Your patient has suspected aplastic anemia and has just returned to the unit to be cared for by you after having bone marrow biopsy done to confirm the diagnosis. Which of the following is the MOST appropriate nursing action?

Assess the patient's lower back for bleeding

Apply a heat pack to the biopsy site for comfort

Have the patient remain bedbound and NPO for 4-6 hours

Give aspirin for hip pain

Answer and Explanation

The Correct Answer is A

A.   This is a crucial action following a bone marrow biopsy, as there is a risk of bleeding at the biopsy site. Monitoring for signs of bleeding or hematoma formation is essential to prevent complications, making this a highly appropriate nursing action.
B.   While applying heat may provide comfort, it is generally not recommended immediately after a biopsy because it can increase blood flow to the area and potentially exacerbate bleeding. Thus, this action may not be appropriate right after the procedure.
C.   While some level of rest is important after a procedure, keeping the patient NPO (nothing by mouth) is unnecessary unless there are specific orders due to anesthesia or other considerations. Additionally, remaining bedbound could increase discomfort or risk of complications like deep vein thrombosis (DVT) if not warranted.
D.   Aspirin should be avoided in this scenario because it is an anticoagulant and can increase the risk of bleeding, particularly after a procedure like a bone marrow biopsy. Instead, other pain management strategies that do not affect clotting should be considered.

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Correct Answer is ["A","C","D"]

Explanation

A. Trauma can cause an elevated WBC count as part of the body’s response to injury. The immune system reacts to tissue damage by increasing WBC production to facilitate healing and fight potential infections.
B. Hyperglycemia itself does not directly cause an elevated WBC count. However, it may be associated with conditions like diabetes, where infections are more common. Therefore, while hyperglycemia can occur concurrently with elevated WBC counts, it is not a direct cause of the increase.
C. Infection is one of the most common causes of an elevated WBC count. The body responds to infections (bacterial, viral, etc.) by increasing WBC production to help combat the invading pathogens.
D. Inflammation, whether due to autoimmune conditions, allergies, or other causes, can also lead to an increase in WBC count. The inflammatory process triggers the immune response, resulting in elevated levels of white blood cells.
E. While steroid injections can influence WBC counts, they often cause a redistribution of white blood cells rather than an increase in production. Corticosteroids can cause a decrease in certain types of white blood cells (like lymphocytes) but may increase neutrophils due to a release from the bone marrow.

A. Distributive B. Hypovolemic C. Obstructive D. Cardiogenic

Correct Answer is A

Explanation

A. This type of shock occurs when there is widespread vasodilation leading to a relative hypovolemia, often seen in conditions like sepsis. Given that the patient has a surgical site infection, this is a plausible consideration. However, distributive shock typically involves more than just hypotension, including symptoms like warm skin and possible fever.
B. This type of shock results from significant fluid loss, leading to inadequate circulating volume. It can occur after surgery due to bleeding or fluid loss, but the context here suggests that the primary issue is infection rather than direct fluid loss.
C. Obstructive shock happens when there is a physical obstruction to blood flow, such as in cases of pulmonary embolism or tension pneumothorax. There’s no indication of obstruction in this scenario related to the infection and hypotension.
D. This shock type occurs when the heart fails to pump effectively, often due to myocardial infarction or severe heart failure. The patient’s history does not suggest heart dysfunction, so this option is less likely.

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Your patient has suspected aplastic anemia and has just returned to the unit to be cared for by you after having bone marrow biopsy done to confirm the diagnosis. Which of the following is the MOST appropriate nursing action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","C","D"]

Explanation

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Correct Answer is A

Explanation

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