Patho chapter 13
A patient has a body mass index (BMI) of 33.7. Which terms can the nurse use in report to describe this finding?
A BMI of 33.7 is in the 30 to 34.9 range which is termed obese class I and obesity. Overweight is classified as 25 to 29.9 while obese class II is 35 to 39.9. Morbidly overweight is obese class III and is a BMI above 40.
A nurse is teaching about the mechanisms involved in alcohol-related carcinogenesis. Which mechanism should the nurse include in the teaching session?
Alcohol promotes carcinogenesis through generation of reactive oxygen species. Induction, not suppression, of cytochrome P-450 2E1 leads to the generation of reactive oxygen species. Increased, not decreased, procarcinogen activation occurs. The bystander effect occurs in radiotherapy, not in alcohol-related carcinogenesis
A woman has recently gained weight and now has a body mass index (BMI) of 30.1 kg/m 2. Which information should the nurse share with this patient regarding BMI and cancer?
Although the exact ways in which obesity increases cancer risk are not totally understood, possible mechanisms explaining obesity's correlation to increased cancer incidence include insulin-insulin-like growth factor 1 axis and sex hormones. Lower degrees of obesity are linked with lower increases in cancer risks. The mechanisms of obesity-associated cancer risks are unclear and may vary by type of tumor and distribution of body fat. High BMI is correlated to increased cancer risk.
A nurse is teaching a health class about the various cancer rates. Which information should the nurse include in the teaching session?
Among women, cancer increased in the following areas: thyroid, melanoma, kidney, pancreas, leukemia, liver, and corpus and uterus. Overall, cancer incidence rates in all racial and ethnic groups and genders combined were stable. Among men, cancer decreased in the following areas: lung/bronchus, colorectal, stomach, and larynx; thyroid cancer increased. For all cancer sites combined and all racial and ethnic groups, cancer incidence rates were higher among men than women.
Upon review of the findings (see chart), which data are most likely to make the nurse suspect that the patient's leukemia is from benzol inhalation?
Benzol inhalation is linked to leukemia in shoemakers and in workers in the rubber cement, explosives, and dyeing industries. Weakness can occur with many diseases, not just cancer, and is not helpful in identifying benzol inhalation. Cigar smoking is associated with cancers of the oral cavity, oropharynx, hypopharynx, larynx, esophagus, and lung, along with coronary heart disease and chronic obstructive pulmonary disease, but not with leukemia or benzol inhalation. Obesity has not been linked to benzol inhalation.
A nurse is discussing the nontargeted effects of ionizing radiation. What is the nurse describing?
Both the bystander and genomic instability effects have been termed "nontargeted" effects. Ionizing radiation acts not only as an initiator of premalignant cell clones but also as a promoter of preexisting premalignant cell alterations that cause mutations; but these facts do not describe the nontargeted effects of ionizing radiation. Developmental plasticity is the degree to which an organism's development is contingent on its environment and does not relate to nontargeted effects. Microribonucleic acid (miRNA) molecules are small RNA molecules that can target epigenetic regulation. The linear no-threshold relationship and linear-quadratic relationship are models that explain whether low-dose radiation will cause mutations or not.
During the history taking of a patient, a nurse discovers the patient is a bidi smoker. For which cancer should the nurse teach the patient precautionary information?
Case-controlled studies indicate bidi smoking can cause cancers of the respiratory and digestive sites. Bidi smoking, a small amount of tobacco wrapped in the leaf of another plant (used in South Asia), delivers higher amounts of nicotine per gram of tobacco and comparable or greater amounts of tar compared with cigarettes. Pipe smokers have an increased risk of dying from cancers of the lung, lip, throat, esophagus, larynx, pancreas, and colon and rectum. Bidi smoking is not associated with testis or renal system cancers.
A nurse is teaching a health class about the effects of tobacco smoking. Which information should the nurse include in the teaching session?
Cigarette smoking is carcinogenic and remains the most important cause of cancer. Tobacco smoking is more common among men (20.5% of adults) than women (15.8%). On average, smokers die 13 to 14 years earlier than nonsmokers. Older adults have the lowest percentage of smokers. It is more common among adults living below the poverty level (27.9%) than those at or above the poverty level (17.0%).
