Title: ASN 210 Week 3 Post Quiz (Remotely Proctored)
Course: 16SP-ASN-210-GH1A1-ADV NUR THROUGH LIFESPAN I > Section: Week 3

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Q: Which statement about carcinogenesis is accurate?
- An initiated cell will always become clinical cancer.
- Cancer becomes a health problem once it is 1 cm in size.
- Normal hormones and proteins do not promote cancer growth.
- Tumor cells need to develop their own blood supply.
A: Tumor cells need to develop their own blood supply.
If right: Tumors need to develop their own blood supply through a process called angiogenesis. An initiated cell needs a promoter to continue its malignant path. Normal hormones and proteins in the body can act as promoters. A 1-cm tumor is a detectable size, but other events have to occur for it to become a health problem.
If wrong: Tumors need to develop their own blood supply through a process called angiogenesis. An initiated cell needs a promoter to continue its malignant path. Normal hormones and proteins in the body can act as promoters. A 1-cm tumor is a detectable size, but other events have to occur for it to become a health problem.

Q: The student nurse learning about cellular regulation understands that which process occurs during the S phase of the cell cycle?
- Actual division (mitosis)
- Doubling of DNA
- Growing extra membrane
- No reproductive activity
A: Doubling of DNA
If right: During the S phase, the cell must double its DNA content through DNA synthesis. Actual division, or mitosis, occurs during the M phase. Growing extra membrane occurs in the G<sub>1</sub> phase. During the G<sub>0</sub> phase, the cell is working but is not involved in any reproductive activity.
If wrong: During the S phase, the cell must double its DNA content through DNA synthesis. Actual division, or mitosis, occurs during the M phase. Growing extra membrane occurs in the G<sub>1</sub> phase. During the G<sub>0</sub> phase, the cell is working but is not involved in any reproductive activity.

Q: The nursing student learning about cancer development remembers characteristics of normal cells. Which characteristics does this include? <b>(Select all that apply.)</b>
- Differentiated function
- Large nucleus-to-cytoplasm ratio
- Loose adherence
- Nonmigratory
- Specific morphology
A: Differentiated function; Nonmigratory; Specific morphology
If right: Normal cells have the characteristics of differentiated function, nonmigratory, specific morphology, a smaller nucleus-to-cytoplasm ratio, tight adherence, and orderly and well-regulated growth.
If wrong: Normal cells have the characteristics of differentiated function, nonmigratory, specific morphology, a smaller nucleus-to-cytoplasm ratio, tight adherence, and orderly and well-regulated growth.

Q: The nursing instructor explains the difference between normal cells and benign tumor cells. What information does the instructor provide about these cells?
- Benign tumors grow through invasion of other tissue.
- Benign tumors have lost their cellular regulation from contact inhibition.
- Growing in the wrong place or time is typical of benign tumors.
- The loss of characteristics of the parent cells is called anaplasia.
A: Growing in the wrong place or time is typical of benign tumors.
If right: Benign tumors are basically normal cells growing in the wrong place or at the wrong time. Benign cells grow through hyperplasia, not invasion. Benign tumor cells retain contact inhibition. Anaplasia is a characteristic of cancer cells.
If wrong: Benign tumors are basically normal cells growing in the wrong place or at the wrong time. Benign cells grow through hyperplasia, not invasion. Benign tumor cells retain contact inhibition. Anaplasia is a characteristic of cancer cells.

Q: The nurse working with oncology clients understands that interacting factors affect cancer development. Which factors does this include? <b>(Select all that apply.)</b>
- Exposure to carcinogens
- Genetic predisposition
- Immune function
- Normal doubling time
- State of euploidy
A: Exposure to carcinogens; Genetic predisposition; Immune function
If right: The three interacting factors needed for cancer development are exposure to carcinogens, genetic predisposition, and immune function.
If wrong: The three interacting factors needed for cancer development are exposure to carcinogens, genetic predisposition, and immune function.

