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.
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Related Questions
Correct Answer is A
Explanation
A. Erythropoietin (Epogen):
Explanation: Erythropoietin is a hormone that stimulates the production of red blood cells. In chronic kidney disease, especially when associated with anemia, the production of erythropoietin by the kidneys may be reduced. Erythropoietin (Epogen) is commonly used to stimulate the production of red blood cells and manage anemia in patients with chronic kidney disease.
B. Eltrombopag (Promacta):
Explanation: Eltrombopag is a medication used to stimulate the production of platelets and is primarily indicated for conditions associated with thrombocytopenia (low platelet count). It is not used to treat anemia associated with chronic kidney disease.
C. GM-CSF (Leukine):
Explanation: Granulocyte-macrophage colony-stimulating factor (GM-CSF or Leukine) is a medication that stimulates the production of white blood cells and is used in certain conditions to address decreased white blood cell counts. It is not typically used for managing anemia.
D. Thrombopoietin (TPO):
Explanation: Thrombopoietin is a hormone that stimulates the production of platelets. Medications that mimic the action of thrombopoietin, such as romiplostim and eltrombopag, are used to treat thrombocytopenia. Thrombopoietin is not used for the treatment of anemia.
Correct Answer is C
Explanation
A. 15 to 20 g of a fast-acting carbohydrate such as orange juice:
This is a standard and initial treatment for hypoglycemia. Fast-acting carbohydrates, like orange juice or glucose tablets, can quickly raise blood sugar levels. However, in the scenario described, the client is still conscious, and glucagon may be a more appropriate choice.
B. I.V. bolus of dextrose 50%:
Intravenous (IV) dextrose is a more aggressive intervention and is typically reserved for severe cases of hypoglycemia or for unconscious patients. It is not the first-line treatment for conscious patients.
C. I.M. or subcutaneous glucagon:
Glucagon is a hormone that raises blood sugar levels by promoting the conversion of stored glycogen in the liver to glucose. It is administered either intramuscularly (I.M.) or subcutaneously. In a conscious patient with hypoglycemia who cannot take oral carbohydrates, glucagon can be an effective and rapid way to raise blood sugar levels.
D. 10 U of fast-acting insulin:
Administering more insulin in a situation of hypoglycemia would worsen the condition. The goal in hypoglycemia is to raise blood sugar, and giving more insulin would have the opposite effect.
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