A nurse is providing teaching for a client who has neutropenia and is receiving chemotherapy. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)

"I will take my temperature daily."

"I will wash my toothbrush weekly."

"I will eat plenty of fresh fruits and vegetables."

"I will change my cat's litter box twice weekly."

"I will avoid crowds."

Answer and Explanation

Correct Answer : A,E

Rationale:

A. "I will take my temperature daily.": Daily temperature monitoring is essential for clients with neutropenia, as even a low-grade fever may be the only early sign of infection due to suppressed immune response. Prompt detection allows for early intervention and treatment.

B. "I will wash my toothbrush weekly.": A neutropenic client should wash or replace their toothbrush more frequently—ideally daily or after each use—to reduce the risk of bacterial growth and oral infections, which they are more vulnerable to.

C. "I will eat plenty of fresh fruits and vegetables.": Fresh, uncooked fruits and vegetables may carry harmful bacteria or fungi and should be avoided unless thoroughly washed or cooked. A neutropenic diet typically excludes raw produce to minimize infection risk.

D. "I will change my cat's litter box twice weekly.": Clients with neutropenia should avoid handling cat litter altogether, as it can harbor Toxoplasma gondii and other pathogens that pose a serious infection risk due to their weakened immune system.

E. "I will avoid crowds.": Avoiding crowds is critical for clients with neutropenia to reduce exposure to airborne and contact-transmissible pathogens, as even minor infections can become life-threatening in immunocompromised individuals.

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Correct Answer is D

Explanation

Rationale:
A. N95 respirator: N95 respirators are required for airborne precautions, such as with tuberculosis, measles, or varicella. Bacterial meningitis, caused by organisms like Neisseria meningitidis, requires droplet precautions, which do not necessitate an N95 mask.

B. Goggles: Goggles are used for protection against splashes or sprays of bodily fluids, particularly in procedures that may cause aerosolization. While helpful in certain situations, goggles are not required as part of standard droplet precautions for meningitis.

C. Disposable gown: Gowns are worn during contact precautions or when there is a risk of contamination from bodily fluids. They are not routinely required for droplet precautions unless the nurse anticipates contact with large amounts of secretions.

D. Surgical mask: A surgical mask is the appropriate PPE for droplet precautions, which are necessary for clients with bacterial meningitis. The mask prevents the spread of infectious respiratory droplets that can travel up to 3 feet during coughing or sneezing.

A. Instruct the client to lift no more than 6.8 kg (15 lb) when at home. B. Turn the client by log rolling with a turning sheet. C. Inform the client to shower on the second postoperative day. D. Remove sterile adhesive strips before discharge.

Correct Answer is B

Explanation

Rationale:

A. Instruct the client to lift no more than 6.8 kg (15 lb) when at home: While it is important to avoid heavy lifting after a lumbar laminectomy, specific weight limits should be prescribed by the provider or physical therapist. Also, this instruction is more appropriate for discharge teaching, not immediate postoperative care.

B. Turn the client by log rolling with a turning sheet: Log rolling maintains spinal alignment and minimizes twisting of the spine, which is critical after spinal surgery. It prevents stress on the operative site and reduces the risk of complications such as spinal cord or nerve injury.

C. Inform the client to shower on the second postoperative day: Showering is usually permitted after surgical wounds have started to seal, but the exact timing depends on the surgeon's orders and the condition of the incision. Automatic showering on day two may not be safe for all clients.

D. Remove sterile adhesive strips before discharge: Sterile adhesive strips (such as Steri-Strips) are typically left in place until they fall off naturally or are removed by a healthcare provider at a follow-up visit. Removing them prematurely can increase infection risk or disrupt healing.

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A nurse is providing teaching for a client who has neutropenia and is receiving chemotherapy. Which of the following client statements indicates an understanding of the teaching? (Select all that apply.)

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Explanation

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Correct Answer is B

Explanation

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