A 69-year-old woman asks the nurse whether it is possible to 'catch' cancer because many of her friends of the same age have been diagnosed with different kinds of cancer. In responding to the woman, the nurse understands that what factor increases the incidence of tumors in older adults?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Decreased size and activity of the thymus gland. As individuals age, the thymus gland undergoes involution, leading to a decrease in its size and activity. The thymus gland is crucial for the development and maturation of T lymphocytes, which play a key role in immune surveillance against cancer cells. Therefore, a decrease in thymus function can compromise the immune system's ability to detect and eliminate abnormal cells, increasing the incidence of tumors in older adults. Regarding the incorrect options: A) An increase in autoantibodies is not the primary factor contributing to the increased incidence of tumors in older adults. Autoantibodies are antibodies that mistakenly target the body's own tissues and cells, leading to autoimmune diseases, not cancer. B) Decreased activity of the bone marrow primarily affects the production of blood cells, not the development of tumors. C) Decreased differentiation of T lymphocytes may impact immune function but is not as directly linked to the increased incidence of tumors in older adults as the decreased size and activity of the thymus gland. Educationally, understanding the age-related changes in the immune system and their implications for cancer development is crucial for nurses and healthcare providers working with older adult populations. This knowledge can inform patient education, preventive care strategies, and early detection practices to promote better health outcomes in aging individuals.

Correct Answer: B

Rationale: In the case of a patient diagnosed with Clostridium difficile and presenting with diarrhea, the correct transmission-based precaution to be used by the nurse is Contact Precautions (Option B). Contact precautions are designed to prevent the spread of infections that are transmitted by direct or indirect contact. Clostridium difficile is primarily spread through contact with contaminated surfaces or objects, making contact precautions the most appropriate choice in this scenario. By wearing gloves and gowns when caring for the patient, the nurse can effectively prevent the transmission of the bacteria to themselves or other patients. Droplet precautions (Option A) are used for infections transmitted through respiratory droplets, such as influenza or pneumonia. Airborne precautions (Option D) are for infections that are transmitted through small particles that remain in the air for an extended period, like tuberculosis. Isolation precautions (Option C) is a general term that encompasses different types of precautions, including contact, droplet, and airborne precautions. In an educational context, understanding the appropriate use of transmission-based precautions is crucial for healthcare professionals to prevent the spread of infections within healthcare settings. By correctly identifying the specific precautions needed for different pathogens, nurses can provide safe and effective care while minimizing the risk of healthcare-acquired infections.

Correct Answer: A

Rationale: The correct answer is A) Kaposi sarcoma. Kaposi sarcoma is a type of cancer caused by human herpesvirus 8 (HHV-8) that often presents with hyperpigmented lesions on the skin, mucous membranes, lungs, and GI tract in individuals with weakened immune systems, such as those with AIDS. These lesions can be purple, brown, or red in color and are a hallmark of Kaposi sarcoma. Option B) Candida albicans is a fungal infection that commonly affects individuals with compromised immune systems, but it does not typically present with hyperpigmented lesions. Candidiasis is more commonly associated with white, patchy lesions in the mouth or genital area. Option C) Herpes simplex type 1 infection and Option D) Varicella-zoster virus infection both present with characteristic lesions (cold sores for herpes simplex and chickenpox or shingles for varicella-zoster), but these do not manifest as hyperpigmented lesions seen in Kaposi sarcoma. Understanding the characteristic presentations of opportunistic infections in individuals with AIDS is crucial for healthcare professionals to provide appropriate care and treatment. Recognizing the specific signs and symptoms of each infection helps in timely diagnosis and management, ultimately improving patient outcomes and quality of life.

Correct Answer: D

Rationale: The correct answer is D) Indiscriminate and continuous proliferation of cells with loss of contact inhibition. This option accurately describes a key defect in cellular proliferation that is involved in the development of cancer. Cancer cells lose the ability to stop dividing when they come into contact with other cells (contact inhibition) and continue to proliferate uncontrollably. Option A is incorrect because a rapid rate of cell proliferation alone is not indicative of cancer, as it can occur in normal physiological processes like wound healing. Option B is incorrect as skipping phases of the cell cycle is not a defining characteristic of cancer. Option C is incorrect as rearrangement of stem cell RNA leading to abnormal protein synthesis is not a common mechanism in the development of cancer. Educationally, understanding the defect in cellular proliferation that contributes to cancer development is crucial in pharmacology. By grasping this concept, healthcare professionals can comprehend the rationale behind anti-cancer drugs that target cell proliferation pathways. It also highlights the importance of regulating cell growth and division to prevent uncontrolled proliferation seen in cancer.

Correct Answer: B

Rationale: In the context of cancer screening for colorectal cancer in individuals over 50 with average risk, the appropriate recommendation is a colonoscopy every 10 years. This is the correct option because a colonoscopy is considered the gold standard for detecting colorectal cancer early, allowing for the removal of precancerous polyps before they develop into cancerous lesions. A) Barium enema every year is not the recommended screening test for colorectal cancer due to its lower sensitivity and specificity compared to colonoscopy. C) Fecal occult blood every 5 years may detect blood in the stool, which can indicate the presence of colorectal cancer, but it is not as comprehensive as a colonoscopy for detecting precancerous lesions and early-stage cancer. D) Annual prostate-specific antigen (PSA) and digital rectal exam are screening tests for prostate cancer, not colorectal cancer, making this option incorrect in the context of the question. Educationally, understanding the rationale behind appropriate cancer screening tests is crucial for nurses to provide evidence-based recommendations to patients. It is essential to know the guidelines for different types of cancer screenings to ensure patients receive the most effective and timely interventions for early detection and prevention of cancer.