Nokea
A client receiving chemotherapy has an extremely low white blood cell count and is immediately placed on neutropenic precautions that include a low-bacteria diet. Which food items is the client now allowed to consume? Select all that apply.
- A. Raw celery
- B. Fresh apple
- C. Italian bread
- D. Tossed salad
- E. Baked chicken
- F. Well-cooked cheeseburger
Correct Answer: C,E,F
Rationale: An extremely low white blood cell count places the client at risk for infection. In the immunocompromised client, a low-bacteria diet is implemented. Italian bread, baked chicken, and a well-done cheeseburger are acceptable to consume because all products are thoroughly cooked. The client avoids eating fresh fruits and vegetables. Fresh fruits and vegetables harbor organisms and place the client at risk for infection.
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The nurse is assigned to care for a client with a diagnosis of preeclampsia. The nurse should plan to implement which action to provide a safe environment?
- A. Maintain fluid and sodium restrictions.
- B. Take the client's vital signs every 4 hours.
- C. Turn off the room lights and draw the window shades.
- D. Encourage visits from family and friends for psychosocial support.
Correct Answer: C
Rationale: Clients with preeclampsia are at risk of developing eclampsia (seizures). Bright lights and sudden loud noises may initiate seizures in this client. A woman with preeclampsia should be placed in a dimly lighted, quiet, private room. Clients with preeclampsia have decreased plasma volume, and adequate fluid and sodium intake is necessary to maintain fluid volume and tissue perfusion. Vital signs need to be monitored more frequently than every 4 hours when preeclampsia is present. Visitors should be limited to allow for rest and prevent overstimulation.
The nurse needs to withdraw a prescribed 7000 units from the medication vial for administration. For a safe dose of medication how many milliliters should the nurse withdraw? Fill in the blank and record your answer using one decimal place.
Correct Answer: 1.4
Rationale: Use the medication calculation formula. Since this is a fill-in-the-blank question, the answer is 1.4 mL,
The nurse is teaching a client with a diagnosis of cardiomyopathy about home care safety measures. Which instruction is most important for the nurse to include?
- A. Reporting pain
- B. Appropriate vasodilator administration
- C. Avoiding over-the-counter medications
- D. Moving slowly from a sitting to a standing position
Correct Answer: D
Rationale: Orthostatic changes can occur in the client with cardiomyopathy as a result of venous return obstruction. Sudden changes in blood pressure may lead to falls. Reporting pain, while important, is not directly related to the issue of safety. Vasodilators are not normally prescribed for the client with cardiomyopathy. Option 3, although important, is not directly related to the issue of safety.
The nurse is planning care for a client with a diagnosis of acute glomerulonephritis. Which action should the nurse instruct the unlicensed assistive personnel (UAP) to implement in the care of the client?
- A. Ambulate the client frequently.
- B. Encourage a diet that is high in protein.
- C. Monitor the temperature every 2 hours.
- D. Remove the water pitcher from the bedside.
Correct Answer: D
Rationale: A client with acute glomerulonephritis commonly experiences fluid volume excess and fatigue. Interventions include fluid restriction, as well as monitoring weight and intake and output. The client may be placed on bed rest or at least encouraged to rest because a direct correlation exists among proteinuria, hematuria, edema, and increased activity levels. The diet is high in calories but low in protein. It is unnecessary to monitor the temperature as frequently as every 2 hours.
The post-myocardial infarction client is scheduled for a technetium-99 m ventriculography (multigated acquisition [MUGA] scan). The nurse should ensure that which item is in place before the procedure?
- A. A Foley catheter
- B. Signed informed consent
- C. A central venous pressure (CVP) line
- D. Notation of allergies to iodine or shellfish
Correct Answer: B
Rationale: MUGA is a radionuclide study used to detect myocardial infarction and decreased myocardial blood flow and to determine left ventricular function. A radioisotope is injected intravenously. Therefore, a signed informed consent is necessary. A Foley catheter and CVP line are not required. The procedure does not use radiopaque dye; therefore, allergy to iodine and shellfish is not a concern.