Which laboratory study is monitored for the patient receiving heparin therapy?

Correct Answer: B

Rationale: The laboratory study monitored for a patient receiving heparin therapy is the Partial Thromboplastin Time (PTT). Heparin is an anticoagulant medication that works by inhibiting clot formation. PTT measures the intrinsic pathway of the coagulation cascade, which is affected by heparin administration. Monitoring the PTT helps ensure that the patient's blood is at the appropriate level of anticoagulation and reduces the risk of bleeding or clot formation.

Correct Answer: A

Rationale: The decreased white blood cell count (WBC) in the blood tests indicates a potential for infection. White blood cells are crucial for fighting off infections in the body. A decrease in WBC count can result in an impaired immune response, making the individual more susceptible to infections. Therefore, the nurse should prioritize the nursing diagnosis of "Potential for infection" to address the heightened risk of infection in the adult with anemia. It is important to monitor for signs and symptoms of infection, provide appropriate hygiene measures, and implement interventions to prevent infections in this individual.

Correct Answer: C

Rationale: Introducing variations in styles of clothing can help the client feel more comfortable and confident despite the abnormal enlargement of her arm due to lymphedema. By wearing different styles of clothing that accommodate the affected arm, the client can still express her personal style and feel good about her appearance. This approach can help improve the client's self-image and self-esteem, supporting her emotionally as she copes with the condition. Placing the arm in a sling, applying cold soaks, or tying a tight bandage are not appropriate suggestions for addressing the client's anxiety and self-image concerns in this situation.

Correct Answer: B

Rationale: Stomatitis is a common side effect of chemotherapy characterized by inflammation and irritation of the mucous membranes in the mouth. This can present as red, painful sores or ulcers on the oral mucosa. The presence of red, open sores in the mouth is indicative of stomatitis and warrants assessment and intervention to manage discomfort and prevent infection in the oral cavity. The other options are not typically associated with stomatitis in the context of chemotherapy.

Correct Answer: C

Rationale: In pediatric pharmacology, calculating appropriate drug dosages is crucial to ensure patient safety and optimal therapeutic outcomes. In this scenario, the correct formula for determining the appropriate morphine dose for the client with oat cell carcinoma of the lung is 5 mg/kg of body weight (Option C). The rationale behind choosing Option C is that dosing medications based on weight is a common practice in pediatrics as it helps adjust for individual variations in drug metabolism and distribution. Morphine dosing in children is often weight-based to prevent under or overdosing, considering pediatric patients have different body compositions compared to adults. Option A (1 mg/kg of body weight) is too low for managing severe pain effectively, especially in the context of carcinoma-related pain. Option B (5 mg/70kg of body weight) does not account for weight variances in pediatric patients, potentially leading to inappropriate dosing. Option D (10 mg/70kg of body weight) is also not appropriate as it could result in overdose in pediatric patients. Educationally, understanding weight-based dosing in pediatrics is fundamental for nurses to provide safe and individualized care to pediatric patients. It highlights the importance of accurate dosage calculations and the impact it has on patient outcomes, especially in scenarios where pain management is critical for the patient's well-being.