A client's electronic health record notes that the client has previously undergone treatment for secondary polycythemia. The nurse should assess for which factor?

Recent blood donation

A history of venous thromboembolism

Evidence of lung disease

Impaired renal function

Answer and Explanation

The Correct Answer is C

Reasoning:

Choice A reason: Recent blood donation is not a primary cause of secondary polycythemia, which results from chronic hypoxia or erythropoietin excess, not blood loss. Donation may temporarily reduce red blood cell count, but it does not drive the increased erythropoiesis seen in secondary polycythemia, making it less relevant.

Choice B reason: A history of venous thromboembolism is a consequence, not a cause, of secondary polycythemia. Increased red blood cell mass elevates blood viscosity, raising clotting risk, but thromboembolism does not trigger polycythemia. The nurse should assess for underlying causes like hypoxia, not its complications.

Choice C reason: Evidence of lung disease is critical to assess, as secondary polycythemia is often caused by chronic hypoxia from conditions like chronic obstructive pulmonary disease. Low oxygen levels stimulate erythropoietin production, increasing red blood cell mass to enhance oxygen delivery, making lung disease a primary factor to evaluate.

Choice D reason: Impaired renal function is not a primary cause of secondary polycythemia. While kidneys produce erythropoietin, renal disease typically causes anemia due to reduced erythropoietin. Rarely, renal tumors may increase erythropoietin, but lung disease is a more common driver of secondary polycythemia in clinical practice.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: Monitoring temperature every 4 hours is critical in neutropenia, a common complication of Hodgkin disease treatment. Low neutrophil counts increase infection risk, and fever is an early sign of infection. Regular temperature checks enable prompt detection and treatment of infections, preventing sepsis in immunocompromised clients.

Choice B reason: Omitting fresh fruits and vegetables is not universally recommended for neutropenia. While some diets limit raw produce to reduce bacterial exposure, this is less critical than fever monitoring. Neutropenic precautions focus on infection prevention, with temperature monitoring being a more direct and urgent intervention.

Choice C reason: Positioning to increase lung expansion is relevant for respiratory conditions but not a priority in neutropenia. Neutropenia increases infection risk, not respiratory compromise. Monitoring for fever is more critical, as infections are the primary concern in clients with low neutrophil counts from Hodgkin disease therapy.

Choice D reason: Avoiding IM injections is important in neutropenia to reduce infection risk at injection sites, but it is secondary to fever monitoring. Injections can introduce bacteria, but fever detection through regular temperature checks is a more proactive and essential intervention for early infection identification in neutropenic clients.

A. Sodium of 140 mEq/L (range 135-145 mEq/L) B. Glucose of 100 mg/dL (range 60-100 mg/dL) C. A blood pressure reading of 135/90 mm Hg D. Potassium of 6.0 mEq/L (range 3.5-5 mEq/L)

Correct Answer is D

Explanation

Reasoning:

Choice A reason: A sodium level of 140 mEq/L is within the normal range and not diagnostic of Addison’s disease. This condition, caused by adrenal insufficiency, typically leads to hyponatremia due to reduced aldosterone, which decreases sodium reabsorption, making a normal sodium level uncharacteristic of the disease.

Choice B reason: A glucose level of 100 mg/dL is normal and not specific to Addison’s disease. Hypoglycemia is more common due to cortisol deficiency, which impairs gluconeogenesis. A normal glucose level does not support the diagnosis, as it does not reflect the metabolic disruptions of adrenal insufficiency.

Choice C reason: A blood pressure of 135/90 mm Hg is elevated but not diagnostic of Addison’s disease. The condition typically causes hypotension due to reduced aldosterone and cortisol, leading to low blood volume and vascular tone. Hypertension suggests another etiology, not adrenal insufficiency.

Choice D reason: A potassium level of 6.0 mEq/L indicates hyperkalemia, a diagnostic sign of Addison’s disease. Aldosterone deficiency reduces potassium excretion in the kidneys, leading to elevated serum potassium. This, combined with hyponatremia and hypotension, is a hallmark of adrenal insufficiency, making hyperkalemia a key diagnostic finding.

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A client's electronic health record notes that the client has previously undergone treatment for secondary polycythemia. The nurse should assess for which factor?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

For a client with Hodgkin disease who has developed neutropenia, what is an appropriate nursing intervention to include in the care plan?

Correct Answer is A

Explanation

The nurse assesses a client who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease?

Correct Answer is D

Explanation

A nurse is caring for a client with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which finding would indicate that the client has developed fluid overload?

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