Question

Nurse is reviewing the medication regimen for a client who has chronic kidney disease (CKD) and is prescribed epoetin alfa. Which of the following findings should the nurse recognize as a reason to withhold the administration of epoetin alfa and contact the health care provider?

Answer 1

Correct Answers:

The client's blood pressure is 155/92 mmHg.

Rationale :

🩸 A blood pressure of 155/92 mmHg is a reason to withhold epoetin alfa and notify the provider because this medication can worsen or cause hypertension.

🩸 Epoetin alfa stimulates the bone marrow to increase red blood cell production, which increases blood viscosity and can contribute to elevated blood pressure.

🩸 Clients receiving epoetin alfa require regular monitoring of blood pressure and hemoglobin levels to prevent complications.

🩸 Uncontrolled hypertension increases the risk of serious complications such as stroke, seizures, and cardiovascular events during epoetin therapy.

🩸 The nurse should hold the medication and contact the provider for evaluation and possible adjustment of treatment.

🩸 This answer is correct because hypertension is a significant adverse effect and safety concern with epoetin alfa administration.

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Answer 2

Correct Answers:

The client's blood pressure is 155/92 mmHg.

Rationale :

💊 Taking the medication twice daily with or without food as prescribed indicates understanding of direct factor Xa inhibitor therapy.

💊 Direct factor Xa inhibitors, such as apixaban, prevent clot formation by directly blocking factor Xa, an important component of the coagulation pathway.

💊 Clients should take the medication consistently at the prescribed dose and schedule to maintain effective anticoagulation.

💊 These medications can generally be taken with or without food, depending on the specific medication instructions.

💊 The client should avoid changing the dose or stopping the medication without provider guidance because this can increase the risk of thromboembolic events.

💊 This answer is correct because consistent, prescribed dosing is essential for maintaining anticoagulant effectiveness.

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Answer 3

Correct Answers:

"I will take the medication twice a day, with or without food, as prescribed by my doctor."

Rationale :

💊 Taking the medication twice daily with or without food as prescribed indicates understanding of direct factor Xa inhibitor therapy.

💊 Direct factor Xa inhibitors, such as apixaban, prevent clot formation by directly blocking factor Xa, an important component of the coagulation pathway.

💊 Clients should take the medication consistently at the prescribed dose and schedule to maintain effective anticoagulation.

💊 These medications can generally be taken with or without food, depending on the specific medication instructions.

💊 The client should avoid changing the dose or stopping the medication without provider guidance because this can increase the risk of thromboembolic events.

💊 This answer is correct because consistent, prescribed dosing is essential for maintaining anticoagulant effectiveness.

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Answer 4

Correct Answers:

Warmth
Erythema
Swelling

Rationale :

🩸 Warmth is an expected finding in deep vein thrombosis (DVT) because the clot causes local inflammation and increased blood flow around the affected vein.

🩸 Erythema (redness) occurs because inflammation from the thrombus irritates surrounding tissues and causes changes in skin appearance.

🩸 Swelling occurs because the blood clot obstructs venous return, causing fluid to accumulate in the affected extremity.

🩸 Clients with DVT may also report unilateral leg pain, tenderness, and a feeling of heaviness in the affected limb.

🩸 The nurse should monitor for complications, especially pulmonary embolism, which may present with sudden dyspnea, chest pain, and tachycardia.

🩸 This answer is correct because DVT commonly causes warmth, redness, and swelling of the affected extremity.

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Answer 5

Correct Answers:

Being a white male
Chemotherapy
Radiation exposure

Rationale :

🧬 Being a white male is a risk factor for chronic myelogenous leukemia (CML) because CML occurs more commonly in older adults and males, with higher incidence reported among White populations.

🧬 Chemotherapy is a risk factor because previous exposure to certain chemotherapy agents can cause DNA damage and increase the risk of developing secondary leukemias.

🧬 Radiation exposure is a recognized risk factor because ionizing radiation can cause genetic mutations in bone marrow cells, contributing to malignant transformation.

🧬 CML is associated with a specific genetic abnormality called the Philadelphia chromosome, which involves a translocation between chromosomes 9 and 22.

🧬 The nurse should teach that many cases of CML occur without a clearly identifiable cause, but environmental and treatment-related exposures can increase risk.

🧬 This answer is correct because CML risk is linked to genetic changes and factors that cause DNA injury, including radiation and some cancer therapies.

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Answer 6

Correct Answers:

Myocardial infarction
Ischemic stroke
Pulmonary embolism

Rationale :

🩸 Myocardial infarction (MI) is life-threatening because a thrombus can obstruct coronary arteries, preventing oxygen delivery to heart muscle and causing myocardial tissue death.

