N352 Exam 2 Practice Questions | Answered with Rationales

N352 Exam 2 Practice Questions | Answered with Rationales Which of the following best defines cancer? A. A disease process characterized by normal cell growth B. A disease process that begins with abnormal cells due to genetic mutations C. A disease that only affects older adults D. A process involving the apoptosis of healthy cells Rationale: Cancer is defined by the presence of abnormal cells that proliferate uncontrollably due to genetic mutations, leading to tumor formation and potential metastasis. What is the term for cancer cells that demonstrate uncontrolled growth and evade programmed cell death? A. Malignant cells B. Benign cells C. Apoptotic cells D. Hyperplastic cells Rationale: Malignant cells are characterized by uncontrolled growth and the ability to avoid apoptosis, leading to tumor formation and metastasis. What is the primary purpose of neoadjuvant therapy? A. To relieve symptoms of cancer B. To fully eliminate the cancer C. To reduce the size of the tumor before primary treatment D. To provide psychological support to patients Rationale: Neoadjuvant therapy is administered before the primary treatment, often surgery, to shrink the tumor, making it easier to remove or more responsive to subsequent treatments. Which of the following is a common side effect of chemotherapy? A. Weight gain B. Alopecia C. Increased energy levels D. Enhanced immune function Rationale: Alopecia, or hair loss, is a well-known side effect of chemotherapy due to its impact on rapidly dividing cells, including hair follicles. Which of the following symptoms would most likely indicate neutropenia in a chemotherapy patient? A. Bradycardia B. Fever C. Nausea D. Diarrhea Rationale: Fever is often an indication of infection, which can occur in neutropenic patients due to the decreased white blood cell count, compromising their immune response. What is the recommended action for a patient experiencing a severe hypersensitivity reaction to chemotherapy? A. Administer a stool softener B. Initiate CPR immediately C. Stop the infusion and administer emergency medications D. Continue the infusion at a slower rate Rationale: In the event of a severe hypersensitivity reaction, it is crucial to stop the infusion immediately and provide emergency medications, such as antihistamines or corticosteroids. Which of the following is true regarding bone marrow suppression as a side effect of chemotherapy? A. It leads to increased red blood cell production B. It can cause thrombocytopenia, increasing bleeding risk C. It has no impact on infection risk D. It is generally well-tolerated by most patients Rationale: Bone marrow suppression can lead to decreased production of blood cells, including platelets (thrombocytopenia), which increases the risk of bleeding. What is the most appropriate nursing intervention for a patient experiencing mucositis due to chemotherapy? A. Encourage spicy foods to stimulate appetite B. Provide soft toothbrushes and magic mouthwash C. Restrict oral intake completely D. Administer a high-fiber diet Rationale: Mucositis can cause painful inflammation of the mucous membranes; providing soft toothbrushes and mouthwash can help maintain oral hygiene and alleviate discomfort. Which type of cancer therapy is intended to prolong survival and contain the disease but does not cure it? A. Neoadjuvant therapy B. Palliative therapy C. Curative therapy D. Adjuvant therapy Rationale: Palliative therapy focuses on relieving symptoms and improving quality of life, especially in advanced stages of cancer, without aiming for a cure. A patient is receiving chemotherapy and reports increased fatigue and weakness. What is the best nursing intervention? A. Encourage the patient to exercise vigorously B. Cluster activities and encourage rest C. Schedule frequent blood draws D. Advise the patient to take a stimulant Rationale: Fatigue is a common side effect of chemotherapy. Clustering activities allows the patient to conserve energy while ensuring necessary care. Which of the following would indicate a need for immediate intervention in a chemotherapy patient? A. Mild rash on the skin B. Blood pressure of 110/70 mmHg C. Fever of 39°C (102°F) with chills D. Nausea and vomiting after treatment Rationale: A fever, especially in a chemotherapy patient, can indicate an infection and requires immediate assessment and intervention. Which of the following describes the growth pattern of malignant tumors? A. Encapsulated and slow-growing B. Uncontrolled and invasive C. Well-differentiated and localized D. Not typically life-threatening Rationale: Malignant tumors grow uncontrollably and can invade surrounding tissues, leading to potential metastasis. What type of chemotherapy administration involves giving drugs in cycles to limit toxicity? A. Continuous infusion B. Intermittent administration C. Single-dose administration D. Combination therapy Rationale: Intermittent