A nurse preparing incoming storm. Which of the following clients should the nurse recommend for discharge planning?

A child who has leukemia and an absolute neutrophil count of 200/mm3 (2.500 to 8.000/mm%)

A child who has a new diagnosis of type diabetes mellitus and is receiving IV insulin

An adolescent who has cystic fibrosis and is receiving their yearly tune-up

An infant who has respiratory syncytial virus and respiratory rate of 70/min

Answer and Explanation

The Correct Answer is B

A) "A child who has leukemia and an absolute neutrophil count of 200/mm³ (2,500 to 8,000/mm³)."
This child is at significant risk for infection due to a severely low neutrophil count, indicating severe neutropenia. Discharge planning for this child would be inappropriate at this time since they need intensive monitoring and care to manage their immunocompromised status and prevent infections.

B) "A child who has a new diagnosis of type 1 diabetes mellitus and is receiving IV insulin."
This child is appropriate for discharge planning. A new diagnosis of type 1 diabetes requires thorough teaching for the family and child about blood glucose monitoring, insulin administration, dietary adjustments, and emergency management. While the child is receiving IV insulin in the hospital, once stabilized, they can be discharged with proper education and support to manage their condition at home.

C) "An adolescent who has cystic fibrosis and is receiving their yearly tune-up."
A cystic fibrosis "tune-up" refers to a period of treatment, often including IV antibiotics and respiratory therapy, to help manage the chronic condition. Since this is part of ongoing care and not an acute issue, discharge planning is not immediately appropriate until the "tune-up" is complete, and the adolescent has stabilized.

D) "An infant who has respiratory syncytial virus (RSV) and a respiratory rate of 70/min."
This infant is at risk for respiratory distress and requires close monitoring. A respiratory rate of 70/min in an infant is elevated, and the child may need additional respiratory support. Discharge planning should not be initiated until the infant's condition improves and they are stable enough to handle care at home.

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Correct Answer is C

Explanation

A) "The client should use a hair dryer on a warm setting to relieve itching inside the cast.": Using a hair dryer on a warm setting to relieve itching inside the cast is not recommended because it could potentially lead to burns or skin irritation. The client should avoid inserting objects inside the cast to scratch, as this could damage the skin or cause an infection.

B) "The client can shower with the cast after 24 hr.": A plaster cast is not waterproof, and the client should avoid getting it wet. Although the cast may feel dry on the outside after 24 hours, it typically takes about 48 hours or longer for a plaster cast to fully dry and harden. Showering with a plaster cast is not safe, as moisture could cause skin irritation or lead to the development of sores or infection.

C) "The client’s extremity should be elevated after the cast is applied.": Elevating the extremity after a cast is applied is a key teaching point to help reduce swelling and improve circulation. This is especially important during the first 24 to 48 hours after cast application. Elevation helps to prevent or manage swelling, which can be a common complication after an injury and cast application.

D) "The client should keep the cast covered until it is dry.": While it is important to keep a cast clean and dry during the drying process, the cast should not be covered with plastic or other materials that could trap moisture. The cast needs air circulation to dry properly, and covering it could lead to the cast becoming too moist, increasing the risk of skin issues or infection.

A. Decreased platelets B. Decreased hemoglobin C. Increased erythrocyte sedimentation rate D. Increased iron level

Correct Answer is C

Explanation

A) Decreased platelets: A decrease in platelet count (thrombocytopenia) is often associated with conditions such as bleeding disorders, bone marrow problems, or certain infections, but it is not a direct indicator of infection. While infections can cause a drop in platelets, this is not a specific or primary indicator of infection.

B) Decreased hemoglobin: A decrease in hemoglobin is typically indicative of anemia, which can result from a variety of causes, including nutritional deficiencies, chronic disease, or blood loss. While anemia can be associated with some infections, it is not a specific indicator of infection.

C) Increased erythrocyte sedimentation rate (ESR): An increased ESR is a nonspecific indicator of inflammation in the body and can be associated with infections, autoimmune diseases, and other inflammatory conditions. It is commonly elevated during infections, as the body responds to the inflammatory process. Therefore, an elevated ESR is a useful laboratory finding when suspecting an infection.

D) Increased iron level: Increased iron levels are typically associated with conditions such as hemochromatosis or iron overload, not with infections. During infections, iron levels can actually decrease due to the body's response to restrict iron availability to pathogens.

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A nurse preparing incoming storm. Which of the following clients should the nurse recommend for discharge planning?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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