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The client is symptomatic with a Hgb of 7.8 g/dL, but refuses blood and blood products transfusions for religious reasons. The nurse should prepare the client that the HCP may prescribe which alternatives?
- A. Epoetin alfa
- B. Folic acid
- C. Albumin
- D. Platelets
- E. Fresh frozen plasma
- F. Granulocytes
Correct Answer: A, B,
Rationale: Epoetin alfa (erythropoietin growth factor; Procrit) promotes erythropoiesis (production of RBCs), thus decreasing the need for transfusions. B. Folic acid promotes erythropoiesis and production of WBCs and platelets. C. Albumin is a blood product. D. Platelets are blood products. E. Plasma is a blood product. F. Granulocytes are blood products.
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The client is experiencing pain due to cancer treatment- The client tells the nurse, “Methadone has always worked well for me in the past.” Which effects of methadone should the nurse consider when administering methadone?
- A. Has a long half-life and high level of potency
- B. May cause an increase in BP and confusion
- C. Causes severe allergic reactions and liver failure
- D. Has active metabolites, but it is well tolerated
Correct Answer: A
Rationale: bg
The nurse and the licensed practical nurse (LPN) are caring for clients on an oncology floor. Which client should not be assigned to the LPN?
- A. The client newly diagnosed with chronic lymphocytic leukemia.
- B. The client who is four (4) hours postprocedure bone marrow biopsy.
- C. The client who received two (2) units of (PRBCs) on the previous shift.
- D. The client who is receiving multiple intravenous piggyback medications.
Correct Answer: D
Rationale: IV piggyback medications (D) require complex assessment (e.g., chemotherapy), beyond LPN scope. New diagnosis (A), post-biopsy (B), and post-transfusion (C) are stable for LPN care.
Which sign/symptom will the nurse expect to assess in the client diagnosed with a vaso-occlusive sickle cell crisis?
- A. Lordosis.
- B. Epistaxis.
- C. Hematuria.
- D. Petechiae.
Correct Answer: C
Rationale: Vaso-occlusive crisis causes ischemia; hematuria (C) results from renal infarction. Lordosis (A) is spinal, epistaxis (B) is bleeding, and petechiae (D) indicate thrombocytopenia.
The nurse assesses that the client with hemolytic anemia has weakness, fatigue, malaise, and skin and mucous membrane pallor. Which finding should the nurse also associate with hemolytic anemia?
- A. Scleral jaundice
- B. A smooth, red tongue
- C. A craving for ice to chew
- D. A poor intake of fresh vegetables
Correct Answer: A
Rationale: A. Jaundice occurs in hemolytic anemia from the shortened life span of the RBC and the breakdown of Hgb. About 80% of heme is converted to bilirubin, conjugated in the liver, and excreted in the bile. The increased bilirubin in the blood causes the jaundice. B. A smooth, red tongue is seen with iron-deficiency anemia. C. A craving for ice is seen with iron-deficiency anemia. D. Folate deficiency occurs in people who rarely eat fresh vegetables.
The client with a primary diagnosis of liver cancer with metastases to the lung is hospitalized with severe dyspnea. The nurse is preparing the client for radiation of the upper chest. Which nursing conclusion about the purpose of radiation therapy for this client is correct?
- A. Radiation therapy is used to cure and control liver cancer.
- B. Radiation therapy is used to prevent future cancer development.
- C. Radiation therapy is used to cure and control lung cancer.
- D. Radiation therapy is used to prevent or relieve distressing symptoms.
Correct Answer: D
Rationale: A. Radiation of the upper chest would have no effect on the liver located in the abdominal cavity. B. Preventing future cancer development is not the intention of radiation therapy for this client. C. Radiation therapy reduces size of tumors but would not be expected to cure cancer in this client. D. Primary liver tumors commonly metastasize to the lung, which can cause obstructive symptoms. In this client, radiation therapy to the lung would be used as a palliative care modality to help relieve distressing symptoms such as dyspnea.