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A.ls with leukemia is receiving Trimetrexate. After reviewing the client's chart, the physician orders Wellcovorin (leucovorin calcium). The rationale for administering leucovorin calcium to a client receiving Trimetrexate is to:
- A. Treat iron-deficiency anemia caused by chemotherapeutic agents
- B. Create a synergistic effect that shortens treatment time
- C. Increase the number of circulating neutrophils
- D. Reverse drug toxicity and prevent tissue damage
Correct Answer: D
Rationale: Leucovorin calcium is given as a rescue therapy to reverse the toxic effects of trimetrexate, protecting healthy cells from damage.
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A client scheduled for a cardiac catheterization tells the nurse, 'My mother died during this same procedure 10 years ago. I'm afraid the same thing will happen to me.' Which of the following responses by the nurse is the most appropriate?
- A. It's normal to be scared. You are safe here. Let's discuss the procedure.
- B. I'll ask the cardiologist to come and speak with you about your concerns.
- C. We have the best outcomes of any facility in the area for this procedure.
- D. Don't worry. The procedure has improved a lot in the last 10 years.
Correct Answer: A
Rationale: Acknowledging the client’s fear and discussing the procedure provides reassurance and addresses concerns therapeutically.
The nurse is teaching the mother of a newborn to care for the umbilical cord. What should the nurse advise the mother to do if the cord becomes soiled with urine or feces?
- A. Swab with alcohol.
- B. Wipe with a dry cloth.
- C. Wash with mild soap and water, rinse and dry.
- D. Swab with povidone-iodine.
Correct Answer: C
Rationale: Washing with mild soap and water, rinsing, and drying (C) cleans the umbilical cord safely without irritation. Alcohol (A) and povidone-iodine (D) may be too harsh, and a dry cloth (B) is ineffective.
A infant weighs 7 pounds at birth. The expected weight by 1 year should be:
- A. 10 pounds
- B. 12 pounds
- C. 18 pounds
- D. 21 pounds
Correct Answer: D
Rationale: Infants typically triple their birth weight by 1 year, so a 7-pound infant should weigh approximately 21 pounds.
An 88-year-old client fractured a hip after a fall in her home. Because of her peripheral vascular disease and asthma, surgery is not an option. The client tells the nurse she does not know how she is going to get better. Which response by the nurse is best?
- A. You'll do just fine.
- B. You can't live alone anymore.
- C. What are you most worried about?
- D. You should get a second opinion.
Correct Answer: C
Rationale: This response encourages the client to express her concerns, allowing the nurse to address specific fears and provide tailored support.
A client is admitted to the emergency room with a gunshot wound to the right arm. After dressing the wound and administering the prescribed antibiotic, the nurse should:
- A. Ask the client if he has any medication allergies
- B. Check the client's immunization record
- C. Apply a splint to immobilize the arm
- D. Administer medication for pain
Correct Answer: C
Rationale: Immobilizing the arm with a splint prevents further tissue damage and promotes healing, which is a priority after initial wound care and antibiotic administration. Checking for allergies should have been done prior to administering antibiotics, and pain management, while important, is secondary to stabilization.