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 B

Explanation

Choice A reason:

Resuming a regular diet immediately after the test may not always be recommended. Depending on the individual's condition and the specific instructions from the healthcare provider, there may be dietary restrictions before or after the procedure.

Choice B reason:

Encouraging fluid intake after the procedure is important because it helps to flush out the contrast dye used during the IVP. Adequate hydration can aid in the elimination of the dye and reduce the risk of kidney damage, especially in individuals with pre-existing kidney conditions.

Choice C reason:

This statement is incorrect. An IVP does not use high-frequency sound waves; it involves taking X-ray images of the urinary tract after a contrast dye is injected into a vein. The dye outlines the kidneys, ureters, and bladder on the X-ray images.

Choice D reason:

The presence of red blood cells in the urinalysis does not typically result in the cancellation of an IVP. However, certain conditions, such as an allergy to the contrast dye or severe kidney impairment, may contraindicate the use of an IVP.

A. Gingivitis B. Xerostomia C. Candidiasis D. Halitosis

Correct Answer is C

Explanation

Choice A reason:
Gingivitis, an inflammation of the gums, is not specifically associated with a decreased CD4+ T-cell count. While individuals with HIV/AIDS may have an increased risk for periodontal diseases due to a compromised immune system, gingivitis is not directly linked to the CD4+ T-cell count¹.

Choice B reason:
Xerostomia, or dry mouth, can be a side effect of medications or secondary to other conditions but is not an infectious condition. It is not directly related to a decreased CD4+ T-cell count, although it may be more common in individuals with HIV/AIDS due to various factors, including medication side effects¹.

Choice C reason:
Candidiasis, also known as oral thrush, is a common opportunistic infection in individuals with HIV/AIDS, especially when the CD4+ T-cell count is significantly decreased. It is caused by the fungus Candida and can lead to white patches in the mouth, soreness, and difficulty swallowing.

Choice D reason:
Halitosis, or bad breath, is not an infectious condition and is not directly associated with a decreased CD4+ T-cell count. It can result from various factors, including oral hygiene, diet, or underlying health conditions, but it is not a specific concern related to HIV/AID.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning to teach a client who is scheduled for an intravenous pyelogram (IVP). Which of the following statements should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse in a clinic is assessing a client who has AIDS and a significantly decreased CD4+ T-cell count. The nurse should recognize that the client is at risk for developing which of the following infectious oral conditions?

Correct Answer is C

Explanation

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?

A nurse in a long-term care facility is caring for an older adult client who had a stroke 4 weeks ago and is unable to move independently. The nurse should monitor for which of the following complications of immobility?

A nurse is creating the plan of care for a client who is immunosuppressed. Which of the following precautions should the nurse include in the plan? (Select all that apply.)

A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

A nurse in a provider's office is assessing a client who reports shoulder pain. Which of the following findings by the nurse indicates a rotator cuff injury?

A nurse is caring for a client who reports low back pain and asks the nurse for specific exercise recommendations. Which of the following activities should the nurse suggest?

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 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?