which clients laboratory value requires immediate intervention by a nurse
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ATI Medical Surgical Proctored Exam 2019 Quizlet

1. Which client's laboratory value requires immediate intervention by a nurse?

Correct answer: D

Rationale: The correct answer is D. A sudden drop in neutrophil count to below 500 indicates severe neutropenia, putting the client at high risk for infections. Neutrophils are essential for fighting off infections, and a significant decrease in their count can compromise the client's immune response. Immediate intervention is necessary to prevent the development of serious infections in the client with neutropenia.

2. Prior to elective surgery, a patient taking warfarin should receive which instruction regarding warfarin therapy?

Correct answer: D

Rationale: Prior to elective surgery, a patient taking warfarin should be instructed to stop taking warfarin around one week before the procedure. This timeframe allows for the effects of warfarin to diminish, lowering the risk of excessive bleeding during surgery. Continuing warfarin until the day of surgery (Choice A) increases the risk of bleeding complications. Stopping warfarin three days before surgery (Choice B) may not provide enough time for the anticoagulant effects to subside. Switching to aspirin before surgery (Choice C) is not recommended as a substitute for warfarin in this context.

3. A patient with rheumatoid arthritis is prescribed methotrexate. What should the nurse include in the patient teaching?

Correct answer: A

Rationale: Patients prescribed methotrexate should be advised to take folic acid supplements as prescribed. Methotrexate can deplete folic acid levels, leading to side effects. By taking folic acid supplements as directed, the patient can reduce the risk of experiencing adverse effects associated with methotrexate therapy. It is important to note that the effects of methotrexate may not be immediate, so realistic expectations should be set with the patient. Alcohol should be avoided while taking methotrexate due to potential interactions and increased risk of liver toxicity. There is no specific recommendation to limit fluid intake to 1 liter per day in relation to methotrexate therapy.

4. A patient with anemia is prescribed ferrous sulfate. What advice should the nurse give regarding the administration of this medication?

Correct answer: B

Rationale: The correct advice for the administration of ferrous sulfate is to take it on an empty stomach for best absorption. This enhances the absorption of iron. If gastrointestinal upset occurs, the medication can be taken with food. Taking ferrous sulfate with dairy products is not recommended as calcium can inhibit iron absorption. Taking it before bedtime is also not recommended. Vitamin C can actually help with the absorption of iron and is often recommended to be taken alongside iron supplements to enhance absorption. Therefore, avoiding vitamin C while taking ferrous sulfate is not correct.

5. A highly successful individual presents to the community mental health center complaining of sleeplessness and anxiety over their financial status. What action should the nurse take to assist this client in diminishing their anxiety?

Correct answer: D

Rationale: Teaching the individual to limit sugar and caffeine intake is an appropriate intervention to reduce anxiety and improve sleep quality. Sugar and caffeine can exacerbate anxiety symptoms and disrupt sleep patterns. By reducing their intake, the individual may experience a decrease in anxiety levels and better sleep. Encouraging daily rituals, reinforcing financial realities, or suggesting alcohol consumption before bed are not evidence-based strategies for managing anxiety and sleeplessness.

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