Nursing Elites

1. Which information shown in the table below about a patient who has just arrived in the emergency department is most urgent for the nurse to communicate to the healthcare provider?

• A. Heart rate
• B. Platelet count
• C. Abdominal pain
• D. White blood cell count

Correct answer: B

Rationale: The correct answer is B: Platelet count. The platelet count is severely decreased, indicating a risk for spontaneous bleeding, which is a critical condition requiring immediate attention. While heart rate, abdominal pain, and white blood cell count are important, a severely decreased platelet count poses a more imminent threat to the patient's health and requires urgent communication to the healthcare provider. The nurse should prioritize addressing this potentially life-threatening issue to ensure prompt intervention and management.

2. A 62-year-old man with chronic anemia is experiencing increased fatigue and occasional palpitations at rest. The nurse would expect the patient's laboratory test findings to include

• A. an RBC count of 4,500,000/μL.
• B. a hematocrit (Hct) value of 38%.
• C. normal red blood cell (RBC) indices.
• D. a hemoglobin (Hgb) of 8.6 g/dL.

Correct answer: B

Rationale: The correct answer is B. In chronic anemia, the hematocrit (Hct) value is a crucial indicator of the proportion of red blood cells in the blood. A hematocrit value of 38% indicates a lower than normal level of red blood cells, which aligns with the patient's symptoms of fatigue and palpitations. Choices A, C, and D are incorrect because a low RBC count, normal RBC indices, and a hemoglobin level of 8.6 g/dL do not specifically address the decreased red blood cell mass associated with chronic anemia.

3. A patient who has acute myelogenous leukemia develops an absolute neutrophil count of 850/µL while receiving outpatient chemotherapy. Which action by the outpatient clinic nurse is most appropriate?

• A. Discuss the need for hospital admission to treat the neutropenia
• B. Teach the patient to administer filgrastim (Neupogen) injections
• C. Plan to discontinue the chemotherapy until the neutropenia resolves
• D. Order a high-efficiency particulate air (HEPA) filter for the patient's home

Correct answer: B

Rationale: The correct answer is B because filgrastim (Neupogen) is a medication used to stimulate the production of neutrophils. Teaching the patient to self-administer these injections can help increase the neutrophil count and reduce the risk of infection. Option A is incorrect as hospital admission may not be necessary if the patient can manage the condition at home. Option C is not ideal as discontinuing chemotherapy can impact the leukemia treatment. Option D is unrelated to managing neutropenia in this scenario.

4. After a patient with pancytopenia undergoes a bone marrow aspiration from the left posterior iliac crest, which action would be important for the nurse to take?

• A. Elevate the head of the bed to 45 degrees.
• B. Have the patient lie on the left side for 1 hour.
• C. Apply a sterile 2-inch gauze dressing to the site.
• D. Use a half-inch sterile gauze to pack the wound.

Correct answer: B

Rationale: After a bone marrow aspiration, it is important to have the patient lie on the left side for 30 to 60 minutes to decrease the risk of bleeding. Elevating the head of the bed to 45 degrees does not directly address the risk of bleeding. Applying a sterile 2-inch gauze dressing to the site is important for wound care but does not specifically address post-procedural positioning. Using a half-inch sterile gauze to pack the wound is not necessary after a bone marrow aspiration.

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