84.

1, 2, 5, 6

Cancer is a common cause of syndrome of inappropriate antidiuretic hormone (SIADH). In

SIADH, excessive amounts of water are reabsorbed by the kidney and put into the systemic
circulation. The increased water causes hyponatremia (decreased serum sodium levels) and
some degree of fluid retention. The syndrome is managed by treating the condition and cause
and usually includes fluid restriction, increased sodium intake, and medication with a
mechanism of action that is antagonistic to antidiuretic hormone. Sodium levels are monitored
closely because hypernatremia can develop suddenly as a result of treatment. The immediate
institution of appropriate cancer therapy, usually radiation or chemotherapy, can cause tumor
regression so that antidiuretic hormone synthesis and release processes return to normal.

96. c. Hypercalcemia is a serum calcium level greater than 10.0 mg/dL. It most often occurs in
clients who have bone metastasis and is a late manifestation of extensive malignancy. The
presence of cancer in the bone causes the bone to release calcium into the bloodstream.
Hypercalcemia is an oncological emergency, and the HCP needs to be notified. Options 2, 3,
and 4 indicate normal laboratory values.

97. d .Bone marrow aspiration or biopsy allows examination of blast cells and other hypercellular
activity. Blood studies will not provide a definitive diagnosis of leukemia.

98. 2, 4, 5

In the immunocompromised client a low-bacteria diet is necessary. This includes avoiding the
intake of fresh fruits and vegetables. Thorough cooking of all food also is required. Cut flowers
or any standing water is removed from the room because either tends to harbor bacteria.
Anyone who enters the client's room should perform strict and thorough hand washing and wear
a mask.

99. a Cachexia accompanies chronic wasting diseases and conditions such as cancer, dehydration, and
starvation. Assessment findings in a client with cachexia include sunken eyes; hollow cheeks; and an
exhausted, defeated expression. Options 1, 3, and 4 are not characteristic of a cachectic appearance.