A nurse is caring for a 66-year-old client who has a new diagnosis of lung cancer.
For each potential healthcare provider's prescription at 4 weeks, click to specify if the prescription is anticipated, nonessential, or contraindicated for the client.
Place the client on droplet precautions.
Insert an indwelling urinary catheter.
Place the client in a private room
Check the client's rectal temperature once daily.
Rinse the client's mouth with 0.9% sodium chloride every 4 hours
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"A"}}
Placing the client on droplet precautions is anticipated as it is a standard practice to prevent infection, especially in immunocompromised patients like those undergoing chemotherapy.
A private room is also anticipated to reduce the risk of infection and provide a controlled environment for the patient's comfort and monitoring.
The insertion of an indwelling urinary catheter may be nonessential unless there is a specific indication, such as urinary retention or close monitoring of output in a critically ill patient, as it can increase the risk of urinary tract infections.
Checking the client's rectal temperature once daily could be contraindicated due to the risk of causing trauma or bleeding, especially considering the client's decreased platelet count, which could lead to increased bleeding risk.
Lastly, rinsing the client's mouth with 0.9% sodium chloride every 4 hours is anticipated to help manage the sore mouth, a common side effect of chemotherapy, and to maintain oral hygiene, which is crucial in preventing infections in immunocompromised patients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. Weight loss can help improve symptoms of polycystic ovarian syndrome (PCOS) by reducing insulin resistance and androgen levels, which are common issues in PCOS.
A. Thyroid function testing is not specifically related to PCOS management, though thyroid function should be monitored if there are symptoms of thyroid dysfunction.
B. A diet with a low glycemic index is generally recommended for managing PCOS, not a high glycemic index.
C. PCOS is associated with decreased fertility rather than increased fertility. Contraception might be recommended for menstrual regulation, but not necessarily two forms due to increased fertility.
Correct Answer is A
Explanation
A. Assessing current anticoagulant use is a priority because t-PA (tissue plasminogen activator) can increase the risk of bleeding, especially if the client has been on anticoagulant medications. It is crucial to determine if there are any contraindications or increased risks for bleeding.
B. While blood pressure control is important, it is secondary to understanding the client's anticoagulant use as it directly affects the safety of t-PA administration.
C. A complete neurologic assessment is important but comes after ensuring there are no contraindications such as recent anticoagulant use that could affect the safety of t-PA.
D. Current treatment for peptic ulcer disease may be relevant for bleeding risks but is not as immediately critical as reviewing anticoagulant use for t-PA safety.
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