Nokea
The nurse on oncology is caring for a client with a white blood count of 600. During evening visitation, a visitor brings a potted plant. What action should the nurse take?
- A. Allow the client to keep the plant
- B. Place the plant by the window
- C. Water the plant for the client
- D. Tell the family members to take the plant home
Correct Answer: D
Rationale: A low WBC (neutropenia) increases infection risk, so the plant, which may harbor bacteria or fungi, should be removed.
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A client with Addison's disease has been receiving glucocorticoid therapy. Which finding indicates a need for dosage adjustment?
- A. Dryness of the skin and mucus membranes
- B. Dizziness when rising to a standing position
- C. A weight gain of 6 pounds in the past week
- D. Difficulty in remaining asleep
Correct Answer: C
Rationale: A weight gain of 6 pounds in a week suggests fluid retention, indicating possible overdosage of glucocorticoids, requiring adjustment.
The oncology nurse is caring for a 24-year-old male client with testicular cancer. Cisplatin IV has been ordered. Which lab value would the nurse notify the health care provider about before administering this medication?
- A. iron 129 mcg/dL
- B. ammonia level 52 mcg/dL
- C. creatinine clearance 23 mL/minute
- D. brain natriuretic peptides (BNP) 36 pg/mL
Correct Answer: C
Rationale: Cisplatin is nephrotoxic; a creatinine clearance of 23 mL/min indicates impaired renal function, requiring provider notification before administration.
A client is receiving an opioid per patient-controlled analgesia (PCA) pump to control postoperative pain; however, when the nurse assesses the client, she finds the client is pale and hypotensive, and has a respiratory rate of 6 breaths per minute. The PCA pump record shows that the limit for maximum dosage was set far too high, resulting in an overdose. The client is very somnolent and barely responsive. What interventions does the nurse anticipate? Select all that apply.
- A. Immediately stop the infusion.
- B. Discontinue the PCA pump.
- C. Administer naloxone per standing orders.
- D. Administer supplementary oxygen.
- E. File an incident report.
Correct Answer: A,C,D,E
Rationale: Opioid overdose requires stopping the infusion (A), administering naloxone (C) to reverse effects, providing oxygen (D) for respiratory depression, and filing an incident report (E). Discontinuing the PCA (B) is not immediate.
A 51-year-old client received a kidney transplant. Which of the following signs and symptoms indicates possible rejection of the kidney? Select all that apply.
- A. increased urine output
- B. increase in blood pressure
- C. weight gain
- D. pain in lower back
- E. decreased creatinine
Correct Answer: B,C,D
Rationale: Kidney rejection causes hypertension (B), fluid retention (weight gain, C), and graft pain (D). Decreased urine output (not increased) and elevated creatinine (not decreased) are typical.
The registered nurse is making assignments for the day. Which client should not be assigned to the pregnant nurse?
- A. The client receiving linear accelerator radiation therapy for lung cancer
- B. The client with a radium implant for cervical cancer
- C. The client who has just been administered soluble brachytherapy for thyroid cancer
- D. The client who returned from an intravenous pyelogram
Correct Answer: B
Rationale: A radium implant emits radiation, posing a risk to the fetus, so the pregnant nurse should not care for this client.