Nokea
The nurse is caring for a client with breast cancer who has been receiving chemotherapy. The client was admitted with an infected lesion on their left leg. The health care provider has ordered filgrastim. What will filgrastim do for this client? Select all that apply.
- A. Increase platelet count
- B. Boost the immune system
- C. Increase white blood cell production
- D. Boost red blood cell production
- E. Increase hematocrit level
Correct Answer: B,C
Rationale: Bone marrow transplantation or administration of drugs that boost white blood cell production, such as filgrastim, may help immunosuppressed clients. Neupogen does not increase the platelet count, hematocrit level, or boost red blood cell production.
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A client has received a diagnosis of Lyme disease. What does the nurse understand about the transmission of infection resulting in this disease?
- A. The disease is spread by a prion.
- B. The disease is spread by single-celled fungi-like microorganisms
- C. The disease is spread by helminths
- D. The disease is spread by arthropods.
Correct Answer: D
Rationale: Example of arthropods includes fleas, ticks, lice, mosquitoes, and mites. Some rickettsial diseases that are spread by arthropods include Lyme disease. Prions may mutate and can be formed by genetic predisposition or acquired by transmission between the same or similar infected animal species and are not the same as arthropods. The disease is not spread by single-celled fungi-like microorganisms or helminths.
The nursing instructor is teaching beginning nursing students about infection. Toward the end of class, the instructor gives the students a scenario of a client with an infection who has developed fever and diarrhea. What should the student nurse instruct the client to avoid?
- A. Tea and coffee
- B. Ice water and broth
- C. Fruit juices
- D. Milk and gelatin
Correct Answer: A
Rationale: A client with fever and diarrhea should avoid tea, coffee, and carbonated beverages containing caffeine because these promote diuresis. The intake of ice water, broth, fruit juices, gelatin, and milk should be encouraged to add proteins and calories.
The nurse is caring for a client with a stage IV leg ulcer. The nurse is closely monitoring the client for sepsis. What would indicate that sepsis has occurred and that the nurse should notify the physician of immediately?
- A. The client feels restless and hungry.
- B. The client exhibits an increased urinary output.
- C. The client's heart rate is greater than 90 beats/minute.
- D. The client's respiratory rate is less than 20 breaths/minute.
Correct Answer: C
Rationale: A heart rate greater than 90 beats/minute or a respiratory rate greater than 20 breaths/minute will indicate that sepsis has occurred. Sepsis does not increase the client's appetite or affect the client's urinary output.
Which of the following would be considered a mechanical defense mechanism?
- A. Cast
- B. Coughing
- C. Clothing
- D. Sunscreen
Correct Answer: B
Rationale: Mechanical defense mechanisms are physical barriers that prevent microorganisms from gaining entry or expel microorganisms before they multiply. Examples are the skin and mucous membranes, physiologic reflexes (e.g., sneezing, coughing, vomiting), and macrophages. Casts, clothing, and sunscreen do not keep microorganisms from gaining entry to the body.
A client informs the nurse of having been using a douche to cleanse the vagina on a daily basis and is now experiencing itching and burning in the vaginal area. What should the nurse explain to the client that occurs when the vaginal pH is changed?
- A. It causes destruction of the normal flora of the vagina and allows the development of vaginal infections.
- B. The bottle must be contaminated with bacteria, and when the pH is changed, it allows the bacteria to enter the vaginal area.
- C. It will cause an allergic reaction in the vaginal area.
- D. When the vaginal pH is changed, it allows cancer cells to spread from the vagina to the cervix.
Correct Answer: A
Rationale: The acid environment is unfavorable for the multiplication of pathogenic bacteria and fungi. A change in vaginal pH or destruction of the normal flora, however, can promote the development of a vaginal infection. Bacteria do not cause the vaginal pH to change; the pH change allows bacteria to grow. Change in vaginal pH does not cause an allergic reaction and does not allow the development of cancer cells.