A nurse runs into an old high school friend after 20 years. She notes her friend continues to smoke after all these years. The friend asks, "Do you think I sound hoarse?"

Question

Upon further assessment, the nurse/friend notes her friend has several warning signs of cancer. Which manifestations would lead to this conclusion? Select all that apply.
A) "I seem to have some difficulty swallowing food… this is new for me."
B) "I seem to have more trouble holding my urine than I use to."
C) "Can you feel how large my lymph nodes are on my neck and armpits (axillae)?"
D) Pericardial friction rub heard on auscultation.
E) Feels subcutaneous emphysema in upper chest area.

Answer 1

Ans: A, C
Feedback:
Tumors that invade the mediastinum may cause hoarseness because of the involvement of the recurrent laryngeal nerve and cause difficulty in swallowing because of compression of the esophagus. An uncommon complication called the superior vena cava syndrome occurs in some persons with mediastinal involvement. Interruption of blood flow in this vessel usually results from compression by the tumor or involved lymph nodes. Urinary incontinence, pericardial friction rub, and subcutaneous emphysema are not related to this cancer but can occur as complications from treatments.