseases like lupus. This statement indicates a lack of awareness regarding the potential impact of infections on SLE symptoms. Option A and C show a better understanding as they address the importance of diet and stress management, which are significant factors that can influence the course of SLE.