An older adult client who is having difficulty passing urine is found to have elevated levels of prostate-specific antigen (PSA). The nurse understands that this finding indicates which of the following?

The client has a harmful gene mutation which puts him at a higher risk for cancer in the future.

The client will need additional testing to determine if he has cancer.

The client has prostate cancer.

The client has benign prostatic hyperplasia (BPH).

Answer and Explanation

The Correct Answer is B

A.   PSA levels themselves do not indicate a gene mutation. Elevated PSA levels are primarily associated with prostate conditions rather than genetic mutations. While certain genetic mutations can predispose individuals to prostate cancer, PSA alone does not diagnose genetic mutations.
B.   Elevated PSA levels can indicate the possibility of prostate cancer, but further testing is necessary to confirm the diagnosis. Additional tests may include a digital rectal exam (DRE), imaging studies (such as ultrasound or MRI), and a prostate biopsy.
C.   Elevated PSA levels can suggest prostate cancer, but they do not definitively diagnose it. Prostate cancer can only be confirmed through a biopsy that identifies cancerous cells in the prostate tissue.
D.   BPH is a non-cancerous enlargement of the prostate gland that commonly occurs in older men. While BPH can cause urinary symptoms similar to prostate cancer, elevated PSA levels are not typically associated with BPH alone. PSA elevation is more specific to prostate cancer but can also occur with other prostate conditions.

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Correct Answer is C

Explanation

A. During chemotherapy, many patients experience nausea, vomiting, and changes in taste or appetite. Spicy and highly-seasoned foods can exacerbate gastrointestinal symptoms and may not be well tolerated. It's generally recommended to encourage bland, easy-to-digest foods to help maintain adequate nutrition and reduce discomfort.
B. Loperamide is not used to prevent nausea; rather, it is an antidiarrheal medication used to treat diarrhea, which can be a side effect of chemotherapy. Nausea prevention is typically managed with antiemetic medications such as ondansetron, metoclopramide, or others prescribed based on the patient's specific needs and chemotherapy regimen.
C. Pain management is an essential aspect of caring for oncology patients, including those receiving chemotherapy. Cancer and its treatment can cause pain directly or indirectly (such as from procedures or complications). Regular and thorough pain assessments allow for timely intervention and improvement in the client's comfort and quality of life.
D. Chemotherapy medications are typically administered through central venous access devices (e.g., central lines, PICC lines) rather than through peripheral veins. This is because chemotherapy drugs can be vesicants (causing tissue damage if they leak out of the vein) or irritants to smaller peripheral veins.
Using a larger gauge peripheral line (e.g., 18 gauge) is not standard practice for administering chemotherapy due to the potential risks and complications associated with peripheral administration.

A. Petechiae on the oral mucosa. B. Hemoglobin of 14 g/dL. C. Bleeding of the gums after oral care. D. Pain and swelling in one leg.

Correct Answer is D

Explanation

A. Petechiae are tiny, pinpoint, red or purple spots on the skin or mucous membranes, caused by bleeding under the skin. While petechiae can indicate bleeding, they are not specific to HIT and can occur due to various reasons, including low platelet count or coagulation disorders. They do not necessarily indicate thrombotic complications associated with HIT.
B. This hemoglobin level is within the normal range for adults and does not directly correlate with HIT. However, it is important to monitor hemoglobin levels in patients with HIT due to the risk of bleeding and thrombosis.
C. Bleeding gums can occur due to various reasons, including gum disease or thrombocytopenia (low platelet count). In HIT, the concern is not just bleeding but also the paradoxical risk of thrombosis despite low platelet counts. Bleeding from mucosal surfaces can indicate underlying thrombocytopenia but does not specifically highlight the thrombotic risk of HIT.
D. This symptom is concerning for deep vein thrombosis (DVT), which is a thrombotic complication associated with HIT. HIT predisposes patients to thrombosis due to the formation of antibodies against

platelet factor 4/heparin complexes, leading to platelet activation and clot formation. DVT is a serious complication that requires immediate intervention to prevent pulmonary embolism (PE).

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An older adult client who is having difficulty passing urine is found to have elevated levels of prostate-specific antigen (PSA). The nurse understands that this finding indicates which of the following?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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