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1. A member of the health care team is researching the etiology and
pathogenesis of a number of clients who are under his care in a hospital
context. Which of the following aspects of clients' situations best
characterizes pathogenesis rather than etiology?
a) -A client who has been exposed to the mycobacterium
tuberculosis bacterium
b) -A client who has increasing serum ammonia levels due to liver cirrhosis
c) -A client who was admitted with the effects of methyl alcohol poisoning
d) -A client with multiple skeletal injuries secondary to a motor vehicle
accident
Correct Answer: A client who has increasing serum ammonia levels due to liver
cirrhosis
2. A 60year-old man has presented to a clinic and is requesting screening for
tumor markers after reading about them in a magazine. What can the clinician
most accurately tell the man about the clinical use of tumor markers?
a) "Tumor markers are a very useful screening tool, but they only exist for a very
few types of cancer."
b) "Tests for the presence of tumor markers are limited by the fact that they are
,only accurate in the very early stages of cancer."
c) "Tumor markers are an excellent screening tool, but it's only practical to test for
those cancers that you're at risk of."
d) "Tumor markers alone aren't enough to confirm whether you have cancer or
not, so they're not a very useful screening tool."
Correct Answer: "Tumor markers alone aren't enough to confirm whether you
have cancer or not, so they're not a very useful screening tool."
3. Which target of both chemotherapy and radiation treatment accounts for
adverse as well as therapeutic effects?
a) Cell-surface receptors
b) Circulating hormone levels
c) Blood vessels
d) Rapidly proliferating cells
Correct Answer: Rapidly proliferating cells
4. A 41-year-old female with a family history of breast cancer has had a baseline
mammogram. She states that she performs monthly self-breast exams but really
has a hard time evaluating her lumps since she has numerous cysts. At her annual
mammogram, the technician views a suspicious area and refers her to the
radiologist. She asks the nurse in the office, "How can a lump appear so quickly?"
The nurse's response is based on which of the following principles?
a) A tumor is undetectable until it has doubled 30 times and contains at least 1
billion cells.
b) Many tumor cells never leave the M-phase of the cell cycle.
c) Cancer cells are undifferentiated and come in various shapes and sizes.
d) If the breast has a lot of cysts, then the fluid within those sacs makes it difficult
to feel the hard lumps of a cancer.
,Correct Answer: -A tumor is undetectable until it has doubled 30 times and
contains at least 1 billion cells.
5. A 77-year-old male client with a diagnosis of stomach cancer has been found to
have metastases in his liver. The client and his family are surprised at this turn of
events, stating that they do not see how he could have developed cancer in his
liver. Which of the following facts would underlie the reply that the care team
provides?
a) The parenchymal tissue of the liver is particularly susceptible to secondary
malignancies.
b) The portal circulatory system brings venous blood from the GI tract into the
liver.
c) Hepatic stromal tissue shares characteristics with cancerous cells, including lack
of anchorage dependence.
d) The proximity of the liver to the stomach allows for direct spread of cancerous
cells due to a lack of contact inhibition.
Correct Answer: -The portal circulatory system brings venous blood from the GI
tract into the liver.
6. A 61-year-old male client is scheduled to begin chemotherapy for the treatment
of his bone cancer shortly. Staff at the cancer center have educated the man and
his wife about the goals, course, and expectations of his treatment. Which of the
following medications and treatments might the man anticipate needing during
and after his course of treatment?
a) Analgesia and corticosteroids
b) Antiemetics and packed red blood cell (PRBC) transfusions
c) Whole blood transfusion and antiplatelet aggregators
d) Diuretics and selective serotonin reuptake inhibitors (SSRIs)
Correct Answer: -Antiemetics and packed red blood cell (PRBC) transfusions
, 7. As part of a screening program for prostate cancer, men at a senior citizen's
center are having their blood levels of prostate-specific antigen (PSA) measured.
Which of the following statements would best characterize high positive
predictive value but low negative predictive value for this screening test?
a) All of the men who had high PSA levels developed prostate cancer; several men
who had low PSA levels also developed prostate cancer.
b) All of the men who had low PSA levels were cancer-free; several men who had
high levels also remained free of prostate cancer.
c) Men who had low PSA levels also displayed false positive results for prostate
cancer; men with high levels were often falsely diagnosed with prostate cancer.
d) The test displayed low sensitivity but high specificity.
Correct Answer: -All of the men who had high PSA levels developed prostate
cancer; several men who had low PSA levels also developed prostate cancer.
8. A patient has been diagnosed with a neurodegenerative disease called multiple
sclerosis (MS). The physician explains to the patient that this disease may be
caused by dysregulated apoptosis. Later that day, the patient asks the nurse what
this means. The NP should reply:
a)-The cells around your nerves don't know how to die correctly.
b)-The cytoplasm should neutralize the various apoptotic inhibitors but isn't
working correctly.
c)-Dysregulated apoptosis has caused an excessive rate of programmed cell death
along the neuro-pathways.
d)-There is an inappropriately low rate of apoptosis occurring within the cells.
Correct Answer: -Dysregulated apoptosis has caused an excessive rate of
programmed cell death along the neuro-pathways.