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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Correct Answer is C

Explanation

A. Using a soft toothbrush is appropriate for preventing bleeding, but it does not directly indicate an understanding of neutropenia or its implications for infection risk.
B. Babysitting a young child may expose the client to infections, which is not safe for someone with neutropenia. This statement shows a lack of understanding.
C. Calling the oncologist when experiencing an increased temperature is critical because it may indicate an infection, which is a major concern for clients with neutropenia. This statement reflects an appropriate understanding of the condition.
D. While wearing a mask can be beneficial in some situations, stating that it must be worn at all times is not necessary and shows a misunderstanding of the guidelines for reducing infection risk in neutropenia.

A. gabapentin B. carbamazepine C. baclofen D. oxycodone

Correct Answer is D

Explanation

A. Gabapentin is an anticonvulsant commonly used to treat neuropathic pain, including trigeminal neuralgia. It works by stabilizing nerve activity and is appropriate for this condition.
B. Carbamazepine is considered the first-line treatment for trigeminal neuralgia as it decreases nerve impulses, which helps reduce pain. It is a commonly prescribed medication for this condition.
C. Baclofen is a muscle relaxant and can be used in combination with anticonvulsants to treat trigeminal neuralgia by reducing muscle spasms associated with nerve irritation.
D. Oxycodone is an opioid analgesic that treats general pain but is not typically effective for the specific type of neuropathic pain experienced in trigeminal neuralgia. Opioids do not address the underlying nerve activity and are not recommended for long-term management of this condition.

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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

What statement indicates that the client understands teaching about neutropenia as a result of bone marrow suppression?

Correct Answer is C

Explanation

The nurse is caring for a patient with trigeminal neuralgia. Which medication to treat the patient's pain would the nurse question?

Correct Answer is D

Explanation

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