The nurse is reviewing the diagnostic studies on a client diagnosed with primary brain cancer. Which lab result would the nurse report to the Primary Care Practitioner (PCP) immediately?

Electrolyte

Normal Value Range

Serum sodium

135-145 mEq/L

Serum chloride

97-107 mEq/L

Serum potassium

3.5-5:3 mEq/L

Serum magnesium

1.6-2.2 mg/dL

Total serum calcium

8.2-10.2 mg/dL

lonized calcium

4.6-5.3 mg/dL

Serum phosphorus

2.5-4.5 mg/dL

Serum osmolality

275-295 mOsm/kg

Urine osmolality

250-900 mOsm/kg

Magnesium 2.0 mEq/L

Sodium 126 mEq/L

Potassium 3.5 mEq/L

Calcium 10 mg/L

Answer and Explanation

The Correct Answer is B

A. Magnesium at 2.0 mEq/L is within the normal range (1.6-2.2 mg/dL) and does not require immediate intervention.
B. A serum sodium level of 126 mEq/L indicates hyponatremia, which can lead to neurological complications, particularly in patients with brain cancer. Immediate reporting is necessary to manage potential risks such as seizures or altered mental status.
C. A potassium level of 3.5 mEq/L is on the lower limit of normal (3.5-5.3 mEq/L) but is still considered acceptable and does not require urgent action.
D. Calcium at 10 mg/L is an incorrect unit for this context, as total serum calcium is typically measured in mg/dL, and 10 mg/dL falls within the normal range (8.2-10.2 mg/dL).

Nursing Test Bank

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Correct Answer is B

Explanation

A. High-protein foods are not typically irritating after an esophagogastrectomy and are essential for healing and maintaining nutritional status. Clients should be encouraged to eat balanced meals with adequate protein.
B. Clients recovering from an esophagogastrectomy should avoid snacking between meals to prevent dumping syndrome, a common complication where food moves too quickly from the stomach to the small intestine. Instead, small, frequent meals should be consumed.
C. While pureed foods may be part of the immediate post-operative diet, the long-term goal is to gradually reintroduce solid foods, following the physician's dietary recommendations. A pureed diet is not necessarily required long-term.
D. Lying flat after meals increases the risk of reflux, which can be particularly harmful to clients recovering from esophageal surgery. Clients should be advised to stay upright after eating to aid digestion and prevent reflux.

A. History of Roux-en-Y gastric bypass surgery B. High fiber, low fat diet C. Personal history of inflammatory bowel disease D. Distant relative with colorectal cancer

Correct Answer is C

Explanation

A. A history of Roux-en-Y gastric bypass surgery is not a direct risk factor for colorectal cancer; in some cases, it may reduce risk due to weight loss and dietary changes.
B. A high fiber, low fat diet is considered protective against colorectal cancer rather than a risk factor.
C. A personal history of inflammatory bowel disease, such as ulcerative colitis or Crohn's disease, significantly increases the risk for developing colorectal cancer due to chronic inflammation and cellular changes in the colon.
D. Having a distant relative with colorectal cancer may increase risk, but the personal history of inflammatory bowel disease is a stronger risk factor warranting emphasis in teaching.

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Electrolyte	Normal Value Range
Serum sodium	135-145 mEq/L
Serum chloride	97-107 mEq/L
Serum potassium	3.5-5:3 mEq/L
Serum magnesium	1.6-2.2 mg/dL
Total serum calcium	8.2-10.2 mg/dL
lonized calcium	4.6-5.3 mg/dL
Serum phosphorus	2.5-4.5 mg/dL
Serum osmolality	275-295 mOsm/kg
Urine osmolality	250-900 mOsm/kg

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client recovering from an esophagogastrectomy is preparing for discharge. What instructions should be included in the dietary teaching for this client?

Correct Answer is B

Explanation

The nurse is participating in a health screening clinic and is preparing teaching materials about colorectal cancer. Which risk factor for colorectal cancer should the nurse include?

Correct Answer is C

Explanation

The nurse is caring for a client who had a bowel resection 2 hours ago for adenocarcinoma removal. It would be necessary for the nurse to immediately notify the surgeon if the client's assessment revealed:

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