administration involves cycles of chemotherapy to allow recovery of normal cells and minimize toxicity. Which of the following factors contributes to the development of drug resistance in cancer cells? A. High patient compliance with treatment B. Genetic mutations in cancer cells C. Regular exercise and a healthy diet D. Effective immune response Rationale: Genetic mutations in cancer cells can lead to changes that enable them to survive despite chemotherapy, contributing to drug resistance. A patient undergoing chemotherapy should be advised to: A. Avoid all physical activity B. Eat whatever they desire, regardless of nutrition C. Maintain good hygiene to reduce infection risk D. Discontinue medications as soon as they feel better Rationale: Maintaining good hygiene is critical for patients undergoing chemotherapy due to their compromised immune systems, reducing the risk of infections. What is the purpose of administering allopurinol in a patient with tumor lysis syndrome? A. To prevent bleeding B. To lower uric acid levels C. To enhance chemotherapy effectiveness D. To boost white blood cell production Rationale: Allopurinol is used to lower uric acid levels in tumor lysis syndrome, which can occur when cancer cells are rapidly destroyed, leading to elevated uric acid levels. Which nursing action is appropriate for a patient experiencing diarrhea due to chemotherapy? A. Administer a high-fiber diet B. Provide prophylactic antiemetics C. Offer oral rehydration solutions and antidarrheal medications D. Encourage complete bed rest Rationale: Diarrhea can lead to dehydration; offering oral rehydration solutions and, if appropriate, antidarrheal medications can help manage symptoms. What should a nurse monitor for in a patient at risk for deep vein thrombosis (DVT) while receiving chemotherapy? A. Unilateral pain and swelling in an extremity B. Increased appetite C. Decreased heart rate D. Elevated blood pressure Rationale: Unilateral pain and swelling are classic signs of DVT, which can be a complication of chemotherapy due to increased clotting risk. Which of the following is a hallmark of benign tumors compared to malignant tumors? A. They are poorly differentiated B. They have the ability to metastasize C. They are encapsulated and grow slowly D. They cause extensive tissue destruction Rationale: Benign tumors are typically encapsulated, grow slowly, and do not invade nearby tissues or metastasize, unlike malignant tumors. What is the role of T lymphocytes in the immune response to cancer? A. They produce antibodies B. They recognize and destroy tumor-associated antigens C. They enhance blood flow to tumors D. They stimulate angiogenesis Rationale: T lymphocytes, particularly cytotoxic T cells, play a crucial role in recognizing and destroying cells that present tumor-associated antigens, thereby combating cancer. A nurse is assessing a patient with atelectasis. Which of the following findings would the nurse expect to observe? A) Decreased tactile fremitus B) Increased breath sounds C) Central cyanosis D) Dullness to percussion Rationale: Central cyanosis is a late sign of hypoxemia and can occur with atelectasis due to impaired gas exchange. Which of the following interventions should be included in the plan of care for a patient at risk for postoperative atelectasis? A) Encourage prolonged bed rest B) Use of incentive spirometry C) Limit fluid intake D) Administer high-flow oxygen Rationale: Incentive spirometry encourages deep breathing and lung expansion, reducing the risk of atelectasis. A nurse is caring for a patient with a pneumothorax. Which of the following findings would indicate a tension pneumothorax? A) Decreased respiratory rate B) Shift of the mediastinum C) Decreased heart rate D) Clear lung sounds bilaterally Rationale: A tension pneumothorax can cause the mediastinum to shift toward the unaffected side due to increased pressure in the pleural space. A patient presents with pleuritic chest pain and dyspnea. Which diagnostic test would most likely confirm the presence of pleural effusion? A) Chest X-ray B) CT scan of the chest C) Bronchoscopy D) Sputum culture Rationale: A chest X-ray is typically used to identify the presence of pleural effusion. A nurse is educating a patient about the use of a Heimlich valve after chest tube insertion. What statement indicates the patient understands the purpose of the Heimlich valve? A) "It helps to increase the pressure in my chest." B) "It prevents air from entering my pleural space." C) "It allows me to breathe more easily without the chest tube." D) "It allows me to go home while the chest tube is in place." Rationale: A Heimlich valve is a one-way valve that allows air to escape but prevents it from entering the pleural space, enabling mobility and discharge with the chest tube. A nurse observes a patient with a pleural effusion who is experiencing difficulty lying flat. What is the most appropriate nursing intervention? A) Place the