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A nurse is caring for a client who is receiving chemotherapy. Which of the following laboratory values should the nurse report to the provider?
- A. WBC 4,500/mm3
- B. Hemoglobin 12 g/dL
- C. Platelet count 250,000/mm3
- D. Platelet count 100,000/mm3
Correct Answer: D
Rationale: The correct answer is D. A platelet count of 100,000/mm3 is lower than the normal range, indicating thrombocytopenia, which is concerning in clients receiving chemotherapy. Thrombocytopenia can lead to an increased risk of bleeding and bruising. Choices A, B, and C fall within the normal range and would not be a cause for concern in a client receiving chemotherapy.
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A nurse is caring for a client who is 32 weeks pregnant and has cardiac disease. Which of the following positions should the nurse place the client in to promote optimal cardiac output?
- A. Semi-Fowler's
- B. Supine with head elevated
- C. Left lateral
- D. Right lateral
Correct Answer: C
Rationale: The correct answer is C: Left lateral. Placing the client in the left lateral position helps promote optimal cardiac output during pregnancy by avoiding pressure on the vena cava. This position improves venous return to the heart and subsequently cardiac output. Option A, Semi-Fowler's position, may not be the best choice for a client with cardiac disease as it does not alleviate pressure on the vena cava. Option B, supine with head elevated, can also compress the vena cava, reducing cardiac output. Option D, right lateral position, does not provide the same benefits as the left lateral position for cardiac output during pregnancy.
What is the best dietary recommendation for a patient with chronic liver disease?
- A. Low protein diet
- B. High protein diet
- C. Low sodium diet
- D. High sodium diet
Correct Answer: A
Rationale: The best dietary recommendation for a patient with chronic liver disease is a low protein diet. In liver disease, the liver may have difficulty processing protein, leading to the accumulation of toxins like ammonia in the body. A low protein diet helps reduce the burden on the liver and minimizes the production of these harmful substances. High protein diets can exacerbate the condition by increasing the workload on the liver. A low sodium diet (Choice C) is also important for liver disease patients as excess sodium can contribute to fluid retention and swelling, but reducing protein intake is the primary focus in these cases.
A client has a new prescription for levothyroxine. Which of the following instructions should the nurse include?
- A. Take this medication in the evening before bed.
- B. Take this medication on an empty stomach.
- C. Take this medication with a full glass of milk.
- D. Take this medication with an antacid if you experience indigestion.
Correct Answer: B
Rationale: The correct instruction when taking levothyroxine is to take it on an empty stomach. This enhances absorption and ensures the medication's effectiveness. Taking it with food or other substances, such as milk or antacids, can interfere with its absorption. Therefore, choices A, C, and D are incorrect.
Which of the following lab values should the nurse monitor for a patient receiving heparin therapy?
- A. Monitor platelet count
- B. Monitor PT/INR
- C. Monitor aPTT
- D. Monitor CBC
Correct Answer: C
Rationale: The correct answer is to monitor aPTT for a patient receiving heparin therapy. The activated partial thromboplastin time (aPTT) is used to assess and adjust heparin dosage to ensure the patient is within the therapeutic range for anticoagulation. Monitoring the aPTT helps in preventing both clotting and bleeding complications. Platelet count (Choice A) is important to monitor for patients receiving antiplatelet therapy, not heparin. PT/INR (Choice B) is typically monitored for patients on warfarin therapy, not heparin. Monitoring the complete blood count (CBC) (Choice D) is essential for various conditions but is not specific to monitoring heparin therapy.
A client has a new prescription for digoxin. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime to prevent nausea.
- B. Take this medication with a full glass of milk.
- C. Notify your provider if you experience visual disturbances.
- D. Report any muscle pain to your provider.
Correct Answer: C
Rationale: The correct answer is C: 'Notify your provider if you experience visual disturbances.' Visual disturbances can indicate digoxin toxicity, so it is essential for clients taking digoxin to report any changes in vision to their healthcare provider. Option A is incorrect because the timing of digoxin administration is crucial, usually in the morning. Option B is inaccurate because digoxin should not be taken with milk as it can affect its absorption. Option D is not directly associated with digoxin use and should not be the priority instruction for a client on this medication.