A nurse wants to teach about the dangers of smoking to a group with high risk. Which group should the nurse address first?
Cigarette smoking is more common among men (20.5%) than women (15.8%), and the prevalence varies by race or ethnicity, or both, with American Indians/Alaska Natives (21.8%) having the highest prevalence and Asians (10.7%) having the lowest.
A nurse is teaching the staff about an epigenetic process. Which information should the nurse include in the teaching session?
DNA mythelantin
A nurse is teaching how dietary components influence epigenetic factors. Which mechanisms should the nurse include?
Dietary components can act directly as mutagens or interfere with mutagen elimination. Nutritional factors may alter cellular processes such as the cell cycle and hormonal regulation. Nutrition is not involved in bystander effect; radiation involves bystander effect.
A nurse is teaching a health class about dietary factors that can increase the risk of colorectal cancer. Which information from the class indicates successful teaching?
Dietary factors, such as alcohol use and processed meats, are thought to increase the risk of colorectal cancer. Hot beverages are not associated with colorectal cancer. Diets high in calcium and fiber are protective against colorectal cancer.
Upon review of a child's history, a nurse discovers the child had many diagnostic radiography test performed in utero. Which cancer should the nurse monitor for in this child?
Exposure to diagnostic radiography in utero has been associated with childhood cancer, particularly leukemia. Breast, bone and uterus are not linked to cancer and diagnostic radiography in utero.
A nurse is teaching a health class about the effects of ultraviolet (UV) radiation. Which information should the nurse include in the teaching session?
Exposure to ultraviolet radiation can emanate from natural (sunlight) and artificial sources (electric lights, tanning lamps). UV radiation is known to cause specific gene mutations. The principal source of exposure for most people is sunlight, not radiation treatments. Skin exposure to UV radiation and ionizing radiation, as well as chemical (xenobiotic) agents/drugs, produces reactive oxygen species in large quantities. The degree of skin damage depends on the intensity and wavelength content, not connexons.
A nurse is talking about the specific cell type that allows transmission between generations. Which cell is the nurse describing?
Germ (sex) cells are the specific cell type that allows transmission between generations. Somatic cells do not transmit to future generations. Target cells are the ones that are damaged or irradiated, which may or may not be germ cells. Bystander cells are the unirradiated cells, which may or may not be germ cells.
Which dietary component should the nurse suggest when asked by a patient for foods to prevent cancer risk?
Green tea can help decrease cancer risk by suppressing cancer stem renewal. Omega-6 fatty acids, smoked sausage, and grilled, blackened foods should be avoided.
A woman is admitted for suspected melanoma. Which area should the nurse assess first?
In women, melanoma is more commonly found on the skin on the lower legs, between the shoulders, and the hips. In men, it is often found on the skin on the head, the neck, between the shoulders, and the hips.
Which information from the patient indicates to the nurse that teaching is successful about the rising incidence of human papillomavirus (HPV) and oropharyngeal cancers?
Individuals with P16-positive tumors have a better prognosis than those with P16-negative tumors. HPV-positive oral cancers are possibly associated with sex-related risk factors, whereas HPV-negative cancers are associated with tobacco and alcohol consumption. HPV oropharyngeal cancer causes P16 to be increased.
A nurse is teaching a wellness class about the relationship of air pollution to cancer risk. Which information from the class indicates successful teaching?
Indoor air pollution is considered more carcinogenic than outdoor air pollution, partly because of environmental cigarette smoke, which is classified as a human carcinogen. Radon is a naturally radioactive gas that is found in rocks and soils, becoming trapped in houses and underground mines. Because the levels of radon are greater in underground mines than in homes, the risk of lung cancer among miners is increased, even in nonsmokers. Notable outdoor (not indoor) pollutants include nitrogen oxides, particulates, and sulfur dioxide.
The nurse is formulating a care plan that includes dietary components to reduce cancer risk. Which information should the nurse share with the patient?
Isothiocyanates from cruciferous vegetables induce the expression of phase II detoxification enzymes, which is protective against cancer, especially colon cancer. Vitamins A and D may suppress cancer stem renewal and decrease cancer risk. Consumption of lycopene-rich vegetable juice was associated with significantly decreased damage to the DNA of lung epithelial cells in healthy adults. Fiber intake can help prevent cancer, especially colon. Cured meat intake is associated with colorectal cancer.
