Nursing Elites

1. The nurse knows that all of the following are risk factors for breast cancer except:

• A. Family history
• B. Nulliparity
• C. Chest xray
• D. Multiple sex partners

Correct answer: D

Rationale: Multiple sex partners are not a recognized risk factor for breast cancer. Breast cancer is primarily influenced by hormonal, genetic, and environmental factors, not sexual activity or the number of sexual partners. Established risk factors for breast cancer include family history, hormonal factors such as early menarche, late menopause, and nulliparity (having no children), as well as certain environmental exposures.

2. An older adult patient is undergoing diagnostic testing for chronic lymphocytic leukemia (CLL). What assessment finding is certain to be present if the patient has CLL?

• A. Increased numbers of blast cells
• B. Increased lymphocyte levels
• C. Intractable bone pain
• D. Thrombocytopenia with no evidence of bleeding

Correct answer: B

Rationale: An increased lymphocyte count (lymphocytosis) is always present in patients with CLL.

3. Gastric cancer is known to have numerous risk factors. Which of the following is not a risk factor?

• A. Diet high in sodium
• B. Diet with high amounts of chili garlic
• C. Smoking
• D. Diet high in fiber

Correct answer: D

Rationale: A diet high in fiber is not a risk factor for gastric cancer; in fact, it is generally considered protective against cancers. High sodium intake (Choice A) has been associated with an increased risk of gastric cancer. Diets with high amounts of chili garlic (Choice B) may irritate the stomach lining, potentially contributing to the development of gastric cancer. Smoking (Choice C) is a well-established risk factor for various types of cancers, including gastric cancer.

4. The healthcare professional working with oncology clients understands that which age-related change increases the older client’s susceptibility to infection during chemotherapy?

• A. Decreased immune function.
• B. Diminished nutritional stores.
• C. Existing cognitive deficits.
• D. Poor physical reserves.

Correct answer: A

Rationale: The correct answer is A: Decreased immune function. Aging leads to a decline in immune function, which increases susceptibility to infections during chemotherapy. This decline is due to changes in the immune system that occur with age. Choices B, C, and D are incorrect because while they may impact overall health in older clients, they do not directly increase susceptibility to infections during chemotherapy like decreased immune function does.

5. A patient’s most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the patient’s cancer cells spread?

• A. Hematologic spread
• B. Lymphatic circulation
• C. Invasion
• D. Angiogenesis

Correct answer: B

Rationale: In the case of lung cancer that has metastasized to the bones and liver, lymphatic circulation is a key mechanism by which cancer cells spread from the primary tumor site to distant organs. Cancer cells can invade nearby lymphatic vessels and travel through the lymphatic system, eventually reaching lymph nodes and spreading to other tissues and organs. This route is significant in the metastasis of many types of cancer, including lung cancer.

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