Nokea
The client is diagnosed with multiple myeloma. The doctor has ordered cyclophosphamide (Cytoxan). Which instruction should be given to the client?
- A. Walk about a mile a day to prevent calcium loss.'
- B. Increase the fiber in your diet.'
- C. Report nausea to the doctor immediately.'
- D. Drink at least eight large glasses of water a day.'
Correct Answer: D
Rationale: Cyclophosphamide can cause hemorrhagic cystitis, so adequate hydration (e.g., 8 glasses of water daily) is essential to flush the bladder and reduce this risk. Walking, fiber, and nausea reporting are not primary concerns with this drug.
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The nurse is caring for a client with a history of cirrhosis. The nurse should give priority to:
- A. Monitoring for bleeding
- B. Administering diuretics
- C. Monitoring blood glucose
- D. Assessing for infection
Correct Answer: A
Rationale: Cirrhosis impairs clotting factor production, increasing bleeding risk, so monitoring for bleeding is a priority.
The client at 34 weeks gestation is admitted with a diagnosis of preterm premature rupture of membranes (PPROM). The nurse should monitor for which complication?
- A. Chorioamnionitis
- B. Preterm delivery
- C. Fetal distress
- D. All of the above
Correct Answer: D
Rationale: PPROM increases the risk of chorioamnionitis (infection) preterm delivery (due to loss of amniotic fluid) and fetal distress (from infection or cord compression). All are potential complications requiring monitoring.
A client receiving Parnate (tranylcypromine) is admitted in a hypertensive crisis. Which food is most likely to produce a hypertensive crisis when taken with the medication?
- A. Processed cheese
- B. Cottage cheese
- C. Cream cheese
- D. Cheddar cheese
Correct Answer: D
Rationale: MAOIs like tranylcypromine interact with tyramine-rich foods like aged cheddar cheese, causing hypertensive crisis. Processed, cottage, and cream cheeses have lower tyramine content.
The nurse is assisting a 4th-day postoperative cholecystectomy client in planning her meals for tomorrow's menu. Which vitamin is the most essential in promoting tissue healing?
- A. Vitamin C
- B. Vitamin B1
- C. Vitamin D
- D. Vitamin A
Correct Answer: A
Rationale: Vitamin C (ascorbic acid) is essential in promoting wound healing and collagen formation. Vitamin B1 (thiamine) maintains normal gastrointestinal (GI) functioning, oxidizes carbohydrates, and is essential for normal functioning of nervous tissue. Vitamin D regulates absorption of calcium and phosphorus from the GI tract and helps prevent rickets. Vitamin A is necessary for the formation and maintenance of skin and mucous membranes. It is also essential for normal growth and development of bones and teeth.
A client is admitted with suspected acute pancreatitis. Which lab finding confirms the diagnosis?
- A. Blood glucose of 260 mg/dL
- B. White cell count of 21,000 cu/mm
- C. Platelet count of 250,000 cu/mm
- D. Serum amylase level of 600 units/dL
Correct Answer: D
Rationale: Elevated serum amylase (typically >3 times normal) is a key diagnostic marker for acute pancreatitis due to pancreatic enzyme leakage. The other findings are nonspecific or normal.