A nursing instructor is evaluating a student caring for a neutropenic client. The instructor concludes that the nursing student demonstrates accurate knowledge of neutropenia based on which of the following interventions?
Monitoring the patient's breathing and reviewing the patients arterial blood gases
Monitoring the patient's temperature and reviewing the patient's complete blood count with differential
Monitoring the patients blood pressure and reviewing the patient's hematocrit
Monitoring the patient's heart rate and reviewing the patient's hemoglobin
The Correct Answer is B
A. Monitoring the patient's breathing and reviewing the patient's arterial blood gases:
Rationale: While respiratory status is crucial in any patient assessment, arterial blood gases primarily evaluate respiratory function. Neutropenia directly affects the immune system, not respiratory function.
Appropriateness: Not directly related to assessing neutropenia.
B. Monitoring the patient's temperature and reviewing the patient's complete blood count with differential:
Rationale: Neutropenia can cause fever due to the increased risk of infection. Monitoring temperature and reviewing the complete blood count (CBC) with differential, specifically the neutrophil count, is essential in evaluating neutropenia and identifying potential infections.
Appropriateness: Correct. Monitoring temperature and reviewing CBC with differential are crucial in assessing neutropenia.
C. Monitoring the patient's blood pressure and reviewing the patient's hematocrit:
Rationale: Blood pressure assessment and hematocrit evaluation are essential aspects of general patient care but are not specific to neutropenia.
Appropriateness: Not directly related to assessing neutropenia.
D. Monitoring the patient's heart rate and reviewing the patient's hemoglobin:
Rationale: Heart rate monitoring and hemoglobin assessment are crucial in various clinical situations but are not specific indicators of neutropenia.
Appropriateness: Not directly related to assessing neutropenia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Stress has likely caused an increase in the client's blood sugar levels:
This statement is accurate. Stress, especially related to surgery, can lead to increased levels of stress hormones, such as cortisol and catecholamines, which can elevate blood sugar levels. Surgery is a physiological stressor that can impact glucose metabolism.
B. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars:
This is the most appropriate choice. Surgery, anesthesia, and changes in fluid balance can affect blood glucose levels. The stress response to surgery can lead to fluctuations in blood sugar, and patients may need insulin during this period.
C. The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures:
This statement is not accurate. Overstimulation is not a common cause of the need for insulin in the context of surgery. The stress and physiological changes associated with surgery are more likely contributors.
D. Alterations in bile metabolism and release have likely caused hyperglycemia:
While alterations in metabolism can impact glucose regulation, in the context of surgery, the primary factors are the stress response, changes in fluid balance, and potential alterations in the ability to eat or drink normally rather than specific effects on bile metabolism.
Correct Answer is B
Explanation
A. To prevent post-prandial hypoglycemia:
This statement is not accurate. Insulin Lispro is a rapid-acting insulin used for mealtime coverage to manage post-prandial glucose levels, but it is not given to prevent hypoglycemia.
B. To treat the carbohydrates the client ate:
This statement is more accurate. Insulin Lispro is used to cover the rise in blood sugar that occurs after meals. It helps regulate glucose levels by managing the effect of ingested carbohydrates.
C. To treat the client's blood glucose level:
This statement is generally correct. Insulin Lispro is administered to manage and lower elevated blood glucose levels, especially in response to meals.
D. As a basal dose to prevent hyperglycemia for up to 24 hours:
This statement is incorrect. Insulin Lispro is a rapid-acting insulin and is not used for basal (long-acting) coverage. Basal insulin is usually provided by long-acting insulin formulations.
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