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 ["A","C","D","E"]

Explanation

A. Multiple myeloma can lead to dehydration and kidney problems. Increasing fluid intake helps to prevent these complications and can also help to reduce the risk of infections.
B. This statement is incorrect. Aspirin should not be taken unless prescribed by a doctor. It can increase the risk of bleeding in people with multiple myeloma.
C. Multiple myeloma can weaken the immune system, making the client more susceptible to infections. Using fragrance-free gel soap can help to reduce the risk of skin irritation and infections.
D. Multiple myeloma can cause bone pain. Using analgesics as needed can help to manage this pain and improve the client's quality of life.
E. Multiple myeloma can weaken bones, increasing the risk of fractures. Installing grab bars in the shower can help to prevent falls and reduce the risk of injuries.

A. a history of multiple sex partners. B. a long history of smoking. C. prolonged exposure to estrogen. D. multiple pregnancies.

Correct Answer is C

Explanation

A. While having multiple sexual partners is associated with an increased risk of sexually transmitted infections (STIs), it is not considered a significant risk factor for uterine cancer specifically. STIs can contribute to other reproductive cancers, such as cervical cancer, but they are not directly linked to the development of uterine cancer.
B. Smoking is a risk factor for various cancers, including cervical and lung cancers, but its association with uterine cancer is not as strong. While some studies suggest a potential link, it is not recognized as a primary risk factor for uterine cancer.
C. Prolonged exposure to unopposed estrogen (estrogen not balanced by progesterone) is the primary risk factor for uterine cancer. This can occur in situations such as obesity (where adipose tissue produces estrogen), hormone replacement therapy without progesterone, and certain medical conditions like polycystic ovary syndrome (PCOS).
D. Having multiple pregnancies is generally considered to have a protective effect against uterine cancer. Pregnancy reduces the number of menstrual cycles a woman has over her lifetime, which can lead to lower lifetime exposure to estrogen.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male 4.51-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-15.5 g/dL
Hematocrit	42% -52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 103/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%
Platelets	150,000-450,000/mm3

ABG Value	Normal Range
PH	7.35-7.45
PaCO2	35-45 mm Hg
HCO3-	22-26 mEq/L
Base excess	-2 to +2
PaO2	80-95 mm Hg
SaO2	>95%

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is developing a discharge plan about home care for a client diagnosed with multiple myeloma. The nurse should emphasize which of the following? (SELECT ALL THAT APPLY)

Correct Answer is ["A","C","D","E"]

Explanation

A client asks the nurse to explain risk factors for uterine cancer. The nurse explains that the number one risk factor is:

Correct Answer is C

Explanation

The nurse is planning care for client who is recovering from a total abdominal hysterectomy for uterine cancer. The nurse would include which intervention to decrease the risk of an embolic event?

The nurse receives report at 0700 on a client who has 500 mL of IV fluid left in the bag. The IV is running at 125 mL per hour. At what time should the nurse expect to change the bag (military time)?

The client is diagnosed with a transient ischemic attack (TIA) and is prescribed clopidogrel. Which statement would indicate the medication education has been effective for this client? The client states, "Clopidogrel

A client diagnosed with a stroke is experiencing homonymous hemianopia. The most appropriate nursing intervention to help the client learn to compensate for this deficit during rehabilitation period would be to:

The nurse is caring for a male patient who complains about a small "lump" that he discovered in his right testicle. What would be the best response by the nurse?