The nurse is assessing a patient who has received the first dose of chemotherapy for leukemia.
Which patient's clinical findings indicate to the nurse that the patient has developed tumor lysis syndrome (TLS)?

Facial swelling and jugular vein distension (JVD).

Muscle weakness, confusion, polyuria, and polydipsia.

Flank pain, elevated uric acid, and cardiac monitor reveals an abnormal rhythm.

Elevated liver function tests, jaundice, and blistering skin rash.

Answer and Explanation

The Correct Answer is C

The correct answer is Choice C.

Choice A rationale

Facial swelling and jugular vein distension (JVD) are indicative of superior vena cava syndrome (SVCS), not tumor lysis syndrome (TLS). SVCS occurs when the superior vena cava, which carries blood from the head, neck, upper chest, and arms to the heart, is obstructed. This can lead to facial swelling, cyanosis, and distended neck veins due to increased venous pressure.

Choice B rationale

Muscle weakness, confusion, polyuria, and polydipsia are symptoms of hypercalcemia. Hypercalcemia is characterized by elevated levels of calcium in the blood, which can cause neuromuscular and cognitive symptoms, excessive urination, and increased thirst.

Choice C rationale

Tumor lysis syndrome (TLS) is characterized by rapid destruction of tumor cells, leading to elevated levels of uric acid, potassium, and phosphate. Symptoms include flank pain due to uric acid crystallization in the kidneys, and abnormal heart rhythms due to hyperkalemia.

Choice D rationale

Elevated liver function tests, jaundice, and blistering skin rash are symptoms of liver toxicity or hepatic dysfunction, possibly due to drug-induced liver injury. These symptoms are not related to tumor lysis syndrome (TLS).

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Correct Answer is A

Explanation

Choice A rationale

Notifying the healthcare provider is the appropriate first action when significant ecchymosis is observed in a patient with Cushing's syndrome, as it may indicate a need for medical intervention.

Choice B rationale

Administering insulin is not relevant as the primary concern here is the ecchymosis, not hyperglycemia.

Choice C rationale

While providing skin care is important, it does not address the potential underlying cause of the ecchymosis, necessitating provider notification first.

Choice D rationale

Monitoring intake and output and daily weight is a general care measure but does not address the immediate concern of ecchymosis observed.

A. Reassure the patient that radiation and chemotherapy will not affect their ability to become pregnant. B. Discuss fertility counseling and contraception options that are available to the patient. C. Refer the patient to the social worker to identify an appropriate pregnancy surrogate. D. Notify the provider that treatment should be delayed until the patient becomes pregnant.

Correct Answer is B

Explanation

Choice A rationale

Chemotherapy and radiation can significantly affect fertility. It would be incorrect to reassure the patient that these treatments will not impact her ability to become pregnant, as these treatments often reduce fertility or cause temporary or permanent infertility.

Choice B rationale

Discussing fertility counseling and contraception options allows the patient to make informed decisions about her reproductive health. Fertility preservation methods, such as egg or embryo freezing, can be considered before starting treatment. This approach respects the patient's desire to become pregnant while acknowledging the impact of cancer treatment.

Choice C rationale

Referring the patient to a social worker for pregnancy surrogacy is premature and not directly addressing the patient's immediate concerns about fertility and treatment. Fertility counseling is a more appropriate initial step.

Choice D rationale

Delaying treatment for cancer to allow for pregnancy can have severe negative impacts on the patient's prognosis and is not advised. Immediate treatment is crucial to control the disease and improve survival chances.

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The nurse is assessing a patient who has received the first dose of chemotherapy for leukemia.Which patient's clinical findings indicate to the nurse that the patient has developed tumor lysis syndrome (TLS)?

Nursing Test Bank

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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The nurse is assessing a patient who has received the first dose of chemotherapy for leukemia.
Which patient's clinical findings indicate to the nurse that the patient has developed tumor lysis syndrome (TLS)?