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 B

Explanation

A) Heart rate of 130 beats per minute
A heart rate of 130 beats per minute is tachycardia, which is often a compensatory response to injury, particularly in cases of trauma, blood loss, or shock. It is common in the initial phase after trauma as the body attempts to compensate for decreased blood volume or oxygen delivery. However, tachycardia alone is not typically fatal in the immediate post-injury period and can often be managed.

B) pH of 7.21 (normal 7.35–7.45)
A pH of 7.21 indicates acidosis, which is life-threatening and typically arises from shock, blood loss, or severe trauma. Acidosis occurs when the body is unable to compensate for lactic acid or other metabolic byproducts that accumulate due to insufficient oxygen delivery to tissues. In the case of a gunshot wound to the abdomen, there is a high risk of internal bleeding, hypoperfusion, and hypoxia, all of which can lead to metabolic acidosis. Severe acidosis can cause organ failure, particularly affecting the heart, kidneys, and brain.

C) Serum potassium 5.7 mEq/L (normal 3.5–5.3)
A serum potassium of 5.7 mEq/L is elevated, but it is moderately high and not typically life-threatening unless it reaches much higher levels (e.g., >6.0 mEq/L), which can cause cardiac arrhythmias. Elevated potassium can occur due to cellular injury (e.g., muscle trauma or rhabdomyolysis), but it would need to be corrected to prevent complications like arrhythmias.

D) Platelet count 200,000 (normal 150,000–450,000)
A platelet count of 200,000 is within the normal range (150,000–450,000) and does not indicate a problem with coagulation. The blood loss and the NG tube hemorrhage mentioned in the scenario suggest that the patient may be at risk for bleeding, but a platelet count in the normal range suggests that the body’s ability to form clots is likely intact.

A. Hypertension treated with medications B. Prostate surgery six months prior C. Use of intravenous substances D. Stroke diagnosed one year ago

Correct Answer is C

Explanation

A) Hypertension treated with medications
Hypertension (high blood pressure) itself is not a direct cause of infectious endocarditis. While untreated or poorly managed hypertension can contribute to cardiovascular complications, it is not typically a risk factor for developing infectious endocarditis. Infectious endocarditis is more commonly associated with conditions that directly involve the heart valves or blood stream, such as intravenous drug use, prior heart valve disease, or certain invasive procedures.

B) Prostate surgery six months prior
While certain surgeries, such as dental or urinary tract procedures, can increase the risk of infectious endocarditis due to transient bacteremia, prostate surgery by itself is not a major risk factor for this condition. Unless there was a complication during the surgery that resulted in bacteremia (e.g., infection), B is not the most likely contributor to the development of infectious endocarditis.

C) Use of intravenous substances
The use of intravenous (IV) substances, especially illicit drugs, is a major risk factor for the development of infectious endocarditis. Intravenous drug use, particularly when non-sterile needles or contaminated substances are used, can introduce bacteria directly into the bloodstream, leading to bacteremia.

D) Stroke diagnosed one year ago
While a history of stroke may indicate underlying cardiovascular disease or embolic events, it is not directly related to the development of infectious endocarditis. Stroke can occur as a complication of infectious endocarditis, particularly if emboli from infected valves travel to the brain. However, a prior stroke itself does not directly contribute to the development of endocarditis.

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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

Correct Answer is B

Explanation

The nurse is caring for a client with infectious endocarditis. Which information obtained from the health history could have contributed to the development of the disease progress?

Correct Answer is C

Explanation

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