The nurse is caring for a client diagnosed with leukemia who has just completed a course of radiation therapy and chemotherapy in preparation for a bone marrow transplant. The nurse notices that the client is febrile, has foul smelling urine, and is complaining of urinary frequency and dysuria. What is the priority nursing action?

Request medical prescription for an antibiotic such as gentamicin

Obtain a full set of vital signs and have the client void in a specimen cup

Increase intake of oral fluids such as cranberry juice

Place the client in protective isolation

Answer and Explanation

The Correct Answer is B

A.   While antibiotics may be necessary if a UTI is confirmed, requesting a prescription would not be the immediate nursing action. The nurse must first assess the situation thoroughly and obtain necessary diagnostic information before medications can be prescribed.
B.   This option is the most appropriate immediate action. Obtaining a full set of vital signs helps assess
the client’s overall condition, including the degree of fever and any signs of systemic infection. Collecting

a urine specimen will facilitate further evaluation, such as a urinalysis and culture, to confirm a UTI and identify the appropriate antibiotic treatment.
C.   While increasing fluid intake can help with urinary tract health and dilute the urine, it is not an immediate priority in this situation. The client may need more urgent assessment and possible medical intervention rather than just dietary changes.
D.   Although protective isolation may be warranted given the client’s immunocompromised state due to chemotherapy and radiation, it is not the immediate priority based on the current symptoms. The focus should first be on assessing and addressing the potential UTI.

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Correct Answer is C

Explanation

A. While the nursing student may assist with feeding, the nurse should always assess the client's swallowing ability and provide direct supervision to ensure the client's safety.
B. Placing food on the affected side of the mouth can increase the risk of aspiration. The food should be placed on the unaffected side of the mouth.
C. Distractions can impair the client's ability to focus on swallowing and increase the risk of aspiration. A quiet environment can help the client concentrate on eating.
D. The head of the bed should be elevated to at least 30 degrees during and after feeding to reduce the risk of aspiration.

A. ovarian cancer occurs primarily among women over age 70 that also have other complicating health problems. B. the causative cancer cell is resistant to chemotherapy or radiation. C. there are no obvious symptoms or problems during the early stages of this disorder. D. radiation therapy is ineffective because the ovaries are located so deep within the pelvis.

Correct Answer is C

Explanation

A. Many women diagnosed with ovarian cancer are indeed older, but the presence of other health problems is not a primary factor in explaining the high death rates. The key issue is more related to late- stage diagnosis rather than age alone.
B. While some ovarian cancer cells can develop resistance to treatment, it is not universally true for all cases. The high mortality rate is more often due to the late stage at which the cancer is diagnosed rather than inherent resistance to treatment. Thus, this option does not fully explain the high death rates.
C. Ovarian cancer often presents with vague symptoms that can be easily overlooked in the early stages, such as bloating, abdominal discomfort, or changes in bowel habits. As a result, many women do not receive a diagnosis until the cancer has progressed to a more advanced stage, contributing significantly to the high mortality rates associated with the disease.
D. While it is true that the ovaries are located deep in the pelvis, the main treatment for ovarian cancer typically involves surgery and chemotherapy rather than radiation therapy. Radiation is not a primary treatment for this cancer type, and this statement does not accurately reflect why the death rates are high.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for the client who has dysphagia following an ischemic stroke. The client is ordered a pureed diet starting today. Which intervention would be appropriate for this client?

Correct Answer is C

Explanation

In educating clients about ovarian cancer, the nurse emphasizes death rates for ovarian cancer are high because:

Correct Answer is C

Explanation

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