A nurse is preparing to administer epoetin to a client who has anemia due to chemotherapy. Which of the following actions should the nurse plan to take?

Review the client’s Hgb level prior to administration.

Use the Z-track method when administering the medication.

Shake the vial for 30 seconds prior to withdrawing the medication.

Ensure the client is not taking iron supplements while on this medication.

Answer and Explanation

The Correct Answer is A

Choice A Reason

Review the client’s Hgb level prior to administration. This is the correct action. Monitoring hemoglobin (Hgb) levels is crucial before administering epoetin because it helps determine the appropriate dosage and ensures the treatment is safe and effective. Epoetin is used to stimulate red blood cell production, and administering it without checking Hgb levels can lead to complications such as hypertension or thromboembolic events if the Hgb level is too high.

Choice B Reason

Use the Z-track method when administering the medication. This statement is incorrect. The Z-track method is used for intramuscular injections to prevent medication from leaking into subcutaneous tissues. Epoetin is typically administered subcutaneously or intravenously, not intramuscularly, so the Z-track method is not applicable.

Choice C Reason

Shake the vial for 30 seconds prior to withdrawing the medication. This statement is incorrect. Shaking the vial of epoetin can damage the protein structure of the medication, rendering it ineffective. The vial should be gently swirled if necessary, but not shaken.

Choice D Reason

Ensure the client is not taking iron supplements while on this medication. This statement is incorrect. Iron supplements are often necessary when administering epoetin because iron is required for the production of hemoglobin. Ensuring adequate iron levels helps maximize the effectiveness of epoetin therapy.

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Correct Answer is A

Explanation

Choice A Reason:

A distended, board-like abdomen is a critical finding that can indicate peritonitis, a severe complication of appendicitis. Peritonitis occurs when the appendix ruptures, leading to infection spreading throughout the abdominal cavity. This condition requires immediate medical intervention to prevent further complications and potential sepsis.

Choice B Reason:

A WBC count of 15,000/mm³ is elevated and suggests an infection, which is common in appendicitis. However, it is not as immediately critical as signs of peritonitis. Elevated WBC counts are expected in cases of appendicitis but do not necessarily indicate a life-threatening emergency.

Choice C Reason:

Rebound tenderness over McBurney’s point is a classic sign of appendicitis and indicates localized inflammation. While it is an important diagnostic sign, it does not require immediate reporting compared to signs of peritonitis.

Choice D Reason:

A temperature of 37.3°C (99.1°F) is only slightly elevated and does not indicate a severe infection or complication. Fever is a common symptom of appendicitis but is not as critical as a distended, board-like abdomen.

A. Expressive aphasia B. Poor impulse control C. Left hemiparesis D. Disorientation to place

Correct Answer is A

Explanation

Choice A Reason:

Expressive aphasia, also known as Broca’s aphasia, is a common symptom of a left-hemisphere stroke. This condition affects the person’s ability to produce speech, although their comprehension may remain intact. The left hemisphere of the brain is typically responsible for language and speech functions, so damage to this area often results in expressive aphasia.

Choice B Reason:

Poor impulse control is more commonly associated with right-hemisphere strokes. The right hemisphere is involved in controlling behavior and emotions, so damage to this area can lead to impulsivity and poor judgment.

Choice C Reason:

Left hemiparesis, or weakness on the left side of the body, is typically a result of a right-hemisphere stroke. Strokes affect the opposite side of the body from the hemisphere where the stroke occurred. Therefore, a left-hemisphere stroke would more likely cause right-sided weakness or paralysis.

Choice D Reason:

Disorientation to place can occur with strokes affecting either hemisphere, but it is not a specific hallmark of left-hemisphere strokes. Cognitive impairments such as disorientation are more generalized and can result from various types of brain injuries.

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A nurse is preparing to administer epoetin to a client who has anemia due to chemotherapy. Which of the following actions should the nurse plan to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A nurse is assessing a client who has had a left-hemisphere stroke. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

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