🩸 Ischemic stroke is life-threatening because an embolus can travel to cerebral arteries and block blood flow, resulting in brain ischemia and neurological damage.

🩸 Pulmonary embolism (PE) is life-threatening because a clot traveling to the pulmonary circulation can obstruct blood flow, impair oxygen exchange, and cause sudden cardiovascular collapse.

🩸 Thromboembolism can occur when a clot forms in the vascular system and travels to critical organs, creating potentially fatal complications.

🩸 Early recognition of symptoms such as chest pain, shortness of breath, neurological deficits, and sudden changes in circulation is essential.

🩸 This answer is correct because MI, ischemic stroke, and PE can rapidly compromise vital organ function and are major complications of thromboembolism.

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Answer 7

Correct Answers:

Obtain the client's blood pressure.

Rationale :

🩸 Obtaining the client’s blood pressure is the correct action before administering epoetin alfa because this medication can cause or worsen hypertension.

🩸 Epoetin alfa stimulates the bone marrow to produce more red blood cells, increasing blood viscosity and potentially raising blood pressure.

🩸 Clients receiving epoetin alfa require regular monitoring of blood pressure and hemoglobin levels to reduce the risk of complications.

🩸 Uncontrolled hypertension increases the risk of serious adverse effects, including stroke, seizures, and cardiovascular events.

🩸 The nurse should assess blood pressure before administration and notify the provider if the client’s blood pressure is elevated.

🩸 This answer is correct because blood pressure monitoring is a priority safety assessment before giving epoetin alfa.

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Answer 8

Correct Answers:

Steak
Low-fat milk
Grilled salmon
Scrambled eggs

Rationale :

🥩 Steak is a good source of vitamin B12 because animal muscle tissue contains naturally occurring B12 needed for red blood cell production and neurological function.

🥩 Low-fat milk provides vitamin B12 because dairy products contain this vitamin and can help prevent deficiency while supporting adequate nutrition.

🥩 Grilled salmon is rich in vitamin B12 because fish and other seafood are excellent sources of this nutrient.

🥩 Scrambled eggs contain vitamin B12 because eggs provide B12 mainly in the yolk.

🥩 Vitamin B12 is essential for DNA synthesis, normal red blood cell formation, and prevention of megaloblastic anemia.

🥩 Clients with B12 deficiency should include foods rich in animal products unless they have dietary restrictions, and some clients may require B12 supplementation or injections.

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Answer 9

Correct Answers:

Uncompensated respiratory alkalosis

Rationale :

🫁 Uncompensated respiratory alkalosis is the correct interpretation because the client has an elevated pH caused by a decrease in carbon dioxide levels.

🫁 A normal arterial pH is 7.35–7.45; a pH of 7.52 indicates alkalemia.

🫁 The low PaCO₂ of 28 mmHg shows that the respiratory system is the cause, usually due to excessive ventilation (hyperventilation), which removes too much carbon dioxide.

🫁 The HCO₃⁻ level remains normal at 24 mEq/L, meaning the kidneys have not yet compensated by altering bicarbonate levels.

🫁 In a compensated respiratory alkalosis, the bicarbonate level would decrease as the kidneys retain less bicarbonate to correct the alkalosis.

🫁 This answer is correct because the pH and PaCO₂ are abnormal while the HCO₃⁻ remains normal, indicating no compensation.

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Answer 10

Correct Answers:

Fever

Rationale :

🦠 Fever is an expected finding in a client with agranulocytosis because the condition causes a severe decrease in neutrophils, which are essential for fighting bacterial infections.

🦠 With reduced neutrophil levels, the client has a weakened immune response and is at high risk for developing serious infections.

🦠 Fever may be the first or only sign of infection because clients with agranulocytosis may not develop typical inflammatory responses.

🦠 The nurse should monitor temperature closely and assess for infection, including sore throat, mouth ulcers, and other signs of illness.

🦠 Clients with agranulocytosis require infection prevention measures such as hand hygiene and avoiding exposure to infectious individuals.

🦠 This answer is correct because fever indicates a possible infection in a client with dangerously low neutrophil levels.

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QLexNursing

1 :
Nurse is reviewing the medication regimen for a client who has chronic kidney disease (CKD) and is prescribed epoetin alfa. Which of the following findings should the nurse recognize as a reason to withhold the administration of epoetin alfa and contact the health care provider?

