A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa.
Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?
The hematocrit (Hct).
The erythrocyte sedimentation rate (ESR).
The platelet count.
The leukocyte count.
The Correct Answer is A
Choice A rationale
The hematocrit (Hct). This statement is correct. Epoetin alfa is used to treat anemia by stimulating the production of red blood cells. An increase in hematocrit levels indicates a therapeutic effect of the medication, as it reflects an increase in the proportion of red blood cells in the blood.
Choice B rationale
The erythrocyte sedimentation rate (ESR). This statement is incorrect. The ESR is a non- specific marker of inflammation and is not used to monitor the therapeutic effect of epoetin alfa. It does not provide information about red blood cell production or anemia.
Choice C rationale
The platelet count. This statement is incorrect. The platelet count measures the number of platelets in the blood, which are involved in clotting. It is not affected by epoetin alfa therapy and does not indicate the therapeutic effect of the medication.
Choice D rationale
The leukocyte count. This statement is incorrect. The leukocyte count measures the number of white blood cells in the blood, which are involved in the immune response. It is not affected by epoetin alfa therapy and does not indicate the therapeutic effect of the medication.
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Correct Answer is A
Explanation
Choice A rationale
Breast cancer can occur in any part of the breast, but ductal breast cancer is most common. This statement is correct because the majority of breast cancers originate in the ducts that carry milk to the nipple. Ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) are the most common types of breast cancer, accounting for about 80% of all cases.
Choice B rationale
Breastfeeding increases the risk of breast cancer in women over 40 years of age. This statement is incorrect. In fact, breastfeeding is known to reduce the risk of breast cancer. The longer a woman breastfeeds, the greater the protective effect. This is thought to be due to hormonal changes that occur during lactation, which may delay the return of menstrual periods and reduce a woman’s lifetime exposure to hormones like estrogen that can promote breast cancer cell growth.
Choice C rationale
Clients who have BRCA1 or BRCA2 gene changes have a decreased risk of breast cancer. This statement is incorrect. Mutations in the BRCA1 and BRCA2 genes significantly increase the risk of developing breast cancer. Women with these mutations have a 45-65% chance of developing breast cancer by age 70, compared to about 12% for women in the general population. These genes normally help repair DNA damage, but when they are mutated, they can lead to the development of cancer.
Choice D rationale
Clients should begin screening mammography annually by the age of 50 years old. This statement is partially correct but not entirely accurate. The American Cancer Society recommends that women with an average risk of breast cancer should start annual mammograms at age 45 and can switch to biennial screening at age 55. However, women should have the option to start screening as early as age 40 if they choose.
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale
Encouraging the client to increase fluid intake is correct. Increasing fluid intake helps to maintain hydration, which is essential for the body to function properly, especially when the client is experiencing fever and muscle aches. Hydration helps to thin mucus, making it easier to expel, and supports the immune system in fighting off infection.
Choice B rationale
Placing the client in a private room is correct. A private room helps to prevent the spread of infection to other patients and healthcare workers. This is particularly important when the client has symptoms such as fever, sore throat, and fatigue, which could indicate a contagious illness.
Choice C rationale
Placing the client on contact precautions is incorrect. Contact precautions are typically used for infections that are spread by direct contact with the patient or their environment, such as MRSA or C. difficile. The symptoms described (headache, muscle aches, fever, sore throat, and fatigue) do not necessarily indicate an infection that requires contact precautions.
Choice D rationale
Wearing a mask when caring for the client is correct. Wearing a mask helps to prevent the transmission of respiratory infections, which can be spread through droplets when the client coughs or sneezes. This is especially important when the client has symptoms such as a sore throat and fever, which could indicate a respiratory infection.