Answer to Question 1
ANS: A
In the absence of neutrophils, as occurs with bone marrow suppression in chemotherapy, fever is the principle sign of infection. Pus, abscesses, and infiltrates on a chest x-ray may all be absent. When a neutropenic patient develops an infection, immediate and vigorous intervention is required. Empiric IV antibiotic therapy should begin while waiting for laboratory results and cultures. It is not correct to wait for culture results before initiating antibiotic therapy. Colony-stimulating factor can minimize neutropenia but does not eliminate the need for IV antibiotics. It is not correct to reassure the patient that a serious infection is unlikely.
Answer to Question 2
ANS: A
Because malignant cells are unresponsive to the feedback mechanisms that regulate cellular proliferation in healthy tissue, they are characterized by unrestrained growth and division. Division of tumor cells is not necessarily rapid. Malignant cells of all types can metastasize. Telomerase is an enzyme that permits repeated division of cancer cells.
Progression of changes leading to lung cancer
Photo of the neck of a patient with non-Hodgkin’s lymphoma showing the swelling associated with enla
Changes in chest configuration and posture
Inspecting a patient’s ear during a physical examination.