a client begins a regimen of chemotherapy her platelet counts falls to 98000 which action is least likely to increase the risk of hemorrhage a client begins a regimen of chemotherapy her platelet counts falls to 98000 which action is least likely to increase the risk of hemorrhage
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Nursing Elites

NCLEX NCLEX-PN

NCLEX-PN Quizlet 2023

1. A client begins a regimen of chemotherapy. Her platelet count falls to 98,000. Which action is least likely to increase the risk of hemorrhage?

Correct answer: Implement reverse isolation.

Rationale: The correct answer is to implement reverse isolation. Reverse isolation is a protective measure used to protect patients from infections, not to affect the risk of hemorrhage. Testing all excreta for occult blood (Choice A) is important to monitor for signs of internal bleeding. Using a soft toothbrush or foam cleaner for oral hygiene (Choice B) is recommended to prevent gum bleeding. Avoiding IM injections (Choice D) is crucial to reduce the risk of bleeding in a client with a low platelet count. Therefore, among the given options, implementing reverse isolation is the least likely to increase the risk of hemorrhage.

2. A client with cirrhosis of the liver presents with ascites. The physician is to perform a paracentesis. For safety, the nurse should ask the client to:

Correct answer: empty his bladder prior to the procedure.

Rationale: When performing a paracentesis, the client must be sitting up to allow the fluid to settle in the lower abdomen. To prevent trauma to the bladder while inserting a needle to aspirate the fluid, the bladder must be empty. Choice A is incorrect as excessive fluid intake can make the procedure more difficult due to increased abdominal distension. Choice B is unrelated to the procedure of paracentesis. Choice D is incorrect as the client should be sitting up, not in the prone position, during the procedure.

3. What is a predisposing factor for cancer of the tongue?

Correct answer: tobacco use

Rationale: Tobacco use is a well-established predisposing factor for cancer of the tongue. Smoking or chewing tobacco can lead to the development of oral cancers, including those affecting the tongue. Obesity, sun exposure, and eating sweets are not directly linked to an increased risk of tongue cancer. Obesity may be associated with other types of cancer, sun exposure can lead to skin cancer, and eating sweets is not a known risk factor for tongue cancer. Therefore, the correct answer is tobacco use, as it has a strong association with the development of tongue cancer, making it a significant predisposing factor.

4. A community health nurse is providing information to a group of older clients about measures to decrease the risk of contracting influenza during peak flu season. The nurse should provide which information?

Correct answer: Clients should wash their hands frequently and keep hands away from the face, especially during peak flu season.

Rationale: During peak influenza season, older clients should take measures to reduce the risk of contracting the flu. The most effective preventive measure is frequent hand hygiene and refraining from touching the face, as this reduces the transmission of the flu virus. While it is advisable to avoid crowds, the direct action of hand hygiene is more impactful. Doing errands early in the morning when crowds are smaller is a good suggestion to reduce exposure but does not address the direct transmission through hands. Drinking enough fluid daily is important for overall health but does not directly reduce the risk of contracting influenza.

5. The nurse is caring for a dying client who has persistently requested that the nurse 'help her to die and be in peace.' According to the Code of Ethics for Nurses, the nurse should:

Correct answer: Try to make the client as comfortable as possible, but refuse to assist in death.

Rationale: According to the Code of Ethics for Nurses, the nurse should try to make the client as comfortable as possible but refuse to assist in death. It is not within the scope of nursing practice to assist in death, even if requested by the client. Choice A is incorrect as advance directives do not directly relate to the client's request for assistance in dying. Choice B is inappropriate as passing the responsibility to another nurse does not address the ethical dilemma at hand. Choice C is incorrect because instructing the client that only a physician can legally assist in suicide does not address the ethical considerations involved in the request. Therefore, the most appropriate action for the nurse is to provide comfort measures while upholding ethical standards and not participating in ending the client's life.

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