The nurse is reviewing lab results for a client receiving chemotherapy for the treatment of cancer. The nurse notes the carcinoembryonic antigen (CEA) was previously 50 ng/ mL and is now 10 ng/mL (normal range 0-2.5 ng/mL) The nurse is aware this finding indicates the:

treatment plan will need to be changed to achieve the desired effect

cancer treatment is having, the desired effect on killing cancer cells

client is at greater risk for tumor lysis syndrome

cancer has increased size and metastatic sites

Answer and Explanation

The Correct Answer is B

A) Treatment plan will need to be changed to achieve the desired effect:
The decrease in the carcinoembryonic antigen (CEA) levels from 50 ng/mL to 10 ng/mL suggests that the cancer is responding to the current treatment, not that the treatment plan needs to be changed. A drop in CEA levels typically indicates a positive response to treatment, such as chemotherapy, in reducing the number or size of cancer cells.

B) Cancer treatment is having the desired effect on killing cancer cells:
Carcinoembryonic antigen (CEA) is a tumor marker that is often elevated in individuals with certain cancers, particularly colorectal cancer. A decrease in CEA levels, as noted in this case (from 50 ng/mL to 10 ng/mL), usually signifies that the treatment is successfully targeting the cancer and reducing the tumor burden. This drop suggests that the chemotherapy is effectively killing cancer cells and reducing the size or activity of the tumor.

C) Client is at greater risk for tumor lysis syndrome:
Tumor lysis syndrome typically occurs when large numbers of cancer cells die rapidly, releasing their intracellular contents into the bloodstream, which can lead to metabolic disturbances like hyperkalemia, hyperphosphatemia, and renal failure. It is more common in aggressive hematologic cancers, such as leukemia or lymphoma, and typically presents with a rapid rise in tumor marker levels, not a decrease.

D) Cancer has increased size and metastatic sites:
An increase in tumor size or the development of metastatic sites would typically result in an increase in CEA levels, not a decrease. Since CEA levels have dropped, it is more likely that the cancer is shrinking or responding to the current treatment. This finding is more indicative of a positive response rather than disease progression.

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Correct Answer is A

Explanation

A) Use the 3-second markers to count the number of QRS complexes in 6 seconds and multiply by 10:
The 3-second markers on the ECG strip represent a fixed time interval. By counting the number of QRS complexes in the 6-second interval (i.e., two 3-second markers), you can estimate the heart rate by multiplying the number of QRS complexes by 10. This method is quick and effective for calculating heart rate in an emergency setting, such as in arrhythmias or when time is of the essence.

B) Print a 1-minute ECG strip and count the number of QRS complexes:
While this is another way to assess the heart rate, it is not a quick method, especially in emergency situations. It is more time-consuming because it involves printing out a full strip (or ensuring you have enough data to calculate a full minute). This approach may be useful for detailed analysis but is not optimal for quickly estimating the ventricular rhythm.

C) Calculate the number of small squares between one QRS complex and the next one and divide by 1500:
This method is more complex and is used for calculating the heart rate with a more precise ECG reading. It requires counting the number of small squares between two QRS complexes and dividing by 1500 (the number of small squares in one minute). This method is accurate but not the fastest option for quickly estimating the heart rate during an emergency.

D) Count the number of large squares in the R-R interval and divide by 300:
counting the number of large squares between two R-R intervals and dividing by 300, you get the heart rate. However, this method is less commonly used in emergency situations because it requires more time and may not be as immediate as using the 3-second markers. It is more applicable when doing a detailed analysis of the rhythm.

A. Prolonged prothrombin time (PT) B. Elevated fibrinogen level C. Decreased platelet court D. Decreased D-dimer level

Correct Answer is D

Explanation

A) Prolonged prothrombin time (PT):
A prolonged PT is a sign of impaired coagulation, which is common in DIC as the clotting factors are consumed. In DIC, both clotting and bleeding occur, leading to prolonged PT. Therefore, a prolonged PT does not reflect a positive outcome. A positive outcome would show normalization or improvement of the clotting profile.

B) Elevated fibrinogen level:
Fibrinogen is often decreased in DIC because it is consumed in the process of forming clots. An elevated fibrinogen level would not indicate a positive outcome in DIC. Instead, fibrinogen levels typically fall in DIC due to widespread clotting activity. A positive outcome would involve a normalization or increase in fibrinogen levels as the condition improves.

C) Decreased platelet count:
Platelet count typically decreases in DIC because platelets are used up in the formation of clots, leading to thrombocytopenia. A decreased platelet count reflects ongoing consumption of platelets and would not be a positive indicator of improvement. In a positive outcome, the platelet count would increase toward normal levels.

D) Decreased D-dimer level:
D-dimer is a product of fibrin degradation and is elevated in conditions like DIC, where abnormal clotting and fibrinolysis are occurring. A decreased D-dimer level indicates that the coagulation process is resolving, and fibrin degradation is returning to normal, reflecting a positive outcome. Monitoring the D-dimer level is a key indicator of improvement in DIC.

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The nurse is reviewing lab results for a client receiving chemotherapy for the treatment of cancer. The nurse notes the carcinoembryonic antigen (CEA) was previously 50 ng/ mL and is now 10 ng/mL (normal range 0-2.5 ng/mL) The nurse is aware this finding indicates the:

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Naxlex Comprehensive Predictor Exams

When using an ECG rhythm strip to quickly estimate the ventricular rhythm for a client, the nurse should:

Correct Answer is A

Explanation

The nurse is evaluating the outcomes for a client diagnosed with disseminated intravascular coagulation (DIC). Which laboratory value reflects a positive outcome?

Correct Answer is D

Explanation

To properly identify a cardiac rhythm, the nurse will obtain the following factors. (SELECT ALL THAT APPLY)

A patient presents to the Emergency Department (ED) reporting right facial weakness. The nurse understands that a patient suffering from Bell's Palsy will exhibit which assessment findings related to the cranial nerve involvement?

The client diagnosed with Parkinson's Disease (PD) is being admitted with a fever and patchy infiltrates in the lung fields on the chest x-ray. Which clinical manifestations of PD would explain this assessment data?

The nurse is monitoring a patient receiving a blood transfusion. For Which symptoms would the nurse stop the transfusion but NOT administer 0,9% normal saline?

The nurse assesses the patient with a spinal cord injury at the level C-7 and finds warm, flushed skin with profuse sweating above the level of injury, and pale, cold skin below the level of injury. The patient is bradycardic, but severely hypertensive. What are the priority nursing interventions?

A nurse is providing care with for a client diagnosed with human immunodeficiency virus. The client discusses concerns about transmitting the virus to their family members. What should the nurse include in client education? The nurse teaches the client to:

The nurse is caring for patient with severe, major burns who is receiving fluid resuscitation per protocol. Which of the following assessments indicate positive outcome?

The Operating Room (OR) nurse is preparing to give report to the Intensive Care Unit (ICU) nurse on a patient who has had surgery after suffering penetrating chest and abdominal trauma. What should the nurse include in the report? (Select All that Apply.)