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Questions 158

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Extract:


Question 1 of 5

A client with a history of chronic lymphocytic leukemia is admitted with complaints of lymphadenopathy. The nurse should give priority to:

Correct Answer: A

Rationale: Lymphadenopathy in chronic lymphocytic leukemia increases infection risk, so monitoring for infection is the priority.

Question 2 of 5

The client is admitted with a diagnosis of chorioamnionitis. Which symptom is most likely to be present?

Correct Answer: A

Rationale: Chorioamnionitis an infection of the amniotic fluid and membranes typically causes maternal fever. Fetal macrosomia decreased contractions and hypotension are not primary symptoms.

Question 3 of 5

The client is receiving a continuous heparin infusion. Which laboratory value should the nurse monitor most closely?

Correct Answer: C

Rationale: Heparin’s anticoagulant effect is monitored by aPTT, with a therapeutic range of 1.5–2.5 times the control value. Platelet count is monitored for heparin-induced thrombocytopenia, but PT and INR are for warfarin.

Question 4 of 5

The mother of a one-year-old with sickle cell anemia wants to know why the condition didn't show up in the nursery. The nurse's response is based on the knowledge that:

Correct Answer: D

Rationale: Fetal hemoglobin (HbF), predominant in newborns, inhibits sickling in sickle cell anemia, delaying symptoms until HbF decreases around 6 months. Newborn screening exists, and infections can trigger crises later.

Question 5 of 5

The nurse is assessing a client with suspected dehydration. Which finding is most indicative?

Correct Answer: B

Rationale: Dry mucous membranes are a classic sign of dehydration due to reduced fluid volume. Decreased (not increased) urine output, tachycardia, and fever may occur but are less specific.

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