Nokea
A student studying leukemia learns the risk factors for developing this disorder. Which risk factors does this include? (Select all that apply.)
- A. Chemical exposure
- B. Genetically modified foods
- C. Ionizing radiation exposure
- D. Vaccinations
- E. Viral infections
Correct Answer: A,C,E
Rationale: Chemical exposure, ionizing radiation, and viral infections are known risk factors for leukemia. Genetically modified foods and vaccinations have not been established as risk factors.
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A client has heparin-induced thrombocytopenia (HIT). The student nurse asks how this is treated. About what drugs does the nurse instructor teach? (Select all that apply.)
- A. Argatroban (Argatroban)
- B. Bivalirudin (Angiomax)
- C. Clopidogrel (Plavix)
- D. Lepirudin (Refludan)
- E. Methylprednisolone (Solu-Medrol)
Correct Answer: A,B,D
Rationale: Argatroban, bivalirudin, and lepirudin are direct thrombin inhibitors used to treat HIT. Clopidogrel is an antiplatelet agent, and methylprednisolone is a steroid, neither used for HIT.
A client with sickle cell disease (SCD) takes hydroxyurea (Droxia). The client presents to the clinic reporting an increase in fatigue. What laboratory result should the nurse report immediately?
- A. Hematocrit: 25%
- B. Hemoglobin: 2.2 mg/dL
- C. Potassium: 3.2 mEq/L
- D. White blood cell count: 38,000/mm3
Correct Answer: D
Rationale: Although individuals with SCD often have elevated white blood cell counts, an extreme elevation like 38,000/mm3 could indicate leukemia, a serious complication of hydroxyurea, or a severe infection, both critical in SCD patients. Hematocrit and hemoglobin levels are typically low in SCD, and the potassium level, while slightly low, is less urgent.
The nurse is caring for a client with leukemia who has the priority problem of fatigue. What action by the client indicates this need has been met?
- A. Doing activities of daily living (ADLs) using rest periods
- B. Helping plan a daily activity schedule
- C. Requesting a sleeping pill at night
- D. Telling visitors to leave when fatigued
Correct Answer: A
Rationale: Fatigue is a common problem for clients with leukemia. This client is managing his or her own ADLs using rest periods, which indicates an understanding of fatigue and how to control it. Helping to plan an activity schedule is a lesser indicator. Requesting a sleeping pill does not control fatigue during the day. Asking visitors to leave when tired is another lesser indicator. Managing ADLs using rest periods demonstrates the most comprehensive management strategy.
A nurse caring for a client with sickle cell disease (SCD) reviews the clients laboratory work. Which finding should the nurse reports to the provider?
- A. Creatinine: 2.9 mg/dL
- B. Hemlacture: 30.9%
- C. Sodium: 147 mEq/L
- D. White blood cell count: 12,000/mm3
Correct Answer: A
Rationale: An elevated creatinine indicates kidney damage, which occurs in SCD. A hematocrit level of 30.9% is an expected finding, as is a slightly elevated white blood cell count. A sodium level of 147 mEq/L, although slightly high, is not concerning.
A client has thrombocytopenia. What client statement indicates the client understands self-management of this condition?
- A. I brush and use dental floss every day.
- B. I chew hard candy for my dry mouth.
- C. I usually put ice on bumps or bruises.
- D. Nonslip socks are best when I walk.
Correct Answer: C
Rationale: The client should be taught to apply ice to areas of minor trauma to reduce bleeding risk. Flossing is not recommended due to the risk of gum bleeding. Hard foods should be avoided to prevent injury, and while nonslip socks promote safety, they do not directly address thrombocytopenia management.