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Questions 149

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Question 1 of 5

The nurse who is caring for a client with cancer notes a WBC of 500 on the laboratory results. Which intervention would be most appropriate to include in the client's plan of care?

Correct Answer: B

Rationale: A WBC of 500 indicates severe neutropenia, increasing infection risk. Avoiding crowds and sick people is critical to prevent infections. The other interventions are less specific.

Question 2 of 5

A child who ingested 18 500-mg acetaminophen tablets 30 minutes ago is seen in the ED. Which of these orders should the nurse do first?

Correct Answer: A

Rationale: Activated charcoal is the priority within 1 hour of acetaminophen overdose to reduce absorption, followed by acetylcysteine to prevent liver damage.

Question 3 of 5

A newly admitted client has sickle cell crisis. He is complaining of pain in his feet and hands. The nurse's assessment findings include a pulse oximetry of 92. Assuming that all the following interventions are ordered, which should be done first?

Correct Answer: C

Rationale: A pulse oximetry of 92 indicates hypoxemia, so administering oxygen is the priority to improve oxygenation and prevent further sickling.

Question 4 of 5

Which of the following factors increase the risk of developing deep vein thrombosis (DVT)? Select all that apply.

Correct Answer: B,C,D,F

Rationale: DVT risk factors include smoking (
B), surgery (
C), oral contraceptives (
D), and immobility (F). Underweight (
A) and high-protein diet (E) are not significant risks.

Question 5 of 5

The nurse is reviewing the results of a sweat test taken from a child with cystic fibrosis. Which finding supports the client's diagnosis?

Correct Answer: B

Rationale: A sweat chloride concentration greater than 60 mEq/L is diagnostic for cystic fibrosis, indicating defective chloride transport.

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