A nurse is outlining a diet which would be helpful in the prevention of cancer.
Which instructions should the nurse include? (Select all that apply.)
Limit intake of red meat and processed food.
Keep alcohol consumption in moderation.
Limit intake of fruits and vegetables.
Be sure to include plenty of nitrites and nitrates in the diet.
Encourage smoked, salt-cured, and charred (blackened) food in the diet.
Correct Answer : A,B
Choice A rationale
Limiting red meat and processed foods is crucial due to their association with increased cancer risk. Red meats contain heme iron and can form N-nitroso compounds during processing or high-temperature cooking, both of which are genotoxic and promote cellular proliferation. Processed meats often contain carcinogens like nitrates and nitrites used as preservatives, which can be converted to carcinogenic nitrosamines in the body, contributing to colorectal cancer risk.
Choice B rationale
Moderate alcohol consumption is advised because ethanol and its metabolite, acetaldehyde, are classified as human carcinogens. Acetaldehyde can cause DNA damage and impair DNA repair mechanisms, leading to mutations that initiate carcinogenesis. Alcohol also influences hormone levels, particularly estrogen, increasing the risk of hormone-sensitive cancers such as breast cancer. It can also cause oxidative stress.
Choice C rationale
Limiting intake of fruits and vegetables is scientifically incorrect for cancer prevention. Fruits and vegetables are rich in antioxidants, vitamins, and phytochemicals. Antioxidants, like vitamin C and E, neutralize free radicals, which are unstable molecules that can damage DNA and contribute to cancer development. Phytochemicals, such as flavonoids and carotenoids, exhibit anti-proliferative and pro-apoptotic effects on cancer cells, inhibiting tumor growth.
Choice D rationale
Including plenty of nitrites and nitrates in the diet is detrimental for cancer prevention. While naturally occurring nitrates in vegetables are generally safe, synthetic nitrites and nitrates, especially in processed meats, can be converted into carcinogenic N-nitroso compounds (nitrosamines) in the gastrointestinal tract. These compounds are potent mutagens that can damage DNA and initiate tumor formation, increasing the risk of various cancers.
Choice E rationale
Encouraging smoked, salt-cured, and charred (blackened) food in the diet increases cancer risk. Smoking and charring meats at high temperatures produce heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs). These compounds are potent carcinogens that can bind to DNA, forming adducts that lead to mutations and promote tumor development in various organs, including the colon, stomach, and prostate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Limiting cold and sun exposure is a correct understanding of skin care during external radiation therapy. Radiation causes direct cellular damage to basal epidermal cells, impairing skin barrier function and increasing sensitivity. Cold can cause vasoconstriction, reducing blood flow to compromised skin and hindering repair. Ultraviolet radiation from the sun further damages DNA, exacerbating inflammation and increasing the risk of erythema, hyperpigmentation, and long-term skin changes like telangiectasias.
Choice B rationale
Scrubbing the radiation markings while showering is an incorrect understanding and can harm the irradiated skin. Radiation causes desquamation, thinning, and increased fragility of the skin due to damage to keratinocytes and fibroblasts. Vigorous scrubbing can lead to further skin breakdown, irritation, and infection by disrupting the compromised epidermal barrier. Markings are essential for accurate daily treatment delivery and should be preserved.
Choice C rationale
Using any type of lotions, potions, or salves is an incorrect understanding of skin care during radiation therapy. Many commercial products contain irritants, alcohol, or fragrances that can exacerbate skin reactions like erythema, pruritus, and desquamation. Petroleum-based products can create a barrier that interferes with the radiation beam's effectiveness. Only physician-approved, non-irritating, water-soluble lotions should be used to soothe and hydrate the skin.
Choice D rationale
Removing any markings for radiation treatment is an incorrect understanding and can compromise the accuracy and effectiveness of radiation therapy. The markings, often temporary tattoos or indelible ink, are precisely placed by the radiation oncologist and dosimetrist to ensure that the radiation beam is accurately directed to the target tumor volume. Their removal would necessitate remarking, potentially leading to treatment delays or inaccuracies.
Correct Answer is A
Explanation
Choice A rationale
Ondansetron is a serotonin 5-HT3 receptor antagonist, which blocks serotonin's action at the chemoreceptor trigger zone and vagal afferent neurons in the gastrointestinal tract. This mechanism effectively reduces nausea and vomiting by preventing the activation of emetic pathways. Administering it as an orally disintegrating tablet (ODT) can be beneficial for patients experiencing significant nausea, as it bypasses the need for swallowing and can be absorbed quickly.
Choice B rationale
Encouraging large, high-calorie meals can exacerbate nausea and vomiting in chemotherapy patients. The gastrointestinal system is often compromised due to the cytotoxic effects of chemotherapy, leading to delayed gastric emptying and increased gastric distension, which can trigger or worsen emetic responses. Small, frequent meals are generally better tolerated to minimize gastrointestinal distress.
Choice C rationale
While ginger is sometimes anecdotally used for nausea, offering ginger ale and crackers before meals may not be universally effective and could even worsen symptoms for some patients due to the sugar content in ginger ale or the dry texture of crackers. The primary focus should be on evidence-based antiemetic pharmacotherapy to manage chemotherapy-induced nausea and vomiting.
Choice D rationale
Instructing the patient to lie down immediately after eating can worsen nausea and reflux, especially if they are experiencing delayed gastric emptying or gastroparesis, common side effects of chemotherapy. Lying flat can promote the backflow of stomach contents into the esophagus. It is generally recommended to remain upright for at least 30 minutes to an hour after meals.
Choice E rationale
Limiting fluid intake to prevent excessive hydration is an incorrect intervention. Chemotherapy patients are at risk for dehydration due to vomiting, diarrhea, and decreased oral intake. Adequate hydration is crucial for maintaining renal function, electrolyte balance, and overall well-being. Encouraging small, frequent sips of fluid is generally recommended.
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