# A nurse is assessing a 58-year-old client with suspected esophageal cancer. Which assessment finding would be most significant for the nurse to report immediately to the healthcare provider? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=540713 > language: ko > subject: Adult Health ## 문제 A nurse is assessing a 58-year-old client with suspected esophageal cancer. Which assessment finding would be most significant for the nurse to report immediately to the healthcare provider? ## 보기 1. Complete inability to swallow liquids with immediate regurgitation **✔ 정답** 2. Mild chest discomfort when swallowing solid foods 3. Hoarse voice that has persisted for 2 weeks 4. Weight loss of 8 pounds over the past 3 months **정답: 1** ## 해설 Complete inability to swallow liquids with immediate regurgitation indicates severe esophageal obstruction, a medical emergency requiring immediate intervention to prevent aspiration and maintain nutrition. Other findings (mild discomfort, hoarseness, weight loss) are less urgent or expected in esophageal cancer. ## 심화 해설 Clinical Priority Analysis The correct answer is Complete inability to swallow liquids with immediate regurgitation. In the context of suspected esophageal cancer, this finding represents a critical progression of dysphagia that demands immediate reporting. Pathophysiology and Clinical Reasoning Dysphagia in esophageal cancer typically follows a predictable progression. Initially, patients experience difficulty swallowing solid foods, which may advance to difficulty with soft foods, and ultimately, to an inability to swallow liquids. When a client reaches the point of being completely unable to swallow liquids with immediate regurgitation, it signifies a near-total or total luminal obstruction. This is a medical emergency for several reasons. First, it places the patient at immediate and severe risk for aspiration, as oral secretions and any ingested material cannot pass into the stomach and may spill into the airway. Second, it completely halts oral hydration and nutrition, leading to rapid dehydration and nutritional decline. As highlighted in the provided evidence, dysphagia can stem not only from intrinsic tumor growth but also from extrinsic esophageal compression by mediastinal masses [2]. A complete obstruction, regardless of the precise mechanism, requires urgent intervention, such as esophageal stenting, to restore lumen patency, prevent aspiration, and allow for oral intake, thereby improving quality of life [1]. Analysis of Other Options Option 2, mild chest discomfort when swallowing solids, is a classic early symptom of esophageal pathology and is consistent with the suspected diagnosis. While it requires thorough investigation, it does not represent an acute, life-threatening change. Option 3, a hoarse voice persisting for 2 weeks, is a significant finding that may indicate tumor invasion of the recurrent laryngeal nerve, a known complication of advanced esophageal or mediastinal malignancy. This finding necessitates prompt reporting and workup, but it does not pose the same immediate risk to airway integrity and hydration as a complete esophageal obstruction. Option 4, an 8-pound weight loss over 3 months, is a critical indicator of the cancer's metabolic impact and chronic nutritional deficit. This finding is highly concerning and must be addressed, but it reflects a gradual decline rather than an acute crisis requiring an immediate, stat-page intervention like a complete inability to swallow. NCLEX-RN Application This question tests the core nursing competency of clinical prioritization, specifically using the ABC (Airway, Breathing, Circulation) framework and Maslow's hierarchy of needs. A complete esophageal obstruction directly threatens the airway (risk of aspiration) and a basic physiological need (hydration). When analyzing assessment data, the nurse must distinguish between expected disease progression, a serious complication, and an acute emergency. The inability to swallow liquids with regurgitation signals a transition from a manageable symptom to an immediate threat to airway patency and physiological stability, making it the most significant finding to report immediately. References (research sources) - [1]Dysphagia Revealing Pulmonary Squamous Cell Carcinoma: Successful Palliation With Esophageal Stenting in an Elderly Patient.Research articleBelaich M, Bentayeb A, El Mazghi M, Assili A, Zouaoui M, Azouaoui M, Hnach Y, Aqodad N. (2026) · DOI: 10.1002/ccr3.72370 - [2]Dysphagia Secondary to Extrinsic Esophageal Compression From an Anterior Mediastinal Squamous Cell Carcinoma.Research articleIzadian Bidgoli A, Gomez Veliz A. (2026) · DOI: 10.7759/cureus.109053 ## 임상 시나리오 Complete Esophageal ObstructionImmediate Priority Nursing Action Inability to swallow liquids with immediate regurgitation indicates a total or near-total luminal obstruction. This is a medical emergency due to the high risk of aspiration and complete cessation of oral hydration. Dysphagia in esophageal cancer typically progresses from solids to soft foods and finally to liquids. The onset of liquid dysphagia signals critical tumor burden and requires urgent intervention such as esophageal stenting to restore lumen patency. CautionKeep the patient NPO immediately. Position the patient upright to minimize aspiration risk of oral secretions. Do not attempt to force oral intake, as this directly increases aspiration risk. ## 핵심 개념 - **Dysphagia** — Difficulty swallowing; in esophageal cancer, it often progresses from solids to liquids as the tumor obstructs the lumen. - **Luminal Obstruction** — Blockage of the esophageal passage, which can lead to complete inability to swallow and immediate regurgitation. - **Aspiration** — Inhalation of foreign material (e.g., saliva, food, liquid) into the airway, a major risk with complete esophageal obstruction. - **Esophageal Stenting** — A palliative intervention to restore lumen patency in cases of malignant obstruction, allowing for oral intake. ## 같은 주제 문제 - [A 65-year-old male patient presents with a 3-month history of difficulty swallowing and un…](https://mymerci.kr/pages/nclex_q.php?qn_id=540712) - [A nurse is assessing a 65-year-old male patient with a 6-week history of odynophagia and r…](https://mymerci.kr/pages/nclex_q.php?qn_id=540714) - [A nurse is caring for a client who underwent esophagectomy for esophageal cancer 24 hours …](https://mymerci.kr/pages/nclex_q.php?qn_id=540715) - [A nurse is caring for a client with esophageal cancer who underwent esophagectomy 48 hours…](https://mymerci.kr/pages/nclex_q.php?qn_id=540716) - [A nurse is caring for a client who underwent colectomy for colon cancer 3 days ago. Which …](https://mymerci.kr/pages/nclex_q.php?qn_id=540717) --- More free questions: [기출문제](https://mymerci.kr/) _학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._