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 B

Explanation

A. A carotid endarterectomy does not involve bypassing the plaques; rather, it directly addresses the blockage.
B. Carotid endarterectomy is a surgical procedure that involves making an incision in the neck to access the carotid artery, where the surgeon removes the atherosclerotic plaques that are causing narrowing and restricting blood flow. This helps reduce the risk of stroke.
C. Carotid endarterectomy is not brain surgery; it is performed on the carotid arteries in the neck. The procedure aims to prevent strokes by improving blood flow to the brain, but it does not involve surgery on the brain itself.
D. This description does not accurately reflect carotid endarterectomy. The procedure does not involve resecting an artery in the brain or using a graft; rather, it focuses on removing plaques from the carotid artery in the neck.

A. Request medical prescription for an antibiotic such as gentamicin B. Obtain a full set of vital signs and have the client void in a specimen cup C. Increase intake of oral fluids such as cranberry juice D. Place the client in protective isolation

Correct Answer is B

Explanation

A. While antibiotics may be necessary if a UTI is confirmed, requesting a prescription would not be the immediate nursing action. The nurse must first assess the situation thoroughly and obtain necessary diagnostic information before medications can be prescribed.
B. This option is the most appropriate immediate action. Obtaining a full set of vital signs helps assess
the client’s overall condition, including the degree of fever and any signs of systemic infection. Collecting

a urine specimen will facilitate further evaluation, such as a urinalysis and culture, to confirm a UTI and identify the appropriate antibiotic treatment.
C. While increasing fluid intake can help with urinary tract health and dilute the urine, it is not an immediate priority in this situation. The client may need more urgent assessment and possible medical intervention rather than just dietary changes.
D. Although protective isolation may be warranted given the client’s immunocompromised state due to chemotherapy and radiation, it is not the immediate priority based on the current symptoms. The focus should first be on assessing and addressing the potential UTI.

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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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