MS2- ONCOLOGY- NCLEX SAUNDERS

MS2- ONCOLOGY- NCLEX SAUNDERS

QUESTIONS AND ANSWERS WITH

VERIFIED SOLUTIONS 100% CORRECT

(GRADED A+)

• The nurse is reviewing lab results for a client with multiple myeloma.

Which finding is expected with this disorder?

• Increased calcium level
• Increased white blood cells
• Decreased blood urea nitrogen level
• Decreased number of plasma cells in the bone marrow

✔✔ Correct Answer: A. Increased calcium level

Rationale:

Multiple myeloma causes bone breakdown, which leads to hypercalcemia. Other

common findings include:

 Increased plasma cells in bone marrow  Anemia  Elevated BUN due to renal involvement  WBC count may vary and is not a key diagnostic indicator.

• When planning care for a client with multiple myeloma, which intervention

is the priority?

• Encouraging fluids
• Providing frequent oral care
• Coughing and deep breathing
• Monitoring the red blood cell count

✔✔ Correct Answer: A. Encouraging fluids

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Rationale:

Hypercalcemia caused by bone destruction is a priority concern in the client with multiple myeloma. The nurse should administer fluids in adequate amounts to maintain a urine output of 1.5 to 2 L/day; this requires about 3 L of fluid intake per day. The fluid is needed not only to dilute the calcium overload but also to prevent protein from precipitating in the renal tubules. Options 2, 3, and 4 may be components of the plan of care but are not the priority in this client.

A client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment finding would the nurse expect to note specifically in the client?

• Fatigue

• Weakness

• Weight gain

4. Enlarged lymph nodes - ANSWER✔✔ANS: 4

Rationale:

Hodgkin's disease is a chronic progressive neoplastic disorder of lymphoid tissue characterized by the painless enlargement of lymph nodes with progression to extralymphatic sites, such as the spleen and liver. Weight loss is most likely to be noted. Fatigue and weakness may occur but are not related significantly to the disease.

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During the admission assessment of a client with advanced ovarian cancer, the nurse recognizes which manifestation as typical of the disease?

• Diarrhea

• Hypermenorrhea

• Abnormal bleeding

4. Abdominal distention - ANSWER✔✔ANS: 4

Rationale:

Clinical manifestations of ovarian cancer include abdominal distention, urinary frequency and urgency, pleural effusion, malnutrition, pain from pressure caused by the growing tumor and the effects of urinary or bowel obstruction, constipation, ascites with dyspnea, and ultimately general severe pain. Abnormal bleeding, often resulting in hypermenorrhea, is associated with uterine cancer.

The nurse is caring for a client with lung cancer and bone metastasis. What signs and symptoms would the nurse recognize as indications of a possible oncological emergency? Select all that apply.

• Facial edema in the morning

• Weight loss of 20 lb (9 kg) in 1 month

• Serum calcium level of 12 mg/dL (3.0 mmol/L) 3 / 4

• Serum sodium level of 136 mg/dL (136 mmol/L)

• Serum potassium level of 3.4 mg/dL (3.4 mmol/L)

6. Numbness and tingling of the lower extremities - ANSWER✔✔ANS: 1, 3, 6

Rationale:

Oncological emergencies include sepsis, disseminated intravascular coagulation, syndrome of inappropriate antidiuretic hormone, spinal cord compression, hypercalcemia, superior vena cava syndrome, and tumor lysis syndrome. Blockage of blood flow to the venous system of the head resulting in facial edema is a sign of superior vena cava syndrome. A serum calcium level of 12 mg/dL (3.0 mmol/L) indicates hypercalcemia. Numbness and tingling of the lower extremities could be a sign of spinal cord compression. Mild hypokalemia and weight loss are not oncological emergencies. A sodium level of 136 mg/dL (136 mmol/L) is a normal level.

A client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing which condition?

• Rupture of the bladder

• The development of a vesicovaginal fistula

• Extreme stress caused by the diagnosis of cancer
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