You are the charge nurse in an oncology unit. A client with an absolute neutrophil count (ANC) of 300/mm³ is placed in protective isolation. Which staff member should you assign to provide care for this client, under the supervision of an experienced oncology RN?

Correct Answer: C

Rationale: In this scenario, assigning the LPN with 2 years of experience on the oncology unit to care for the client with a low ANC is the most appropriate choice. The LPN's familiarity with oncology unit protocols, procedures, and patient population makes them well-suited for this assignment. Their experience indicates they have likely received specific training in managing oncology patients, including those in protective isolation. Option A, the LPN from the same-day-surgery unit, lacks the specialized experience required for oncology care. Option B, the RN from the float pool with a background in surgical care, may not have the expertise needed for oncology patients. Option D, the RN from the ED, may also lack the specialized knowledge and skills necessary for caring for oncology patients in protective isolation. In an educational context, this question highlights the importance of matching staff expertise with the specific needs of patients in different care settings. It underscores the significance of experience and training in specialized areas like oncology, where patients often require complex care and interventions. By understanding the rationale behind staffing assignments, healthcare professionals can ensure the best possible outcomes for their patients.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Check the skin for signs of redness or peeling. Delegating this task to a nursing assistant is appropriate because it involves a basic observation skill that a nursing assistant can perform under supervision. Monitoring the skin for signs of redness or peeling is crucial in identifying early manifestations of radiation-induced skin reactions, which is a common side effect in clients receiving radiation therapy for Hodgkin's lymphoma in the groin area. Option B) Applying alcohol-free lotion after cleaning involves a level of judgment and understanding of the specific requirements for radiation-induced skin care, making it more suitable for a licensed nurse to perform. Option C) Explaining good skin care to the client and family requires a higher level of education and communication skills that are typically within the scope of a registered nurse or advanced practice nurse. Option D) Cleaning the skin over the area daily with a mild soap may seem like a simple task, but it is important to note that cleaning the skin of a client undergoing radiation therapy requires specific protocols and considerations to prevent further damage, making it more appropriate for a licensed nurse to carry out. Educationally, understanding the rationale behind delegating tasks based on the complexity and required skill level is crucial for effective and safe patient care delegation in healthcare settings. It ensures that tasks are assigned to the appropriate personnel based on their scope of practice, competency, and the specific needs of the patient.

Correct Answer: C

Rationale: In hematology, understanding the different blood cells and their significance is crucial for diagnosing various conditions. In this question, the correct answer is C) Reticulocyte. Reticulocytes are immature red blood cells that are released by the bone marrow into the bloodstream. An increase in reticulocyte count indicates an increased rate of erythropoiesis, which is the process of red blood cell production. This can occur in response to conditions such as anemia or blood loss, where the body needs to produce more red blood cells to maintain oxygen-carrying capacity. Now, let's analyze why the other options are incorrect: A) Basophil: Basophils are a type of white blood cell involved in allergic reactions and parasitic infections. They are not directly related to erythropoiesis. B) Monocyte: Monocytes are another type of white blood cell that plays a role in immune response and inflammation. They are not involved in red blood cell production. D) Lymphocyte: Lymphocytes are a type of white blood cell critical for immune function. They are not associated with erythropoiesis. Understanding the correlation between different blood cells and their functions is essential for healthcare professionals, especially in hematology and oncology settings where blood disorders are commonly encountered. By knowing which blood cell indicates increased erythropoiesis, clinicians can better interpret blood test results and make informed clinical decisions for their patients.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Lymphedema. Lymphedema is the swelling that occurs due to the accumulation of lymph fluid in the tissues when the lymphatic system is impaired or damaged. In the case of a woman who has undergone a right breast mastectomy, lymph nodes may have been removed or damaged during surgery, leading to impaired lymphatic drainage and resulting in swelling in the affected arm, known as lymphedema. Option B) Right-sided heart failure is incorrect as it does not typically present with isolated severe swelling in the right arm. Option C) Wound on her right hand is irrelevant to the situation described. Option D) Refusal to use her right arm would not cause severe swelling but rather disuse atrophy or weakness. Educationally, understanding the potential complications of breast surgery, such as lymphedema, is crucial for healthcare providers involved in the care of these patients. Recognizing the signs and symptoms of lymphedema allows for early intervention and management to improve the patient's quality of life and prevent further complications. This case underscores the importance of post-operative monitoring and patient education regarding lymphedema prevention strategies.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Bleeding. When laboratory test results show increased fibrin split products (FSPs), it indicates that there is an increased breakdown of fibrin clots in the body. This breakdown can lead to a state of hypercoagulability, where the blood is more prone to clotting. Monitoring the patient for signs of bleeding is crucial because although paradoxical, an increased risk of bleeding can occur due to the consumption of clotting factors in the process of fibrinolysis. This can manifest as abnormal bleeding from various sites. Option A) Fever is not directly related to increased FSPs and would not be the most appropriate nursing action in this context. Option C) Faintness is also not directly related to the breakdown of fibrin clots and is not a typical manifestation of increased FSPs. Option D) Thrombotic episodes might seem plausible due to the hypercoagulable state, but the primary concern in this scenario is monitoring for bleeding complications. Educationally, understanding the implications of abnormal laboratory results like increased FSPs is crucial for nurses caring for patients with hematologic or oncologic conditions. Recognizing the significance of these results and knowing the appropriate nursing actions can help prevent serious complications and improve patient outcomes.