Nokea
Cup of decatfeinated coffee for breakfast and lunch, 90 mL apple juice, 120 mL ice cream, 180 mL chicken broth, mashed potatoes, few bites of chicken, bowl of carrots, 240 mL milk, and 90 mL gelatin. How many milliliters should the nurse record for the client’s 8-hour fluid intake? __________ L (Record your answer as a whole number.)
Correct Answer: 2200
Rationale: First convert to milliliters: l L = 1000 mL;
1 oz = 30 mL
Next add the values for fluids: 1000 + 240 + 240 + 90 + 120 + 180 + 240 + 90 = 2200
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The client is diagnosed with chronic lymphocytic leukemia (CLL) after routine laboratory tests during a yearly physical. Which is the scientific rationale for the random nature of discovering the illness?
- A. CLL is not serious, and clients die from other causes first.
- B. There are no symptoms with this form of leukemia.
- C. This is a childhood illness and is self-limiting.
- D. In early stages of CLL, the client may be asymptomatic.
Correct Answer: D
Rationale: Early CLL is often asymptomatic (D), detected via routine labs. CLL is serious (A), has symptoms later (B), and is adult-onset (C), not self-limiting.
A child who has leukemia is to have a bone marrow biopsy performed. How will the child be positioned for this procedure?
- A. On his side with the top knee flexed
- B. Prone
- C. Modified Trendelenburg position
- D. On his back with his head elevated 30 degrees
Correct Answer: B
Rationale: The prone position is used for a bone marrow biopsy from the iliac crest to access the site safely.
Fifteen minutes after the nurse has initiated a transfusion of packed red blood cells, the client becomes restless and complains of itching on the trunk and arms. Which intervention should the nurse implement first?
- A. Collect urine for analysis.
- B. Notify the laboratory of the reaction.
- C. Administer diphenhydramine, an antihistamine.
- D. Stop the transfusion at the hub.
Correct Answer: D
Rationale: Restlessness/itching suggest a transfusion reaction; stopping at the hub (D) prevents further reaction. Urine collection (A), notification (B), and Benadryl (C) follow.
The nurse is caring for the following clients. Which client should the nurse assess first?
- A. The client whose partial thromboplastin time (PTT) is 38 seconds.
- B. The client whose hemoglobin is 14 g/dL and hematocrit is 45%.
- C. The client whose platelet count is 75,000 per cubic millimeter of blood.
- D. The client whose red blood cell count is 4.8 x 106/mm3.
Correct Answer: C
Rationale: Platelets 75,000 (C) indicate thrombocytopenia, risking bleeding, a priority. PTT 38 (A) is therapeutic, Hb/Hct (B) are normal, and RBC 4.8 (D) is normal.
The client diagnosed with end-stage renal disease (ESRD) has developed anemia. Which would the nurse anticipate the HCP prescribing for this client?
- A. Place the client in reverse isolation.
- B. Discontinue treatments until blood count improves.
- C. Monitor CBC daily to assess for bleeding.
- D. Give client erythropoietin, a biologic response modifier.
Correct Answer: D
Rationale: ESRD causes erythropoietin deficiency; prescribing erythropoietin (D) treats anemia. Isolation (A), stopping treatment (B), and daily CBC (C) are inappropriate.