A nurse is planning care for a client who has leukemia and is prescribed bed rest. Which of the following interventions should the nurse include in the plan?

Have the client perform pulmonary hygiene every 8 hr.

Place the client on airborne precautions.

Turn the client every 4 hr and apply powder to moist areas.

Assess the client's urine for odor and cloudiness.

Answer and Explanation

The Correct Answer is D

- Rationale for Choice A: Pulmonary hygiene is important for preventing pneumonia, especially in bedridden clients. However, it is not specific to the care of a client with leukemia unless they have a respiratory complication which necessitates such an intervention.
- Rationale for Choice B: Airborne precautions are typically used for clients who have infections that can be transmitted through the air, such as tuberculosis. Leukemia does not require airborne precautions unless the client has a coexisting airborne infection.
- Rationale for Choice C: Regular turning of the client can help prevent pressure ulcers and is a good practice for any bedridden patient. However, the use of powder is controversial as it can cake and lead to skin breakdown, and is not specifically indicated for leukemia care.
- Rationale for Choice D: Assessing the client's urine for odor and cloudiness is an important part of care for clients with leukemia. They are at increased risk for urinary tract infections due to immunosuppression, and changes in urine can indicate an infection that needs prompt treatment.

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Correct Answer is B

Explanation

Choice A rationale:

Phenytoin should be administered slowly to avoid adverse effects. Infusing 800 mg over 5 minutes is too rapid and can lead to cardiovascular complications.

Choice B rationale:

Rationale: After administering phenytoin via IV, it's important to flush the IV line with normal saline (0.9% sodium chloride) to ensure the medication is fully delivered to the client and to prevent any residual medication from precipitating in the IV line.

Choice C rationale:

Flushing with heparin is not standard practice for administering phenytoin.

Choice D rationale:

Phenytoin should be administered in normal saline, not in D5W (dextrose 5% in water), to avoid precipitation.

A. "I feel like my mood has been all over the place." B. "I recently started hearing voices in my head." C. “I cannot trust you enough to tell you how I feel." D. "just don't feel like doing things I usually enjoy." E. "just don't feel like doing things I usually enjoy."

Correct Answer is D

Explanation

Choice A rationale:

Rapid mood swings are not a defining characteristic of major depressive disorder.

Choice B rationale:

Hearing voices is a symptom more commonly associated with conditions like schizophrenia.

Choice C rationale:

Expressing mistrust of the nurse is not a specific symptom of major depressive disorder.

Choice D rationale:

A hallmark symptom of major depressive disorder is anhedonia, which is the diminished ability to experience pleasure or interest in previously enjoyed activities.

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A nurse is planning care for a client who has leukemia and is prescribed bed rest. Which of the following interventions should the nurse include in the plan?

Nursing Test Bank

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