Nokea
A patient who had a total hip replacement had an intraoperative hemorrhage 14 hours ago. Which laboratory test result would the nurse expect?
- A. Hematocrit of 46%
- B. Hemoglobin of 13.8 g/dL
- C. Elevated reticulocyte count
- D. Decreased white blood cell (WBC) count
Correct Answer: C
Rationale: The correct answer is C: Elevated reticulocyte count. Hemorrhage leads to the release of reticulocytes (immature red blood cells) from the bone marrow into circulation as a compensatory mechanism to replenish lost red blood cells. This response helps in restoring the oxygen-carrying capacity of the blood. Choices A and B, hematocrit of 46% and hemoglobin of 13.8 g/dL, may not reflect the immediate response to hemorrhage within 14 hours. Choice D, decreased white blood cell (WBC) count, is not directly related to the body's response to hemorrhage.
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A postoperative patient receiving a transfusion of packed red blood cells develops chills, fever, headache, and anxiety 35 minutes after the transfusion is started. After stopping the transfusion, what action should the nurse take?
- A. Give the PRN diphenhydramine
- B. Send a urine specimen to the laboratory
- C. Administer PRN acetaminophen (Tylenol)
- D. Draw blood for a new type and crossmatch
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A patient with pancytopenia of unknown origin is scheduled for the following diagnostic tests. The nurse will provide a consent form to sign for which test?
- A. Bone marrow biopsy
- B. Abdominal ultrasound
- C. Complete blood count (CBC)
- D. Activated partial thromboplastin time (aPTT)
Correct Answer: A
Rationale: In the case of a patient with pancytopenia of unknown origin, a bone marrow biopsy is usually indicated to determine the cause. A bone marrow biopsy is a minor surgical procedure that requires the patient or guardian to sign a surgical consent form. Abdominal ultrasound (Choice B) is not typically used to diagnose pancytopenia. A Complete Blood Count (CBC) (Choice C) is a routine blood test and does not require a specific consent form. Activated Partial Thromboplastin Time (aPTT) (Choice D) is a coagulation test and not typically performed to diagnose pancytopenia.
Which patient requires the most rapid assessment and care by the emergency department nurse?
- A. The patient with hemochromatosis who reports abdominal pain
- B. The patient with neutropenia who has a temperature of 101.8°F
- C. The patient with thrombocytopenia who has oozing gums after a tooth extraction
- D. The patient with sickle cell anemia who has had nausea and diarrhea for 24 hours
Correct Answer: B
Rationale: The correct answer is B because a neutropenic patient with a fever is at high risk for developing sepsis. Sepsis can progress rapidly and lead to life-threatening complications. Immediate assessment, obtaining cultures, and initiating antibiotic therapy are essential in this situation. Choices A, C, and D do not present with the same level of urgency as a neutropenic patient with a fever. Abdominal pain in a hemochromatosis patient, oozing gums after a tooth extraction in a thrombocytopenic patient, and nausea and diarrhea in a patient with sickle cell anemia, while concerning, do not indicate the same immediate risk of sepsis as a neutropenic patient with a fever.
A healthcare provider reviews the laboratory data for an older patient. The healthcare provider would be most concerned about which finding?
- A. Hematocrit of 35%
- B. Hemoglobin of 11.8 g/dL
- C. Platelet count of 400,000/μL
- D. White blood cell (WBC) count of 2800/μL
Correct Answer: D
Rationale: A low white blood cell (WBC) count in an older patient is concerning as it indicates a potential compromise in the patient's immune function. White blood cells are crucial for fighting infections and a low count could lead to an increased risk of infections. Hematocrit, hemoglobin, and platelet count are important parameters to assess, but a low WBC count takes priority in this case due to its direct impact on immune health.
An appropriate nursing intervention for a hospitalized patient with severe hemolytic anemia is to
- A. provide a diet high in vitamin K
- B. alternate periods of rest and activity
- C. teach the patient how to avoid injury
- D. place the patient on protective isolation
Correct Answer: B
Rationale: In severe hemolytic anemia, the priority nursing intervention is to alternate periods of rest and activity. This approach helps to balance activity levels to prevent excessive fatigue while promoting mobility and preventing complications such as muscle weakness or deconditioning. Providing a diet high in vitamin K (choice A) is not directly related to managing hemolytic anemia. Teaching the patient how to avoid injury (choice C) is important but may not be the immediate priority. Placing the patient on protective isolation (choice D) is not indicated for hemolytic anemia, as it is not a contagious condition.