A nurse is contributing to the development of an oral care protocol for clients who are receiving chemotherapy. Which of the following resources should the nurse utilize to identify interventions?

Standards of care published by the Oncology Nursing Society

Recommendations from a nurse who has worked in an outpatient chemotherapy clinic

A qualitative study exploring clients’ perspectives on receiving chemotherapy

A chapter on chemotherapy in a published textbook

Answer and Explanation

The Correct Answer is A

A.   Standards of care published by reputable organizations, such as the Oncology Nursing Society, provide evidence-based guidelines and best practices.
B.   While the experience of a nurse in a chemotherapy clinic is valuable, it may not represent standardized, evidence-based practices.
C.   A qualitative study may provide insights into clients' perspectives but may not necessarily offer specific interventions for oral care.
D.   Published textbooks can be valuable resources, but standards of care from professional organizations are generally more up-to-date and evidence-based.

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Correct Answer is B

Explanation

A. A butterfly rash on the face is associated with systemic lupus erythematosus (SLE), not rheumatoid arthritis.
B. Ulnar deviation of the joints is a characteristic finding in rheumatoid arthritis, caused by inflammation and destruction of the joint structures.
C. Heberden’s nodes are associated with osteoarthritis, not rheumatoid arthritis.
D. Bouchard’s nodes are also associated with osteoarthritis, not rheumatoid arthritis.

A. Vomiting Hypoglycemia B. Hypertension C. Altered mental status D. Elevated WBC’s count

Correct Answer is C

Explanation

A. Vomiting is not a specific manifestation of sepsis.
B. Hypertension is not a typical finding in sepsis; hypotension is more common.
C. Altered mental status, such as confusion or lethargy, can be a sign of sepsis- induced organ dysfunction.
D. While an elevated white blood cell (WBC) count is often seen in infection, it alone does not indicate sepsis. The key in sepsis is the body's dysregulated response to infection leading to organ dysfunction.

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A nurse is contributing to the development of an oral care protocol for clients who are receiving chemotherapy. Which of the following resources should the nurse utilize to identify interventions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who reports having stiffness in her joints. Which of the following findings should indicate to the nurse that the client may have rheumatoid arthritis?

Correct Answer is B

Explanation

A nurse is collecting data on a client who has an infection. Which of the following findings is a manifestation of sepsis?

Correct Answer is C

Explanation

A nurse is collecting data from a client who is receiving chemotherapy and is showing manifestations of malnutrition. Which of the following indicates a Vitamin C deficiency?

A nurse is assisting with the care of a client who is in hemorrhagic shock and has a prescription for packed red blood cells. Which type of blood can be administered to the client while awaiting blood from a type and cross-match?

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