3 :
A nurse is providing discharge instructions to a client who will continue to take a direct factor Xa inhibitor at home. Which of the following statements by the client indicates an understanding?

4 :
A nurse is caring for a client who has deep vein thrombosis (DVT) of their right lower leg. Which of the following manifestations should the nurse expect? (Select All that Apply.)

5 :
A charge nurse is providing an in-service to a group of nurses about chronic myelogenous leukemia (CML). Which of the following should the nurse include in the teaching as risk factors for this condition? (Select All that Apply.)

6 :
A nurse manager is providing an in-service for a group of nurses about thromboembolism. Which of the following conditions should the nurse manager include as life-threatening? (Select All that Apply.)

7 :
A nurse is preparing to administer epoetin alfa to a client who has anemia due to a chemotherapy medication. Which of the following actions should the nurse take prior to administering the medication?

8 :
A nurse is providing dietary teaching to a client who has a new onset of vitamin B12 deficiency. Which of the following foods should the nurse encourage the client to include in their diet? (Select All that Apply.)

9 :
A client with respiratory alkalosis presents with an arterial blood gas (ABG) result showing a pH of 7.52, PaCO₂ of 28 mmHg, and HCO₃⁻ of 24 mEq/L. What is the correct interpretation of this ABG result?

10 :
A nurse is assessing a client who has agranulocytosis. Which of the following findings should the nurse expect to find?

QLexNursing

1 : Nurse is reviewing the medication regimen for a client who has chronic kidney disease (CKD) and is prescribed epoetin alfa. Which of the following findings should the nurse recognize as a reason to withhold the administration of epoetin alfa and contact the health care provider?

3 : A nurse is providing discharge instructions to a client who will continue to take a direct factor Xa inhibitor at home. Which of the following statements by the client indicates an understanding?

4 : A nurse is caring for a client who has deep vein thrombosis (DVT) of their right lower leg. Which of the following manifestations should the nurse expect? (Select All that Apply.)

5 : A charge nurse is providing an in-service to a group of nurses about chronic myelogenous leukemia (CML). Which of the following should the nurse include in the teaching as risk factors for this condition? (Select All that Apply.)

6 : A nurse manager is providing an in-service for a group of nurses about thromboembolism. Which of the following conditions should the nurse manager include as life-threatening? (Select All that Apply.)

7 : A nurse is preparing to administer epoetin alfa to a client who has anemia due to a chemotherapy medication. Which of the following actions should the nurse take prior to administering the medication?

8 : A nurse is providing dietary teaching to a client who has a new onset of vitamin B12 deficiency. Which of the following foods should the nurse encourage the client to include in their diet? (Select All that Apply.)

9 : A client with respiratory alkalosis presents with an arterial blood gas (ABG) result showing a pH of 7.52, PaCO₂ of 28 mmHg, and HCO₃⁻ of 24 mEq/L. What is the correct interpretation of this ABG result?

10 : A nurse is assessing a client who has agranulocytosis. Which of the following findings should the nurse expect to find?

1 :
Nurse is reviewing the medication regimen for a client who has chronic kidney disease (CKD) and is prescribed epoetin alfa. Which of the following findings should the nurse recognize as a reason to withhold the administration of epoetin alfa and contact the health care provider?

3 :
A nurse is providing discharge instructions to a client who will continue to take a direct factor Xa inhibitor at home. Which of the following statements by the client indicates an understanding?

4 :
A nurse is caring for a client who has deep vein thrombosis (DVT) of their right lower leg. Which of the following manifestations should the nurse expect? (Select All that Apply.)

5 :
A charge nurse is providing an in-service to a group of nurses about chronic myelogenous leukemia (CML). Which of the following should the nurse include in the teaching as risk factors for this condition? (Select All that Apply.)

6 :
A nurse manager is providing an in-service for a group of nurses about thromboembolism. Which of the following conditions should the nurse manager include as life-threatening? (Select All that Apply.)

7 :
A nurse is preparing to administer epoetin alfa to a client who has anemia due to a chemotherapy medication. Which of the following actions should the nurse take prior to administering the medication?

8 :
A nurse is providing dietary teaching to a client who has a new onset of vitamin B12 deficiency. Which of the following foods should the nurse encourage the client to include in their diet? (Select All that Apply.)

9 :
A client with respiratory alkalosis presents with an arterial blood gas (ABG) result showing a pH of 7.52, PaCO₂ of 28 mmHg, and HCO₃⁻ of 24 mEq/L. What is the correct interpretation of this ABG result?

10 :
A nurse is assessing a client who has agranulocytosis. Which of the following findings should the nurse expect to find?