Nokea
Which of the following laboratory tests should the nurse use to determine whether the prescribed filgrastim is effective in the treatment of a patient who is receiving chemotherapy for acute lymphocytic leukemia?
- A. Platelet count
- B. Reticulocyte count
- C. Total lymphocyte count
- D. Absolute neutrophil count
Correct Answer: D
Rationale: Filgrastim increases the neutrophil count and function in neutropenic patients. Although total lymphocyte, platelet, and reticulocyte counts also are important to monitor in this patient, the absolute neutrophil count is used to evaluate the effects of filgrastim.
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The nurse is caring for a patient with neutropenia who is started on a cephalosporin. Which of the following common adverse effects should the nurse observe for in the patient?
- A. Nephrotoxicity
- B. Rash
- C. Ototoxicity
- D. Fever
- E. Pruritus
Correct Answer: B,D,E
Rationale: Adverse effects common to cephalosporins include rashes, fever, and pruritus. Adverse effects common to aminoglycosides include nephrotoxicity and ototoxicity.
The nurse is caring for a patient with anemia who is experiencing increased fatigue and occasional palpitations at rest. Which of the following laboratory findings should the nurse expect?
- A. Normal red blood cell (RBC) indices
- B. Hematocrit (Hct) of 38%
- C. Hemoglobin (Hb) of 86 g/L
- D. RBC count of 4.5 x 10^12/L
Correct Answer: C
Rationale: The patient's clinical manifestations indicate moderate anemia, which is consistent with an Hb of 60-100 g/L. The other values are all within the range of normal.
Which of the following menu choices indicate that the patient understands the nurse's teaching about best dietary choices for iron-deficiency anemia?
- A. Omelet and whole wheat toast
- B. Cantaloupe and cottage cheese
- C. Strawberry and banana fruit plate
- D. Cornmeal muffin and orange juice
Correct Answer: A
Rationale: Eggs and whole grain breads are high in iron. The other choices are appropriate for other nutritional deficiencies, but are not the best choice for a patient with iron-deficiency anemia.
Which of the following laboratory information should the nurse monitor to detect heparin-induced thrombocytopenia (HIT) in a patient who is receiving a continuous heparin infusion?
- A. Prothrombin time
- B. Erythrocyte count
- C. Fibrinogen degradation products
- D. Activated partial thromboplastin time
Correct Answer: D
Rationale: Platelet aggregation in HIT causes neutralization of heparin so that the activated partial thromboplastin time will be shorter and more heparin will be needed to maintain therapeutic levels. The other data will not be affected by HIT.
Which of the following newly admitted patients should the nurse assign as a roommate for a patient who has aplastic anemia?
- A. A patient with severe heart failure
- B. A patient who has viral pneumonia
- C. A patient who has right leg cellulitis
- D. A patient with multiple abdominal drains
Correct Answer: A
Rationale: Patients with aplastic anemia are at risk for infection because of the low white blood cell production associated with this type of anemia, so the nurse should avoid assigning a roommate with any possible infectious process.