Nokea
Which of the following is a possible treatment plan for a client diagnosed with leukemia?
- A. Dialysis
- B. Therapeutic phlebotomy
- C. Splenectomy
- D. Stem cell transplant
Correct Answer: D
Rationale: Leukemia's marrow takeover needs a reset stem cell transplant swaps diseased cells for healthy ones, a potential cure or remission shot. Dialysis aids kidneys, not blood. Phlebotomy drains polycythemia. Splenectomy's rare, symptom-based. Nurses prep for transplant, eyeing this radical fix, a game-changer in leukemia's brutal playbook.
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When using induced hypotension during orthognathic surgery:
- A. Mean arterial blood pressure may be reduced to 30% of normal in patients of ASA grade I.
- B. The stress response to surgery is attenuated.
- C. Drugs that cause relative bradycardia are useful adjuncts.
- D. The desired effects of clonidine are mediated by αâ‚-adrenoceptors.
Correct Answer: C
Rationale: Induced hypotension in orthognathic surgery reduces bleeding, enhancing visibility. Mean arterial pressure (MAP) drops to 50-65 mmHg (not 30% of normal, ~20-25 mmHg, which risks ischemia), safe in ASA I patients with monitoring. Stress response attenuation occurs with deep anaesthesia, not hypotension alone. Bradycardia-inducing drugs (e.g., β-blockers, remifentanil) stabilize haemodynamics, aiding controlled hypotension by lowering cardiac output safely. Clonidine, an α₂-agonist (not αâ‚), reduces sympathetic outflow, supporting hypotension and sedation. Invasive monitoring mitigates pressure injury risk. Bradycardia's role enhances technique precision, minimizing transfusion needs while maintaining perfusion in healthy patients.
A patient who is being treated for stage IV lung cancer tells the nurse about new-onset back pain. Which action should the nurse take first?
- A. Give the patient the prescribed PRN opioid.
- B. Assess for sensation and strength in the legs.
- C. Notify the health care provider about the symptoms.
- D. Teach the patient how to use relaxation to reduce pain.
Correct Answer: B
Rationale: Stage IV lung cancer plus back pain flags spinal cord compression leg checks for numbness or weakness come first; paralysis kills fast. Opioids , calls , or relaxation follow. Nurses in oncology prioritize this neuro's the lifeline, catching mets' chaos early.
A patient with metastatic cancer of the colon experiences severe vomiting after each administration of chemotherapy. Which action, if taken by the nurse, is appropriate?
- A. Have the patient eat large meals when nausea is not present.
- B. Offer dry crackers and carbonated fluids during chemotherapy.
- C. Administer prescribed antiemetics 1 hour before the treatments.
- D. Give the patient a glass of a citrus fruit beverage during treatments.
Correct Answer: C
Rationale: Chemo vomiting's a beast pre-dosing antiemetics (e.g., ondansetron) an hour before blocks the gut-brain puke loop, the gold standard. Big meals overload; crackers and soda or citrus during treatment spark nausea acidity and fizz don't help. Nurses in oncology time this right prevention trumps mopping up, keeping patients steady.
A 58-year-old woman with chronic gout is visiting the dietitian and the correct dietary advice given is:
- A. To stop fried food and eat fish for better gout control
- B. To increase fructose drinks as it removes uric acid from urine
- C. Avoid soybeans and plant proteins
- D. Stop alcohol and reduce animal protein
Correct Answer: D
Rationale: Gout diet cut booze, meat; fructose spikes uric, soy's fine, mushrooms hurt, cherries help. Nurses steer this chronic food fix.
The nurse caring for oncology clients knows that which form of metastasis is the most common?
- A. Bloodborne
- B. Direct invasion
- C. Lymphatic spread
- D. Via bone marrow
Correct Answer: A
Rationale: Metastasis is the process by which cancer spreads from its original site to distant parts of the body, a critical concern in oncology nursing. Among the various mechanisms, bloodborne metastasis is the most common, as cancer cells often enter the bloodstream and travel to organs like the lungs, liver, or brain. This occurs because the circulatory system provides an efficient pathway for tumor cells to disseminate widely, especially in cancers like breast or lung cancer. Lymphatic spread is also frequent, particularly in carcinomas, where cells travel via lymph nodes, but it is less dominant than bloodborne spread across all cancer types. Direct invasion involves cancer growing into adjacent tissues, which is a local process rather than true metastasis. Bone marrow is not a medium for metastasis but a potential site where cancer can settle, such as in leukemia or multiple myeloma. Understanding that bloodborne metastasis predominates helps nurses prioritize monitoring for systemic symptoms and complications, such as organ dysfunction, in clients with advanced cancer.