Nokea
The client’s laboratory values are RBCs 5.5 (x106/mm3), WBCs 8.9 (x103/mm3), and platelets 189 (x103/mm3). Which intervention should the nurse implement?
- A. Prepare to administer packed red blood cells.
- B. Continue to monitor the client.
- C. Request an order for Neupogen, a biologic response modifier.
- D. Institute bleeding precautions.
Correct Answer: B
Rationale: Labs are normal (RBC 5.5, WBC 8.9, platelets 189); continue monitoring (B). Transfusions (A), Neupogen (C), and bleeding precautions (D) are unnecessary.
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The client who received 50 mL from a unit of whole blood has low back pain. In response to this client’s symptom, which action should be taken by the nurse first?
- A. Reposition the client.
- B. Assess the pain further.
- C. Administer an analgesic.
- D. Stop the blood transfusion.
Correct Answer: D
Rationale: A. Repositioning focuses on treating the client’s back pain and not on the blood transfusion, which could be the cause of the back pain. B. Further assessment should occur after stopping the blood transfusion. C. The client may need an analgesic for pain control, but this should occur after stopping the blood transfusion. D. Low back pain is a symptom of a potentially life-threatening acute hemolytic reaction. The pain is caused from agglutination of RBCs in the kidneys and renal vasoconstriction. Hemolytic reactions occur most often within the first 50 mL of the infusion.
The client diagnosed with esophageal cancer is having work-related problems that are interfering with the client's treatment. Which organization should the nurse advise the client to contact for assistance with these issues?
- A. National Cancer Institute
- B. Leukemia Society of America
- C. Corporate Angel Network
- D. Patient Advocate Foundation
Correct Answer: D
Rationale: A. The National Cancer Institute answers questions and has free information about cancer. B. The Leukemia Society of America provides education regarding leukemia. C. The Corporate Angel Network provides free plane transportation for cancer clients going to and from treatment centers. D. The Patient Advocate Foundation provides counseling to resolve job-related problems.
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.
The nurse is discussing the prevention of bladder cancer with the client. Which factors that increase the client’s risk for bladder cancer should the nurse emphasize?
- A. Consuming caffeine beverages
- B. Smoking tobacco products
- C. Consuming multivitamins daily
- D. Prolonged exposure to paint smells
- E. Prolonged exposure to rubber smells
Correct Answer: B, D, E, A
Rationale: Consumption of caffeine is not associated with an increased risk for bladder cancer. B. Smoking is the number one cause of bladder cancer in the world. C. Studies show a protective effect with an increased intake of vitamins A, B6, and E. D. Exposure to aromatic amines in the textile and paint industries is clearly associated with bladder cancer. E. Exposure to aromatic amines in the rubber industry is clearly associated with bladder cancer.
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.