D454 Adult Health III - Set 4 - Part 3

Correct Answer: The donated cells are infused intravenously

Option d is correct because hematopoietic stem cell transplant involves infusing the donated stem cells through an intravenous line, similar to a blood transfusion, and does not require a surgical incision. Option a is incorrect because stem cells are not injected directly into the bone marrow during transplantation, as the cells naturally migrate to the marrow space after being infused into the bloodstream through venous access. Option b is incorrect because hematopoietic stem cell transplant does not involve a large surgical incision, and correcting this misconception helps reduce patient anxiety about the transplant procedure and recovery process. Option c is incorrect because stem cells are not administered through a feeding tube, as they must enter the vascular system directly through intravenous infusion to circulate and engraft in the bone marrow.

Correct Answer: Hospitalization usually lasts two to four weeks

Option b is correct because patients undergoing hematopoietic stem cell transplant typically require hospitalization for two to four weeks for monitoring, infection prevention, and management of potential complications like graft-versus-host disease. Option a is incorrect because discharge within two to three days is far too early for stem cell transplant patients, as they require extended monitoring during the critical engraftment period when infection risk is highest. Option c is incorrect because three to six months of continuous inpatient hospitalization overstates the typical length of stay, though outpatient monitoring continues for an extended period after the initial hospital discharge. Option d is incorrect because the length of hospitalization is determined by clinical factors including engraftment status and complication management, not by insurance company authorization or financial considerations alone.

Correct Answer: Ask if he has any questions or concerns about it

Option a is correct because the best nursing approach is to invite the patient to express his questions and concerns, which validates his feelings and supports patient-centered communication during a difficult treatment decision. Option b is incorrect because emphasizing only positive outcomes without addressing the patient's expressed concerns is dismissive and does not support the therapeutic relationship or informed consent process. Option c is incorrect because discussing insurance coverage does not address the patient's emotional concerns about the procedure and shifts the conversation away from his expressed need to feel heard and supported. Option d is incorrect because implying that transplant is the only option may not be accurate and creates pressure that undermines the patient's autonomy in making an informed decision about his own treatment path.

Correct Answer: Active metastatic cancer requiring ongoing treatment

Option c is correct because metastatic cancer is an absolute contraindication to organ transplantation because the immunosuppressive therapy required after transplant would accelerate the growth and spread of existing cancer. Option a is incorrect because well-controlled diabetes does not automatically disqualify a patient from transplant candidacy, as many diabetic patients successfully receive kidney transplants with appropriate management plans in place. Option b is incorrect because a history of successfully treated hepatitis C no longer precludes transplant candidacy, as advances in antiviral therapy allow previously infected patients to be evaluated on individual disease status. Option d is incorrect because patients with human immunodeficiency virus who have achieved undetectable viral loads may still be considered transplant candidates depending on their overall health status and disease management.

Correct Answer: Immunosuppression after transplant would accelerate cancer growth

Option d is correct because the immunosuppressive medications required to prevent organ rejection would simultaneously suppress the immune system's ability to fight existing cancer, allowing metastatic disease to spread rapidly. Option a is incorrect because the surgical demands of transplantation are not the primary contraindication, as many critically ill patients tolerate transplant surgery when the underlying condition does not conflict with immunosuppressive therapy. Option b is incorrect because anesthesia tolerance is assessed individually and is not the reason metastatic cancer disqualifies transplant candidacy, as the contraindication relates specifically to post-transplant immunosuppression effects. Option c is incorrect because organ allocation decisions are based on medical contraindications and likelihood of success rather than categorical exclusion policies, and the real concern is the interaction between immunosuppression and active cancer.

Correct Answer: A cup of strawberry yogurt between meals

Option a is correct because strawberry yogurt provides both high protein and high calorie content in a palatable form, making it a preferred snack choice for cancer patients who need to maximize nutritional intake. Option b is incorrect because lemon sherbet is primarily sugar and water with minimal protein content, and it does not provide the protein and calorie density needed to support a cancer patient experiencing significant weight loss. Option c is incorrect because a plain fruit salad with melon provides hydration and vitamins but lacks adequate protein and calorie density to meaningfully address the significant weight loss occurring during cancer treatment. Option d is incorrect because plain saltine crackers with water offer minimal protein and limited calories, and this combination does not meet the high-protein and high-calorie requirements of a cancer patient losing weight.

Correct Answer: Add strained baby meats to casseroles and soups

Option c is correct because adding strained baby meats to casseroles and soups is a practical strategy that boosts protein content without significantly increasing portion size for patients who cannot tolerate large meals. Option a is incorrect because replacing all meals with commercial protein shakes eliminates dietary variety, may worsen taste fatigue, and does not address the patient's need for enjoyable meals that support overall quality of life. Option b is incorrect because doubling portion sizes directly contradicts the patient's reported difficulty tolerating large portions, and this approach is likely to further suppress appetite and reduce overall food intake. Option d is incorrect because eliminating carbohydrates removes an essential energy source and does not effectively increase absolute protein intake, and cancer patients need balanced nutrition including adequate calories from all macronutrients.

Correct Answer: High-protein foods like roasted chicken for tissue repair

Option d is correct because high-protein foods like roasted chicken support tissue repair and healing in the radiation treatment field, as protein is essential for cellular recovery and maintaining immune function during therapy. Option a is incorrect because raw vegetable salads contain high insoluble fiber that stimulates bowel motility and may worsen radiation-induced gastrointestinal symptoms, making them inappropriate during abdominal radiation treatment. Option b is incorrect because low-calorie rice cakes do not provide adequate protein or calories to support tissue healing, and cancer patients undergoing radiation need nutrient-dense foods rather than low-calorie options. Option c is incorrect because sugary beverages provide empty calories without the protein needed for tissue repair, and excessive sugar intake does not support the healing process or overall nutritional status during treatment.

Correct Answer: A gentle saline solution rinsed multiple times daily

Option b is correct because saline solution is the recommended mouth rinse for chemotherapy-induced oral mucositis, as it gently cleanses without damaging fragile healing tissue when used before and after meals and at bedtime. Option a is incorrect because hydrogen peroxide damages healing oral tissue and delays mucosal recovery, even when diluted, making it an inappropriate choice for patients with chemotherapy-induced oral mucositis. Option c is incorrect because alcohol-based antiseptic mouthwash causes burning pain on contact with ulcerated tissue and further dries and damages the already compromised oral mucosa during chemotherapy treatment. Option d is incorrect because lemon glycerin swabs have a drying and irritating effect on oral mucosa, which worsens existing ulceration rather than promoting the moist healing environment needed for tissue recovery.

Correct Answer: Administer the prescribed oral anesthetic gel

Option c is correct because applying prescribed anesthetic gel before meals numbs the painful oral ulcers, allowing the patient to eat more comfortably and improve caloric intake to reverse the ongoing weight loss. Option a is incorrect because while ice chips may provide temporary mild relief, they do not deliver the targeted analgesic effect of prescribed anesthetic gel and are insufficient for managing severe mucositis pain during meals. Option b is incorrect because a high-fiber smoothie may irritate oral ulcers and worsen gastrointestinal symptoms, and the priority intervention is pain management with anesthetic gel rather than changing food consistency alone. Option d is incorrect because encouraging rapid eating does not reduce pain and may cause choking or aspiration, while the appropriate approach is to manage pain effectively before meals so the patient can eat comfortably.