What finding supports the diagnosis of acquired immunodeficiency syndrome (AIDS) in the individual with HIV?

Correct Answer: D

Rationale: The correct answer is D) Cytomegalovirus retinitis. This finding supports the diagnosis of acquired immunodeficiency syndrome (AIDS) in an individual with HIV because cytomegalovirus retinitis is an opportunistic infection that typically occurs in individuals with severely compromised immune systems, such as those with advanced HIV/AIDS. Option A) Flu-like symptoms are non-specific and can be present in various conditions, not specific to AIDS. Option B) Oral hairy leukoplakia is often seen in individuals with HIV but is not a definitive indicator of AIDS. Option C) CD4+ T cells 200–500/µL is a low CD4 count, but the diagnosis of AIDS is typically based on a CD4 count below 200/µL or the presence of an AIDS-defining condition, like cytomegalovirus retinitis. Educationally, understanding the specific opportunistic infections associated with advanced HIV/AIDS is crucial for healthcare professionals to accurately diagnose and manage individuals with the disease. This knowledge helps in providing appropriate care and treatment to improve patient outcomes.

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.

Correct Answer: B

Rationale: In the context of aging, hyponatremia is a normal change due to age-related alterations in renal function and hormonal regulation. As individuals age, their kidneys become less efficient at conserving sodium, leading to a decreased ability to concentrate urine and retain sodium. This can result in a relative dilution of sodium in the body, contributing to hyponatremia in older adults. Hyperkalemia (option A) is not a normal change of aging. It is more commonly associated with conditions such as renal failure or certain medications. Decreased insensible fluid loss (option C) and increased plasma oncotic pressures (option D) are not typical age-related changes and are not directly related to fluid and electrolyte balance in the aging population. Understanding age-related changes in fluid and electrolyte balance is crucial for nurses caring for older adults to anticipate and address potential imbalances. By recognizing the normal physiological changes associated with aging, nurses can provide better care and prevent complications related to fluid and electrolyte disturbances in this population.