Bladder Cancer

A nurse is assessing a 68-year-old male client who has been diagnosed with bladder cancer. Which assessment finding would be most significant for the nurse to report immediately to the healthcare provider?

1 Complaint of mild lower back pain rated 3/10 on pain scale
2 Presence of small blood clots in urine sample
3 Sudden onset of severe flank pain with nausea and vomiting ✓ 정답
4 Frequency of urination every 2-3 hours during the day

해설

Sudden severe flank pain with nausea/vomiting suggests ureteral obstruction, a urologic emergency requiring immediate intervention. Other findings like mild pain, blood clots, or frequency are common but less urgent.

같은 주제 다음 문제A nurse is assessing a 55-year-old female client who has been diagnosed with bladder cance…이 문제가 수록된 문제집[개념+기출] 엔클렉스(NCLEX), 이거 하나면 됩니다69,000원

Clinical Reasoning and Prioritization

When caring for a client with bladder cancer, the nurse must rapidly differentiate between expected disease manifestations and acute complications that signal a threat to organ function or life. The correct answer is the sudden onset of severe flank pain with nausea and vomiting.

Pathophysiology and Clinical Significance

Bladder cancer can cause urinary tract obstruction through direct tumor invasion, bulky intraluminal growth, or clot retention. A sudden obstruction, particularly at the ureterovesical junction or higher, leads to an acute post-renal acute kidney injury (AKI). The resulting hydronephrosis rapidly stretches the renal capsule, producing severe, colicky flank pain. The accompanying nausea and vomiting are visceral reflexes triggered by the intense pain and capsular distension ^[3].

This presentation is a urological emergency. Unrelieved obstruction causes a rapid deterioration of kidney function, diagnosed by a rise in serum creatinine and a decrease in urine output ^[3]. Without immediate intervention, such as percutaneous nephrostomy or ureteral stenting, the obstruction can lead to irreversible nephron damage and life-threatening electrolyte imbalances like hyperkalemia. This aligns with the understanding that in urological conditions, AKI frequently results from genitourinary tract obstruction and requires prompt diagnosis and management to correct the underlying cause ^[3].

Analysis of Other Options

- Option 1 (Mild lower back pain): While pain requires assessment and management, a low-intensity, non-acute complaint does not signal an immediate physiological crisis. It is a lower priority than a finding indicative of acute organ obstruction.
- Option 2 (Small blood clots in urine): Hematuria with clots is a common and expected finding in bladder cancer. It requires monitoring for clot retention and anemia but does not represent an acute, emergent change in status like sudden obstruction.
- Option 4 (Urinary frequency every 2-3 hours): This is a classic lower urinary tract symptom associated with bladder lesions and irritation. It is a chronic management issue, not an acute emergency, and does not take priority over a finding that suggests impending renal failure.

The nurse’s immediate priority is to recognize the clinical picture of acute ureteral obstruction—sudden severe flank pain with systemic symptoms—and report it immediately to prevent permanent kidney damage ^[3].

References (research sources)

[3]
Acute kidney injury in urological conditions.Research articleWeerapolchai K, Lumlertgul N, Srisawat N, Ostermann M. (2026) · DOI: 10.2478/abm-2026-0002

NCLEX Question Bank 엔클렉스 3,445 문제 · 로그인 없이 바로 볼 수 있어요

마이메르시로 국가고시 완벽 대비

기출문제와 상세 해설을 무료로. 내 약점을 분석하고 진도를 관리하며 더 똑똑하게 공부하세요.

무료로 시작하기

App Store Google Play

학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요.

이 문제가 수록된 문제집 [개념+기출] 엔클렉스(NCLEX), 이거 하나면 됩니다 문제집 3,445문제 · 69,000원

문제집 보기 다음 문제

같은 단원 문제

마이메르시로 국가고시 완벽 대비

기출문제와 상세 해설을 무료로. 내 약점을 분석하고 진도를 관리하며 더 똑똑하게 공부하세요.

무료로 시작하기

다음 문제 무료로 시작하기

성장을 멈추지 마세요

A nurse is assessing a 68-year-old male client who has been diagnosed with bladder cancer. Which assessment finding would be most significant for the nurse to report immediately to the healthcare provider?

마이메르시로 국가고시 완벽 대비