ATI RN
ATI Oncology Questions
1. The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breathe and the nurse’s rapid assessment reveals that the patient’s jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct answer: B
Rationale: Superior vena cava syndrome (SVCS) occurs when the superior vena cava, the large vein responsible for returning blood from the upper body to the heart, becomes obstructed or compressed, often due to a tumor, such as metastasized breast cancer. SVCS results in impaired venous drainage, leading to symptoms like distended jugular veins, facial swelling, difficulty breathing (dyspnea), and upper body edema. It is a medical emergency that requires prompt intervention to restore blood flow and alleviate symptoms.
2. The clinical nurse educator is presenting health promotion education to a patient who will be treated for non-Hodgkin lymphoma on an outpatient basis. The nurse should recommend which of the following actions?
- A. Avoiding direct sun exposure in excess of 15 minutes daily
- B. Avoiding grapefruit juice and fresh grapefruit
- C. Avoiding highly crowded public places
- D. Using an electric shaver rather than a razor
Correct answer: C
Rationale: Patients with non-Hodgkin lymphoma (NHL) often experience a compromised immune system due to both the disease itself and the effects of treatments like chemotherapy and radiation, which cause myelosuppression (decreased production of blood cells, including white blood cells). This puts them at significant risk for infections. Avoiding crowded places is a crucial preventive measure, as it reduces the patient's exposure to pathogens that could lead to infections, which can be particularly severe due to their weakened immune system.
3. An oncology nurse educator is providing health education to a patient who has been diagnosed with skin cancer. The patient’s wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?
- A. Malignant cells contain more fibronectin than normal body cells.
- B. Malignant cells contain proteins called tumor-specific antigens.
- C. Chromosomes contained in cancer cells are more durable and stable than those of normal cells.
- D. The nuclei of cancer cells are unusually large, but regularly shaped.
Correct answer: B
Rationale: Malignant (cancer) cells often express tumor-specific antigens (TSAs), which are proteins or markers on the surface of cancer cells that are not found on normal cells. These antigens are produced due to genetic mutations in cancer cells and can sometimes be used to help the immune system recognize and attack cancerous cells. Tumor-specific antigens play a key role in cancer diagnosis, monitoring, and targeted therapies.
4. The cells of a normal individual can replicate in a specified rate. If the rate of replication becomes uncontrollable, which of the following is lacking from the patient?
- A. Apoptosis
- B. Contact inhibition
- C. Stable cells
- D. Labile cells
Correct answer: B
Rationale: Contact inhibition is a regulatory mechanism that prevents cells from proliferating once they reach a certain density. Normally, when cells grow and touch each other (such as in a monolayer), they stop dividing, maintaining tissue integrity and structure. When contact inhibition is lacking, as in many cancerous cells, cells continue to grow and divide uncontrollably, leading to tumor formation. This loss of regulation is a hallmark of cancerous growth.
5. A nurse working with oncology clients knows that an age-related decrease in which function increases the older client’s susceptibility to infection during chemotherapy?
- A. Immune function.
- B. Kidney function.
- C. Liver function.
- D. Cardiac function.
Correct answer: A
Rationale: As people age, the immune system becomes less efficient, a phenomenon known as immunosenescence. This decline in immune function includes reduced production of immune cells (such as T cells and B cells) and diminished responses to infections. During chemotherapy, which further suppresses the immune system, older clients are at a significantly higher risk of developing infections due to this age-related decrease in immune function. This is especially concerning because chemotherapy targets rapidly dividing cells, which include immune cells, making it even harder for the body to fight off infections.
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