patient in a supine position B) Administer pain medication C) Elevate the head of the bed D) Encourage deep breathing exercises Rationale: Elevating the head of the bed helps relieve dyspnea and discomfort associated with pleural effusion. In a patient with atelectasis, which of the following assessments would indicate the need for immediate intervention? A) Low O2 saturation ( 90%) B) Mild cough C) Clear lung sounds D) Patient reports of mild dyspnea Rationale: A low O2 saturation indicates significant hypoxemia, requiring immediate intervention to improve oxygenation. A patient with a history of lung cancer develops a pleural effusion. The nurse expects which type of fluid to be present? A) Transudate B) Exudate C) Purulent D) Hemorrhagic Rationale: In malignancies like lung cancer, pleural effusions are often exudative due to increased capillary permeability. What is the priority nursing action for a patient experiencing symptoms of pneumothorax? A) Encourage the patient to take deep breaths B) Administer supplemental oxygen C) Notify the healthcare provider D) Position the patient in high Fowler's position Rationale: Immediate notification of the healthcare provider is crucial for timely intervention, including potential chest tube placement. Which of the following interventions is essential for a patient recovering from thoracentesis? A) Position the patient in a supine position B) Monitor respiratory status and vital signs C) Encourage ambulation immediately D) Restrict fluid intake Rationale: Monitoring is crucial after thoracentesis to assess for potential complications, including re-expansion pulmonary edema or pneumothorax. A nurse is planning care for a patient with a chest tube. Which of the following is a priority nursing action? A) Encourage the patient to cough B) Ensure the chest tube is clamped C) Assess the drainage system for leaks D) Change the dressing around the chest tube site Rationale: Assessing for leaks in the drainage system is crucial to maintain proper function and prevent complications. A patient presents with sudden shortness of breath and chest pain. Which assessment finding would be most indicative of a pneumothorax? A) Hypoactive bowel sounds B) Decreased breath sounds on one side C) Dullness to percussion D) Increased tactile fremitus Rationale: Decreased breath sounds on one side are a classic finding in pneumothorax due to air in the pleural space. Which statement by the patient indicates a need for further education regarding incentive spirometry? A) "I will use this every hour while I'm awake." B) "I should hold my breath for 2-3 seconds after inhaling." C) "I can use this while lying flat in bed." D) "I need to repeat the steps 10 times in an hour." Rationale: The patient should be in an upright position to effectively use incentive spirometry. Which nursing intervention is most important when administering Isoniazid (INH) for TB? A) Monitor for signs of hepatotoxicity B) Assess for allergic reactions C) Teach the patient about dietary restrictions D) Administer with food What is the priority nursing action when a patient receiving Rifampin reports yellowing of the skin? A) Reassure the patient that this is a common side effect B) Document the finding and continue monitoring C) Notify the healthcare provider immediately D) Advise the patient to increase fluid intake Which of the following is a key nursing consideration when administering Ethambutol? A) Monitor liver function tests B) Assess for vision changes C) Administer with milk D) Monitor blood pressure What is the recommended action for a nurse when a patient with TB expresses fear about their diagnosis? A) Provide educational materials about TB B) Minimize the patient's feelings and reassure them C) Refer the patient to a psychologist D) Avoid discussing the topic further Which lab test should be monitored for a patient taking Rifampin and Isoniazid concurrently? A) Complete blood count (CBC) B) Liver function tests C) Renal function tests D) Thyroid function tests When providing education about TB medications, which statement by the patient indicates a need for further teaching? A) "I need to take my medications exactly as prescribed." B) "I can stop taking the medication once I feel better." C) "I should report any signs of jaundice." D) "I should keep all my follow-up appointments." What dietary advice should the nurse provide to a patient taking Isoniazid? A) Increase calcium intake B) Avoid alcohol and tyramine-rich foods C) Eat high-fat meals D) Avoid carbohydrates In which situation should a nurse hold a dose of TB medication? A) The patient is experiencing a mild headache B) The patient reports a new rash C) The patient is experiencing abdominal pain D) The patient has a scheduled follow-up appointment Which nursing assessment is most crucial before initiating TB treatment with a new medication regimen? A) Assess for current medications and allergies B) Conduct a full respiratory assessment