Urinary Disorders Q 146 - Gyan Darpan : Learning Portal
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Monday 4 April 2022

Urinary Disorders Q 146

If a client’s prostate enlargement is caused by a malignancy, which of the following blood examinations should the nurse anticipate to assess whether metastasis has occurred?
    A. Serum creatinine level
    B. Serum acid phosphatase level
    C. Total nonprotein nitrogen level
    D. Endogenous creatinine clearance time

Correct Answer: B. Serum acid phosphatase level

The most specific examination to determine whether a malignancy extends outside of the prostatic capsule is a study of the serum acid phosphatase level. The level increases when a malignancy has metastasized. The prostate-specific antigen (PSA) determination and a digital rectal examination are done when screening for prostate cancer.

Option A: Elevated serum creatinine levels and a decreased CrCl rate are usually indications for abnormal renal function. For these patients, it is recommended to perform a thorough history, physical exam, renal ultrasound, and urinalysis. Creatinine is a breakdown product of dietary meat and creatine phosphate found in skeletal muscle. Its production in the body is dependent on muscle mass.
Option C: Total nonprotein nitrogen level gives information about kidney function, not prostate malignancy. The accumulation of nitrogenous compounds in the blood constitutes the most characteristic biochemical change of renal insufficiency. The degree of retention is variously expressed in terms of the concentration of blood urea, blood urea nitrogen (BUN), or nonprotein nitrogen (NPN), and this may occasionally cause confusion. The BUN, widely used in the United States, and the blood urea level, more frequently employed in Europe, can be used interchangeably (by using a conversion factor of 2:1). The NPN however cannot be accurately converted to BUN.
Option D: Creatinine clearance (CrCl) is the volume of blood plasma cleared of creatinine per unit time. It is a rapid and cost-effective method for the measurement of renal function. A physician may require a creatinine clearance test from patients when routine blood creatinine levels or the estimated GFR are not within normal ranges.

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