The practical nurse (PN) is caring for an older client who is receiving chemotherapy for lung cancer. Which finding is the highest priority for the PN to report to the charge nurse?
Reference ranges:
Blood urea nitrogen (BUN): [Adult: 10 to 20 mg/dL or 3.6 to 7.1 mmol/L] Platelets: [150,000 to 400,000/mm3 or 150 to 400 x 10^9/L]
Periodic nausea and vomiting.
Decreased deep tendon reflexes.
Platelet count 135,000/mm3 or 135 x 10^9/L
Blood urea nitrogen 75 mg/dL or 12.9 mmol/L
The Correct Answer is D
A high blood urea nitrogen (BUN) level indicates impaired renal function, which can be caused by dehydration, infection, or nephrotoxic drugs. Chemotherapy can damage the kidneys and increase the risk of renal failure. The PN should report this finding to the charge nurse, as it may require fluid replacement, dose adjustment, or discontinuation of the chemotherapy.
The other options are not correct because:
A. Periodic nausea and vomiting are common side effects of chemotherapy that can be managed with antiemetics, hydration, and dietary modifications. They are not as urgent as a high BUN level.
B. Decreased deep tendon reflexes may indicate hypocalcemia, hypomagnesemia, or peripheral neuropathy, which can be caused by chemotherapy or other factors. They are not as urgent as a high BUN level.
C. A platelet count of 135,000/mm3 or 135 x 10^9/L is slightly below the normal range, but not significantly low. Chemotherapy can cause thrombocytopenia, which increases the risk of bleeding. The PN should monitor the client for signs of bleeding, but this finding is not as urgent as a high BUN level.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Asking another nurse about administering adult dosages to children may provide some insights, but it is not a reliable or definitive source of information. The PN should directly communicate with the healthcare provider who wrote the prescription to ensure accuracy and safety.
Choice B rationale:
Call the healthcare provider and clarify the prescription.
Choice C rationale:
While requesting verification from the charge nurse is reasonable, the charge nurse may not have the authority to change or clarify the prescription. The most appropriate action is to directly contact the healthcare provider responsible for the child's care.
Choice D rationale:
Telling the pharmacy to send an accurate child's dosage assumes that the pharmacy made an error, which may not be the case. The PN should confirm the prescription with the healthcare provider to avoid potential mistakes or misunderstandings.
Correct Answer is C
Explanation
"I realize that my life must go on, but sometimes I wonder why.”
Choice A rationale:
This statement may indicate frustration with physical limitations, which is common in older adults, especially after surgery. It does not necessarily indicate a need for bereavement counseling.
Choice B rationale:
Difficulty remembering simple things can be attributed to normal aging processes or other factors not directly related to bereavement.
Choice C rationale:
Expressing a sense of wondering "why”. after the loss of a spouse suggests ongoing grief and a potential need for bereavement counseling to process feelings and find meaning in life after the loss.
Choice D rationale:
Depending on children who live close-by is a common support mechanism for older adults and does not directly indicate a need for bereavement counseling.
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