A nurse is caring for a client who has neutropenia due to HIV. Which of the following precautions should the nurse take while caring for this client?

Wear an N95 respirator.

Insert an indwelling urinary catheter to monitor urinary output.

Monitor the client's vital signs every 8 hr.

Use a dedicated stethoscope.

Answer and Explanation

The Correct Answer is D

A. Wearing an N95 respirator is not necessary when caring for a client with neutropenia due to HIV unless the client has respiratory symptoms or is undergoing procedures that generate aerosols.

B. Inserting an indwelling urinary catheter should be avoided unless necessary, as it can

introduce the risk of infection, which is particularly concerning in clients with neutropenia.

C. Monitoring vital signs every 8 hours may not provide sufficient frequency for detecting changes in a client with neutropenia who may be at risk for rapid deterioration.

D. Using a dedicated stethoscope helps prevent the spread of infection to other clients by avoiding cross-contamination, which is especially important when caring for a client with neutropenia who is at increased risk of infection.

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Correct Answer is A

Explanation

A. Gastroenteritis can lead to dehydration and electrolyte imbalances, which can cause lethargy and confusion. This indicates a potentially serious condition requiring immediate attention.

B. While cystic fibrosis requires management, the symptoms described (thick, productive cough and thirst) are not immediately life-threatening.

C. Sickle cell anemia pain is significant but may not require immediate intervention if the client has just received analgesia and is being monitored.

D. While a morning fasting capillary glucose of 185 mg/dL is elevated in a client with diabetes mellitus, it does not require immediate intervention unless accompanied by symptoms of hyperglycemia such as confusion or lethargy.

A. Metoprolol B. Clopidogrel C. Metformin D. Digoxin

Correct Answer is C

Explanation

A. Metoprolol is a beta-blocker used to treat hypertension and other cardiovascular conditions.

While it may be important for the provider to be aware of all medications, it is not the priority to report in this scenario.

B. Clopidogrel is an antiplatelet medication used to prevent blood clots in individuals at risk for cardiovascular events. While it may have implications for the procedure, it is not the priority to report in this scenario.

C. Metformin is an oral antidiabetic medication commonly used to treat type 2 diabetes. It is

important to report because there may be specific considerations regarding its use in the context of a colonoscopy, such as the risk of lactic acidosis.

D. Digoxin is a medication used to treat heart failure and certain arrhythmias. While it may have implications for the procedure, it is not the priority to report in this scenario.

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A nurse is caring for a client who has neutropenia due to HIV. Which of the following precautions should the nurse take while caring for this client?

Nursing Test Bank

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