Which strategy is most important for a nurse to include when planning care for a patient who has neutropenia?

Restricting all visitors.

Placing the patient in a private room.

Advising the patient to use only an electric shaver.

Wearing a gown and gloves when in direct contact with the patient.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Restricting all visitors might be beneficial in preventing infections, but it is not the most important strategy for a patient with neutropenia. The main concern is the risk of infections due to the compromised immune system.

Choice B rationale:

Placing the patient in a private room is crucial for a neutropenic patient. Neutropenia, characterized by a low absolute neutrophil count (ANC), significantly compromises the patient's immune system, making them highly susceptible to infections. Isolating the patient helps minimize the risk of exposure to pathogens, reducing the likelihood of infections.

Choice C rationale:

Using an electric shaver instead of a razor is advisable to prevent cuts and minimize the risk of skin infections. While this is a good practice, it is not the most important strategy compared to isolating the patient and using personal protective equipment (PPE) during direct patient care.

Choice D rationale:

Wearing a gown and gloves when in direct contact with the patient is essential to prevent the spread of infections. This is a necessary measure, but isolating the patient in a private room takes precedence as it minimizes the risk of exposure to pathogens, providing a safer environment for the neutropenic patient.

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Correct Answer is C

Explanation

Choice A rationale:

Metabolic acidosis is characterized by low blood pH and low bicarbonate ion levels. In this case, the patient has a high bicarbonate ion level (25 mEq/L), indicating a compensatory response to respiratory acidosis. Metabolic alkalosis, on the other hand, would present with high pH and high bicarbonate ion levels.

Choice B rationale:

Metabolic alkalosis is characterized by high blood pH and high bicarbonate ion levels. The patient's bicarbonate ion level (25 mEq/L) is within the normal range, and the low pH and high PaCO2 (49 mm Hg) indicate respiratory acidosis, not metabolic alkalosis.

Choice C rationale:

Respiratory acidosis is characterized by low blood pH and high partial pressure of carbon dioxide (PaCO2) levels. In this case, the patient has a low pH (7.29) and elevated PaCO2 (49 mm Hg), indicating respiratory acidosis. The elevated bicarbonate ion level (25 mEq/L) is a compensatory response. Respiratory alkalosis would present with high pH and low PaCO2 levels.

Choice D rationale:

Respiratory alkalosis is characterized by high blood pH and low PaCO2 levels. The patient's PaCO2 level is elevated (49 mm Hg), indicating respiratory acidosis, not alkalosis. The low pH (7.29) further supports the diagnosis of respiratory acidosis.

A. Palpitations. B. Conjunctival pallor. C. Sternal tenderness. D. Heart rate of 104 beats/min.

Correct Answer is ["B","D"]

Explanation

Choice A rationale:

Palpitations are not directly related to a low hemoglobin level. They can occur due to various cardiac conditions but are not specific to anemia.

Choice B rationale:

Conjunctival pallor is a common physical finding in patients with low hemoglobin levels (anemia) Anemia leads to reduced oxygen-carrying capacity, causing paleness in mucous membranes such as the conjunctiva.

Choice C rationale:

Sternal tenderness is not a typical finding associated with low hemoglobin levels. It is more often associated with conditions affecting the sternum or adjacent structures, such as infections or inflammation.

Choice D rationale:

A heart rate of 104 beats/min can be a compensatory response to anemia. When the body senses reduced oxygen levels due to anemia, the heart rate may increase to pump more blood and oxygen to vital organs, attempting to compensate for the low hemoglobin levels.

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Which strategy is most important for a nurse to include when planning care for a patient who has neutropenia?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Which finding would the nurse expect to see in a patient with a hemoglobin level of 8 g/dL? Select all that apply.One, some, or all responses may be correct.

Correct Answer is ["B","D"]

Explanation

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