The nurse is caring for a patient with leukemia who has an absolute neutrophil count (ANC) of 500/mm³. What interventions will the nurse include in the plan of care for this patient related to this finding? Select All That Apply.

Administer filgrastim (granulocyte colony stimulating factor (G-CSF)) as ordered.

Keep the patient's central line insertion site clean and open to air.

Educate the patient and family about food safety and hygiene.

Provide a high-protein, high-calorie diet.

Answer and Explanation

Correct Answer : A,C,D

Choice A rationale

Administering filgrastim (G-CSF) as ordered is crucial for patients with a low ANC. Filgrastim stimulates the production of neutrophils in the bone marrow, helping to reduce the risk of infections. For a patient with an ANC of 500/mm³, which indicates severe neutropenia, this intervention can significantly enhance the immune response and decrease susceptibility to infections.

Choice B rationale

Keeping the patient's central line insertion site clean and open to air is incorrect and could increase the risk of infection. Central line sites must be covered with a sterile dressing to prevent bacterial contamination and infection. Open exposure to air can introduce pathogens, especially in a patient with neutropenia.

Choice C rationale

Educating the patient and family about food safety and hygiene is essential for preventing infections in patients with neutropenia. Proper food handling and hygiene practices reduce the risk of bacterial and other infections. This education can help patients and their families implement measures to protect the patient from potential sources of infection.

Choice D rationale

Providing a high-protein, high-calorie diet is appropriate for supporting the patient's overall health and recovery. High-protein and high-calorie foods support the body's immune function, repair tissues, and maintain energy levels. Proper nutrition is vital for patients with leukemia to help them cope with the demands of their illness and treatment.

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Correct Answer is C

Explanation

Choice A rationale

Diagnostic surgery involves procedures done to confirm a diagnosis, such as a biopsy. In this case, the patient has already received a positive result on a breast tumor marker test, so the purpose of surgery is not to diagnose but to prevent the development of breast cancer.

Choice B rationale

Palliative surgery is performed to relieve symptoms or improve quality of life in patients with serious illnesses, often in advanced stages of cancer. The patient’s request for a bilateral mastectomy is not intended to alleviate symptoms but rather to reduce the risk of developing breast cancer.

Choice C rationale

Prophylactic surgery is performed to reduce the risk of cancer in patients with a high predisposition to certain cancers, such as those with a family history or genetic mutations like BRCA1 or BRCA2. The patient’s request for a bilateral mastectomy falls into this category, as it aims to prevent the potential future development of breast cancer.

Choice D rationale

Reconstructive surgery is performed to restore the appearance or function of body parts after trauma, surgery, or congenital defects. While patients undergoing mastectomies may later opt for reconstructive surgery to restore breast appearance, the patient’s current request for a bilateral mastectomy is to proactively prevent breast cancer, not for reconstruction purposes. .

A. Metformin. B. Warfarin. C. Sertraline. D. Methylprednisolone.

Correct Answer is B

Explanation

Choice A rationale

Metformin is used to manage diabetes, primarily by improving insulin sensitivity and reducing glucose production in the liver. Levothyroxine, used to treat hypothyroidism, does not significantly impact the action of metformin. The two medications do not have a direct interaction that decreases metformin's efficacy.

Choice B rationale

Levothyroxine can decrease the action of warfarin by increasing the metabolism of clotting factors in the liver, which may reduce the anticoagulant effect of warfarin. This interaction necessitates closer monitoring of INR (International Normalized Ratio) levels and potential dose adjustments of warfarin to maintain its therapeutic effect.

Choice C rationale

Sertraline is an antidepressant that belongs to the selective serotonin reuptake inhibitor (SSRI) class. While it can interact with other medications, levothyroxine does not significantly decrease its action. Therefore, no major adjustments are needed when both drugs are prescribed together.

Choice D rationale

Methylprednisolone, a corticosteroid, is used for its anti-inflammatory and immunosuppressant properties. Levothyroxine does not decrease the action of methylprednisolone. These medications do not have a significant pharmacological interaction that would require adjusting methylprednisolone’s dosage.

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The nurse is caring for a patient with leukemia who has an absolute neutrophil count (ANC) of 500/mm³. What interventions will the nurse include in the plan of care for this patient related to this finding? Select All That Apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a woman with a family history of breast cancer who received a positive result on a breast tumor marker test.The patient is requesting a bilateral mastectomy.This is an example of which type of oncologic treatment?

Correct Answer is C

Explanation

The nurse is caring for a patient who has a new prescription for levothyroxine.The nurse will include in the teaching plan that levothyroxine decreases the action of which medication?

Correct Answer is B

Explanation

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The nurse is caring for a patient with hypothyroidism who is prescribed levothyroxine.Which assessment data indicates to the nurse that the medication has been effective?

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The nurse is caring for a patient who is scheduled for thyroid diagnostic testing.Which information, that may affect the test results, should be documented on the patient's electronic medical record (EMR) and communicated to the personnel conducting the test?

The nurse on the oncology unit is caring for a patient receiving chemotherapy for treatment of leukemia.Which patient finding is the nurse's priority for implementing interventions?

The nurse is teaching a patient about taking immunosuppressant medications after an allogeneic stem cell transplant to treat leukemia.What will the nurse teach is the indication for this treatment?

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