a client with a history of prostate cancer is in the clinic and reports new onset of severe low back pain what action by the nurse is most important
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Nursing Elites

ATI RN

Oncology Test Bank

1. A client with a history of prostate cancer is in the clinic and reports new onset of severe low back pain. What action by the nurse is most important?

Correct answer: A

Rationale: The correct action by the nurse is to assess the client’s gait and balance. Severe low back pain in a client with a history of prostate cancer may indicate spinal cord compression, a serious complication. Assessing gait and balance can help determine if there is any spinal cord involvement, which requires immediate medical attention. Asking about changes in urinary symptoms (choice B) is important to assess for possible urinary obstruction, but assessing gait and balance takes precedence due to the risk of spinal cord compression. Documenting the report thoroughly (choice C) is essential but not the most immediate action needed. Inquiring about recent activities (choice D) is not as critical as assessing for spinal cord involvement.

2. The nurse is instructing a client on ways to reduce the risk of lymphedema after a mastectomy. Which of the following should be emphasized?

Correct answer: D

Rationale: After a mastectomy, particularly when lymph nodes are removed, patients are at increased risk for developing lymphedema, which is a buildup of lymph fluid that can cause swelling in the affected arm. Wearing tight clothing can constrict lymphatic flow and increase the risk of developing lymphedema by impeding normal lymphatic drainage. Therefore, it is crucial to advise patients to avoid tight-fitting clothing, especially around the chest and arm areas.

3. A patient with advanced leukemia is responding poorly to treatment. The nurse finds the patient tearful and trying to express his feelings, but he is clearly having difficulty. What is the nurses most appropriate action?

Correct answer: C

Rationale: Providing emotional support and discussing the uncertain future are crucial.

4. The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm?

Correct answer: B

Rationale: After a mastectomy, particularly when lymph nodes are removed, there is an increased risk of lymphedema in the affected arm due to impaired lymphatic drainage. Elevating the affected arm above heart level helps promote lymphatic drainage and reduces the risk of swelling. This intervention facilitates the return of lymph fluid and helps prevent fluid accumulation in the arm.

5. The nurse is caring for a client who is at risk for tumor lysis syndrome. Which laboratory value requires the nurse to intervene?

Correct answer: C

Rationale: Tumor lysis syndrome (TLS) is a potentially life-threatening condition that occurs when large numbers of cancer cells die rapidly, releasing their contents into the bloodstream. This can overwhelm the kidneys and lead to acute kidney injury. Creatinine is a waste product filtered out of the blood by the kidneys, and an elevated creatinine level is a sign of kidney dysfunction or damage. In TLS, increased creatinine levels indicate that the kidneys are struggling to filter out the excess waste products from cell breakdown, requiring immediate intervention to prevent further complications, such as acute renal failure.

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