An appropriate nursing intervention for a patient with non-Hodgkin's lymphoma whose platelet count drops to 18,000/μL during chemotherapy is to
check all stools for occult blood.
encourage fluids to 3000 mL/day.
provide oral hygiene every 2 hours.
check the temperature every 4 hours.
The Correct Answer is A
A. Correct. A platelet count <20,000/μL increases bleeding risk. Checking for occult blood helps detect hidden gastrointestinal bleeding.
B. Incorrect. Hydration is important but does not directly address thrombocytopenia management.
C. Incorrect. While oral hygiene is important, frequent brushing could cause bleeding with low platelets.
D. Incorrect. Monitoring temperature is important for infection risk but does not address bleeding concerns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Hct 45%. – Normal range for hematocrit (Hct) is 38-50%. No need to report.
B. Hgb 14.7 g/dL. – Normal range for hemoglobin (Hgb) is 13-17 g/dL. No need to report.
C. WBC 1,700/mm³. – Correct Answer. Normal WBC count is 4,000-11,000/mm³. A WBC count of 1,700/mm³ (neutropenia) places the patient at high risk for infection, requiring immediate intervention.
D. Platelets 160,000/mm³. – Normal range for platelets is 150,000-450,000/mm³. No need to report.
Correct Answer is C
Explanation
A. Incorrect. Regular insulin should be given before a meal to allow time for onset; giving it after eating delays its effect, increasing hyperglycemia risk.
B. Incorrect. Administering regular insulin after breakfast is inappropriate as it may not align with meal-related glucose spikes.
C. Correct. Regular insulin has an onset of 30 minutes. Administering it at 0730 ensures optimal timing for glucose control when breakfast is eaten at 0800.
D. Incorrect. Giving insulin too early (at 0700) increases the risk of hypoglycemia before food intake.
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