Nokea
After change-of-shift report on the oncology unit, which patient should the nurse assess first?
- A. Patient who has a platelet count of 82,000/μL after chemotherapy
- B. Patient who has xerostomia after receiving head and neck radiation
- C. Patient who is neutropenic and has a temperature of 100.5°F (38.1°C)
- D. Patient who is worried about getting the prescribed long-acting opioid on time
Correct Answer: C
Rationale: Neutropenia plus fever 100.5°F screams infection risk, a sepsis threat needing instant assessment per ABCs in this chemo-ravaged unit. Platelets at 82,000 bleed less urgently; xerostomia's dry mouth annoys, not kills; opioid timing's comfort, not crisis. Nurses hit fever first, anticipating cultures or antibiotics, a life-saving triage in oncology's fragile lineup.
You may also like to solve these questions
Risk factors for developing COPD do not include:
- A. Smoking - passive or active
- B. Age
- C. High fat diet
- D. Indoor and outdoor air pollution
Correct Answer: C
Rationale: COPD's lung wreckers smoking, age, pollution scar airways, no dodge. High fat diet fattens, not chokes lungs; it's metabolic, not respiratory. Nurses target smoke and smog, not butter, a chronic breath stealer's true culprits.
Non modifiable risk factors for developing chronic illness include:
- A. Smoking and hypertension
- B. Sedentary lifestyle and diabetes
- C. Family history and socio-political factors
- D. Working/living conditions and stress
Correct Answer: C
Rationale: Non-modifiable risk factors are inherent traits or circumstances that cannot be changed, unlike modifiable factors tied to behavior or environment. Smoking and hypertension are modifiable through lifestyle changes or medical intervention, not fixed. Sedentary lifestyle is a choice, and diabetes, while influenced by genetics, is often manageable, making them modifiable. Family history, such as genetic predisposition to diseases like cancer or heart disease, is unalterable, and socio-political factors like access to healthcare shaped by policy or socioeconomic status are beyond individual control, fitting the non-modifiable category. Working and living conditions, plus stress, can be adjusted with resources or coping strategies, classifying them as modifiable. The distinction lies in control: family history and socio-political factors remain static, influencing chronic illness risk without personal alteration, as noted in foundational chronic disease literature like Farrell (2017), emphasizing genetics and societal context over mutable habits.
A client admitted for sickle cell crisis is distraught after learning her child also has the disease. What response by the nurse is best?
- A. Both you and the father are equally responsible for passing it on
- B. There are many good treatments for sickle cell disease these days
- C. It's not your fault; there is no way to know who will have this disease
- D. It's understandable that you are upset about this news. Would you like to talk about what you're feeling?
Correct Answer: D
Rationale: Sickle cell's genetic blow autosomal recessive hits emotionally. Acknowledging distress and offering to talk validates feelings, fostering coping over blame or facts alone. Blaming genetics risks guilt, while touting treatments sidesteps her pain. Denying fault misleads carriers are predictable via screening but misses empathy. Nurses prioritize therapeutic communication, opening dialogue to process this crisis, a compassionate bridge to support mother and child through sickle cell's lifelong challenges.
Which of the following cancer patients could potentially be placed together as roommates?
- A. A patient with a neutrophil count of 1000/mm³
- B. A patient who underwent debulking of a tumor to relieve pressure
- C. A patient receiving high-dose chemotherapy after a bone marrow harvest
- D. A patient who is post-op laminectomy for spinal cord compression
Correct Answer: B
Rationale: Roommate pairing hinges on infection risk and care needs. The debulking patient tumor reduced for symptom relief and post-laminectomy patient spinal decompression both underwent palliative surgeries, not inherently immunocompromised, making them compatible. A neutrophil count of 1000/mm³ signals moderate neutropenia, needing isolation to dodge infections. High-dose chemotherapy post-bone marrow harvest obliterates immunity, demanding strict protection. The surgical pair's stability, lacking acute immune suppression, allows safe cohabitation, a nurse's practical call to optimize space and reduce cross-infection risks in cancer care settings.
A 72 years old man is diagnosed to have Type 2 DM, hypertension and hyperlipidemia with stage 3 chronic kidney disease. He is otherwise well and asymptomatic. He is referred to you for follow-up care. His blood pressure is 142/70 mmHg with HbA1c 6.5%. You would continue his following medications EXCEPT
- A. Hydrochlorothiazide 12.5 mg OD
- B. Simvastatin 40 mg ON
- C. Aspirin 100 mg OD
- D. Glibenclamide 10 mg bid
Correct Answer: D
Rationale: Stage 3 CKD eGFR 30-59 means glibenclamide's out; it piles up, risking hypoglycemia in shaky kidneys. Thiazide holds BP, simvastatin guards lipids, aspirin shields heart, irbesartan protects kidneys all stay. Nurses swap sulphonylureas here, dodging chronic sugar crashes in fragile renal states.