A nurse is assessing a client diagnosed with renal cancer. The client is complaining of flank pain. Which additional assessment finding should the nurse expect?

Flank mass and hematuria

Dark tarry stool and mental status change

Shortness of breath and chest pain

Urinary frequency and hypotension

Answer and Explanation

The Correct Answer is A

A.   Renal cancer can often present with a palpable flank mass due to tumor growth. Hematuria (blood in the urine) is also a common finding in patients with kidney tumors and can result from bleeding within the renal system. Flank pain, especially in the context of renal cancer, often accompanies these findings.
B.   Dark, tarry stools (melena) suggest gastrointestinal bleeding, which is not directly associated with renal cancer. Mental status changes could indicate various issues, such as metabolic imbalances or anemia, but they are not specific findings for renal cancer.
C.   While patients with advanced cancer may experience shortness of breath due to metastasis to the lungs or other complications, chest pain is not a direct finding associated with renal cancer. These symptoms could indicate other issues, such as cardiac or pulmonary problems.
D.   While urinary frequency can occur due to various urinary tract issues, it is not a classic symptom of renal cancer. Hypotension is also not a typical finding associated with renal cancer unless there is significant blood loss or other complications.

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Correct Answer is A

Explanation

A. Egg donation involves collecting eggs from a woman before undergoing fertility-compromising treatments. These eggs can then be fertilized with sperm and frozen for future use. This allows couples to have biological children after completing cancer treatment.
B. There should be no difficulty conceiving once the client is in full remission. While it is possible for some women to conceive after completing treatment for ALL, the risk of fertility problems remains. Additionally, the time it takes to achieve full remission can vary, and there is no guarantee that fertility will return to normal.
C. Encourage the couple to look into adoption once a cure is achieved. While adoption is a viable option for couples who cannot have biological children, it is important to discuss all available options with the client and her husband before they make a decision.
D. The priority at this time is beginning treatment in the hope for an eventual cure. While it is important to prioritize the treatment of ALL, it is also important to address the couple's concerns about fertility. By discussing egg donation, the nurse can help the couple make informed decisions about their future.

A. Apply bacitracin liberally to the affected areas B. Request a medical prescription for diphenhydramine or hydroxyzine C. Instruct client to shower with cool water and use a mild soap D. Clip fingernails and encourage the use of prescribed lotions

Correct Answer is ["B","C","D"]

Explanation

A. Bacitracin is an antibiotic ointment typically used to prevent or treat bacterial infections in minor cuts and scrapes. It is not appropriate for treating a pruritic rash associated with GVHD. The rash may not be due to an infection but rather an immune response, so using bacitracin would not address the underlying issue.
B. Diphenhydramine (Benadryl) and hydroxyzine are antihistamines that can help alleviate itching and provide relief from pruritus. Requesting a prescription for one of these medications is an appropriate response to manage the symptoms of GVHD.
C. Showering with cool water can soothe irritated skin and reduce itching. Using mild soap helps to avoid further irritation or dryness that harsher soaps can cause. This intervention supports skin care and helps manage pruritus effectively.
D. Clipping fingernails can help prevent skin damage from scratching, which could lead to secondary infections. Encouraging the use of prescribed lotions can help keep the skin moisturized and alleviate dryness, further addressing the pruritus associated with GVHD.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male: 451-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-155 g/dL
Hematocrit	42%-52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 10/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%


Platelets	150,000-450,000/mm3

A nurse is assessing a client diagnosed with renal cancer. The client is complaining of flank pain. Which additional assessment finding should the nurse expect?

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Naxlex Comprehensive Predictor Exams

The nurse caring for a 27-year-old female client diagnosed with acute lymphoblastic leukemia (ALL). She and her husband are concerned about the ability to eventually have children. What should the nurse include in the discussion with this client and her husband?

Correct Answer is A

Explanation

The client has developed graft versus host disease (GVHD) during treatment for acute lymphoblastic leukemia (ALL). The client has a generalized pruritic rash on the trunk and the extremities. What nursing measures should the nurse use to address this problem?

Correct Answer is ["B","C","D"]

Explanation

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