A nurse is reviewing hematology laboratory results of a client receiving intravenous chemotherapy for leukemia. Which of the following laboratory findings prompts the nurse to initiate neutropenic precautions?

A white blood cell count of 1000/mm3

A red blood cell count of 5 million/mm3

A clotting time of 10 minutes

A thrombocyte count of 90,000 cells/mm3

Answer and Explanation

The Correct Answer is A

Choice A reason: This is correct. A white blood cell count of 1000/mm3 indicates severe neutropenia, which is a condition of having abnormally low levels of neutrophils, a type of white blood cell that fights infections. Neutropenic precautions are measures to protect the client from exposure to pathogens, such as wearing a mask, gloves, and gown, avoiding contact with sick people, and practicing good hygiene.

Choice B reason: This is incorrect. A red blood cell count of 5 million/mm3 is within the normal range for both males and females. It does not indicate any risk of infection or bleeding.

Choice C reason: This is incorrect. A clotting time of 10 minutes is also within the normal range, which is 8 to 15 minutes. It does not indicate any risk of infection or bleeding.

Choice D reason: This is incorrect. A thrombocyte count of 90,000 cells/mm3 is low, but not low enough to require neutropenic precautions. Thrombocytes, also known as platelets, are responsible for blood clotting. A low thrombocyte count increases the risk of bleeding, but not infection. The normal range for thrombocyte count is 150,000 to 450,000 cells/mm3.

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Correct Answer is D

Explanation

Choice A reason: This is incorrect. Generalized muscle weakness and severe muscle spasms are not late manifestations of amyotrophic lateral sclerosis, but rather early or intermediate symptoms. Amyotrophic lateral sclerosis is a progressive neurodegenerative disorder that affects the motor neurons that control voluntary muscles. The disease causes muscle weakness, stiffness, twitching, and cramps.

Choice B reason: This is incorrect. Mental confusion and aggressive behaviors are not common manifestations of amyotrophic lateral sclerosis, but rather signs of dementia or other psychiatric disorders. Amyotrophic lateral sclerosis does not usually affect the cognitive or emotional functions of the brain, except in some rare cases.

Choice C reason: This is incorrect. Dysarthria and decreased clarity of spoken words are not late manifestations of amyotrophic lateral sclerosis, but rather intermediate or advanced symptoms. Dysarthria is a speech disorder that results from the weakness or paralysis of the muscles involved in speech production. It causes slurred, slow, or distorted speech.

Choice D reason: This is correct. Impairment of respiratory muscles and cognition remains intact are common late manifestations of amyotrophic lateral sclerosis. As the disease progresses, the respiratory muscles become weak and unable to support breathing. This can lead to respiratory failure and death. However, the cognition of the patient usually remains intact until the end, as the disease does not affect the higher functions of the brain.

A. decreasing intracranial pressure with decerebrate posturing. B. increasing intracranial pressure with decorticate posturing. C. decreasing intracranial pressure with decorticate posturing. D. increasing intracranial pressure with decerebrate posturing.

Correct Answer is B

Explanation

Choice A reason: Decreasing intracranial pressure with decerebrate posturing is not the correct answer. Decerebrate posturing is a sign of severe brain damage that involves the extension and outward rotation of the arms and legs, and the arching of the back. It is not associated with decreasing intracranial pressure, but rather with increased pressure or brainstem compression.

Choice B reason: Increasing intracranial pressure with decorticate posturing is the correct answer. Decorticate posturing is a sign of severe brain damage that involves the flexion of the arms at the elbows and the extension of the legs. It is associated with increased intracranial pressure or lesions in the cerebral hemispheres.

Choice C reason: Decreasing intracranial pressure with decorticate posturing is not the correct answer. Decorticate posturing is a sign of severe brain damage that involves the flexion of the arms at the elbows and the extension of the legs. It is not associated with decreasing intracranial pressure, but rather with increased pressure or lesions in the cerebral hemispheres.

Choice D reason: Increasing intracranial pressure with decerebrate posturing is not the correct answer. Decerebrate posturing is a sign of severe brain damage that involves the extension and outward rotation of the arms and legs, and the arching of the back. It is associated with increased intracranial pressure or brainstem compression, but it is not the posture described in the question.

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A nurse is reviewing hematology laboratory results of a client receiving intravenous chemotherapy for leukemia. Which of the following laboratory findings prompts the nurse to initiate neutropenic precautions?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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