A nurse is caring for a client who is receiving cisplatin for the treatment of ovarian cancer. The client's most recent complete blood count (CBC) is shown in the table below. It is important for the nurse to consider which of the following for the client?

- WBC: 1,400/mm³

- RBC: 4.3 x 10¹²/L

- Hgb: 12.1 g/dL

- Hct: 36.5%

- Platelets: 170,000/mm³

- Albumin: 4.5 g/dL

Given the options:

The client should receive an erythropoiesis-stimulating agent.

The client should receive a diet with increased protein.

The client has an increased risk of infection.

The client has an increased risk for bleeding.

Answer and Explanation

The Correct Answer is C

Choice A reason: The use of erythropoiesis-stimulating agents (ESAs) is indicated for anemia due to chemotherapy¹. However, the client's hemoglobin (Hgb) level is 12.1 g/dL, which is within the normal range (normal: 12-15.5 g/dL for women). Therefore, administering an ESA is not indicated based on the Hgb level provided.

Choice B reason: A diet with increased protein can be beneficial for patients undergoing chemotherapy as it helps in tissue repair and immune system function. However, the client's albumin level is 4.5 g/dL, which falls within the normal range (normal: 3.4-5.4 g/dL), suggesting adequate protein intake. Thus, there is no indication that the client requires an increased protein diet based on the albumin level provided.

Choice C reason: The client's white blood cell (WBC) count is 1,400/mm³, which is below the normal range (normal: 4,500-11,000/mm³). This condition, known as leukopenia, significantly increases the risk of infection³. Therefore, the nurse should prioritize monitoring for signs of infection and implementing infection control measures.

Choice D reason: The client's platelet count is 170,000/mm³, which is within the normal range (normal: 150,000-450,000/mm³). Although cisplatin can cause thrombocytopenia, the current platelet count does not indicate an increased risk for bleeding⁴. Therefore, this choice is not correct based on the platelet count provided.

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Correct Answer is C

Explanation

Choice A reason:

Bathroom privileges after premedication are not typically restricted unless the premedication impairs the client's ability to ambulate safely. However, it is important to ensure that the client does not fall or injure themselves due to the effects of the medication.

Choice B reason:

Drinking 8 oz of water is generally not advised immediately before surgery due to the risk of aspiration during anesthesia. Clients are usually instructed to fast, which includes not drinking any liquids, for a certain period before surgery.

Choice C reason:

Preoperative diazepam may be administered 30 minutes before surgery to help reduce anxiety and induce sedation. Diazepam is a benzodiazepine that can calm the client and facilitate a smoother induction of anesthesia.

Choice D reason:

Enema administration is not a standard preoperative procedure for a client undergoing a cholecystectomy unless there is a specific indication. The primary focus is on preventing infection and managing pain.

A. Thyroid stimulating hormone B. Blood glucose C. Partial thromboplastin time D. Testosterone E. Total cholesterol

Correct Answer is ["A","B","D","E"]

Explanation

Choice A reason: Thyroid stimulating hormone (TSH)
TSH levels can affect sexual function. Both hyperthyroidism and hypothyroidism can lead to ED. Hyperthyroidism can cause premature ejaculation, while hypothyroidism can reduce libido and cause ED. Therefore, assessing thyroid function is important in the evaluation of ED.

Choice B reason: Blood glucose
Diabetes mellitus is a common cause of ED. High blood glucose levels can damage blood vessels and nerves that control erection. Therefore, testing for diabetes with a blood glucose test is a standard part of the ED evaluation.

Choice C reason: Partial thromboplastin time (PTT)
PTT is not typically used to evaluate ED. It measures the time it takes for blood to clot and is usually used to assess bleeding disorders or the effectiveness of blood-thinning medication.

Choice D reason: Testosterone
Low testosterone levels can lead to a decrease in sexual desire and ED. Testosterone replacement therapy may improve the situation if this is the case. Hence, measuring testosterone levels is a critical part of the ED workup.

Choice E reason: Total cholesterol
High cholesterol can lead to atherosclerosis, which can impede blood flow to the penis and cause ED. Therefore, a lipid profile, including total cholesterol, is often checked when evaluating ED.

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Naxlex Comprehensive Predictor Exams

The nurse is planning preoperative care for a client who has a fractured wrist. Which of the following should the nurse include in the client's plan of care?

Correct Answer is C

Explanation

A nurse is caring for a client who has erectile dysfunction. Which of the following lab tests should the nurse expect will be ordered to evaluate this client? (Select All that Apply.)

Correct Answer is ["A","B","D","E"]

Explanation

A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply)

A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect?

A nurse is teaching a client who has hepatitis A about preventing the transmission of the virus. Which of the following strategies should the nurse include in the teaching?

A nurse is caring for a client who is receiving radiation therapy to treat lung cancer. Which of the following actions should the nurse take?

A nurse is planning care for a client who is 2 hours postoperative following a transurethral resection of the prostate (TURP). The client is receiving continuous bladder irrigation. Which of the following interventions should the nurse include?

Which of the following questions is most important to ask a client who might have been exposed to HIV after being sexually assaulted?

A nurse is assessing a client at a dermatology clinic. Which of the following findings places the client at risk for developing malignant melanoma?

A nurse is providing discharge teaching for a client who is postoperative following a simple mastectomy. The client is to begin outpatient radiation therapy the next day. Which of the following instructions about maintaining skin integrity should the nurse include?