A nurse is caring for a client receiving chemotherapy. The nurse should identify that a client who has myelosuppression is at risk for which of the following conditions?

Diarrhea and dehydration

Anorexia and malnutrition

Full body alopecia

Bleeding from the gums

Answer and Explanation

The Correct Answer is D

A.   These symptoms are more commonly associated with gastrointestinal side effects of chemotherapy.
B.   These symptoms are common due to the impact of chemotherapy on the gastrointestinal system.
C.   Hair loss is a common side effect of chemotherapy, but it is not associated with myelosuppression.
D.   Myelosuppression can lead to decreased platelet production, resulting in an increased risk of bleeding, including gum bleeding.

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Correct Answer is C

Explanation

A. Encouraging the client to talk about his feelings is important, but understanding the client's current perception of his body image comes first to guide appropriate interventions.
B. Discussing coping strategies is relevant, but understanding the client's current perception helps tailor coping strategies to his specific concerns.
C. Determining the client's perception of his body image is the first step to assess the extent of the issue and plan interventions accordingly.
D. Assisting the client to acknowledge a distorted body image may be necessary, but understanding the client's current perception precedes interventions.

A. A client who has a sprained left ankle. B. A client who has an open traumatic brain injury and agonal breaths. C. A client who has sustained a partial amputation of the right leg. D. A client who is deceased. E. A client who has sustained a major burn to the upper torso and extremities.

Correct Answer is B

Explanation

A. A client who has a sprained left ankle is typically categorized as a lower priority in triage.
B. A client who has an open traumatic brain injury and agonal breaths should be assigned a red tag and indicates immediate or emergent care; this client requires immediate attention.
C. A client who has sustained a partial amputation of the right leg requires urgent care but may not be as immediately life-threatening as option B.
D. A client who is deceased typically does not receive further medical intervention in a mass casualty situation.
E. While serious, the severity may not necessitate immediate intervention compared to option B.
F. This is typically categorized as a lower priority in triage.

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A nurse is caring for a client receiving chemotherapy. The nurse should identify that a client who has myelosuppression is at risk for which of the following conditions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is contributing to the plan of care for a client who has a disturbed body image following a motor vehicle crash that resulted in a right arm amputation. Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

A nurse is assisting in performing triage on several clients following a mass casualty event. The nurse should assign a red tag to which of the following clients?

Correct Answer is B

Explanation

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