Nokea
The nurse and an unlicensed assistive personnel (UAP) are caring for clients in a bone marrow transplantation unit. Which nursing task should the nurse delegate?
- A. Take the hourly vital signs on a client receiving blood transfusions.
- B. Monitor the infusion of antineoplastic medications.
- C. Transcribe the HCP’s orders onto the medication administration record (MAR).
- D. Determine the client’s response to the therapy.
Correct Answer: A
Rationale: Taking vital signs (A) is within UAP scope during transfusions. Monitoring chemo (B), transcribing orders (C), and evaluating response (D) require nursing judgment.
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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.
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.
Which interrelated psychological concept is priority for the nurse caring for a client diagnosed with leukemia?
- A. Comfort.
- B. Stress.
- C. Grieving.
- D. Coping.
Correct Answer: C
Rationale: Leukemia’s life-threatening nature makes grieving (C) a priority, addressing loss of health. Comfort (A), stress (B), and coping (D) are secondary.
The nurse is completing a care plan for a client diagnosed with leukemia. Which independent problem should be addressed?
- A. Infection.
- B. Anemia.
- C. Nutrition.
- D. Grieving.
Correct Answer: A
Rationale: Infection (A) is critical in leukemia due to neutropenia, requiring independent nursing actions (e.g., hygiene). Anemia (B), nutrition (C), and grieving (D) are collaborative or secondary.
Which collaborative treatment would the nurse anticipate for the client diagnosed with DIC?
- A. Administer oral anticoagulants.
- B. Prepare for plasmapheresis.
- C. Administer frozen plasma.
- D. Calculate the intake and output.
Correct Answer: C
Rationale: Frozen plasma (C) replaces clotting factors in DIC. Oral anticoagulants (A) worsen bleeding, plasmapheresis (B) is rare, and I&O (D) is routine.