The nurse is caring for a client with a history of breast cancer who is receiving chemotherapy. Which side effect should the nurse monitor for?

Neutropenia

Hypertension

Hyperkalemia

Weight gain

Answer and Explanation

The Correct Answer is A

Choice A reason: Neutropenia, a low neutrophil count, is a common chemotherapy side effect due to bone marrow suppression, increasing infection risk. Monitoring neutrophil counts is critical, as infections in breast cancer patients can be life-threatening, making it the priority side effect to assess.

Choice B reason: Hypertension is not a typical chemotherapy side effect, though some agents cause cardiovascular effects. Neutropenia is more common, compromising immunity, making it the priority to monitor, as infections pose an immediate threat in breast cancer patients on chemotherapy.

Choice C reason: Hyperkalemia is rare with chemotherapy, except in tumor lysis syndrome. Neutropenia is a frequent side effect, increasing infection risk due to marrow suppression, making it the priority to monitor, as it directly impacts patient safety during breast cancer treatment.

Choice D reason: Weight gain is not a primary chemotherapy side effect; weight loss is more common due to nausea. Neutropenia is critical to monitor, as low neutrophils increase infection risk, requiring urgent intervention in breast cancer patients undergoing chemotherapy.

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Correct Answer is B

Explanation

Choice A reason: Anorexia is common in hepatitis due to systemic inflammation but is nonspecific, occurring in many conditions. Clay-colored stools directly indicate impaired bile excretion from liver dysfunction, a hallmark of hepatitis, making it a more diagnostic finding.

Choice B reason: Clay-colored stools are highly indicative of hepatitis, as liver inflammation impairs bile production or excretion, reducing bilirubin in feces. This causes pale stools, reflecting hepatic dysfunction, making it a key finding to confirm hepatitis over nonspecific symptoms like anorexia.

Choice C reason: Brown, foamy urine is not typical of hepatitis. Dark urine from bilirubinuria may occur, but foamy urine suggests proteinuria, unrelated to liver dysfunction. Clay-colored stools are more specific, indicating bile flow obstruction, a direct sign of hepatitis pathology.

Choice D reason: Hematemesis indicates gastrointestinal bleeding, not a primary hepatitis feature. While advanced liver disease may cause variceal bleeding, clay-colored stools are an earlier, more specific sign of hepatitis-related bile impairment, making them the priority finding in acute cases.

A. IgE-mediated response B. Cell-mediated hypersensitivity C. Autoimmune response D. Type II hypersensitivity

Correct Answer is A

Explanation

Choice A reason: An IgE-mediated (Type I) hypersensitivity reaction, like anaphylaxis, occurs post-bee sting, with rapid onset of rash, shortness of breath, hypotension, and tachycardia. IgE antibodies trigger mast cell degranulation, releasing histamine, causing vasodilation, bronchoconstriction, and systemic symptoms, matching the client’s acute presentation.

Choice B reason: Cell-mediated (Type IV) hypersensitivity involves T-cells, causing delayed reactions like contact dermatitis, not rapid systemic symptoms. Bee sting reactions are immediate, driven by IgE, not T-cells. Rash, hypotension, and respiratory distress indicate anaphylaxis, not a delayed cell-mediated response.

Choice C reason: Autoimmune responses involve self-directed antibodies, as in lupus, not triggered by external allergens like bee stings. The client’s acute rash, hypotension, and respiratory distress suggest an IgE-mediated anaphylactic reaction, not an autoimmune process, which is unrelated to acute allergen exposure.

Choice D reason: Type II hypersensitivity involves antibody-mediated cytotoxicity, as in transfusion reactions, not allergen-induced systemic symptoms. Bee sting reactions are IgE-driven, causing immediate anaphylaxis with rash and hypotension, not cytotoxic damage, making Type II inappropriate for the client’s acute presentation.

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The nurse is caring for a client with a history of breast cancer who is receiving chemotherapy. Which side effect should the nurse monitor for?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a client with suspected hepatitis. Which finding is most indicative of this condition?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

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