NUR 402 Exam 4 NCLEX Questions The nurse is caring for a patient receiving an initial dose of chemotherapy to treat a rapidly growing metastatic colon cancer. The nurse is aware that this patient is at risk for tumor lysis syndrome (TLS) and will monitor the patient closely for which ab normality associated with this oncologic emergency? A) Hypokalemia B) Hypouricemia C) Hypocalcemia D) Hypophosphatemia - correct answer C) Hypocalcemia TLS is a metabolic complication characterized by rapid release of intracellular components in response to chemotherapy. This can rapidly lead to acute renal injury. The hallmark signs of TLS are hyperuricemia, hyperphosphatemia, hyperkalemia, and hypocalcemia. The nurse is caring for a patient suffering from anorexia secondary to chemotherapy. Which strateg y would be most appropriate for the nurse to use to increase the patient's nutritional intake? A) Increase intake of liquids at mealtime to stimulate the appetite. B) Serve three large meals per day plus snacks between each meal. C) Avoid the use of liquid protein supplements to encourage eating at mealtime. D) Add items such as skim milk powder, cheese, honey, or peanut butter to selected foods. - correct answer D) Add items such as skim milk powder, cheese, honey, or peanut butter to selected foods. The nurse can increase the nutritional density of foods by adding items high in protein and/or calories (such as peanut butter, skim milk powder, cheese, honey, or brown sugar) to foods the patient will eat. Increasing fluid intake at mealtime fills the stomac h with fluid and decreases the desire to eat. Small frequent meals are best tolerated. Supplements can be helpful. NUR 402 Exam 4 NCLEX Questions Which item would be most beneficial when providing oral care to a patient with metastatic cancer who is at risk for oral tissue injury second ary to chemotherapy? A) Firm -bristle toothbrush B) Hydrogen peroxide rinse C) Alcohol -based mouthwash D) 1 tsp salt in 1 L water mouth rinse - correct answer D) 1 tsp salt in 1 L water mouth rinse A salt -water mouth rinse will not cause further irritatio n to oral tissue that is fragile because of mucositis, which is a side effect of chemotherapy. A soft -bristle toothbrush will be used. One teaspoon of sodium bicarbonate may be added to the salt -water solution to decrease odor, alleviate pain, and dissolve mucin. Hydrogen peroxide and alcohol -based mouthwash are not used because they would damage the oral tissue. Which nursing diagnosis is most appropriate for a patient experiencing myelosuppression secondary to chemotherapy for cancer treatment? A) Acute p ain B) Hypothermia C) Powerlessness D) Risk for infection - correct answer D) Risk for infection Myelosuppression is accompanied by a high risk of infection and sepsis. Hypothermia, powerlessness, and acute pain are also possible nursing diagnoses for pat ients undergoing chemotherapy, but the threat of infection is paramount. Previous administrations of chemotherapy agents to a cancer patient have resulted in diarrhea. Which dietary modification should the nurse recommend? A) A bland, low -fiber diet B) A high -protein, high -calorie diet NUR 402 Exam 4 NCLEX Questions C) A diet high in fresh fruits and vegetables D) A diet emphasizing whole and organic foods - correct answer A) A bland, low -
fiber diet Patients experiencing diarrhea secondary to chemotherapy and/or radiation therapy often benefit from a diet low in seasonings and roughage before the treatment. Foods should be easy to digest and low in fat. Fresh fruits and vegetables are high in fiber and should be minimized during treatment. Whole and organic foods do not prevent dia rrhea. A 33 -year -old patient has recently been diagnosed with stage II cervical cancer. What should the nurse understand about the patient's cancer? A) It is in situ. B) It has metastasized. C) It has spread locally. D) It has spread extensively. - correct answer C) It has spread locally. Stage II cancer is associated with limited local spread. Stage 0 denotes cancer in situ; stage I denotes tumor limited to the tissue of origin with localized tumor growth. Stage III denotes extensive local and regional sp read. Stage IV denotes metastasis. Which cellular dysfunction in the process of cancer development allows defective cell proliferation? A) Proto -oncogenes B) Cell differentiation C) Dynamic equilibrium D) Activation of oncogenes - correct answer C) Dynami c equilibrium NUR 402 Exam 4 NCLEX Questions Dynamic equilibrium is the regulation of proliferation that usually only occurs to equal cell degeneration or death or when the body has a physiologic need for more cells. Cell differentiation is the orderly process that progresses a cell fr om a state of immaturity to a state of differentiated maturity. Mutations that alter the expression of proto -oncogenes can activate them to function as oncogenes, which are tumor -inducing genes and alter their differentiation. A patient has been diagnosed with Burkitt's lymphoma. In the initiation stage of cancer, the cells genetic structure is mutated. Exposure to what may have functioned as a carcinogen for this patient? A) Bacteria B) Sun exposure C) Most chemicals D) Epstein -Barr virus - correct answer D) Epstein -Barr virus Burkitt's lymphoma consistently shows evidence of the presence of Epstein -Barr virus in vitro. Bacteria do not initiate cancer. Sun exposure causes cell alterations leading to melanoma and squamous and basal cell skin carcinoma. Long -term exposure to certain chemicals (e.g., ethylene oxide, chloroform, benzene) is known to initiate cancer. What can the nurse do to facilitate cancer prevention for the patient in the promotion stage of cancer development? A) Teach the patient to exercis e daily. B) Teach the patient promoting factors to avoid. C) Tell the patient to have the cancer surgically removed now. D) Teach the patient which vitamins will improve the immune system. - correct answer B) Teach the patient promoting factors to avoid. The promotion stage of cancer is characterized by the reversible proliferation of the altered cells. Changing the lifestyle to avoid promoting factors (dietary fat,
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