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.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A reason:
In primary hypothyroidism, the thyroid gland is underactive and does not produce sufficient thyroid hormones, including Free T4. Therefore, we would not expect an elevation of Free T4 in primary hypothyroidism; instead, its levels would typically be low or normal.

Choice B reason:
Thyroid stimulating hormone (TSH) levels are elevated in primary hypothyroidism because the pituitary gland releases more TSH in an attempt to stimulate the thyroid gland to produce more thyroid hormones. This is a compensatory response to the low levels of circulating thyroid hormones, particularly thyroxine (T4).

Choice C reason:
Serum T3 levels may be low or normal in primary hypothyroidism. T3 is the active form of thyroid hormone and is usually converted from T4. If T4 levels are low, T3 levels may also be affected; however, T3 levels are not the primary diagnostic marker for hypothyroidism and do not typically show elevation in this condition.

Choice D reason:
Serum T4 levels are typically low in primary hypothyroidism because the thyroid gland is not producing enough of this hormone. An elevation of serum T4 would not be expected unless the patient is receiving treatment for hypothyroidism.

A. Weight loss B. Hematuria C. Bradycardia D. Hypertension

Correct Answer is A

Explanation

Choice A reason:
Weight loss is a common finding in individuals with uncontrolled type 1 diabetes mellitus. Due to the lack of insulin, the body cannot utilize glucose effectively, leading to the breakdown of body fat and muscle for energy, resulting in weight loss.

Choice B reason:
Hematuria, or blood in the urine, is not a typical finding associated with uncontrolled type 1 diabetes mellitus. While diabetes can cause kidney damage over time, leading to proteinuria, hematuria would not be an expected finding solely due to uncontrolled diabetes.

Choice C reason:
Bradycardia, or a slower than normal heart rate, is not a common finding in uncontrolled type 1 diabetes mellitus. In fact, diabetes can sometimes cause autonomic neuropathy, which can affect the heart rate, but this typically does not result in bradycardia.

Choice D reason:
Hypertension is more commonly associated with type 2 diabetes mellitus, often due to insulin resistance. In type 1 diabetes, especially when uncontrolled, hypertension is not a typical finding unless there is coexisting kidney damage.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. The nurse should anticipate an elevation of which of the following laboratory values?

Correct Answer is B

Explanation

A nurse is caring for a client who has uncontrolled type 1 diabetes mellitus. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

A nurse is caring for a client who has lung cancer and is scheduled for a lobectomy. The nurse should prepare the client to expect which of the following after the procedure?

A nurse is providing teaching about dietary supplements to a client who has erectile dysfunction and has been prescribed nitroglycerin. Which of the following statements is the most important for the nurse to include in the teaching?

A nurse is caring for a client who has a prescription for balanced skeletal traction with a Thomas splint for the treatment of a fractured femur. Which of the following interventions should the nurse implement to prevent pressure points from developing around the edges of the splint?

A nurse is caring for a client who has Stage IV lung cancer and was prescribed opioid medications for pain management. The client is unable to engage in most physical activities. Which of the following manifestations should the nurse anticipate?

A nurse is reviewing the BUN and creatinine levels of an older adult client who has chronic kidney disease. The nurse should expect which of the following findings?

A nurse in the emergency department is monitoring a client who has a cervical spinal cord injury from a fall. The nurse should monitor the client for which of the following complications? (Select all that apply.)

A nurse is formulating a teaching plan about herpes zoster for a group of older adults at a community center. The nurse should include which of the following information in the plan?

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.)