To what is the increase in emerging and untreatable infections attributed (select all that apply)?

Correct Answer: A

Rationale: The correct answer includes options A, B, C, and E. The evolution of new infectious agents, inappropriate use of antibiotics, human encroachment into wilderness areas, and an increased number of immunosuppressed individuals contribute significantly to the rise in untreatable infections. Transmission from humans to animals is less relevant compared to zoonotic transmission from animals to humans.

Correct Answer: D

Rationale: In this scenario, the appropriate nursing intervention for a patient with acute HIV infection who is not yet ready to start antiretroviral therapy is to teach the patient about immune enhancement (option D). This intervention is crucial in empowering the patient to take an active role in managing their health. Teaching the patient about immune enhancement can help them understand the importance of strengthening their immune system through strategies such as proper nutrition, exercise, stress management, and avoiding opportunistic infections. By educating the patient on these aspects, they can potentially slow the progression of the disease and improve their overall well-being. Option A, assisting with end-of-life issues, is not appropriate at this stage of the illness as the patient is not in a terminal phase. Option B, providing care during acute exacerbations, is more reactive and does not address the proactive approach of immune enhancement. Option C, providing physical care for chronic diseases, is not as relevant because the patient is currently in the acute phase of HIV infection. From an educational perspective, understanding the rationale behind immune enhancement empowers nurses to engage patients in self-care practices that can positively impact their health outcomes. It also highlights the importance of individualized care and patient education in managing chronic conditions like HIV.

Correct Answer: A

Rationale: In pharmacology, understanding oncogenes is crucial for comprehending cancer development. The correct answer to the question, "Which word identifies a mutation of protooncogenes?" is A) Oncogenes. Protooncogenes are normal genes that can become oncogenes when mutated, leading to uncontrolled cell growth and potentially cancer. By selecting option A, students demonstrate knowledge of this transformation. Option B) Retrogenes are not related to protooncogenes or cancer development. Retrogenes are genes that are duplicated via reverse transcription and integration into the genome. Option C) Oncofetal antigens are markers found on cancer cells, not mutated genes involved in cancer initiation like protooncogenes. Option D) Tumor angiogenesis factor is a protein that promotes the growth of blood vessels to supply a tumor with nutrients, not directly related to protooncogene mutations. Educationally, understanding the distinction between protooncogenes and oncogenes is fundamental in recognizing the genetic basis of cancer. This knowledge aids in targeted therapies and prevention strategies. Students should grasp the concept that a normal gene, when mutated, can become an oncogene, driving abnormal cell proliferation and potentially leading to cancer.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Intraarterial. Regional chemotherapy involves delivering chemotherapy directly to a specific region of the body, in this case, the area affected by metastasis from primary colorectal cancer. Intraarterial delivery allows for the direct infusion of chemotherapy into the artery supplying the tumor, maximizing drug concentration at the site of action while minimizing systemic exposure and side effects. Option A) Intrathecal delivery involves administering medications into the spinal canal and is typically used for medications that need to reach the central nervous system, not for regional chemotherapy for colorectal cancer metastasis. Option C) Intravenous delivery is systemic and delivers medication throughout the entire body, which is not ideal for regional chemotherapy targeting a specific area. Option D) Intraperitoneal delivery involves administering medications into the peritoneal cavity and is more commonly used for certain types of cancers like ovarian cancer, not specifically for metastasis from primary colorectal cancer. Understanding the appropriate delivery system for chemotherapy is crucial in ensuring effective treatment outcomes and minimizing adverse effects. Educating healthcare professionals on the rationale behind choosing the right delivery system for specific conditions is essential for providing quality patient care in oncology settings.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) increase urine output with hydration therapy. When a patient with leukemia undergoing chemotherapy develops hyperkalemia and hyperuricemia, it indicates tumor lysis syndrome (TLS), which is an oncologic emergency. The priority treatment is to increase urine output through hydration therapy to prevent renal damage from the accumulation of metabolites released during rapid cell destruction. Option B) establish electrocardiographic (ECG) monitoring is incorrect because while ECG monitoring is important in assessing cardiac function, it is not the priority in this situation where renal function is at risk due to TLS. Option C) administer a bisphosphonate such as pamidronate (Aredia) is incorrect as bisphosphonates are used to manage hypercalcemia caused by malignancy or bone metastases, not hyperkalemia and hyperuricemia. Option D) restrict fluids and administer hypertonic sodium chloride solution is incorrect because restricting fluids can exacerbate the renal damage caused by TLS, and hypertonic sodium chloride solution may worsen hyperkalemia. Educationally, understanding the pathophysiology of TLS and its management is crucial for nurses caring for patients undergoing chemotherapy. Recognizing the signs of TLS and knowing the appropriate interventions can help prevent potentially life-threatening complications in oncology patients. Prioritizing interventions based on the patient's condition is essential in providing safe and effective care.