A nurse is caring for a client who is receiving cisplatin for the treatment of ovarian cancer. The client's most recent complete blood count (CBC) is shown in the table below. It is important for the nurse to consider which of the following for the client?
- WBC: 1,400/mm³
- RBC: 4.3 x 10¹²/L
- Hgb: 12.1 g/dL
- Hct: 36.5%
- Platelets: 170,000/mm³
- Albumin: 4.5 g/dL
Given the options:
The client should receive an erythropoiesis-stimulating agent.
The client should receive a diet with increased protein.
The client has an increased risk of infection.
The client has an increased risk for bleeding.
The Correct Answer is C
Choice A reason: The use of erythropoiesis-stimulating agents (ESAs) is indicated for anemia due to chemotherapy¹. However, the client's hemoglobin (Hgb) level is 12.1 g/dL, which is within the normal range (normal: 12-15.5 g/dL for women). Therefore, administering an ESA is not indicated based on the Hgb level provided.
Choice B reason: A diet with increased protein can be beneficial for patients undergoing chemotherapy as it helps in tissue repair and immune system function. However, the client's albumin level is 4.5 g/dL, which falls within the normal range (normal: 3.4-5.4 g/dL), suggesting adequate protein intake. Thus, there is no indication that the client requires an increased protein diet based on the albumin level provided.
Choice C reason: The client's white blood cell (WBC) count is 1,400/mm³, which is below the normal range (normal: 4,500-11,000/mm³). This condition, known as leukopenia, significantly increases the risk of infection³. Therefore, the nurse should prioritize monitoring for signs of infection and implementing infection control measures.
Choice D reason: The client's platelet count is 170,000/mm³, which is within the normal range (normal: 150,000-450,000/mm³). Although cisplatin can cause thrombocytopenia, the current platelet count does not indicate an increased risk for bleeding⁴. Therefore, this choice is not correct based on the platelet count provided.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Arthralgia, or joint pain, is a common symptom associated with heterotopic ossification (HO), especially when it occurs near joints. The ectopic bone formation can lead to restricted movement and pain during joint movement.
Choice B reason:
Bradycardia, or a slower than normal heart rate, is not directly associated with HO. While spinal cord injuries can affect autonomic control and potentially lead to bradycardia, it is not a symptom specifically linked to the presence of HO.
Choice C reason:
Fecal impaction may occur in patients with spinal cord injuries due to mobility issues and changes in bowel function, but it is not a direct result of HO. HO does not typically affect bowel movements unless the ossification is in a location that mechanically obstructs the bowel.
Choice D reason:
Hypertension, or high blood pressure, is not a symptom commonly associated with HO. While individuals with spinal cord injuries may experience dysregulation of blood pressure, this is not specifically related to HO.
Correct Answer is C
Explanation
Choice A reason:
A personal trainer working with a client who has HIV is at low risk for contracting the virus. HIV is not transmitted through casual contact, sweat, or saliva. The risk would increase only if there were exposure to blood or other body fluids through an open wound or mucous membrane.
Choice B reason:
An occupational therapist working with a client who has HIV also has a low risk of contracting the virus. Similar to a personal trainer, unless there is direct exposure to blood or body fluids, the transmission risk is minimal.
Choice C reason:
A phlebotomist who collects blood from clients who have HIV is at the greatest risk among the listed individuals. Phlebotomists are healthcare professionals who are frequently exposed to blood, which is a bodily fluid that can transmit HIV if proper precautions are not taken.
Choice D reason:
A nurse who collects urine samples is at a lower risk compared to a phlebotomist. HIV is not typically transmitted through urine unless it contains blood. However, the risk is still present if there is exposure to blood-contaminated urine through cuts or mucous membranes.
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