Nokea
A client with acute leukemia develops a low white blood cell count. In addition to the institution of isolation, the nurse should:
- A. Request that foods be served with disposable utensils
- B. Ask the client to wear a mask when visitors are present
- C. Prep IV sites with mild soap and water and alcohol
- D. Provide foods in sealed, single-serving packages
Correct Answer: D
Rationale: Sealed, single-serving foods reduce infection risk in neutropenic patients.
You may also like to solve these questions
The nurse is preparing to administer a unit of red blood cells (RBCs) to an anemic client. From starting the infusion (puncturing the blood pack) to completion, infusion of the pack should occur within which time period?
- A. 8 hours
- B. 6 hours
- C. 4 hours
- D. 2 hours
Correct Answer: C
Rationale: RBC transfusions must be completed within 4 hours to minimize bacterial growth and ensure safety.
The nursing assistant finds a client on the floor. Once the client is safe, which of the following should the nurse do next?
- A. document the event in the client's medical record only
- B. document the event in the client's medical record and file an incident report
- C. document the event in the client's medical record and have the nursing assistant file an incident report
- D. have the nursing assistant file an incident report
Correct Answer: B
Rationale: Falls require documentation in the medical record and an incident report to track safety issues and ensure follow-up.
The nurse is assessing a client with suspected hyperthyroidism. Which of the following findings would the nurse expect?
- A. Weight gain and lethargy.
- B. Tremors and heat intolerance.
- C. Bradycardia and cool skin.
- D. Increased appetite and constipation.
Correct Answer: B
Rationale: tremors and heat intolerance are common symptoms of hyperthyroidism due to increased metabolic rate
The schizophrenic client has become disruptive and requires seclusion. Which staff member can institute seclusion?
- A. The security guard
- B. The registered nurse
- C. The licensed practical nurse
- D. The nursing assistant
Correct Answer: B
Rationale: An RN has the authority to initiate seclusion based on clinical judgment.
The nurse is assessing a client at home who is receiving outpatient hemodialysis 12 hours a week. The nurse knows the client needs further instruction about proper diet when he states which of the following?
- A. I drink prune juice when I'm constipated.
- B. I drink ginger ale with lunch.
- C. I drink 1 cup of milk with my dinner.
- D. My bread choice is white rather than whole grain.
Correct Answer: C
Rationale: Milk is high in phosphorus and potassium, which should be limited in hemodialysis patients to prevent electrolyte imbalances.