An oncology nurse is contributing to the care of a patient who has failed to respond appreciably to conventional cancer treatments. As a result, the care team is considering the possible use of biologic response modifiers (BRFs). The nurse should know that these achieve a therapeutic effect by what means?

Correct Answer: B

Rationale: The correct answer is B: Focusing the patient's immune system exclusively on the tumor. Biologic response modifiers (BRMs) work by enhancing the body's natural defenses to target and attack cancer cells specifically. This approach helps the immune system to recognize and destroy cancer cells while minimizing harm to normal cells. A: Promoting the synthesis and release of leukocytes - This is not the primary mechanism of action for BRMs. While leukocytes play a role in the immune response, BRMs target the immune system's response to tumors. C: Potentiating the effects of chemotherapeutic agents and radiation therapy - While some BRMs may be used in combination with these treatments, their primary mode of action is not to enhance the effects of chemotherapy or radiation therapy. D: Altering the immunologic relationship between the tumor and the patient - This choice is too broad and vague. BRMs specifically aim to direct the immune response towards targeting the tumor cells, rather than altering the overall immunologic relationship

Correct Answer: A

Rationale: The correct answer is A: Accessibility of health care services. The nurse is monitoring disparities in access to healthcare services among different population groups. This is important as it can influence health outcomes and the prevalence of complications. Outcomes of health conditions (B) are impacted by access to care. Prevalence of complications (C) and incidence of diseases (D) can also be influenced by disparities in accessing healthcare services. However, the primary focus of the nurse's assessment in this scenario is on the accessibility of healthcare services as a key factor contributing to health care disparities.

Correct Answer: C

Rationale: The correct answer is C: Whisper test. The nurse can perform a whisper test by whispering a series of numbers or words at a distance from the child to see if they can repeat them accurately. If the child struggles to hear and repeat the whispered words, it could indicate hearing loss. Rationale: A: Audiometry is a comprehensive hearing test that measures the range and sensitivity of hearing, not suitable for a quick preliminary assessment. B: Rinne test and D: Weber test are both tuning fork tests used to assess conductive and sensorineural hearing loss, not ideal for a quick initial screening of hearing loss. Summary: The Whisper test is the most suitable choice as it provides a quick and simple way to preliminarily assess hearing loss by evaluating the child's ability to hear and repeat whispered sounds accurately.

Correct Answer: B

Rationale: The correct answer is B because pregnant patients with Class II heart disease should avoid strenuous activity to prevent further strain on the heart. Strenuous activity can increase the risk of complications in these patients. Option A is incorrect as excessive weight gain can exacerbate heart disease. Option C is incorrect because limiting fluid intake can lead to dehydration, which is harmful during pregnancy. Option D is incorrect as a diet high in calcium is not specifically indicated for pregnant patients with Class II heart disease.

Correct Answer: A

Rationale: The correct answer is A: Promotion of HPV immunization. This strategy is effective in preventing cervical cancer by targeting the main cause, which is Human Papillomavirus (HPV). The HPV vaccine can protect against the most common types of HPV that cause cervical cancer. Encouraging young women to delay first intercourse (B) does not directly prevent HPV transmission, as the virus can be transmitted through other means. Smoking cessation (C) is important for overall health but does not specifically prevent cervical cancer. Vitamin D and calcium supplementation (D) may have general health benefits but do not directly prevent cervical cancer. Using safer sex practices (E) can reduce the risk of HPV transmission but does not provide the same level of protection as HPV immunization.

Correct Answer: B

Rationale: The correct answer is B: Jejunostomy tube. This tube is chosen because the patient has a history of aspiration pneumonia, which puts them at risk for aspiration if feeds are administered into the stomach. By administering feeds through a jejunostomy tube, the risk of aspiration pneumonia is minimized as the feed bypasses the stomach. Nasogastric tube (A) and Nasointestinal tube (C) would still deliver feeds to the stomach, increasing the risk of aspiration. PEG tube (D) is also not ideal as it delivers feeds directly to the stomach, which is not recommended for patients at risk for aspiration.

Correct Answer: D

Rationale: The correct answer is D because it provides an accurate and comprehensive response to the pregnant patient's question about the risk of her baby being born with HIV. Here's the step-by-step rationale: 1. Option D acknowledges the possibility of the baby contracting HIV at different stages: before, during, or after delivery. This covers all potential scenarios and educates the patient about the risks. 2. By mentioning the different possible transmission times, the nurse highlights the importance of proper prenatal care, delivery planning, and postnatal care to minimize the risk of HIV transmission to the baby. 3. This response empowers the patient with knowledge about the potential risks and emphasizes the importance of seeking appropriate medical interventions to prevent mother-to-child transmission of HIV. 4. In contrast, options A, B, and C provide less informative or inaccurate responses that do not address the patient's concerns adequately, making them incorrect choices. In summary, option D is the best response as it educates the patient about the risks of HIV transmission

Correct Answer: C

Rationale: The correct answer is C: Lobules and ducts. Each lobe of the breast consists of lobules, which are responsible for milk production, and ducts, which transport the milk to the nipple. This is essential for breastfeeding. Modified tendons and ligaments (choice A) are not present in the lobes of the breast. Connective tissue and smooth muscle (choice B) are important components of the breast but do not specifically make up the lobes. Endocrine glands and sebaceous glands (choice D) are not the primary elements within the lobes of the breast responsible for milk production and transport. The lobules and ducts are vital components for the functioning of the breast in lactation.

Correct Answer: D

Rationale: The correct answer is D because setting the scanner to female is incorrect for a patient who has had a hysterectomy as they do not have a uterus. This could lead to inaccurate results. Palpating the symphysis pubis (A) ensures proper positioning, wiping the scanner head with alcohol (B) maintains infection control, and applying gel (C) facilitates sound wave transmission.