Nursing Elites

1. Which action will the admitting nurse include in the care plan for a patient who has neutropenia?

• A. Avoid intramuscular injections
• B. Check temperature every 4 hours
• C. Omit fruits or vegetables from the diet
• D. Place a 'No Visitors' sign on the door

Correct answer: B

Rationale: The correct answer is B: 'Check temperature every 4 hours.' Neutropenic patients have a weakened immune system due to low levels of neutrophils, which are a type of white blood cell that helps fight infections. Monitoring the patient's temperature every 4 hours is crucial because the earliest sign of infection in a neutropenic patient is often a fever. This allows for early detection of any potential infections. Choices A, C, and D are incorrect because avoiding intramuscular injections, omitting fruits or vegetables from the diet, and placing a 'No Visitors' sign on the door are not specific actions directly related to managing neutropenia or monitoring for signs of infection.

2. Which instruction will the nurse plan to include in discharge teaching for a patient admitted with a sickle cell crisis?

• A. Take a daily multivitamin with iron
• B. Limit fluids to 2 to 3 quarts per day
• C. Avoid exposure to crowds when possible
• D. Drink only two caffeinated beverages daily

Correct answer: C

Rationale: The correct answer is C: 'Avoid exposure to crowds when possible.' This instruction is crucial in discharge teaching for a patient admitted with a sickle cell crisis because exposure to crowds increases the risk of infection, which is the most common cause of sickle cell crisis. Choices A, B, and D are incorrect. Taking a daily multivitamin with iron (Choice A) may be beneficial for some individuals but is not specifically related to managing sickle cell crisis. Limiting fluids to 2 to 3 quarts per day (Choice B) is not typically recommended for patients with sickle cell crisis, as adequate hydration is important. Drinking only two caffeinated beverages daily (Choice D) is not a priority instruction in managing sickle cell crisis.

3. A patient is considering options to manage his/her coronary artery disease. The nurse explains a coronary artery bypass graft procedure will:

• A. Cure the patient's coronary artery disease.
• B. Replace the leaking valve in the heart.
• C. Connect grafts to aorta to improve blood flow.
• D. Place a permanent pacemaker on the heart muscle.

Correct answer: C

Rationale: The correct answer is C. A coronary artery bypass graft procedure involves connecting grafts to the aorta to improve blood flow to the heart muscle by bypassing blocked or narrowed coronary arteries. This procedure does not cure coronary artery disease but helps improve blood supply to the heart. Choices A, B, and D are incorrect because a bypass graft procedure does not cure the underlying disease, replace heart valves, or involve the placement of a pacemaker.

4. Which task for a patient with neutropenia is appropriate for the registered nurse (RN) to delegate to a licensed practical/vocational nurse (LPN/LVN)?

• A. Assessing the patient for signs and symptoms of infection
• B. Teaching the patient the purpose of neutropenic precautions
• C. Administering subcutaneous filgrastim (Neupogen) injection
• D. Developing a discharge teaching plan for the patient and family

Correct answer: C

Rationale: The correct answer is C because administering subcutaneous medications falls within the education and scope of practice of an LPN/LVN. Assessing the patient for signs and symptoms of infection, teaching the patient, and developing a discharge plan are tasks that require an RN level of education and scope of practice. LPN/LVNs can assist in patient care, but tasks that involve assessment, teaching, and care planning are typically the responsibility of an RN.

5. Which collaborative problem will the nurse include in a care plan for a patient admitted to the hospital with idiopathic aplastic anemia?

• A. Potential complication: seizures
• B. Potential complication: infection
• C. Potential complication: neurogenic shock
• D. Potential complication: pulmonary edema

Correct answer: B

Rationale: The correct answer is B: Potential complication: infection. Patients with idiopathic aplastic anemia have pancytopenia, which puts them at a high risk for infections due to decreased production of all blood cells (red blood cells, white blood cells, and platelets). Infection is a significant concern in these patients. Choices A, C, and D are incorrect because seizures, neurogenic shock, and pulmonary edema are not typically associated with idiopathic aplastic anemia. While seizures can occur in some conditions that affect the brain, neurogenic shock is related to spinal cord injury, and pulmonary edema is more commonly seen in conditions like heart failure.

Similar Questions