Nokea
A male client with pernicious anemia takes supplemental folate and self-administers monthly Vitamin B12 injections. He reports feeling increasingly fatigued. Which laboratory value should the nurse review?
- A. Complete blood count
- B. Serum ferritin level
- C. Serum potassium level
- D. Liver function tests
Correct Answer: A
Rationale: Fatigue in pernicious anemia may indicate inadequate treatment. A complete blood count helps assess hemoglobin and red blood cell levels.
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An adult client is admitted with diabetic ketoacidosis (DKA) and a urinary tract infection (UTI). Prescriptions for intravenous antibiotics and an insulin infusion are initiated. Which serum laboratory value warrants the most immediate intervention by the nurse?
- A. Glucose of 350 mg/dl
- B. White blood cell count of 15,000 mm3
- C. Blood PH of 7.30
- D. Potassium of 2.5 mEq/L
Correct Answer: D
Rationale: A potassium level of 2.5 mEq/L is dangerously low and must be corrected immediately to prevent cardiac arrhythmias.
Membranous glomerulonephritis:
- A. Is typically associated with immune complex deposition
- B. Presents with nephritic syndrome
- C. Is associated with highly selective proteinuria
- D. Deposits of IgG on the glomerular membrane
Correct Answer: A
Rationale: Membranous glomerulonephritis is characterized by immune complex deposition, particularly IgG, on the glomerular basement membrane, leading to proteinuria.
Which is a clinical manifestation of the systemic venous congestion that can occur with heart failure?
- A. Tachypnea
- B. Tachycardia
- C. Peripheral edema
- D. Pale, cool extremities
Correct Answer: C
Rationale: Peripheral edema, especially periorbital edema, is a clinical manifestation of systemic venous congestion. Tachypnea is a manifestation of pulmonary congestion. Tachycardia and pale, cool extremities are clinical manifestations of impaired myocardial function.
The nurse reviews the laboratory results for a child with a suspected diagnosis of rheumatic fever. The nurse knows that which laboratory study would assist in confirming the diagnosis?
- A. Immunoglobulin
- B. Red blood cell count
- C. White blood cell count
- D. Anti-streptolysin O titer
Correct Answer: D
Rationale: The Anti-streptolysin O titer is used to confirm a diagnosis of rheumatic fever as it indicates a recent streptococcal infection, which is a precursor to rheumatic fever.
A child develops carditis from rheumatic fever. Which areas of the heart are affected by carditis?
- A. Coronary arteries
- B. Heart muscle and the mitral valve
- C. Aortic and pulmonic valves
- D. Contractility of the ventricles
Correct Answer: B
Rationale: The tissues that cover the heart and heart valves are affected. The heart muscle may be involved and the mitral valve is frequently involved.