Nokea
A client is admitted with suspected acute pancreatitis. Which lab finding confirms the diagnosis?
- A. Blood glucose of 260 mg/dL
- B. White cell count of 21,000 cu/mm
- C. Platelet count of 250,000 cu/mm
- D. Serum amylase level of 600 units/dL
Correct Answer: D
Rationale: Elevated serum amylase levels, particularly above 3 times the normal range, confirm acute pancreatitis due to pancreatic enzyme release.
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The nurse is part of an interdisciplinary team in a rehabilitation unit. Which of the following statements by a client is most important to be communicated to the social worker on the team?
- A. I can't afford to hire anyone to help me when I am discharged.
- B. I'm worried about falling when I go home.
- C. I need to learn how to get in and out of the shower.
- D. I'm not sure what kinds of adaptive equipment I will need.
Correct Answer: A
Rationale: Inability to afford help (A) is a social issue requiring the social worker's intervention for resources. Other concerns (B, C, D) are addressed by therapy or nursing.
Two nurses are preparing to pull a client up in the bed. Which actions by the nurses are correct in regard to safe client handling? Select all that apply.
- A. place the bed in the lowest position possible
- B. ask the client to cross her arms over her chest if she is able
- C. use a patient lifting device, such as a Hoyer lift, if needed
- D. extend the elbows out away from the body while pulling client up
- E. place the head of the bed flat or slightly Trendelenburg if the client can tolerate it
Correct Answer: B, C, E
Rationale: Asking the client to cross arms, using a lifting device if needed, and flattening the bed or using slight Trendelenburg promote safe handling. The bed should be at working height, and elbows should stay close to the body.
A nurse has received report on the day's clients. In planning morning rounds, which client is the priority to see?
- A. a new admission with a UTI and fever
- B. a client who is NPO for surgery later in the morning
- C. a client complaining of nausea after eating breakfast
- D. a client recently complaining of shortness of breath
Correct Answer: D
Rationale: Shortness of breath indicates a potential respiratory or cardiac issue, making this client the priority for immediate assessment.
A client who has been taking Coumadin (warfarin) was stabbed in the upper arm. His prothrombin time is over twice the normal amount. The nurse anticipates an order for
- A. fresh frozen plasma
- B. whole blood
- C. platelets
- D. packed red blood cells
Correct Answer: A
Rationale: Elevated prothrombin time indicates excessive anticoagulation. Fresh frozen plasma provides clotting factors to reverse warfarin’s effect and control bleeding.
A client with a head injury has an intracranial pressure (ICP) monitor in place. Cerebral perfusion pressure calculations are ordered. If the client's ICP is 22 and the mean pressure reading is 70, what is the client's cerebral perfusion pressure?
- A. 92
- B. 72
- C. 58
- D. 48
Correct Answer: D
Rationale: Cerebral perfusion pressure (CPP) = Mean Arterial Pressure (MAP) - ICP. Given MAP = 70 and ICP = 22, CPP = 70 - 22 = 48. Thus, the answer is 48.