Nokea
Which set of classification values indicates the most extensive and progressed cancer?
- A. T1 N0 M0
- B. T10 N0 M0
- C. T1 N1 M0
- D. T4 N3 M1
Correct Answer: D
Rationale: TNM staging gauges cancer extent: T (tumor size), N (node involvement), M (metastasis). T4 N3 M1 marks the worst T4 signals a large, invasive tumor, N3 extensive nodal spread, M1 distant metastases, painting a picture of widespread, advanced disease. T1 N0 M0 is small, localized, no spread early stage. T10 isn't standard (likely T1), still less severe. T1 N1 M0 has minor nodal involvement, not extensive. T4 N3 M1's combination screams progression, guiding nurses to expect aggressive care or palliation, a stark contrast to earlier stages' hopeful prognosis, critical for planning in advanced cancer.
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The nurse is teaching the parents of a 15-year-old who is being treated for acute myelogenous leukemia about the side effects of chemotherapy. For which of the following symptoms should the parents seek medical care immediately?
- A. Earache, stiff neck or sore throat
- B. Blisters, ulcers or a rash appear
- C. A temperature of 101.5 degrees Fahrenheit
- D. Difficulty or pain when swallowing
Correct Answer: C
Rationale: Chemotherapy for acute myelogenous leukemia suppresses the immune system by reducing white blood cell production, leaving the child highly susceptible to infections. A fever of 101.5°F is a critical sign in this context, as it may indicate an infection that, without a functioning immune response, could rapidly progress to sepsis a life-threatening condition. Parents must seek immediate medical care to evaluate and treat the underlying cause, often requiring emergency department intervention. While earache, stiff neck, or sore throat could suggest infection, they are less urgent without fever and may not necessitate immediate action unless severe. Blisters, ulcers, or rashes might reflect chemotherapy side effects like mucositis or drug reactions, manageable with outpatient care unless infected. Difficulty swallowing could stem from mucositis or infection, but fever trumps it in urgency due to its systemic implications. Educating parents to prioritize fever ensures timely intervention, aligning with oncology nursing's focus on preventing complications in immunocompromised pediatric patients.
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.
Regarding infective endocarditis in an IVDU
- A. Usually presents with fever and respiratory symptoms
- B. Usually involves the mitral valve
- C. The commonest organism is staph epidermidis
- D. Negative blood cultures exclude the diagnosis
Correct Answer: A
Rationale: IVDU endocarditis fever, lung emboli from tricuspid, not mitral, Staph aureus, cultures miss some. Nurses hear this chronic right-side roar.
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 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.