A patient wants to decrease colon cancer risk by exercising. How many hours a week should the nurse suggest?
Much of the literature suggests that between 3.5 and 4 hours of vigorous activity per week are necessary to optimize protection for colon cancer. 1.5 to 2 and 2.5 to 3 are not enough hours while 4.5 to 5 is too much.
A nurse is teaching a health class about risk factors for cancer. Which information from members of the class indicates successful teaching?
Occupational exposures, ionizing radiation, sun exposure, and obesity are risk factors for cancer. Adequate fruit and vegetable intake helps prevent cancer.
A nurse is teaching a health class about alcohol and cancer risks. Which information should the nurse include in the teaching session?
Overall, there are strong data linking alcohol with cancers of the mouth, pharynx, larynx, esophagus, liver, colon rectum, and breast. Alcohol interacts with smoke, increasing the risk of malignant tumors. Tobacco use and alcohol use are known etiologic factors in esophageal, head, and neck cancers. There is no consistent relationship between alcohol and cancers of the lung, prostate, kidney, or bladder. The evidence does not show any "safe limit" of alcohol intake.
Which phase of enzymes protect against xenobiotics in patients?
Phase II detoxification enzymes protect against a large array of reactive intermediates and non activated xenobiotics. Enzymes that activate xenobiotics are called phase I activation enzymes. There are no phases III and IV.
A nurse is teaching a health class about how physical activity reduces the risk of cancer. Which information indicates the class understands the types of cancer that can be reduced with activity?
Physical activity has been linked to the reduction of breast cancer and colon cancer. For colon cancer, physical activity increases gut motility, which reduces the length of time (transit time) that the bowel lining is exposed to potential mutagens. For breast cancer, vigorous physical activity may decrease exposure of breast tissue to ovarian hormones, insulin, and insulin growth factor (IGF). Chronic hepatitis B and C infection has been linked to liver cancer. Alcohol intake has been linked to oral, esophageal, and liver cancers. Kidney cancer has been linked to tobacco smoking and radiation.
Which term should the nurse use to describe the degree to which a patient's development is influenced by the environment?
The degree to which an organism's development is influenced by the environment is termed development plasticity. Transgenerational phenotype is transmitted to future generations via germline inheritance. Methylome is a set of nucleic acid methylation modifications in the genome or cell at birth. Genomic instability is an increased tendency of the genome to acquire mutations when various processes involved in maintaining and replicating the genome are dysfunctional; instability can occur from radiation.
Which term should the nurse use to describe the degree to which a patient's development is influenced by the environment? Methylome Genomic instability Developmental plasticity Transgenerational phenotype
The degree to which an organism's development is influenced by the environment is termed development plasticity. Transgenerational phenotype is transmitted to future generations via germline inheritance. Methylome is a set of nucleic acid methylation modifications in the genome or cell at birth. Genomic instability is an increased tendency of the genome to acquire mutations when various processes involved in maintaining and replicating the genome are dysfunctional; instability can occur from radiation.
Which cancer risks are decreased when a patient eats nonstarchy vegetables?
The risk of developing cancer of the mouth, stomach, and larynx is decreased when nonstarchy vegetables are consumed. Lung cancer and pancreatic cancer are not affected by nonstarchy vegetables. Fruits help decrease lung cancer, while foods containing folate decreases pancreatic cancer.
A patient drinks alcohol in excessive quantities. Which areas should the nurse monitor as they are most likely to develop cancer related to the alcohol consumption?
There are strong data linking alcohol with cancers of the mouth (oral cavity), pharynx, larynx, esophagus, liver, colorectum, and breast. Spleen cancer is not associated with alcohol intake.
A nurse is teaching about xenobiotics. Which information should the nurse include?
Xenobiotics include toxic, mutagenic, and carcinogenic chemicals, which are transported in the blood by lipoproteins, not through the lymphatic system. Xenobiotics penetrate lipid membranes. Xenobiotics are very common in the average human diet.
A patient uses a cell phone every day and is asking about the health risks associated with electromagnetic radiation sources and cancer. How should the nurse reply?
causes tumors over 7 year period.