The nurse is reviewing the diagnostic studies on a client diagnosed with primary brain cancer. Which lab result would the nurse report to the Primary Care Practitioner (PCP) immediately?

Electrolyte

Normal Value Range

Serum sodium

135-145 mEq/L

Serum chloride

97-107 mEq/L

Serum potassium

3.5-5:3 mEq/L

Serum magnesium

1.6-2.2 mg/dL

Total serum calcium

8.2-10.2 mg/dL

lonized calcium

4.6-5.3 mg/dL

Serum phosphorus

2.5-4.5 mg/dL

Serum osmolality

275-295 mOsm/kg

Urine osmolality

250-900 mOsm/kg

Magnesium 2.0 mEq/L

Sodium 126 mEq/L

Potassium 3.5 mEq/L

Calcium 10 mg/L

Answer and Explanation

The Correct Answer is B

A. Magnesium at 2.0 mEq/L is within the normal range (1.6-2.2 mg/dL) and does not require immediate intervention.
B. A serum sodium level of 126 mEq/L indicates hyponatremia, which can lead to neurological complications, particularly in patients with brain cancer. Immediate reporting is necessary to manage potential risks such as seizures or altered mental status.
C. A potassium level of 3.5 mEq/L is on the lower limit of normal (3.5-5.3 mEq/L) but is still considered acceptable and does not require urgent action.
D. Calcium at 10 mg/L is an incorrect unit for this context, as total serum calcium is typically measured in mg/dL, and 10 mg/dL falls within the normal range (8.2-10.2 mg/dL).

Nursing Test Bank

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Free Nursing Study Resources

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

Explanation

A. An irregular border is a key characteristic of potentially cancerous skin lesions, particularly melanoma. Melanomas often have uneven, poorly defined edges.
B. Asymmetry is another sign of melanoma. If one half of a lesion does not match the other in shape or size, it should be evaluated by a healthcare professional.
C. Any lesion that has been increasing in size, particularly over a short period, is a concern and should be checked. Rapid growth can be a sign of malignancy.
D. A lesion with a diameter of less than 4 mm is generally less concerning, as most cancerous lesions are larger. However, the other factors (such as asymmetry and border irregularity) are more significant for diagnosis.
E. Ecchymosis (bruising) is not typically associated with cancerous skin lesions. Skin cancers like melanoma present as new or changing moles, not bruising.

A. Slow the rate of infusion B. Apply a warm compress to the site C. Discontinue the infusion D. Check for blood return

Correct Answer is C

Explanation

A. Slowing the rate of infusion may provide some temporary relief, but it does not address the underlying issue and may worsen the situation.
B. Applying a warm compress may soothe discomfort but is not the priority action when a burning sensation is reported, which could indicate potential extravasation.
C. Discontinuing the infusion is the best first action to prevent further damage to the tissue and to assess for complications such as infiltration or extravasation.
D. Checking for blood return can help assess the patency of the IV line, but the priority is to stop the infusion immediately to prevent complications.

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Electrolyte	Normal Value Range
Serum sodium	135-145 mEq/L
Serum chloride	97-107 mEq/L
Serum potassium	3.5-5:3 mEq/L
Serum magnesium	1.6-2.2 mg/dL
Total serum calcium	8.2-10.2 mg/dL
lonized calcium	4.6-5.3 mg/dL
Serum phosphorus	2.5-4.5 mg/dL
Serum osmolality	275-295 mOsm/kg
Urine osmolality	250-900 mOsm/kg

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is educating adolescent high school students about when to seek medical attention regarding suspected cancerous skin lesions. Which of the following are included in the nurse's teaching? The lesion has:

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

Explanation

A client, who is receiving intravenous chemotherapy into a peripheral vein, says that the arm burns terribly in and around the intravenous site. What is the nurse's best first action?

Correct Answer is C

Explanation

A jaundiced client has just been diagnosed with stage IV pancreatic cancer. The nurse anticipates the client will display which clinical manifestation?

Which of the following interventions would the nurse emphasize during education to assist the patient diagnosed with trigeminal neuralgia in managing their pain?

The nurse is caring for a client receiving radiation therapy for treatment of oral cancer. Which new finding is the greatest concern?

A client receives chemotherapy with an agent that causes thrombocytopenia. Which intervention is most important to teach the client?

The nurse is performing an assessment on a patient. How would the nurse best evaluate improvement or deterioration in the neurologic status?

The client is hospitalized for insertion of an internal cervical radiation implant. While giving care, the nurse finds the radiation implant in the bed. The initial action by the nurse is to:

The nurse teaches a diabetic client how to perform foot care. Which action by the client would indicate that they can correctly perform foot care?

In evaluating dietary teaching for the client with chemotherapy-induced neutropenia, the nurse would be concerned if the client made which food choice?