A nurse is caring for a 54-year-old male client in the oncology unit who is undergoing chemotherapy for colorectal cancer. The nurse must evaluate the client’s condition based on provided exhibits to determine which assessments indicate an improvement in the client’s condition.

Exhibits

Which of the following assessments indicates an improvement in the client’s condition?

Oral health

Bleeding episodes

Weight change

WBC count

Platelet count

Answer and Explanation

Correct Answer : B,D,E

Choice A rationale: Oral health indicates the absence of mucositis or other oral complications, which is good, but it doesn't necessarily reflect overall improvement in the client's cancer or chemotherapy response.
Choice B rationale: The absence of bleeding episodes is significant. This suggests that the client's platelet count has improved, reducing the risk of bleeding, which is an important indicator of recovery.
Choice C rationale: While weight maintenance or gain can be an indicator of health improvement, the slight decrease in weight from January to February (70.5 kg to 69 kg) does not suggest an improvement.
Choice D rationale: An increase in the WBC count to within the normal range (4.2 x 10⁹/L) is a positive sign. It indicates that the client’s immune system is recovering, which is crucial during chemotherapy.
Choice E rationale: The improvement in platelet count to within the normal range (150 x 10⁹/L) suggests a reduced risk of bleeding and reflects better bone marrow function, which is a positive outcome of the treatment.

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Correct Answer is D

Explanation

Choice A rationale
Prednisone does not increase bone density; in fact, long-term use can cause bone demineralization and osteoporosis.
Choice B rationale
Prednisone can actually increase the risk of infection by suppressing the immune system.
Choice C rationale
Prednisone does not improve peripheral blood flow; it mainly works by reducing inflammation and suppressing immune responses.
Choice D rationale
Prednisone helps to reduce creatinine levels by decreasing inflammation and immune responses, which is beneficial in treating acute kidney rejection.

A. Examine the client for hepatomegaly. B. Assess the client for a hypersensitivity reaction. C. Check the results of the client's most recent CBC. D. Evaluate the client for hypercalcemia.

Correct Answer is C

Explanation

Choice A rationale
Examining the client for hepatomegaly can be part of a broader assessment but does not directly address the fatigue related to chemotherapy, particularly cisplatin, which is known to cause bone marrow suppression.
Choice B rationale
Assessing for a hypersensitivity reaction is important during chemotherapy, but it does not specifically address the issue of fatigue, which is often related to blood cell counts.
Choice C rationale
Checking the results of the client's most recent CBC (complete blood count) is crucial because cisplatin can cause anemia, leukopenia, and thrombocytopenia, all of which can lead to significant fatigue.
Choice D rationale
Evaluating for hypercalcemia is not typically associated with cisplatin treatment; it is more relevant in malignancies associated with bone metastasis or overproduction of parathyroid hormone-related protein.

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has a new prescription for prednisone to treat acute kidney rejection. The nurse should inform the client that which of the following is a therapeutic effect of this medication?

Correct Answer is D

Explanation

A nurse is caring for a client who is receiving cisplatin to treat bladder cancer. After several treatments, the client reports fatigue. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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