Nokea
A client is being treated for anemia and has a hemoglobin level of 9.6 g/dL. What does the nurse understand is the basic nutritional component of heme in hemoglobin that the client may be deficient in?
- A. Folic acid
- B. Copper
- C. Protein
- D. Iron
Correct Answer: D
Rationale: Iron is the basic nutritional component of heme in hemoglobin. Folic acid is essential for the maturation of red blood cells. Copper (minute amount) is involved in the transfer of iron from storage to plasma.
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A client is brought to the emergency department with suspected bleeding esophageal varices. Which hemoglobin level should the nurse immediately report to the physician?
- A. 13.0 g/dL
- B. 10.2 g/dL
- C. 5.0 g/dL
- D. 11.4 g/dL
Correct Answer: C
Rationale: The nurse should immediately report a 5.0 g/dL, which is a critical low level. A 13.0 g/dL is a normal level, 11.4 is slightly low, and 10.2 is low.
A client is taking a medication that has the side effect of depressing the hematopoietic system. What signs of leukopenia should the nurse monitor for while the client is taking this drug?
- A. Fever, sore throat, and chills
- B. Nausea and vomiting
- C. Diarrhea, diaphoresis, and fever
- D. Intolerance to heat and rash
Correct Answer: A
Rationale: Closely monitor clients taking medications that depress the hematopoietic system, particularly thrombocytes and leukocytes. Signs of leukopenia include fever, sore throat, and chills. Nausea and vomiting, diarrhea, diaphoresis, heat intolerance, and rash are not indicative of leukocytosis.
When obtaining vital signs from a client who has reduced erythrocyte production and a hemoglobin level of 8.2 g/dL, what results would be indicative of these lab studies?
- A. Heart rate of 120 beats/minute
- B. Respiratory rate of 16 breaths/minute
- C. Blood pressure of 140/90 mm Hg
- D. Oxygen saturation of 95%
Correct Answer: A
Rationale: A rapid pulse rate can indicate reduced erythrocytes or inadequate hemoglobin levels. The respiratory rate for this client is within normal range. Hypertension is not indicative of a low hemoglobin level, and what is usually seen would be hypotension. The oxygen saturation level is within normal range.
The nurse is caring for three clients who have the following blood count values: Client A has 24,500/mm?³ white blood cells (WBCs), client B has 13.4 g/dL hemoglobin, and client C has a 250,000/mm?³ platelet count. Which statement correctly describes the condition of each client?
- A. Client A has a normal WBC count, client B has a higher hemoglobin count than normal, and client C has a normal platelet count.
- B. Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count.
- C. Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a higher platelet count than normal.
- D. Client A has a lower WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count.
Correct Answer: B
Rationale: The normal leukocyte count is between 5000 and 10,000/mm?³. Client A has an increased number of leukocytes greater than 10,000/mm?³ and hence has leukocytosis. In adults, the normal amount of hemoglobin is 12.0 to 17.4 g/dL; therefore, client B has a normal hemoglobin count. A normal circulating platelet count is 150,000 to 350,000/mm?³ platelets; therefore, client C has a normal platelet count.
A student nurse is having difficulty understanding the function of globulins. What information can the client provide to the student regarding the function of globulins?
- A. Immunologic agents
- B. Destruction of invading organisms
- C. Precursors to clot formation
- D. Transport of oxygen to the tissues
Correct Answer: A
Rationale: Globulins function primarily as immunologic agents; they prevent or modify some types of infectious diseases. Globulins do not destroy invading organisms, participate in clot formation, or transport oxygen to the tissues.