Nokea
Which of the following patients would probably not benefit from a >5-10% weight loss?
- A. A 28-year-old female with BMI 37 kg/m² and oligomenorrhea but planning for fertility in the future
- B. A 40-year-old man with BMI 26 kg/m², who has a strong family history of diabetes, recently diagnosed with prediabetes
- C. A 21-year-old man with BMI 42 kg/m² with no known medical problems and a family history of T2DM
- D. A 70-year-old female, BMI 26 kg/m², with well-controlled T2DM on two oral anti-diabetic medications and osteoporosis
Correct Answer: D
Rationale: A 5-10% weight loss benefits most with obesity-related conditions improving fertility (BMI 37), prediabetes (BMI 26), or T2DM risk (BMI 42). The 70-year-old with BMI 26, well-controlled T2DM, and osteoporosis may not benefit significantly; weight loss could worsen bone density, and her diabetes is managed, reducing urgency. Her age and comorbidities shift focus to stability, not weight reduction, guiding physicians in chronic care prioritization.
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An oncology nurse is contributing to the care of a patient who has failed to respond appreciably to conventional cancer treatments. As a result, the care team is considering the possible use of biologic response modifiers (BRMs). The nurse should know that these achieve a therapeutic effect by what means?
- A. Promoting the synthesis and release of leukocytes
- B. Focusing the patient's immune system exclusively on the tumor
- C. Potentiating the effects of chemotherapeutic agents and radiation therapy
- D. Altering the immunologic relationship between the tumor and the patient
Correct Answer: D
Rationale: BRMs (e.g., interferon, IL-2) tweak the immune-tumor dance revving up the body's attack or slowing cancer's evasion, not just pumping out leukocytes or boosting chemo/radiation. They don't laser-focus immunity but shift the balance, like marking tumors for T-cells. Nurses in oncology grasp this, knowing BRMs offer a Hail Mary when standard stuff flops, targeting that host-tumor interplay.
A patient who is diagnosed with cervical cancer classified as Tis, N0, M0 asks the nurse what the letters and numbers mean. Which response by the nurse is accurate?
- A. The cancer involves only the cervix.
- B. The cancer cells look like normal cells.
- C. Further testing is needed to determine the spread of the cancer.
- D. It is difficult to determine the original site of the cervical cancer.
Correct Answer: A
Rationale: Tis, N0, M0 means carcinoma in situ cancer's stuck to the cervix's surface, no invasion (T0), no lymph nodes (N0), no metastases (M0). It's early, contained. B's wrong grading, not staging, covers cell look (differentiation). C's off no spread's confirmed already. D's nonsense the cervix is the origin. Nurses break this down in oncology to ease fears only the cervix' signals a shot at cure with local treatment, not systemic chaos yet.
The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the patient is requesting a bilateral mastectomy. This surgery is an example of what type of oncologic surgery?
- A. Salvage surgery
- B. Palliative surgery
- C. Prophylactic surgery
- D. Reconstructive surgery
Correct Answer: C
Rationale: A bilateral mastectomy here is prophylactic removing nonvital breasts to prevent cancer in a high-risk patient with a positive tumor marker and family history. It's about risk reduction, not treatment of existing disease. Salvage surgery tackles recurrence after a less aggressive initial approach, like resecting a regrown tumor. Palliative surgery eases symptoms (e.g., pain from obstruction) in advanced cases, not prevention. Reconstructive surgery restores form or function post-treatment, like breast reconstruction after curative mastectomy. Prophylactic fits this preemptive strike, driven by genetic or familial risk (e.g., BRCA mutations), a growing trend in oncology to outpace cancer's onset, guided by nurses supporting informed, tough choices.
A chemotherapeutic agent that is classified as a vesicant is capable of what effect if deposited into subcutaneous tissue?
- A. Tissue necrosis, damage to tendons, nerves and blood vessels
- B. Mild discomfort
- C. Bruising and paraesthesia
- D. No side effects
Correct Answer: A
Rationale: Vesicants like doxorubicin chew tissue necrosis, nerve-tendon wreck if leaked, not mild or nil. Nurses dread this, a chronic chemo spill.
The nurse on a bone marrow transplant unit is caring for a patient with cancer who is preparing for HSCT. What is a priority nursing diagnosis for this patient?
- A. Fatigue related to altered metabolic processes
- B. Altered nutrition: less than body requirements related to anorexia
- C. Risk for infection related to altered immunologic response
- D. Body image disturbance related to weight loss and anorexia
Correct Answer: C
Rationale: HSCT obliterates marrow, tanking immunity risk for infection soars as neutrophils vanish, making it the top nursing diagnosis pre-transplant. Sepsis can kill fast in this window, unlike fatigue or nutrition issues, which matter but aren't immediate threats. Body image might nag later with hair loss or weight shifts, but infection's the killer to watch. Nurses lock in on this, driving strict isolation and monitoring, knowing a stray germ could derail everything in oncology's high-stakes transplant game.