Q: The nurse caring for oncology clients knows that which form of metastasis is the most common?
- Bloodborne
- Direct invasion
- Lymphatic spread
- Via bone marrow
A: Bloodborne
If right: Bloodborne metastasis is the most common way for cancer to metastasize. Direct invasion and lymphatic spread are other methods. Bone marrow is not a medium in which cancer spreads, although cancer can occur in the bone marrow.
If wrong: Bloodborne metastasis is the most common way for cancer to metastasize. Direct invasion and lymphatic spread are other methods. Bone marrow is not a medium in which cancer spreads, although cancer can occur in the bone marrow.

Q: A student nurse asks the nursing instructor what “apoptosis” means. What response by the instructor is best?
- Growth by cells enlarging
- Having the normal number of chromosomes
- Inhibition of cell growth
- Programmed cell death
A: Programmed cell death
If right: Apoptosis is programmed cell death. With this characteristic, organs and tissues function with cells that are at their peak of performance. Growth by cells enlarging is hyperplasia. Having the normal number of chromosomes is euploidy. Inhibition of cell growth is contact inhibition.
If wrong: Apoptosis is programmed cell death. With this characteristic, organs and tissues function with cells that are at their peak of performance. Growth by cells enlarging is hyperplasia. Having the normal number of chromosomes is euploidy. Inhibition of cell growth is contact inhibition.

Q: Which are steps in the process of making an antigen-specific antibody? <b>(Select all that apply.)</b>
- Antibody-antigen binding
- Invasion
- Opsonization
- Recognition
- Sensitization
A: Antibody-antigen binding; Invasion; Recognition; Sensitization
If right: The seven steps in the process of making antigen-specific antibodies are: exposure/invasion, antigen recognition, sensitization, antibody production and release, antigen-antibody binding, antibody binding actions, and sustained immunity. Opsonization is the adherence of an antibody to the antigen, marking it for destruction.
If wrong: The seven steps in the process of making antigen-specific antibodies are: exposure/invasion, antigen recognition, sensitization, antibody production and release, antigen-antibody binding, antibody binding actions, and sustained immunity. Opsonization is the adherence of an antibody to the antigen, marking it for destruction.

Q: The student nurse learns that the most important function of inflammation and immunity is which purpose?
- Destroying bacteria before damage occurs
- Preventing any entry of foreign material
- Providing protection against invading organisms
- Regulating the process of self-tolerance
A: Providing protection against invading organisms
If right: The purpose of inflammation and immunity is to provide protection to the body against invading organisms, whether they are bacterial, viral, protozoal, or fungal. These systems eliminate, destroy, or neutralize the offending agents. The cells of the immune system are the only cells that can distinguish self from non-self. This function is generalized and incorporates destroying bacteria, preventing entry of foreign invaders, and regulating self-tolerance.
If wrong: The purpose of inflammation and immunity is to provide protection to the body against invading organisms, whether they are bacterial, viral, protozoal, or fungal. These systems eliminate, destroy, or neutralize the offending agents. The cells of the immune system are the only cells that can distinguish self from non-self. This function is generalized and incorporates destroying bacteria, preventing entry of foreign invaders, and regulating self-tolerance.

Q: The student nurse is learning about the functions of different antibodies. Which principles does the student learn? <b>(Select all that apply.)</b>
- IgA is found in high concentrations in secretions from mucous membranes.
- IgD is present in the highest concentrations in mucous membranes.
- IgE is associated with antibody-mediated hypersensitivity reactions.
- IgG comprises the majority of the circulating antibody population.
- IgM is the first antibody formed by a newly sensitized B cell.
A: IgA is found in high concentrations in secretions from mucous membranes.; IgE is associated with antibody-mediated hypersensitivity reactions.; IgG comprises the majority of the circulating antibody population.; IgM is the first antibody formed by a newly sensitized B cell.
If right: Immunoglobulin A (IgA) is found in high concentrations in secretions from mucous membranes. Immunoglobulin E (IgE) is associated with antibody-mediated hypersensitivity reactions. The majority of the circulating antibody population consists of immunoglobulin G (IgG). The first antibody formed by a newly sensitized B cell is immunoglobulin M (IgM). Immunoglobulin D (IgD) is typically present in low concentrations.
If wrong: Immunoglobulin A (IgA) is found in high concentrations in secretions from mucous membranes. Immunoglobulin E (IgE) is associated with antibody-mediated hypersensitivity reactions. The majority of the circulating antibody population consists of immunoglobulin G (IgG). The first antibody formed by a newly sensitized B cell is immunoglobulin M (IgM). Immunoglobulin D (IgD) is typically present in low concentrations.

