After chemotherapy has begun for a child with acute leukemia, which of the following interventions to prevent acute tumor lysis syndrome would the nurse perform?
Oxygenation
Pain management
Hydration
Corticosteroids
The Correct Answer is C
Rationale:
A. Oxygenation: While maintaining adequate oxygen is important for overall care, it does not directly prevent acute tumor lysis syndrome (TLS), which is caused by the rapid breakdown of malignant cells and release of intracellular contents.
B. Pain management: Managing discomfort is necessary for patient well-being, but it does not address the metabolic imbalances (hyperkalemia, hyperuricemia, hyperphosphatemia, hypocalcemia) that occur in TLS.
C. Hydration: Adequate IV hydration increases urine output, helps flush out excess potassium and uric acid, and reduces the risk of uric acid crystal precipitation in the kidneys.
D. Corticosteroids: While steroids may be part of leukemia treatment protocols, they are not the primary intervention to prevent TLS and may even contribute to rapid tumor breakdown if used in high doses.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Development of rheumatic fever: Rheumatic fever is a serious delayed autoimmune complication that can follow untreated or inadequately treated streptococcal pharyngitis. It affects the heart, joints, and nervous system, making its assessment essential at follow-up.
B. Infection that may cause a tooth abscess: A tooth abscess is not related to streptococcal pharyngitis. Dental infections stem from poor oral hygiene or dental trauma, rather than streptococcal throat infections.
C. Nephrosis of the kidney: Post-streptococcal glomerulonephritis, not nephrosis, is a potential renal complication of streptococcal infection, characterized by inflammation of the kidney’s filtering units rather than nephrotic syndrome.
D. Swollen lymph nodes that obstruct the airway: While lymphadenopathy can occur with throat infections, obstruction of the airway by swollen nodes is rare. Airway obstruction would more likely result from severe tonsillar swelling or abscess formation rather than lymph node enlargement alone.
Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}
Explanation
Rationale for Correct Choices:
• 402: The ANC (Absolute Neutrophil Count) is calculated by multiplying the total WBC count by the percentage of neutrophils (segs + bands) and then dividing by 100. Here, ANC = 2235 × (15 + 3)% = 2235 × 0.18 = approximately 402. This is below the critical threshold of 500, indicating neutropenia.
• Yes: Since the ANC is below 500, the patient is at high risk for infection and should be placed on neutropenic precautions to minimize exposure to pathogens and protect the immunocompromised patient.
Rationale for Inorrect Choices:
• 340: This value is too low to represent the ANC based on the given WBC and differential counts. It does not accurately reflect the neutrophil count in this case.
• 1000: This is above the typical neutropenia threshold of 500 cells/mm³ and thus would not indicate neutropenic precautions are needed. This answer does not match the calculation from the provided data.
• No: Given the ANC of 402, the patient is neutropenic, and standard precautions are insufficient to protect against infections in this immunocompromised state.
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