A patient with lung cancer is being treated with chemotherapy and radiation. Which lab values will the nurse monitor to detect bone marrow suppression? Select all that apply.

Platelet count

Red blood cell (RBC) count

Basophil count

Neutrophil count

Answer and Explanation

Correct Answer : A,B,D

A. Platelet count: Chemotherapy and radiation commonly suppress megakaryocyte production in the bone marrow, leading to thrombocytopenia. A decreased platelet count increases the risk of spontaneous bleeding and impaired clot formation. Monitoring platelet levels allows early detection of marrow suppression and guides precautions or interventions.

B. Red blood cell (RBC) count: Myelosuppressive therapy can reduce erythropoiesis, resulting in anemia. A declining RBC count may lead to fatigue, dyspnea, and reduced oxygen-carrying capacity. Serial monitoring helps assess the severity of marrow suppression and determine the need for interventions such as erythropoiesis-stimulating agents or transfusion.

C. Basophil count: Basophils represent a very small fraction of circulating leukocytes and are not used as a primary indicator of bone marrow suppression. While they originate from the marrow, changes in basophil count are neither sensitive nor specific markers of chemotherapy-induced myelosuppression. Other white blood cell parameters provide more clinically meaningful data.

D. Neutrophil count: Neutropenia is a major and potentially life-threatening consequence of bone marrow suppression, significantly increasing the risk of infection. The absolute neutrophil count (ANC) is especially important in oncology patients to guide infection precautions and determine chemotherapy dosing adjustments. Monitoring neutrophils is critical for early identification of immunosuppression.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

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

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is D

Explanation

A. Confirm that the patient's consent form is signed and in the chart: Ensuring informed consent is critical for legal and ethical reasons, but it does not directly prevent immediate life-threatening complications during transport of an intubated patient.

B. Notify the surgical team of the patient's arrival time: Communicating with the surgical team is important for workflow and preparedness, but it does not directly safeguard the patient’s airway or oxygenation during transport.

C. Document the time the patient left the unit and who accompanied them: Accurate documentation is essential for accountability and continuity of care, yet it does not actively prevent physiologic compromise during transport.

D. Ensure that portable oxygen and suction equipment are functioning and available: Maintaining a patent airway and adequate oxygenation is the highest priority for an intubated patient. Portable oxygen and suction are critical in case of accidental extubation, obstruction, or respiratory compromise during transport, making this the most important safety measure

A. BP 102/56 mm Hg B. Urine output 15 ml for 2 hours C. Arterial oxygen saturation 92% D. Apical pulse 110 beats/min

Correct Answer is B

Explanation

A. BP 102/56 mm Hg: This blood pressure is slightly low but may still be sufficient to maintain perfusion in some patients. Early compensatory mechanisms in shock can maintain perfusion despite borderline hypotension, so while it warrants monitoring, it is not the most critical finding.

B. Urine output 15 ml for 2 hours: Oliguria is a sensitive early indicator of inadequate tissue perfusion in shock. A urine output of less than 0.5 mL/kg/hr reflects decreased renal perfusion and potential impending acute kidney injury, making this the most urgent finding requiring immediate assessment and intervention.

C. Arterial oxygen saturation 92%: Oxygen saturation of 92% is mildly reduced and may indicate early hypoxemia. While concerning, it is less immediately critical than evidence of end-organ hypoperfusion, such as severely reduced urine output.

D. Apical pulse 110 beats/min: Tachycardia is a compensatory response in shock to maintain cardiac output. While it signals stress on the cardiovascular system, it is expected in early shock and is less immediately dangerous than oliguria indicating organ hypoperfusion.

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

A patient with lung cancer is being treated with chemotherapy and radiation. Which lab values will the nurse monitor to detect bone marrow suppression? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to transport an intubated patient to the operating room for an emergent surgical procedure. Which nursing action is most important to ensure patient safety during transport?

Correct Answer is D

Explanation

When caring for a patient who has shock, which assessment finding will be of greatest concern to the nurse?

Correct Answer is B

Explanation

The cancer patient complains of facial and neck swelling, assessment findings reveal periorbital edema and distention of the veins in the chest. Based on these findings, the nurse should suspect which oncologic emergency?

The nurse is assessing a patient with multiple traumas, who is at risk for developing respiratory distress syndrome. What assessment finding does the nurse expect as an early sign of respiratory distress syndrome?

A nurse is caring for a patient with a right radial arterial line. Which action should the nurse take?

The nurse is caring for a patient who has had a mitral valve replacement. What information does the nurse need to include in the discharge instructions?

The nurse distinguishes that a patient may experience which signs and symptoms related to diabetes insipidus (DI)?

A patient enters the Emergency Department complaining of nausea and vomiting. The nurse notes a sweet, fruity breath odor, Blood glucose reveals 540 mg/dl. What does the nurse recognize as the priority intervention?

Use the attached image. During change-of-shift report, the nurse learns that a patient with a head injury has decorticate posturing to noxious stimulation. Which positioning shown in the accompanying figure will the nurse expect to observe?

A patient's ECG monitor shows an accelerated junctional rhythm at a rate of 78 beats/minute. What is the nurse's priority intervention?