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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A reason:
The statement "HIPAA is a federal law, not a state law" is correct. HIPAA is indeed a federal law that provides national standards to protect the privacy of personal health information.

Choice B reason:
The statement "HIPAA established regulations for individually identifiable health information in verbal, electronic, or written form" is also correct. HIPAA does regulate how individually identifiable health information should be protected and handled across various forms of communication.

Choice C reason:
The statement "Information about a client can be disclosed to family members at any time" indicates a need for further teaching. Under HIPAA, protected health information can only be disclosed to family members under certain conditions, such as when the patient has given permission or when it is directly relevant to the family member's involvement in the patient's care.

Choice D reason:
The statement "A client's address would be an example of personally identifiable information" is correct. Under HIPAA, a client's address is considered personally identifiable information, which is protected and cannot be disclosed without proper authorization.

A. Avoid prolonged sitting. B. Sleep on a soft mattress. C. Apply heat for 10 minutes every hour. D. Sleep in a side-lying position with flexed knees. E. Try padded shoe insoles.

Correct Answer is ["A","D","E"]

Explanation

Choice B reason:
Sleeping on a soft mattress is not recommended for preventing low back pain. A medium-firm mattress often provides better support for the spine. A soft mattress may allow the body to sink in too deeply, causing misalignment of the spine during sleep.

Choice C reason:
Applying heat for 10 minutes every hour is not a standard recommendation for preventing low back pain. While heat therapy can help relax muscles and relieve pain, it is typically advised to apply heat for longer periods, such as 15-20 minutes, and not as frequently as every hour.

Choice D reason:
Sleeping in a side-lying position with flexed knees can help maintain the natural curve of the spine and minimize back strain. This position can also reduce pressure on the back and is often recommended for those with low back pain.

Choice E reason:
Trying padded shoe insoles can help minimize back strain by providing additional support and cushioning for the feet, which can improve alignment and reduce the impact on the back during walking or standing.

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing information about the Health Insurance Portability and Accountability Act (HIPAA) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching?

Correct Answer is C

Explanation

A nurse is educating coworkers about how to minimize back strain and avoid repeated episodes of low back pain. Which of the following strategies should the nurse include? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

A nurse is reviewing the BUN and creatinine levels of an older adult client who has chronic kidney disease. The nurse should expect which of the following findings?

A nurse is assessing a client who is being admitted from the Post-Anesthesia Care Unit (PACU) following an abdominal hysterectomy. Which of the following assessments is the nurse's priority?

A nurse is educating a client who was recently diagnosed with cancer and tells the nurse they are worried about infertility following radiation treatment. Which of the following interventions should the nurse recommend?

A nurse is caring for a client who has uncontrolled type 1 diabetes mellitus. Which of the following findings should the nurse expect?

A nurse is reviewing the laboratory data of a client following a hemodialysis treatment. The nurse should expect to find a decrease in which of the following laboratory values?

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following manifestations of peritonitis?

The nurse is caring for a client who has prostate cancer. Which of the following manifestations does the nurse attribute to the advancing disease process?

A nurse is caring for a client who has just returned from the Post-Anesthesia Care Unit (PACU) with an intravenous (IV) fluid infusion and a nasogastric (NG) tube in place following abdominal surgery. Which of the following data is the priority for the nurse to assess?