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A client with neutropenia has an absolute neutrophil count of 900. What is the client's risk of infection?
- A. Normal risk.
- B. Moderate risk.
- C. High risk.
- D. Extremely high risk.
Correct Answer: C
Rationale: An absolute neutrophil count (ANC) of 900 indicates moderate to severe neutropenia (ANC <1,000). This places the client at high risk for infection, as neutrophils are critical for fighting pathogens. Normal risk is ANC >1,500, and extremely high risk is ANC <200.
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The nurse is providing discharge instructions to a client who underwent left eye cataract surgery with a lens implant. Which statement by the client would indicate a correct understanding of the teaching?
- A. I should avoid getting water in the eye for 3 to 7 days after surgery.'
- B. It is okay for me to resume normal chores such as vacuuming.'
- C. It is okay for me to have green or yellow, thick drainage from the eye.'
- D. I may take aspirin for any pain I may experience.'
Correct Answer: A
Rationale: Avoiding water in the eye for 3-7 days post-cataract surgery prevents infection. Heavy chores like vacuuming, abnormal drainage, and aspirin use (which risks bleeding) are contraindicated.
The nurse is assessing a client with cirrhosis who has developed hepatic encephalopathy. The nurse should notify the physician of a decrease in which lab serum that is a potential precipitating factor for hepatic encephalopathy?
- A. Aldosterone.
- B. Creatinine.
- C. Potassium.
- D. Protein.
Correct Answer: C
Rationale: Hypokalemia (C) can precipitate hepatic encephalopathy by increasing ammonia production. Aldosterone (A), creatinine (B), and protein (D) are less directly related.
In planning care for the client who has had a stroke, the nurse should obtain a history of the client's functional status before the stroke because?
- A. The rehabilitation plan will be guided by it.
- B. Functional status before the stroke will help predict outcomes.
- C. It will help the client recognize his physical limitations.
- D. The client can be expected to regain much of his functioning.
Correct Answer: A
Rationale: A pre-stroke functional status history guides the rehabilitation plan by setting realistic goals based on prior abilities. Predicting outcomes, recognizing limitations, or expecting full recovery are secondary or unrealistic.
A client treated for hypertension with furosemide (Lasix), atenolol (Tenormin), and ramipril (Altace) develops a second degree heart block Mobitz type 1. Which of the following actions should the nurse take?
- A. Administer a 250 mL fluid bolus.
- B. Withhold the atenolol.
- C. Prepare for cardioversion.
- D. Set up for an arterial line.
Correct Answer: B
Rationale: Atenolol, a beta-blocker, can exacerbate heart block by slowing conduction. Withholding it and consulting the physician is the priority.
The nurse is conducting a postoperative assessment of a client on the first day after renal surgery. Which of the following findings would be most important for the nurse to report to the physician?
- A. Temperature, 99.8°F (37.7°C).
- B. Urine output, 20 mL/hour.
- C. Absence of bowel sounds.
- D. A 2€ x 2€ area of serosanguineous drainage on the flank dressing.
Correct Answer: B
Rationale: Urine output of 20 mL/hour is critically low, indicating potential renal compromise or obstruction, requiring immediate physician notification.