A client with metastatic breast cancer reports new onset of mid-thoracic back pain that worsens when lying down. The client also states, "My legs feel weak today."

Rationale: A. These findings suggest possible spinal cord compression, an oncologic emergency commonly seen in metastatic cancer. The priority nursing action is focused assessment—evaluating lower-extremity strength, sensation, and monitoring for bowel or bladder dysfunction. Early detection of neurological deficits is critical to prevent permanent paralysis and guides urgent intervention. B. Inserting an IV and administering fluids does not address the underlying neurological concern. While IV access may eventually be needed, it is not the priority action in this situation. C. Notifying the health care provider is essential, but nursing priority follows the assessment-first principle. The nurse must first gather critical data about neurological status to report accurate and complete information. D. Elevating the head of the bed and administering oxygen is appropriate for respiratory distress, which is not indicated in this scenario. These interventions do not address the suspected spinal cord compression.