C) Obtain a baseline weight D) Evaluate nutritional status What should the nurse monitor closely in a patient taking Pyrazinamide? A) Blood glucose levels B) Visual acuity C) Uric acid levels D) Electrolyte levels Which instruction is essential for a patient receiving directly observed therapy (DOT) for TB? A) The patient can take medications at any time. B) The patient must take medications in front of a healthcare provider. C) The patient can skip doses if feeling well. D) The patient does not need follow-up appointments. What is the priority nursing diagnosis for a patient with active TB? A) Impaired gas exchange related to lung infection B) Ineffective coping related to diagnosis of TB C) Risk for infection related to immunosuppression D) Knowledge deficit related to disease process When should a nurse administer TB medications in relation to meals? A) Before meals B) With meals C) After meals D) It does not matter Which of the following should a nurse include in discharge teaching for a patient with TB? A) It is safe to return to work after 2 weeks of therapy. B) Continue to follow up until two negative cultures are obtained. C) Medications can be discontinued when symptoms improve. D) Avoid all contact with other people during treatment. What symptom should a nurse instruct a patient to report immediately when taking TB medications? A) Nausea B) Dizziness C) New visual changes D) Insomnia Which patient is at highest risk for developing TB? A) A 30-year-old female with asthma B) A 45-year-old male with a history of diabetes C) A 60-year-old male with chronic kidney disease D) A 25-year-old female who is immunocompromised due to HIV What is the most important nursing action when a patient is started on combination therapy for TB? A) Educate the patient about possible drug interactions B) Monitor the patient for therapeutic effects only C) Encourage medication adherence D) Assess for drug resistance Which patient assessment finding would indicate a potential side effect of Isoniazid? A) Hypertension B) Peripheral neuropathy C) Diarrhea D) Dry mouth What nursing action is appropriate for a patient receiving long-term TB therapy? A) Schedule follow-up visits every 6 months B) Instruct the patient to stop medications when feeling better C) Educate about potential side effects and when to report them D) Limit dietary protein intake What is an appropriate nursing intervention for a patient experiencing anxiety about TB treatment? A) Dismiss the patient's concerns as unfounded B) Refer the patient to a social worker immediately C) Provide information and answer questions about the treatment process D) Tell the patient to focus on positive thoughts What is the primary mode of transmission for Tuberculosis (TB)? A) Direct contact with infected surfaces B) Airborne transmission via respiratory secretions C) Vector-borne transmission D) Fecal-oral route Which of the following best describes the characteristics of Mycobacterium tuberculosis? A) Gram-negative anaerobic bacillus B) Acid-fast aerobic rod with a waxy cell wall C) Spirillium bacterium D) Non-pathogenic bacteria What is the Ghon complex in TB? A) A type of immune response B) A granuloma with a central area known as Ghon tubercle C) A method of diagnostic testing D) A form of TB vaccine What is the difference between latent TB and active TB? A) Latent TB is treatable; active TB is not. B) Latent TB has no symptoms; active TB is symptomatic. C) Latent TB is contagious; active TB is not. D) Latent TB is only found in children; active TB occurs in adults. Which of the following is a common clinical manifestation of TB? A) Fever and chills B) Night sweats C) Joint pain D) Headache What is the purpose of the Mantoux Tuberculin Skin Test (TST)? A) To diagnose active TB B) To determine if a person has been exposed to TB bacteria C) To assess lung function D) To measure oxygen saturation What does a positive IGRA (Interferon Gamma Release Assay) test indicate? A) The patient has active TB. B) The patient has been infected with TB bacteria. C) The patient has been vaccinated against TB. D) The patient has no history of TB exposure. Which medication is considered first-line treatment for active TB? A) Rifampin B) Isoniazid (INH) C) Ethambutol D) Pyrazinamide What is the most significant adverse effect of Isoniazid (INH)? A) Rash B) Nausea C) Hepatotoxicity D) Peripheral neuropathy What should a patient taking Rifampin be advised regarding body secretions? A) They may turn blue. B) They may turn yellow-green. C) They may turn red-orange. D) They will remain unchanged. Why should patients avoid alcohol while taking TB medications? A) Alcohol interacts with all medications. B) Alcohol increases the risk of hepatotoxicity. C) Alcohol causes drowsiness. D) Alcohol reduces the effectiveness of the treatment. What is a major concern when treating TB with medications? A) Drug resistance B) Medication adherence C) Gastrointestinal upset D) Allergic reactions