Nokea
The nurse is caring for a client receiving chemotherapy. The client is prescribed filgrastim to improve the function of the immune system. Which finding does the nurse anticipate in response to the medication?
- A. Decrease in serum uric acid
- B. Increase in hemoglobin level
- C. Increase in neutrophil count
- D. Increase in platelet count
Correct Answer: C
Rationale: Filgrastim stimulates neutrophil production, so an increase in neutrophil count (C) is expected. It does not affect uric acid (A), hemoglobin (B), or platelets (D).
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The nurse is preparing to obtain a urine specimen for culture and sensitivity from a client who has an indwelling urinary catheter that was inserted 2 days ago. Which of the following actions should the nurse take?
- A. Attach a sterile syringe to the specimen port.
- B. Withdraw a sample of fluid from the balloon port.
- C. Empty urine from the urinary drainage bag into a specimen container.
- D. Collect all urine from the urinary drainage bag during a 24-hour period.
Correct Answer: A
Rationale: Using a sterile syringe at the specimen port (A) ensures a clean sample. Balloon port (B), drainage bag (C), or 24-hour collection (D) risk contamination.
Parents of a 6 month-old breast fed baby ask the nurse about increasing the baby's diet. Which of the following should be added first?
- A. Cereal
- B. Eggs
- C. Meat
- D. Juice
Correct Answer: A
Rationale: Cereal. Strained cereal is recommended as the first solid food for breastfed infants, per pediatric guidelines.
The nurse is giving home care to a 69-year-old client who has severe arthritis. Which comment made by the client would indicate to the nurse that the client is experiencing normal changes associated with the aging process?
- A. I have such a hard time with the pain in my feet and knees.
- B. I have had loose stools for the last few months.
- C. My children say I keep my apartment too warm.
- D. I have a hard time at night because the lights are all big and fuzzy.
Correct Answer: C
Rationale: Feeling cold and preferring a warmer environment is a normal age-related change due to decreased thermoregulation. Pain, loose stools, and visual changes may indicate pathology requiring further investigation.
The nurse is reinforcing teaching about home administration of sublingual nitroglycerin tablets to a client with stable angina. Which client statement indicates the need for further teaching?
- A. I can take 1 tablet every 5 minutes, up to 3 times, for chest pain.'
- B. I should call 911 if my chest pain isn't relieved by nitroglycerin.'
- C. I will call my doctor's office if I start experiencing chest pain at rest.'
- D. I will keep one bottle of nitroglycerin in the house and one in the car.'
Correct Answer: D
Rationale: Keeping nitroglycerin in a car (D) risks exposure to heat, reducing efficacy, requiring further teaching. Other statements (A, B, C) are correct.
The nurse is caring for an 87 year-old client with urinary retention. Which finding should be reported immediately?
- A. Fecal impaction
- B. Infrequent voiding
- C. Stress incontinence
- D. Burning with urination
Correct Answer: A
Rationale: Fecal impaction. The nurse should report fecal impaction or constipation which can cause obstruction of the bladder outlet. Bladder outlet obstruction is a common cause of urine retention in the elderly.