The nurse is caring for a patient with lymphoma who is receiving chemotherapy.
The patient's laboratory results are below.
What interventions will the nurse implement related to these results? ANC (Absolute neutrophil count): 2400/mm³. Hemoglobin: 8.4 g/dL. Hematocrit: 25.9%. Platelets: 6,000/mm³.

Implement neutropenic precautions and administer broad-spectrum antibiotics.

Implement contact isolation precautions and administer intravenous prednisone.

Implement bleeding precautions and administer platelet transfusion.

Implement bedrest and administer packed red blood cell transfusion.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Neutropenic precautions and broad-spectrum antibiotics are indicated for patients with neutropenia to prevent infections. However, the patient's ANC is within the normal range (2400/mm³), so these measures are not necessary. This choice does not address the low hemoglobin and platelet count.

Choice B rationale

Contact isolation precautions and intravenous prednisone are not relevant to the patient's current condition. Prednisone is an immunosuppressive corticosteroid used for inflammatory and autoimmune conditions, but it does not address the patient's anemia or thrombocytopenia.

Choice C rationale

Bleeding precautions and platelet transfusion are appropriate interventions for the patient. The platelet count is critically low (6,000/mm³), putting the patient at high risk for spontaneous bleeding. Platelet transfusion is needed to increase platelet levels and reduce bleeding risk. Bleeding precautions, such as avoiding invasive procedures and using gentle oral care, help minimize the risk of hemorrhage.

Choice D rationale

Bedrest and packed red blood cell transfusion address the patient's anemia (hemoglobin 8.4 g/dL, hematocrit 25.9%). While these interventions are necessary to improve oxygen-carrying capacity, they do not address the critical issue of thrombocytopenia. Combining interventions C and D would be ideal for comprehensive care, but based on the question, Choice C is most critical for immediate bleeding risk management. .

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Correct Answer is ["B","C","E"]

Explanation

Choice A rationale

Levothyroxine should be taken on an empty stomach, typically 30-60 minutes before breakfast, to ensure proper absorption. Taking it with food can interfere with its effectiveness.

Choice B rationale

Monitoring for chest pain or symptoms of angina is crucial as levothyroxine can increase the heart rate and potentially exacerbate pre-existing heart conditions, especially in elderly patients.

Choice C rationale

Monitoring prothrombin time is important for patients taking warfarin because levothyroxine can enhance the anticoagulant effect of warfarin, increasing the risk of bleeding.

Choice D rationale

Stopping levothyroxine abruptly can cause severe hypothyroid symptoms, so it should not be discontinued without consulting a healthcare provider.

Choice E rationale

Hypothyroidism patients are often more sensitive to sedatives, so reducing the dose of any sedative agents can prevent excessive sedation and other adverse effects. .

A. Tumor lysis syndrome (TLS). B. Hypercalcemia. C. Spinal cord compression. D. Superior vena cava syndrome (SVCS).

Correct Answer is D

Explanation

Choice A rationale

Tumor lysis syndrome (TLS) results from the rapid breakdown of cancer cells, leading to metabolic imbalances such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Symptoms can include nausea, vomiting, diarrhea, muscle cramps, and arrhythmias. TLS is a metabolic emergency seen in high-turnover cancers like leukemia or lymphoma and is not associated with symptoms like jugular venous distention or edema in the face, neck, and arms.

Choice B rationale

Hypercalcemia, often due to bone metastasis or certain paraneoplastic syndromes, presents with symptoms such as confusion, lethargy, constipation, nausea, polyuria, and polydipsia. It is not related to the symptoms described in the question, which are indicative of a different oncologic emergency.

Choice C rationale

Spinal cord compression occurs when a tumor compresses the spinal cord, leading to symptoms like severe back pain, weakness, sensory changes, and autonomic dysfunction. It does not explain the symptoms of jugular venous distention, facial, neck, and arm edema.

Choice D rationale

Superior vena cava syndrome (SVCS) occurs when a tumor compresses the superior vena cava, leading to decreased venous return from the upper body. Symptoms include shortness of breath, jugular venous distention, and edema of the face, neck, and arms due to impaired blood flow. This is an oncologic emergency requiring prompt intervention to reduce the obstruction.

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The nurse is caring for a patient with lymphoma who is receiving chemotherapy.The patient's laboratory results are below.What interventions will the nurse implement related to these results? ANC (Absolute neutrophil count): 2400/mm³. Hemoglobin: 8.4 g/dL. Hematocrit: 25.9%. Platelets: 6,000/mm³.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient newly diagnosed with hypothyroidism who has a new prescription for levothyroxine 50 mcg orally.Which interventions will the nurse include in the plan of care? Select All That Apply.

Correct Answer is ["B","C","E"]

Explanation

The nurse is caring for a patient with lung cancer who suddenly develops shortness of breath, jugular venous distention, and edema in the face, neck, and arms.The nurse promptly notifies the healthcare provider that the patient is exhibiting signs of which oncologic emergency?

Correct Answer is D

Explanation

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