nurse mike is providing care to a client with chronic myelogenous leukemia cml the nurse knows that the client is at risk for tumor lysis syndrome whi
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Nursing Elites

ATI RN

Oncology Questions

1. Nurse Mike is providing care to a client with chronic myelogenous leukemia (CML). The nurse knows that the client is at risk for tumor lysis syndrome. Which of the following laboratory values requires immediate intervention?

Correct answer: A

Rationale: The correct answer is A: Increased uric acid level. In tumor lysis syndrome, rapid cell destruction releases large amounts of potassium, phosphate, and nucleic acids into the bloodstream. Uric acid can accumulate rapidly, leading to hyperuricemia, which can result in kidney damage due to urate crystal deposition. Immediate intervention is necessary to prevent renal complications. Choices B, C, and D are incorrect because while electrolyte imbalances are common in tumor lysis syndrome, hyperuricemia with potential kidney damage is the priority concern that requires immediate attention.

2. 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.

3. An older adult patient is undergoing diagnostic testing for chronic lymphocytic leukemia (CLL). What assessment finding is certain to be present if the patient has CLL?

Correct answer: B

Rationale: An increased lymphocyte count (lymphocytosis) is always present in patients with CLL.

4. A nurse is preparing to administer filgrastim to a client undergoing chemotherapy. What is the primary purpose of this medication?

Correct answer: A

Rationale: Filgrastim is primarily used to increase white blood cell production in clients undergoing chemotherapy.

5. A patient’s most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the patient’s cancer cells spread?

Correct answer: B

Rationale: In the case of lung cancer that has metastasized to the bones and liver, lymphatic circulation is a key mechanism by which cancer cells spread from the primary tumor site to distant organs. Cancer cells can invade nearby lymphatic vessels and travel through the lymphatic system, eventually reaching lymph nodes and spreading to other tissues and organs. This route is significant in the metastasis of many types of cancer, including lung cancer.

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