You are caring for a patient with an Absolute Neutrophil Count (ANC) of 400. The physician orders the patient to be placed on neutropenic precautions. Which of the following would be appropriate to implement? (Select all that apply)

Use a positive pressure room if available

Restrict any visitors until the patient's ANC counts return to normal

Use a negative pressure room if available

No live plants or fruits in the room

Ensure all entrants into room wash their hands

Answer and Explanation

Correct Answer : A,B,D,E

A.   A positive pressure room helps prevent outside air (and potential pathogens) from entering the room, providing a safer environment for neutropenic patients.
B.   Visitors can introduce infections, so it’s wise to restrict them, especially those who are ill or have been exposed to infectious diseases.
C.   Negative pressure rooms are used for patients with airborne infections (like tuberculosis) to prevent pathogens from escaping the room. Neutropenic patients require a protected environment, not one that allows outside air to flow in.
D.   Live plants and unwashed fruits can harbor bacteria and fungi that pose a risk to neutropenic patients, who have compromised immune systems.
E.   Hand hygiene is one of the most effective ways to prevent the spread of infections. Everyone entering the room should wash their hands to minimize the risk of introducing pathogens.

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Correct Answer is D

Explanation

A. Methotrexate (MTX) is a disease-modifying antirheumatic drug (DMARD) that helps slow disease progression but does not provide immediate pain relief. NSAIDs and steroids may be used for symptomatic relief, but MTX alone can manage both pain and disease progression over time.
B. This response is unprofessional and dismissive. It implies that the medication regimen is based solely on the patient's insurance coverage rather than their medical needs. It does not address the patient’s question and could undermine trust in the healthcare team.
C. Methotrexate does not primarily treat nausea; rather, it is used to manage rheumatoid arthritis. While some patients may experience nausea as a side effect of MTX or other medications, this is not its primary purpose.
D. Methotrexate is indeed a DMARD that can take weeks to months to show its full benefits in controlling inflammation and slowing disease progression. Meanwhile, NSAIDs or corticosteroids may be prescribed to provide quicker relief from symptoms such as pain and swelling.

A. Anemia B. Pancytopenia C. Neutropenia D. Leukopenia

Correct Answer is B

Explanation

A. While anemia is a common finding in aplastic anemia, it is not the most comprehensive answer. Aplastic anemia results in a deficiency of all blood cell types due to bone marrow failure, so while anemia is present, it does not fully capture the extent of the disorder.
B. This is the most accurate choice. Pancytopenia refers to the simultaneous reduction of red blood cells, white blood cells, and platelets. In aplastic anemia, the bone marrow fails to produce adequate blood cells, leading to this triad of cytopenias, making it the hallmark of the disease.
C. Neutropenia, which is a low level of neutrophils (a type of white blood cell), can occur in aplastic anemia. However, it is only one component of the broader condition and does not represent the complete picture of the disease.
D. Leukopenia refers to a low white blood cell count. Like neutropenia, it can be a finding in aplastic anemia, but it does not encompass the anemia and thrombocytopenia that also occur.

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You are caring for a patient with an Absolute Neutrophil Count (ANC) of 400. The physician orders the patient to be placed on neutropenic precautions. Which of the following would be appropriate to implement? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

Your patient has just received a new diagnosis of Rheumatoid Arthritis. They are confused about their prescriptions, however. They ask you "Why am I receiving so many medications? I thought this 'MTX' drug was the one that would treat my arthritis?". What is your BEST response?

Correct Answer is D

Explanation

Which of the following assessment findings is the MOST likely for a patient who is diagnosed with Aplastic Anemia? Select the BEST answer.

Correct Answer is B

Explanation

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