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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Free Nursing Study Resources

Correct Answer is A

Explanation

Choice A reason:
Alendronate is a bisphosphonate, which is commonly prescribed for Paget's disease of the bone. Bisphosphonates help regulate bone growth and can be a lifelong medication for managing this condition. They work by inhibiting osteoclasts, the cells that break down bone tissue, which helps to normalize the bone remodeling process.

Choice B reason:
Colchicine is used to treat gout and not typically used for Paget's disease. It works by reducing the inflammation caused by uric acid crystals but does not affect the bone remodeling process that is characteristic of Paget's disease.

Choice C reason:
Allopurinol is also used to treat gout by decreasing uric acid production in the body. Like colchicine, it is not used to treat Paget's disease because it does not address the abnormal bone metabolism associated with the condition.

Choice D reason:
Prednisone is a corticosteroid used to reduce inflammation in various conditions. While it may be used in some cases to manage pain and inflammation associated with Paget's disease, it is not a primary treatment for the disease itself and does not regulate bone growth like bisphosphonates do.

A. "Dietary supplements have not been tested and approved by the government." B. "Dietary supplements can cause a drug-drug interaction with nitrates." C. "There is not enough evidence that dietary supplements are effective for erectile dysfunction." D. "Dietary supplements may be expensive and are not typically covered by insurance."

Correct Answer is B

Explanation

Choice A reason:
While it is true that many dietary supplements have not been tested and approved by the government, this is not the most critical information for a client taking nitroglycerin. The primary concern with dietary supplements is their potential interaction with other medications.

Choice B reason:
This is the most important statement for the nurse to include. Dietary supplements, especially those containing L-arginine or other compounds that affect blood flow, can have serious interactions with nitrates like nitroglycerin, potentially leading to dangerously low blood pressure.

Choice C reason:
The effectiveness of dietary supplements for erectile dysfunction varies, and there is indeed a lack of evidence for many of these products. However, the immediate concern for a client taking nitroglycerin is the risk of interaction, not the general effectiveness of supplements.

Choice D reason:
The cost and insurance coverage of dietary supplements can be a concern for clients, but it is not as critical as understanding the potential risks associated with their use alongside prescribed medications like nitroglycerin.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with a new diagnosis of Paget's disease. The nurse anticipates the provider will prescribe which of the following medications for this client?

Correct Answer is A

Explanation

A nurse is providing teaching about dietary supplements to a client who has erectile dysfunction and has been prescribed nitroglycerin. Which of the following statements is the most important for the nurse to include in the teaching?

Correct Answer is B

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 discussing the differences between skeletal and skin traction with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding?

A nurse is monitoring a client who is postoperative following a thyroidectomy. Which of the following data should the nurse identify as the priority to monitor?

A nurse in an emergency room is caring for a client who sustained partial-thickness burns to both lower legs, chest, face, and both forearms. Which of the following is the priority action the nurse should take?

A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect? (Select all that apply.)

A nurse is planning care for a client who is 2 hours postoperative following a transurethral resection of the prostate (TURP). The client is receiving continuous bladder irrigation. Which of the following interventions should the nurse include?

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?