Nokea
The nurse working in the bloodmobile is screening clients to determine if they qualify for blood donation of whole blood. Besides asking for identification and age, which questions should the nurse ask during the screening interview?
- A. “If you have a tattoo, on what date did you receive the tattoo?”
- B. “Have you had any close contact with anyone with HIV or hepatitis?”
- C. “If you smoke, when was the last time you smoked tobacco products?”
- D. “When were you last immunized for rubella, mumps, or varicella?”
- E. “Did you receive blood products anywhere outside of the United States?”
Correct Answer: A, B, D, E
Rationale: Persons ineligible to donate blood include those with a history of a recent tattoo. B. Persons ineligible to donate blood include those who’ve had close contact with a person with HIV or hepatitis. C. Persons who smoke tobacco products may donate blood unless they have a recent history of asthma. D. Persons ineligible to donate blood include those immunized for rubella, mumps, or varicella within the last month. E. Persons ineligible to donate blood include those receiving transfusions in the United Kingdom, Gibraltar, or the Falkland Islands because of the increased likelihood of transmitting Creutzfeldt-Jakob disease.
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The client who has renal cancer that has metastasized rates pain at a 9 on a 0 to 10 pain scale. Which medication should the nurse plan to administer now and then schedule to be administered at the prescribed dosing interval?
- A. Meperidine
- B. Propoxyphene
- C. Pentazocine
- D. Oxycodone
Correct Answer: D
Rationale: A. Meperidine (Demerol) is not recommended because it causes CNS toxicity from metabolites. It should not be used for the treatment of chronic pain. B. Propoxyphene
The client is diagnosed with chronic myeloid leukemia and leukocytosis. Which signs/symptoms would the nurse expect to find when assessing this client?
- A. Frothy sputum and jugular vein distention.
- B. Dyspnea and slight confusion.
- C. Right upper quadrant tenderness and nausea.
- D. Increased appetite and weight gain.
Correct Answer: B
Rationale: CML with leukocytosis causes fatigue, dyspnea, and confusion (B) from hyperviscosity. Sputum/JVD (A) suggest heart failure, RUQ/nausea (C) suggest liver issues, and appetite/weight gain (D) are unlikely.
The nurse is preparing to administer epoetin alfa to the client who has chemotherapy-associated anemia. The nurse recognizes the need to consult with the HCP before administration when the client makes which statements?
- A. “I spend most of my days lying on the couch.”
- B. “I usually eat a lot of salads for my main meals.”
- C. “I seem to have an aversion to eating eggs right now.”
- D. “I developed a blood clot in my leg on my last admission.”
- E. “I hope this helps so I don’t have to have a blood transfusion.”
Correct Answer: A, D
Rationale: Erythropoiesis-stimulating agents, such as epoetin alfa (Epogen), can cause thromboembolic events. It would be concerning if the client had limited activity because this could further increase the client’s risk of a thromboembolic event. B. Dark green, leafy vegetables are high in iron and help with Hgb synthesis and therefore would be beneficial. C. Eggs are high in iron, but there are other food sources high in iron that the client can consume if an aversion exists. D. A history of a thromboembolic event and use of epoetin alfa increase the client’s risk for another thromboembolic event. E. The use of epoetin alfa is recommended as a treatment option for clients with chemotherapy-associated anemia and an Hgb concentration that is approaching, or has fallen below, 10 g/dL, to increase the Hgb level and decrease the need for a transfusion.
A home-care nurse is following up with the client who was diagnosed with liver cancer 3 months ago. Which assessment information should the nurse communicate to the HCP?
- A. Client is weak and pale and remained in bed throughout the visit
- B. Client’s weight has remained unchanged since the previous visit.
- C. Client reports itching is relieved with diphenhydramine cream.
- D. Client’s pain level averages a 7 on a 0 to 10 scale with scheduled opioids.
Correct Answer: D
Rationale: A. Finding that the client with liver cancer is weak and pale would be important to document, but it does not warrant immediate communication to the HCP because it may be expected. B. The client’s weight being stable would not necessitate communication to the HCP, but a significant decrease would. C. Abdominal itching may occur with liver cancer, but the fact that it is relieved with diphenhydramine (Benadryl) is positive and would not necessitate a call to the HCP. D. The client’s pain level is high and does not seem to be controlled with the current opioid schedule. The nurse should notify the HCP to request a change in analgesic medication, dosing schedule, or administration route.
The client diagnosed with cancer has been undergoing systemic treatments and has red blood cell deficiency. Which signs and symptoms should the nurse teach the client to manage?
- A. Nausea associated with cancer treatment.
- B. Shortness of breath and fatigue.
- C. Controlling mucositis and diarrhea.
- D. The emotional aspects of having cancer.
Correct Answer: B
Rationale: RBC deficiency (anemia) causes shortness of breath and fatigue (B), which clients should manage. Nausea (A), mucositis/diarrhea (C), and emotions (D) are unrelated to anemia.