Nokea
A client with a history of chronic lymphocytic leukemia is admitted with fatigue and pallor. Which laboratory value should the nurse monitor?
- A. Hemoglobin
- B. White blood cell count
- C. Platelet count
- D. All of the above
Correct Answer: D
Rationale: Chronic lymphocytic leukemia can cause anemia (low hemoglobin), infection risk (abnormal WBCs), and bleeding risk (low platelets), requiring monitoring of all values.
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To prevent development of peripheral neuropathies associated with isoniazid administration, the nurse should teach the client to:
- A. Avoid excessive sun exposure.
- B. Follow a low-cholesterol diet.
- C. Obtain extra rest.
- D. Supplement the diet with pyridoxine (vitamin B6).
Correct Answer: D
Rationale: Isoniazid can deplete vitamin B6, leading to neuropathy; supplementation prevents this side effect.
Select the types and stages of conflict that are accurately paired with their description. Select all that apply.
- A. Frustration: The phase of conflict that is characterized with personal agendas and obstruction
- B. Conceptualization: The phase of conflict that occurs when contending parties have developed a clear and objective understanding of the nature of the conflict and factors that have led to it
- C. Taking action: The phase of conflict that is characterized with individual responses to and feelings about the conflict
- D. Resolution: The type of conflict that can be resolved
- E. Avoidance-Avoidance: A stage of conflict that occurs when there are NO alternatives that are acceptable to the contending parties
- F. Approach- Approach Conflicts: The type of conflict that occurs when the people involved in the conflict want more than one alternatives or actions that could resolve the conflict.
- G. Approach-Avoidance Conflicts: The type of conflict that occurs when the people involved in the conflict believe that all of the alternatives are NEITHER completely satisfactory nor completely dissatisfactory.
Correct Answer: B,D,F,G
Rationale: Conceptualization is correctly described as understanding the conflict's nature. Resolution refers to conflicts that can be resolved. Approach-Approach (F) involves choosing between desirable alternatives, and Approach-Avoidance (G) involves alternatives with both positive and negative aspects. Frustration is not about personal agendas but emotional responses, Taking action involves implementing solutions, not just feelings, and Avoidance-Avoidance is a type, not a stage, of conflict.
A client had a positive Papanicolaou smear and underwent cryosurgery with laser therapy. What information should the nurse provide the client as a part of discharge teaching?
- A. Pain can be relieved with opioid analgesics.
- B. Sitz baths are soothing to the irritated tissues.
- C. Vaginal discharge should be clear and watery.
- D. There should be absolutely no odor or vaginal discharge.
Correct Answer: C
Rationale: Cryosurgery is a procedure that involves freezing cervical tissues. Vaginal discharge should be clear and watery after the procedure. There is mild pain after the procedure, but opioid analgesics would not be required. Tub and sitz baths are avoided while the area is healing, which takes about 10 weeks. The client will begin to slough off dead cell debris, which may be odorous. This resolves within approximately 8 weeks.
Sertraline is prescribed for a client in the treatment of depression. Before administering the medication, the nurse reviews the client's record and consults with the primary health care provider when which finding is noted?
- A. Prescribed phenelzine sulfate
- B. A history of diabetes mellitus
- C. A history of myocardial infarction
- D. A history of irritable bowel syndrome
Correct Answer: A
Rationale: Sertraline is a serotonin reuptake inhibitor. Serious potentially fatal reactions may occur if sertraline is administered concurrently with a monoamine oxidase inhibitor (MAOI). Phenelzine sulfate is an MAOI. MAOIs should be stopped at least 14 days before sertraline therapy. Sertraline should also be stopped at least 14 days before MAOI therapy. The remaining options are not concerns associated with the administration of this medication.
A client with a diagnosis of breast cancer is prescribed letrozole (Femara). The nurse should instruct the client to report which of the following side effects immediately?
- A. Hot flashes.
- B. Bone pain.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: Bone pain may indicate bone loss or metastasis, a serious side effect of letrozole requiring immediate reporting.