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 A

Explanation

Choice A reason: Eyes are deviated to the right is an assessment finding that indicates increased intracranial pressure and possible herniation of the brain. It is a sign of cranial nerve III palsy, which affects the movement of the eye and the size of the pupil. It is a medical emergency that requires immediate intervention.

Choice B reason: Amnesia to the cause of the trauma is an assessment finding that indicates memory loss and possible concussion. It is a sign of damage to the temporal lobe, which is involved in memory formation and retrieval. It is not a medical emergency, but it requires further evaluation and monitoring.

Choice C reason: Complaint of mild headache is an assessment finding that indicates pain and discomfort. It is a common symptom of traumatic brain injury, but it is not specific or severe. It can be managed with analgesics and rest.

Choice D reason: Pupils constrict from 5 mm to 2 mm with direct light stimulus is an assessment finding that indicates normal pupillary response. It is a sign of intact cranial nerve II and III function, which control the vision and the pupil size. It is not a cause for concern or notification.

A. macrocytic, normochromic B. microcytic, hypochromic C. normocytic, normochromic D. microcytic, normochromic

Correct Answer is A

Explanation

Choice A reason: This is correct. Folic acid deficiency causes macrocytic, normochromic anemia, which means that the red blood cells are larger than normal, but have normal color and hemoglobin content. Folic acid is a vitamin that is needed for the synthesis of DNA and the maturation of red blood cells.

Choice B reason: This is incorrect. Microcytic, hypochromic anemia means that the red blood cells are smaller than normal and have less color and hemoglobin content. This type of anemia is caused by iron deficiency, not folic acid deficiency.

Choice C reason: This is incorrect. Normocytic, normochromic anemia means that the red blood cells are normal in size, color, and hemoglobin content, but there are fewer of them. This type of anemia is caused by blood loss, hemolysis, or bone marrow failure, not folic acid deficiency.

Choice D reason: This is incorrect. Microcytic, normochromic anemia means that the red blood cells are smaller than normal, but have normal color and hemoglobin content. This type of anemia is rare and is caused by disorders of red blood cell production, such as thalassemia or sideroblastic anemia, not folic acid deficiency.

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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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