what are the nursing interventions for a patient with neutropenia

ATI LPN

ATI PN Comprehensive Predictor 2023 Quizlet

1. What are the nursing interventions for a patient with neutropenia?

A. Monitor for signs of infection and administer antibiotics
B. Isolate the patient and provide a low-microbial diet
C. Monitor vital signs and avoid unnecessary invasive procedures
D. Encourage the patient to engage in social activities

Correct answer: A

Rationale: The correct nursing interventions for a patient with neutropenia include monitoring for signs of infection and administering antibiotics. Neutropenia is characterized by a low neutrophil count, which increases the risk of infections. Monitoring for signs of infection allows for early detection and prompt treatment, while administering antibiotics helps prevent or treat any infections that may occur. Isolating the patient and providing a low-microbial diet (Choice B) are not necessary unless the patient develops an active infection. Monitoring vital signs and avoiding unnecessary invasive procedures (Choice C) are important but do not specifically address the increased infection risk in neutropenic patients. Encouraging the patient to engage in social activities (Choice D) is not appropriate for a neutropenic patient due to the risk of exposure to infectious agents.

2. A nurse is preparing to perform a sterile dressing change. Which of the following actions should the nurse take when setting up the sterile field?

A. Place the cap from the solution sterile side up on a clean surface.
B. Open the outermost flap of the sterile kit away from the body.
C. Place the sterile dressing within 1.25 cm (0.5 in) of the edge of the sterile field.
D. Set up the sterile field 5 cm (2 in) above waist level.

Correct answer: A

Rationale: To maintain the sterility of the field, the nurse should place the cap from the solution sterile side up on a clean surface. This action helps prevent contamination. Choice B is incorrect because opening the outermost flap toward the body increases the risk of introducing contaminants onto the sterile field. Choice C is incorrect as the sterile dressing should be placed at least 2.5 cm (1 in) from the edge of the sterile field to prevent accidental contamination. Choice D is incorrect because setting up the sterile field above waist level could lead to inadvertent contact and compromise the field's sterility.

3. A nurse is teaching a client who has ulcerative colitis about dietary recommendations. Which of the following instructions should the nurse include?

A. Avoid high-fiber foods
B. Increase intake of spicy foods
C. Consume foods high in fiber
D. Eat large, infrequent meals

Correct answer: C

Rationale: The correct answer is C: 'Consume foods high in fiber.' Consuming high-fiber foods helps manage symptoms of ulcerative colitis by promoting regular bowel movements. Choices A, B, and D are incorrect. Avoiding high-fiber foods can worsen symptoms as fiber is beneficial for digestive health. Increasing the intake of spicy foods can exacerbate inflammation in the digestive tract, leading to more discomfort. Eating large, infrequent meals can put more strain on the digestive system, which is not ideal for managing ulcerative colitis.

4. What is the key management strategy for diabetic ketoacidosis (DKA)?

A. Administer insulin
B. Monitor blood glucose
C. Administer IV fluids
D. All of the above

Correct answer: D

Rationale: The key management strategy for diabetic ketoacidosis (DKA) involves a comprehensive approach that includes administering insulin to lower blood glucose levels, monitoring blood glucose levels to ensure they are within the target range, and administering IV fluids to correct dehydration and electrolyte imbalances. Choosing 'All of the above' as the correct answer is the most appropriate because all three interventions are essential components of DKA management. Administering insulin alone without addressing fluid status and monitoring blood glucose could lead to complications. Similarly, solely focusing on IV fluids or blood glucose monitoring without insulin administration would not effectively manage DKA.

5. How should a healthcare professional assess a patient with chest pain?

A. Assess the severity of pain and monitor ECG
B. Administer nitroglycerin and provide oxygen
C. Administer aspirin and provide pain relief
D. Monitor for nausea and administer IV fluids

Correct answer: A

Rationale: When assessing a patient with chest pain, the initial step is to assess the severity of pain and monitor the electrocardiogram (ECG) to look for signs of cardiac issues. Administering nitroglycerin and oxygen (Choice B) is a treatment option for suspected cardiac chest pain but should not precede a thorough assessment. Administering aspirin and providing pain relief (Choice C) may be indicated later, but the priority is to assess the situation first. Monitoring for nausea and administering IV fluids (Choice D) is not the initial assessment for chest pain unless there are specific indications present.