Q: The nurse working with clients who have autoimmune diseases understands that what component of cell-mediated immunity is the problem?
- CD4+ cells
- Cytotoxic T cells
- Natural killer cells
- Suppressor T cells
A: Suppressor T cells
If right: Suppressor T cells help prevent hypersensitivity to one’s own cells, which is the basis for autoimmune disease. CD4+ cells are also known as helper/inducer cells, which secrete cytokines. Natural killer cells have direct cytotoxic effects on some non-self cells without first being sensitized. Suppressor T cells have an inhibitory action on the immune system. Cytotoxic T cells are effective against self cells infected by parasites such as viruses or protozoa.
If wrong: Suppressor T cells help prevent hypersensitivity to one’s own cells, which is the basis for autoimmune disease. CD4+ cells are also known as helper/inducer cells, which secrete cytokines. Natural killer cells have direct cytotoxic effects on some non-self cells without first being sensitized. Suppressor T cells have an inhibitory action on the immune system. Cytotoxic T cells are effective against self cells infected by parasites such as viruses or protozoa.

Q: The nurse working in an organ transplantation program knows that which individual is typically the best donor of an organ?
- Child
- Identical twin
- Parent
- Same-sex sibling
A: Identical twin
If right: The recipient’s immune system recognizes donated tissues as non-self except in the case of an identical twin, whose genetic makeup is identical to the recipient.
If wrong: The recipient’s immune system recognizes donated tissues as non-self except in the case of an identical twin, whose genetic makeup is identical to the recipient.

Q: The nurse understands that which type of immunity is the longest acting?
- Artificial active
- Inflammatory
- Natural active
- Natural passive
A: Natural active
If right: Natural active immunity is the most effective and longest acting type of immunity. Artificial and natural passive do not last as long. “Inflammatory” is not a type of immunity.
If wrong: Natural active immunity is the most effective and longest acting type of immunity. Artificial and natural passive do not last as long. “Inflammatory” is not a type of immunity.

Q: The student nurse caring for clients who have cancer understands that the general consequences of cancer include which client problems? <b>(Select all that apply.)</b>
- Clotting abnormalities from thrombocythemia
- Increased risk of infection from white blood cell deficits
- Nutritional deficits such as early satiety and cachexia
- Potential for reduced gas exchange
- Various motor and sensory deficits
A: Increased risk of infection from white blood cell deficits; Nutritional deficits such as early satiety and cachexia; Potential for reduced gas exchange; Various motor and sensory deficits
If right: The general consequences of cancer include reduced immunity and blood-producing functions, altered GI structure and function, decreased respiratory function, and motor and sensory deficits. Clotting problems often occur due to thrombocytopenia (not enough platelets), not thrombocythemia (too many platelets).
If wrong: The general consequences of cancer include reduced immunity and blood-producing functions, altered GI structure and function, decreased respiratory function, and motor and sensory deficits. Clotting problems often occur due to thrombocytopenia (not enough platelets), not thrombocythemia (too many platelets).

Q: The nurse working with oncology clients understands that which age-related change increases the older client’s susceptibility to infection during chemotherapy?
- Decreased immune function
- Diminished nutritional stores
- Existing cognitive deficits
- Poor physical reserves
A: Decreased immune function
If right: As people age, there is an age-related decrease in immune function, causing the older adult to be more susceptible to infection than other clients. Not all older adults have diminished nutritional stores, cognitive dysfunction, or poor physical reserves.
If wrong: As people age, there is an age-related decrease in immune function, causing the older adult to be more susceptible to infection than other clients. Not all older adults have diminished nutritional stores, cognitive dysfunction, or poor physical reserves.

