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

Assess the client for a hypersensitivity reaction

Evaluate the client for hypercalcemia

Examine the client for hepatomegaly

Check the results of the client's most recent CBC

Answer and Explanation

The Correct Answer is D

Rationale:
A. Hypersensitivity reactions to cisplatin typically involve symptoms like rash, shortness of breath, or facial swelling—not fatigue alone.
B. Hypercalcemia is more commonly associated with cancers like multiple myeloma or bone metastases, and it usually causes confusion, nausea, or constipation—not just fatigue.
C. Hepatomegaly may occur in metastatic disease but is not a routine complication of cisplatin and is less directly linked to fatigue.
D. Fatigue in a client receiving chemotherapy such as cisplatin is commonly due to anemia, a result of bone marrow suppression. Checking the complete blood count (CBC) is essential to assess for decreased red blood cells or other cytopenias.

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Correct Answer is D

Explanation

Rationale:
A. Applying heat in the first 24–48 hours after a sprain can increase swelling and is not recommended. Cold therapy (ice) is preferred initially to reduce inflammation.
B. Wrapping should start from the toes and move upward toward the knee to promote venous return and proper compression, not from the knee down.
C. Bearing weight too soon can worsen the injury; rest and limited movement are advised initially.
D. Applying ice during the first 24–48 hours helps reduce swelling and pain, and is an appropriate self-care measure for a recent ankle sprain, indicating proper understanding of discharge instructions.

A. Activities that could result in bleeding B. Oral fluid intake between meals only C. Fresh flowers and potted plants in the room D. All visitors are banned from entering the client's room.

Correct Answer is C

Explanation

Rationale:
A. Activities that could result in bleeding are more appropriate precautions for clients with thrombocytopenia, not neutropenia.
B. Restricting oral fluids to between meals is unnecessary and may lead to inadequate hydration, especially during cancer treatment.
C. Fresh flowers and potted plants can harbor bacteria and fungi, which pose a significant infection risk to neutropenic clients. These should be restricted.
D. A complete ban on visitors is unnecessary. Visitors should be screened for illness and follow hand hygiene protocols, but supportive visitation is still encouraged when safe

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is discharging a client who came to the outpatient clinic with an ankle sprain. Which of the following statements should the nurse identify as an indication that the client understands the discharge instructions?

Correct Answer is D

Explanation

A nurse is planning care for a client who is being treated with chemotherapy and radiation for metastatic breast cancer and who has neutropenia. Which of the following restrictions should the nurse include in the client's plan of care?

Correct Answer is C

Explanation

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