The nurse monitors for which clinical manifestation of metastasis to the liver in the patient diagnosed with esophageal cancer?
Dysphagia
Jaundice
Emesis
Hypercalcemia
The Correct Answer is B
A. Dysphagia is a common symptom of esophageal cancer itself, not necessarily a sign of liver metastasis. Dysphagia occurs due to the tumor obstructing the esophagus.
B. Jaundice, characterized by a yellowing of the skin and sclera, can indicate liver dysfunction or metastasis to the liver. When cancer spreads to the liver, it can disrupt its normal functioning, leading to an accumulation of bilirubin in the body, causing jaundice.
C. Vomiting can occur in esophageal cancer due to obstruction or in advanced stages of the disease, but it is not a direct sign of metastasis to the liver.
D. Hypercalcemia can occur in some cancers, but it is not a typical manifestation of liver metastasis from esophageal cancer. It is more commonly seen in cancers such as breast, lung, or multiple myeloma.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The stoma will be edematous in appearance; this is an expected finding 24 hours after surgery. Mild to moderate edema is normal due to surgical manipulation and should gradually decrease over time.
B. Bowel sounds are often hypoactive or absent immediately post-op due to anesthesia and bowel manipulation, not hyperactive.
C. The colostomy appliance typically remains in place unless there's a leak or issue; routine replacement is not expected at 24 hours post-op.
D. A descending end colostomy involves only one stoma from the proximal end of the bowel; there is no distal stoma, so this option does not apply.
Correct Answer is D
Explanation
A. A small amount of green-tinged fluid from the nasogastric tube is typically expected after bowel resection surgery. The green fluid is usually bile and is a normal finding as the gastrointestinal system adjusts post-operatively.
B. No bowel sounds noted during the assessment can be a normal finding in the immediate post-operative period, particularly after bowel surgery, due to the effects of anesthesia and surgical manipulation. Bowel sounds may be absent for a short time but should gradually return.
C. While this oxygen saturation level of 89% while the client is sleeping is lower than ideal (usually 92% or higher), a drop in oxygen saturation can be due to the effects of anesthesia or sleep, and it may resolve with repositioning or other interventions. However, this may warrant monitoring.
D. Increasing abdominal distention is the most concerning finding and would require immediate notification of the surgeon. It could indicate a bowel obstruction, ileus, or perforation, all of which are serious complications after a bowel resection. Immediate intervention is needed to prevent further complications such as sepsis or shock.
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