You are caring for a patient with an Absolute Neutrophil Count (ANC) of 400. The physician orders the patient to be placed on neutropenic precautions. Which of the following would be appropriate to implement? (Select all that apply)

Use a positive pressure room if available

Restrict any visitors until the patient's ANC counts return to normal

Use a negative pressure room if available

No live plants or fruits in the room

Ensure all entrants into room wash their hands

Answer and Explanation

Correct Answer : A,B,D,E

A.   A positive pressure room helps prevent outside air (and potential pathogens) from entering the room, providing a safer environment for neutropenic patients.
B.   Visitors can introduce infections, so it’s wise to restrict them, especially those who are ill or have been exposed to infectious diseases.
C.   Negative pressure rooms are used for patients with airborne infections (like tuberculosis) to prevent pathogens from escaping the room. Neutropenic patients require a protected environment, not one that allows outside air to flow in.
D.   Live plants and unwashed fruits can harbor bacteria and fungi that pose a risk to neutropenic patients, who have compromised immune systems.
E.   Hand hygiene is one of the most effective ways to prevent the spread of infections. Everyone entering the room should wash their hands to minimize the risk of introducing pathogens.

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Correct Answer is A

Explanation

A. Gouty arthritis, or gout, is characterized by the accumulation of uric acid crystals in the joints, leading to sudden and severe pain, especially in the big toe (podagra). The presence of tophi (deposits of uric acid crystals under the skin) on the left toe is a classic sign of chronic gout. The patient's high BMI and frequent beer consumption also increase the risk for elevated uric acid levels, contributing to gout.
B. Rheumatoid arthritis is an autoimmune condition that typically causes symmetric joint pain and stiffness, often involving the small joints of the hands and feet. It is less likely to present with tophi and is usually not linked to a history of beer consumption or a specific joint (like the big toe) in isolation.
C. Systemic lupus erythematosus (SLE) can cause joint pain, but it usually involves multiple joints in a symmetrical pattern and is associated with a range of other systemic symptoms. The presence of tophi and the specific pain in the big toe point more toward gout.
D. Osteoarthritis is a degenerative joint disease that commonly affects weight-bearing joints and can cause pain, especially with movement. However, it does not typically cause the acute attacks or the presence of tophi that are characteristic of gout.

A. PT/INR B. C-reactive protein (CRP) C. Erythrocyte sedimentation rate (ESR) D. Procalcitonin (PCT)

Correct Answer is A

Explanation

A. PT (Prothrombin Time) and INR (International Normalized Ratio) are tests primarily used to evaluate blood coagulation and the effectiveness of anticoagulant therapy. While they can provide some insight into a patient's overall health, they are not specific indicators of inflammation.
B. CRP is a protein produced by the liver in response to inflammation. It is a well-established marker for detecting acute inflammation and is commonly used in clinical settings to assess inflammatory conditions.
C. ESR measures how quickly red blood cells settle at the bottom of a test tube. An elevated ESR is a classic indicator of inflammation in the body and is commonly used in diagnosing various inflammatory conditions.
D. Procalcitonin is a biomarker that can indicate bacterial infections and systemic inflammation. It is increasingly used in clinical practice to assess the severity of infection and inflammation, particularly in cases of sepsis.

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You are caring for a patient with an Absolute Neutrophil Count (ANC) of 400. The physician orders the patient to be placed on neutropenic precautions. Which of the following would be appropriate to implement? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Which of the following lab tests is NOT commonly ordered to ascertain whether the patient is experiencing large amounts of inflammation?

Correct Answer is A

Explanation

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