# A nurse is assessing a 58-year-old female client who presents with complaints of abdominal bloating, pelvic pressure, and early satiety for the past 3 months. Which assessment finding would be most concerning for ovarian cancer? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=540694 > language: ko > subject: Adult Health ## 문제 A nurse is assessing a 58-year-old female client who presents with complaints of abdominal bloating, pelvic pressure, and early satiety for the past 3 months. Which assessment finding would be most concerning for ovarian cancer? ## 보기 1. Irregular menstrual periods with heavy bleeding 2. Palpable abdominal mass with ascites **✔ 정답** 3. Frequent urinary tract infections 4. Lower back pain radiating to the legs **정답: 2** ## 해설 A palpable abdominal mass with ascites indicates advanced ovarian cancer with possible metastasis, requiring urgent evaluation. Other options are less specific or typical of other conditions. ## 심화 해설 Clinical Presentation and Risk Assessment The client’s symptoms of abdominal bloating, pelvic pressure, and early satiety persisting for 3 months align with the non-specific presentation of ovarian cancer described in the reference material. Ovarian cancer frequently presents with vague abdominal symptoms, which contributes to the challenge of early detection. The reference notes that over 70% of patients worldwide are diagnosed at advanced stages, underscoring the critical need for nurses to recognize findings that raise the index of suspicion beyond common benign conditions [1]. Analysis of Assessment Findings Among the options provided, the finding most concerning for ovarian cancer is a palpable abdominal mass with ascites. This combination represents a more advanced disease presentation and directly reflects the pathophysiology of ovarian cancer. As the tumor grows, it can form a palpable mass and seed malignant cells into the peritoneal cavity, disrupting fluid balance and leading to the accumulation of ascites. This clinical picture is a hallmark sign that requires immediate and thorough diagnostic evaluation. The other options, while potentially present in various gynecological or pelvic conditions, lack the specificity and gravity of a mass with ascites in the context of the stated symptoms: - Irregular menstrual periods with heavy bleeding are more commonly associated with benign conditions like uterine fibroids, endometrial pathology, or perimenopausal hormonal changes. While ovarian tumors can sometimes affect menstruation, it is not the most direct or concerning indicator. - Frequent urinary tract infections suggest an infectious or irritative bladder process. Although an ovarian mass can cause urinary frequency by exerting external pressure, it does not cause true infections. - Lower back pain radiating to the legs is a non-specific symptom often linked to musculoskeletal issues or nerve compression. While advanced pelvic malignancy can cause such pain through nerve involvement, it is less specific than the finding of a mass and ascites. Diagnostic Reasoning and Clinical Implications The reference highlights that ovarian cancer survival is profoundly stage-dependent, with Stage I having a 90% 5-year survival rate compared to only 15% for Stage IV [1]. The presence of a palpable mass and ascites strongly suggests disease that has progressed beyond a very early stage, making this the most alarming assessment finding. Recognizing this clinical picture is crucial for the nurse, as it necessitates prompt advocacy for the diagnostic tests mentioned in the reference, such as cancer antigen 125 (CA-125) blood testing and a pelvic ultrasound, to facilitate rapid secondary care referral and triage [1].References (research sources) - [1]Identifying the best diagnostic test for ovarian cancer - synopsis of Refining Ovarian Cancer Test accuracy Scores (ROCkeTS) research.Research articleSundar S, Agarwal R, Scandrett K, Davenport C, Sturdy L, Ottridge R, Deeks J, ROCkeTS collaborators. (2026) · DOI: 10.3310/bdhs6485 ## 임상 시나리오 Ovarian Cancer Assessment Red FlagsRecognizing advanced disease indicators A palpable abdominal mass combined with ascites in a postmenopausal woman with persistent bloating and early satiety is highly suspicious for advanced ovarian cancer. This reflects peritoneal seeding by malignant cells. Vague, persistent symptoms like pelvic pressure and abdominal bloating lasting more than 2-3 weeks warrant further investigation, as over 70% of cases are diagnosed at an advanced stage. CautionDo not dismiss nonspecific abdominal symptoms in older women. The combination of a mass and ascites is a late sign requiring immediate diagnostic imaging and referral to gynecologic oncology. ## 핵심 개념 - **Ascites** — Pathological accumulation of fluid in the peritoneal cavity, often a sign of advanced ovarian cancer due to peritoneal seeding. - **Early Satiety** — Feeling full after eating only a small amount of food, which can be caused by an abdominal mass pressing on the stomach. - **Palpable Mass** — A lump or growth that can be felt during physical examination, indicating a possible tumor. ## 같은 주제 문제 - [A nurse is assessing a 58-year-old female client who presents with complaints of abdominal…](https://mymerci.kr/pages/nclex_q.php?qn_id=540693) - [A nurse is caring for a 58-year-old female client who underwent total abdominal hysterecto…](https://mymerci.kr/pages/nclex_q.php?qn_id=540695) - [A nurse is caring for a 58-year-old woman who underwent total abdominal hysterectomy with …](https://mymerci.kr/pages/nclex_q.php?qn_id=540696) - [A nurse is caring for a 62-year-old woman who underwent total abdominal hysterectomy with …](https://mymerci.kr/pages/nclex_q.php?qn_id=540697) - [A nurse is caring for a 55-year-old female client who underwent debulking surgery for stag…](https://mymerci.kr/pages/nclex_q.php?qn_id=540698) --- More free questions: [기출문제](https://mymerci.kr/) _학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._