Nokea
Which medication is contraindicated for a client diagnosed with leukemia?
- A. Bactrim, a sulfa antibiotic.
- B. Morphine, a narcotic analgesic.
- C. Epogen, a biologic response modifier.
- D. Gleevec, a genetic blocking agent.
Correct Answer: C
Rationale: Epogen (C) stimulates RBC production, risky in leukemia due to blast proliferation. Bactrim (A) treats infections, morphine (B) manages pain, and Gleevec (D) targets CML.
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The nurse is preparing the client for a bone marrow biopsy of the iliac crest. Place the nurse’s actions in order of priority.
- A. Premedicate with lorazepam
- B. Obtain a signed informed consent
- C. Position prone and provide emotional support
- D. Verify that the HCP has explained the procedure
- E. Check for signs of bleeding every 2 hours for 24 hours
- F. Teach what may be expected during the procedure
Correct Answer: D, F, B, A, C, E:
Rationale: Verify that the HCP has explained the procedure. The HCP should include the purpose, intended outcomes, and potential complications. F. Teach what may be expected during the procedure, including that pressure or discomfort may be experienced. B. Obtain a signed informed consent. This is obtained only after the HCP has met with the client and teaching is completed. A. Premedicate with lorazepam (Ativan). Midazolam (Versed) is another option for sedation. A local anesthetic is used at the site, and some clients may not need sedation. C. Position prone and provide emotional support. The client should be prone because the iliac crest is the site being used for this biopsy, but the position will vary with the site. Holding the client’s hand and using guided imagery help support the client. E. Check for signs of bleeding every 2 hours for 24 hours. A pressure dressing is applied by the HCP after the procedure. Ice can be applied to reduce bruising and for comfort.
The client is diagnosed with non-Hodgkin’s lymphoma. Which nursing concept should the nurse identify as priority?
- A. Immunity.
- B. Grieving.
- C. Perfusion.
- D. Clotting.
Correct Answer: A
Rationale: NHL impairs immunity (A) via lymph node dysfunction, increasing infection risk, a priority. Grieving (B), perfusion (C), and clotting (D) are secondary.
Which statement is the scientific rationale for infusing a unit of blood in less than four (4) hours?
- A. The blood will coagulate if left out of the refrigerator for greater than four (4) hours.
- B. The blood has the potential for bacterial growth if allowed to infuse longer.
- C. The blood components begin to break down after four (4) hours.
- D. The blood will not be affected; this is a laboratory procedure.
Correct Answer: B
Rationale: Blood must infuse within 4 hours (B) to minimize bacterial growth risk. Coagulation (A) is not primary, components (C) degrade minimally, and lab procedure (D) is incorrect.
The charge nurse in the intensive care unit is making client assignments. Which client should the charge nurse assign to the graduate nurse who has just finished the three (3)-month orientation?
- A. The client with an abdominal peritoneal resection who has a colostomy.
- B. The client diagnosed with pneumonia who has acute respiratory distress syndrome.
- C. The client with a head injury developing disseminated intravascular coagulation.
- D. The client admitted with a gunshot wound who has an H&H of 7 and 22.
Correct Answer: A
Rationale: Colostomy care (A) is stable and suitable for a new graduate. ARDS (B), DIC (C), and severe anemia (D) are critical, requiring experienced care.
A child with leukemia bruises easily. This is most likely due to which of the following?
- A. Decreased fibrinogen levels
- B. Excessive clotting elsewhere in the body
- C. Decreased platelets
- D. Decreased erythrocytes
Correct Answer: C
Rationale: Leukemia causes bone marrow failure, leading to decreased platelets, which results in easy bruising.