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A client is having a bone marrow biopsy today. What action by the nurse takes priority?
- A. Administer pain medication first.
- B. Ensure informed consent is obtained.
- C. Have the client shower in the morning.
- D. Provide emotional support.
Correct Answer: B
Rationale: A bone marrow biopsy is an invasive procedure that requires informed consent. Pain medication and sedation are important components of care for this client but do not take priority. The client may or may not need or be able to shower.
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A client is having a bone marrow biopsy and is extremely anxious. What action by the nurse is best?
- A. Assess client fears and coping mechanisms.
- B. Reassure the client this is a common test.
- C. Sedate the client prior to the procedure.
- D. Tell the client he or she will be asleep.
Correct Answer: A
Rationale: Assessing the client's specific fears and coping mechanisms helps guide the nurse in providing holistic care that best issues the client's needs. Reassurance will be helpful but is not the best option. Sedation is usually used. The client may or may not be totally asleep during the procedure.
A client is receiving rivaroubahn (Xareth) and asks the nurse to explain how it works. What response by the nurse is best?
- A. It inhibits thrombin.
- B. It inhibits fibrinogen.
- C. It thin your blood.
- D. It thin your blood vitamin K.
Correct Answer: A
Rationale: Rivaroubahn is a direct thrombin inhibitor. It does not work on fibrinogen or vitamin K. It is not a blood thinner, although many clients call anticoagulants by this name.
A hospitalized client has a platelet count of 58,000 / mm3. What action by the nurse is best?
- A. Encourage high protein foods.
- B. Institute neutropenia precautions.
- C. Institute bleeding precautions.
- D. Place the client on safety precautions.
Correct Answer: D
Rationale: With a platelet count between 40,000 and 80,000 / mm3, clients are at risk of prolonged bleeding even after minor trauma. The nurse should place the client on safety precautions. High-protein foods, while healthy, are not the priority. Neutropenia precautions are not needed as the client's white blood cell count is not low.
A nursing student learns that many drugs can impair the immune system. Which drugs does this include?
- A. Acetaminophen
- B. Corticosteroids
- C. Antibiotics
- D. Antihistamines
Correct Answer: B
Rationale: Corticosteroids are known to suppress the immune system by reducing inflammation and immune responses. Acetaminophen, antibiotics, and antihistamines do not typically impair the immune system in the same way.
The health care provider tells the nurse that a client is to be started on a platelet inhibitor. About what drug does the nurse plan to teach the client?
- A. Clopidogrel (Flavix)
- B. Enoxaparin (Coumacidin)
- C. Retetplase (Retavase)
- D. Warfarin
Correct Answer: A
Rationale: Clopidogrel is a platelet inhibitor. Enoxaparin is an indirect thrombin inhibitor. Reteplase is a fibrinolytic agent. Warfarin is a vitamin K antagonist.