Page 1363 - Saunders Comprehensive Review For NCLEX-RN

4. Decreased leukocyte count
484. The nurse is providing medication instructions to a client with breast cancer
who is receiving cyclophosphamide. The nurse should tell the client to take
which action?
1. Take the medication with food.
2. Increase fluid intake to 2000 to 3000 mL daily.
3. Decrease sodium intake while taking the medication.
4. Increase potassium intake while taking the medication.
485. A client with non-Hodgkin’s lymphoma is receiving daunorubicin. Which
finding would indicate to the nurse that the client is experiencing an adverse
effect related to the medication?
1. Fever
2. Sores in the mouth and throat
3. Complaints of nausea and vomiting
4. Crackles on auscultation of the lungs
486. The nurse is monitoring the laboratory results of a client receiving an
antineoplastic medication by the intravenous route. The nurse plans to
initiate bleeding precautions if which laboratory result is noted?
1. A clotting time of 10 minutes
2. An ammonia level of 10 mcg/dL (6 mcmol/L).
9
3
3. A platelet count of 50,000 mm (50 × 10 /L)
9
3
4. A white blood cell count of 5000 mm (5.0 × 10 /L)
Answers

472. Answer: 3

Rationale: To ensure that the client receives optimal doses of chemotherapy,
dosing is usually based on the total BSA, which requires a current accurate height
and weight for BSA calculation (before each medication administration). Asking the
client about his or her height and weight may lead to inaccuracies in determining a
true BSA and dosage. Calculating body mass index and measuring abdominal girth
will not provide the data needed.
Test-Taking Strategy: Recall the basis for dosing chemotherapy. Recalling that a
current accurate height and weight need to be obtained for BSA calculation and
chemotherapy dosing will direct you to the correct option. Eliminate option 4
because it is an unreliable way of obtaining the information. Next, eliminate options
1 and 2 because they are comparable or alike and do not relate to chemotherapy
dosing.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Adult Health: Oncology
Health Problem: N/A
Priority Concepts: Cellular Regulation; Clinical Judgment
Reference: Potter et al. (2017), p. 612.

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