Q: The nurse has taught a client with cancer ways to prevent infection. What statement by the client indicates that more teaching is needed?
- “I should take my temperature daily and when I don’t feel well.”
- “I will wash my toothbrush in the dishwasher once a week.”
- “I won’t let anyone share any of my personal items or dishes.”
- “It’s alright for me to keep my pets and change the litter box.”
A: “It’s alright for me to keep my pets and change the litter box.”
If right: Clients should wash their hands after touching their pets and should not empty or scoop the cat litter box. The other statements are appropriate for self-management.
If wrong: Clients should wash their hands after touching their pets and should not empty or scoop the cat litter box. The other statements are appropriate for self-management.

Q: Four clients are receiving tyrosine kinase inhibitors (TKIs). Which of these four clients should the nurse assess first?
- Client with dry, itchy, peeling skin
- Client with a serum calcium of 9.2 mg/dL
- Client with a serum potassium of 2.8 mEq/L
- Client with a weight gain of 0.5 pound (1.1 kg) in 1 day
A: Client with a serum potassium of 2.8 mEq/L
If right: TKIs can cause electrolyte imbalances. This potassium level is very low, so the nurse should assess this client first. Dry, itchy, peeling skin can be a problem in clients receiving biologic response modifiers, and the nurse should assess that client next because of the potential for discomfort and infection. This calcium level is normal. TKIs can also cause weight gain, but the client with the low potassium level is more critical.
If wrong: TKIs can cause electrolyte imbalances. This potassium level is very low, so the nurse should assess this client first. Dry, itchy, peeling skin can be a problem in clients receiving biologic response modifiers, and the nurse should assess that client next because of the potential for discomfort and infection. This calcium level is normal. TKIs can also cause weight gain, but the client with the low potassium level is more critical.

Q: After receiving the hand-off report, which client should the oncology nurse see first?
- Client who is afebrile with a heart rate of 108 beats/min
- Older client on chemotherapy with mental status changes
- Client who is neutropenic and in protective isolation
- Client scheduled for radiation therapy today
A: Older client on chemotherapy with mental status changes
If right: Older clients often do not exhibit classic signs of infection, and often mental status changes are the first observation. Clients on chemotherapy who become neutropenic also often do not exhibit classic signs of infection. The nurse should assess the older client first. The other clients can be seen afterward.
If wrong: Older clients often do not exhibit classic signs of infection, and often mental status changes are the first observation. Clients on chemotherapy who become neutropenic also often do not exhibit classic signs of infection. The nurse should assess the older client first. The other clients can be seen afterward.

Q: A nurse works with clients who have alopecia from chemotherapy. What action by the nurse takes priority?
- Helping clients adjust to their appearance
- Reassuring clients that this change is temporary
- Referring clients to a reputable wig shop
- Teaching measures to prevent scalp injury
A: Teaching measures to prevent scalp injury
If right: All of the actions are appropriate for clients with alopecia. However, the priority is client safety, so the nurse should first teach ways to prevent scalp injury.
If wrong: All of the actions are appropriate for clients with alopecia. However, the priority is client safety, so the nurse should first teach ways to prevent scalp injury.

Q: A nurse works on an oncology unit and delegates personal hygiene to an unlicensed assistive personnel (UAP). What action by the UAP requires intervention from the nurse?
- Allowing a very tired client to skip oral hygiene and sleep
- Assisting clients with washing the perianal area every 12 hours
- Helping the client use a soft-bristled toothbrush for oral care
- Reminding the client to rinse the mouth with water or saline
A: Allowing a very tired client to skip oral hygiene and sleep
If right: Even though clients may be tired, they still need to participate in hygiene to help prevent infection. The other options are all appropriate.
If wrong: Even though clients may be tired, they still need to participate in hygiene to help prevent infection. The other options are all appropriate.