A client receiving chemotherapy develops a cough that is productive of yellow-tinged sputum. After determining that the client is afebrile, which is the priority action for the practical nurse (PN) to take?
Plan to re-assess the client's temperature in two hours.
Notify the charge nurse of the assessment findings.
Measure and record the client's intake and output.
Provide oral hygiene on a regular, frequent schedule.
The Correct Answer is B
A. Re-assessing the client’s temperature is important but not the priority action since the client is currently afebrile and the cough with yellow sputum could indicate an infection or other condition needing immediate attention.
B. Notifying the charge nurse of the assessment findings is the priority because the yellow-tinged sputum in a client receiving chemotherapy might indicate an infection or complication that requires further investigation and possible intervention.
C. Measuring and recording intake and output is important for overall fluid balance but does not address the immediate concern of a productive cough with potential infection.
D. Providing regular oral hygiene is part of general care but does not address the potential underlying cause of the productive cough and yellow-tinged sputum.
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Related Questions
Correct Answer is ["B","D","E"]
Explanation
A. Bacterial conjunctivitis is not a reportable infectious disease according to the CDC. While it is a common condition, it does not fall under the mandatory reporting requirements for public health.
B. Diphtheria is a reportable disease because it is a severe bacterial infection that can lead to outbreaks and severe health consequences. Reporting helps track and control the spread of this potentially life-threatening disease.
C. Pediculosis (head lice) is not a reportable disease by the CDC. It is a common parasitic infestation but does not require mandatory reporting for public health surveillance.
D. Anthrax is a reportable disease due to its potential for severe illness and its use as a bioterrorism agent. Reporting anthrax is crucial for monitoring and managing outbreaks and potential public health threats.
E. Tuberculosis is a reportable disease because it is a serious infectious disease that can spread in communities and requires public health measures to manage and prevent outbreaks.
Correct Answer is B
Explanation
A. Understanding that prostate cancer mostly affects older men reflects awareness but does not necessarily indicate acceptance of the prognosis.
B. Expressing that the client has found support from faith and family and rejecting negative outlooks shows a level of emotional acceptance and coping with the reality of advanced cancer.
C. Believing that the disease was undetected for a long time suggests denial or frustration rather than acceptance of the prognosis.
D. A desire to try every possible treatment reflects hope and possibly denial rather than acceptance of the prognosis.
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