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. Requesting antidepressant medication may be appropriate later, but it does not address the immediate need for emotional support and communication.
B. Encouraging the client to verbalize feelings about their diagnosis provides an opportunity for the client to express their concerns and emotions, fostering a therapeutic relationship and aiding in emotional processing.
C. While explaining improved prognosis can provide hope, it may minimize the client’s feelings of fear and uncertainty and could be perceived as dismissive.
D. Allowing time for reflection is important, but it should be balanced with the need for communication and support to prevent isolation.

A. Lesion of cranial nerve IX B. Vestibular disease C. Dysfunction of the cerebellum D. Arteriovenous malformation (AVM) at frontal lobe

Correct Answer is C

Explanation

A. A lesion of cranial nerve IX primarily affects swallowing and taste sensations rather than motor coordination or balance, so this is unlikely to explain the patient's symptoms.
B. Vestibular disease typically results in vertigo and balance issues, but the specific observations of slow alternating movements and loss of balance during the Romberg Test suggest a different underlying cause.
C. Dysfunction of the cerebellum would explain the patient's difficulties with rapid alternating movements and balance issues, as the cerebellum is responsible for coordinating motor activity and maintaining posture and balance. This aligns with the assessment findings, indicating a probable cerebellar dysfunction.
D. While an AVM in the frontal lobe could affect motor control, the specific symptoms presented, such as the inability to perform rapid movements and balance issues, are more characteristic of cerebellar dysfunction rather than a frontal lobe lesion.

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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 nurse is caring for a client who has been newly diagnosed with cancer. The client has become withdrawn from family members. Which strategy will the nurse use to assist the client at this time?

Correct Answer is B

Explanation

Correct Answer is C

Explanation

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