A nurse cares for a client who has a family history of colorectal cancer. The client states, "My father and my brother had colon cancer. What is the chance that I will get cancer?" How would the nurse respond?
"You should have a colonoscopy more frequently to identify abnormal polyps early."
"Preemptive surgery and chemotherapy will remove cancer cells and prevent cancer."
"You are safe. This is an autosomal dominant disorder that skips generations."
"If you eat a low-fat and low-fiber diet your chances decrease significantly."
The Correct Answer is A
Choice A reason: Having two first-degree relatives with colorectal cancer significantly increases an individual's lifetime risk. Clinical guidelines recommend that these high-risk individuals begin screening at an earlier age (usually age 40 or 10 years younger than the earliest diagnosis) and undergo more frequent colonoscopies to detect and remove precancerous polyps before they become malignant.
Choice B reason: Preemptive surgery (such as a total colectomy) and chemotherapy are extreme measures and are generally not indicated for someone with a family history unless they have a confirmed genetic syndrome like FAP. Prophylactic chemotherapy is not a standard medical practice for cancer prevention in the absence of a current diagnosis or high-stage disease.
Choice C reason: This statement is medically inaccurate and dangerous. Colorectal cancer risk does not "skip generations" in a predictable way. Furthermore, while some forms of colon cancer are autosomal dominant (like Lynch syndrome), having first-degree relatives with the disease always necessitates increased vigilance and screening rather than a false sense of security.
Choice D reason: While diet is a modifiable risk factor, a "low-fat and low-fiber" diet is actually associated with an increased risk of colorectal cancer. High fiber is protective. Furthermore, for someone with a strong familial predisposition, lifestyle changes alone are insufficient; they must be coupled with rigorous clinical surveillance via colonoscopy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Shortness of breath during rapid fluid resuscitation in a patient with acute kidney injury is a critical sign of fluid volume overload and impending pulmonary edema. Since the kidneys cannot effectively process and excrete the fluid, the nurse must immediately stop or slow the infusion to prevent further respiratory distress.
Choice B reason: While calculating the mean arterial pressure (MAP) is important for assessing perfusion status in a hypotensive patient, it is not the priority when the patient is showing signs of acute respiratory distress. The immediate physical threat to the patient's airway and breathing takes precedence over performing hemodynamic calculations.
Choice C reason: Taking the pulse is a necessary part of a physical assessment, but it does not treat the underlying cause of the patient's new-onset shortness of breath. The immediate priority is to cease the intervention (rapid fluid bolus) that is likely causing the acute physiological decompensation and fluid shift into the lungs.
Choice D reason: A pulmonary artery catheter is an invasive hemodynamic monitoring tool. While it may eventually be used in a critical care setting to manage complex fluid status, it is not an appropriate or timely first response to an acute episode of shortness of breath during a fluid bolus.
Correct Answer is A
Explanation
Choice A reason: Calcium acetate is a phosphate binder. In clients with CKD, the kidneys cannot excrete phosphorus, leading to hyperphosphatemia. Phosphate binders are taken with meals to bind phosphorus from food in the intestinal tract, forming an insoluble complex that is excreted in the feces, thereby reducing systemic absorption and serum levels.
Choice B reason: Doxycycline is a broad-spectrum tetracycline antibiotic. It is used to treat various bacterial infections and has no role in the management of phosphorus or electrolyte imbalances in chronic kidney disease. In fact, some tetracyclines must be used with caution in renal impairment due to potential nephrotoxicity or accumulation.
Choice C reason: Lisinopril is an ACE inhibitor used to manage hypertension and provide renal protection by reducing intraglomerular pressure in the early stages of CKD. While it is a common medication for these patients, it does not lower serum phosphorus levels and can actually cause a risk of hyperkalemia in advanced renal failure.
Choice D reason: Magnesium sulfate is an electrolyte replacement or anticonvulsant. It is generally avoided or used with extreme caution in CKD patients because the kidneys are responsible for magnesium excretion. Administering it could lead to magnesium toxicity (hypermagnesemia), and it has no clinical utility in the reduction of serum phosphorus.
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