Nokea
A Schilling test has been ordered for a client suspected of having pernicious anemia. What is the nurse's primary responsibility in relation to this test?
- A. Collect the blood samples
- B. Collect a 24-hour urine sample
- C. Assist the client to x-ray
- D. Administer an enema
Correct Answer: B
Rationale: The Schilling test involves administering radioactive vitamin B12 orally and collecting a 24-hour urine sample to assess absorption, indicating the nurse's primary responsibility.
You may also like to solve these questions
The client diagnosed with leukemia has central nervous system involvement. Which instruction should the nurse teach?
- A. Sleep with the HOB elevated to prevent increased intracranial pressure.
- B. Take an analgesic medication for pain only when the pain becomes severe.
- C. Explain radiation therapy to the head may result in permanent hair loss.
- D. Discuss end-of-life decisions prior to cognitive deterioration.
Correct Answer: D
Rationale: CNS leukemia risks cognitive decline; discussing end-of-life decisions (D) is critical before deterioration. HOB elevation (A) is for ICP, not routine, analgesics (B) should be proactive, and hair loss (C) is secondary.
Which concepts could the nurse identify for a client diagnosed with lymphoma? Select all that apply.
- A. Coping.
- B. Hematologic regulation.
- C. Tissue perfusion.
- D. Clotting.
- E. Clinical judgment.
Correct Answer: A,B,C,D
Rationale: Lymphoma involves coping (A) with diagnosis, hematologic regulation (B) via lymph dysfunction, perfusion (C) due to node obstruction, and clotting (D) from thrombocytopenia. Clinical judgment (E) is a nursing process, not a patient concept.
The nurse receives orders after notifying an HCP about the client who has tachycardia, diaphoresis, and an elevated temperature after treatments for ALL. Which order should be the nurse’s priority?
- A. Portable chest x-ray in the client’s room
- B. Urine culture, and blood cultures x 2
- C. Vancomycin 500 mg IV q6h
- D. Filgrastim 0.3 mg subcut daily
Correct Answer: B
Rationale: A. The results of the portable CXR will help determine if the cause is a respiratory infection. It will not change the treatment. B. Urine and blood cultures are priority; these should be obtained before antibiotics are administered. C. National recommendations are to administer broad-spectrum antibiotics such as vancomycin (Vancocin) within 1 hour of a suspected infection diagnosis. The antibiotics may be changed after culture and sensitivity reports are available (usually 24 to 48 hours). D. It takes 4 days for filgrastim (Neupogen) to return the neutrophil count to baseline, so this is not priority. Filgrastim should not be given within 24 hours of cytotoxic chemotherapy.
The client diagnosed with sickle cell anemia comes to the emergency department complaining of joint pain throughout the body. The oral temperature is 102.4°F and the pulse oximeter reading is 91%. Which action should the emergency department nurse implement first?
- A. Request arterial blood gases STAT.
- B. Administer oxygen via nasal cannula.
- C. Start an IV with an 18-gauge angiocath.
- D. Prepare to administer analgesics as ordered.
Correct Answer: B
Rationale: SpO2 91% and fever suggest hypoxia in SCA crisis; oxygen via cannula (B) addresses this first. ABGs (A), IV (C), and analgesics (D) follow to confirm hypoxia, hydrate, and manage pain.
The client diagnosed with cancer has been undergoing systemic treatments and has red blood cell deficiency. Which signs and symptoms should the nurse teach the client to manage?
- A. Nausea associated with cancer treatment.
- B. Shortness of breath and fatigue.
- C. Controlling mucositis and diarrhea.
- D. The emotional aspects of having cancer.
Correct Answer: B
Rationale: RBC deficiency (anemia) causes shortness of breath and fatigue (B), which clients should manage. Nausea (A), mucositis/diarrhea (C), and emotions (D) are unrelated to anemia.