Advanced Oncology Certified Nurse Practitioner (AOCNP) Certification Practice Test

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Which of the following is NOT a risk factor for TLS?

Dehydration
Oliguria
Advanced age
Hyperuricemia

The correct answer is: Advanced age

Advanced age is considered a less significant direct risk factor for tumor lysis syndrome (TLS) compared to other options listed. While it is true that older patients may have a different physiological response to cancer and treatment, the most commonly recognized risk factors for TLS are metabolic and physiological changes associated with the cancer itself and its treatment. Dehydration contributes to the risk of TLS as it can decrease renal perfusion and lead to increased uric acid concentrations in the blood. Oliguria, or reduced urine output, is a serious concern for TLS as it hampers the kidneys' ability to excrete uric acid and other metabolites, leading to their accumulation. Hyperuricemia, which refers to elevated levels of uric acid in the blood, is a direct consequence of tumor lysis and is a hallmark feature of TLS. In contrast, while advanced age may affect the overall management of cancer treatment and outcomes, it does not have the same direct biochemical implications that the other options have in precipitating TLS. Hence, recognizing the primary metabolic pathways and their implications is crucial in understanding the risk factors associated with this syndrome.