Question 1

While the nurse is obtaining the health history of a 75-year-old female patient, which of the following has the greatest implication for the development of cancer?&#10;A) Being a woman&#10;B) Family history of hypertension&#10;C) Cigarette smoking as a teenager&#10;D) Advancing age

Accepted Answer

According to the American Cancer Society, the most important risk factor for cancer development is advancing age.

Question 2

A cancer patient's susceptibility to the syndrome of inappropriate antidiuretic hormone (SIADH) can be suspected with which of the following laboratory results?&#10;A) Serum potassium of 5.2 mmol/L&#10;B) Serum sodium of 120 mmol/L&#10;C) Hematocrit of 40%&#10;D) Blood urea nitrogen (BUN) of 10 mg/dL

Accepted Answer

In SIADH, there is increased secretion of antidiuretic hormone (ADH) from the posterior pituitary gland, leading to increased water reabsorption from the distal convoluted tubule and collecting duct. As a result, weight increases and serum sodium and hematocrit levels are diluted, and, hence, a low serum sodium level is seen. ADH has no direct effect on serum potassium, because potassium is primarily an intracellular electrolyte and changes in the serum concentration of potassium rarely occur in SIADH. The blood urea nitrogen is normal.

Question 3

What is the priority nursing diagnosis for a patient experiencing chemotherapy-induced anemia?&#10;A) Risk for injury related to poor blood clotting&#10;B) Fatigue related to decreased cellular oxygenation&#10;C) Disturbed body image related to skin color changes&#10;D) Imbalanced nutrition, less than body requirements related to anorexia

Accepted Answer

Decreased numbers of red blood cells (RBCs) result in decreased cellular oxygenation and less energy. Decreased numbers of RBCs alone do not change the patient's blood-clotting ability. Although skin color changes and altered nutrition also occur with anemia, fatigue due to decreased cellular oxygenation is a priority nursing diagnosis.

Question 4

While planning care for a patient experiencing fatigue due to chemotherapy, which of the following is the most appropriate nursing intervention?&#10;A) Prioritization and administration of nursing care throughout the day&#10;B) Completing all nursing care in the morning so the patient can rest the remainder of the day&#10;C) Completing all nursing care in the evening when the patient is more rested&#10;D) Limiting visitors, thus promoting the maximal amount of hours for sleep

Accepted Answer

Pacing activities throughout the day conserves energy, and nursing care should be paced as well. Fatigue is a common side effect of cancer and treatment; and while adequate sleep is important, an increase in the number of hours slept will not resolve the fatigue. Restriction of visitors does not promote healthy coping and can result in feelings of isolation.

Question 5

A patient is not certain whether she and her family should participate in a genetic screening plan. She asks the nurse why the X-linked recessive disorder that has been noted in some of her family members is expressed in males more frequently than in females. What is the nurse's best response?

A) "The disease tends to show up in males because they do not have a second X chromosome to balance the expression of the gene."
B) "One X chromosome of a pair is always inactive in females. This inactivity effectively negates the effects of the gene."
C) "Females are known to have more effective DNA repair mechanisms than males, thus negating the damage caused by the recessive gene."
D) "Expression of genes from the male's Y chromosome does not occur in females, so they are essentially immune to the effects of the gene."

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Accepted Answer

Because the number of X chromosomes in males and females is not the same (1:2), the number of X-linked chromosome genes in the two genders is also unequal. Males have only one X chromosome for any gene on the X chromosome. As a result, X-linked recessive genes have a dominant expressive pattern of inheritance in males and a recessive expressive pattern of inheritance in females. This difference in expression occurs because males do not have a second X chromosome to balance the expression of any recessive gene on the first X chromosome. It is incorrect to say that one X chromosome of a pair is always inactive in females or that females have more effective DNA repair mechanisms than males. Also, it is not true that females can be immune to the effects of a gene, because genes from the male's Y chromosome are not expressed in females.

Question 6

The nurse is caring for a patient who received a bone marrow transplant 10 days ago. The nurse would monitor for which of the following clinical manifestations that could indicate a potentially life-threatening situation?

A) Mucositis
B) Confusion
C) Depression
D) Mild temperature elevation

Accepted Answer

During the first 100 days after a bone marrow transplant, patients are at high risk for life-threatening infections. The earliest sign of infection in an immunosuppressed patient can be a mild fever. Mucositis, confusion, and depression are possible clinical manifestations but are representative of less life-threatening complications.

Question 7

In caring for a patient following lobectomy for lung cancer, which of the following should the nurse include in the plan of care?&#10;A) Position the patient on the operative side only.&#10;B) Avoid administering narcotic pain medications.&#10;C) Keep the patient on strict bed rest.&#10;D) Instruct the patient to cough and deep breathe.

Accepted Answer

Postoperative deep breathing and coughing is important to promote oxygenation and clearing of secretions. Pain medications will be given to lessen pain and allow for deep breathing and coughing. Strict bed rest is not instituted, because early ambulation will help lessen postoperative complications such as deep vein thrombosis. Prolonged lying on the operative side is avoided.

Question 8

The nurse would incorporate which of the following into the plan of care as a primary prevention strategy for reduction of the risk for cancer?&#10;A) Yearly mammography for women aged 40 years and older&#10;B) Using skin protection during sun exposure while at the beach&#10;C) Colonoscopy at age 50 and every 10 years as follow-up&#10;D) Yearly prostate specific antigen (PSA) and digital rectal exam for men aged 50 and over

Accepted Answer

Primary prevention of cancer involves avoidance to known causes of cancer, such as sun exposure. Secondary screening involves physical and diagnostic examination.

Question 9

A female patient complains of a &#34;scab that just won't heal&#34; under her left breast. During your conversation, she also mentions chronic fatigue, loss of appetite, and slight cough, attributed to allergies. What is the nurse's best action?&#10;A) Continue to conduct a symptom analysis to better understand the patient's symptoms and concerns.&#10;B) End the appointment and tell the patient to use skin protection during sun exposure.&#10;C) Suggest further testing with a cancer specialist and provide the appropriate literature.&#10;D) Tell her to put a bandage on the scab and set a follow-up appointment in one week.

Accepted Answer

A comprehensive health history is vital to treating and caring for the patient. Often times, symptoms are vague. The nurse should conduct a symptom analysis to gather as much information as possible. Questions should address the duration of the symptoms and include the location, characteristics, aggravating and relief factors, and any treatments taken thus far.

Question 10

A patient with prostate cancer is taking estrogen daily to control tumor growth. He reports that his left calf is swollen and painful. Which of the following would be the nurse's best action?&#10;A) Instruct the client to keep the leg elevated.&#10;B) Measure the calf circumference and compare the measurement with the right calf circumference measurement.&#10;C) Apply ice to the calf after a 10-minute massage of the area.&#10;D) Document assessment findings as an expected response with estrogen therapy.

Accepted Answer

An adverse reaction to hormonal manipulation therapy is the development of thrombus formation. Massaging a calf that is swollen and painful is never correct, because this action might break a clot, causing formation of an embolus, which could then travel to the lungs.

Question 11

While collecting a health history on a patient admitted for colon cancer, which of the following questions would be a priority to ask this patient?&#10;A) &#34;Have you noticed any blood in your stool?&#34;&#10;B) &#34;Have you been experiencing nausea?&#34;&#10;C) &#34;Do you have back pain?&#34;&#10;D) &#34;Have you noticed any swelling in your abdomen?&#34;

Accepted Answer

The answer of While collecting a health history on a...

Deck 12: Cellular Regulation