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A patient's complete blood count shows a hemoglobin of 200 g/L and a hematocrit of 54%. Which of the following questions should the nurse ask to determine possible causes of this finding?
- A. Has there been any recent weight loss?
- B. Do you have any problems with your vision?
- C. What is your intake of fruits and vegetables?
- D. Have you noticed any dark or bloody stools?
Correct Answer: B
Rationale: The hemoglobin and hematocrit results indicate polycythemia, which may cause visual abnormalities. The other questions will be appropriate for patients who are anemic.
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The nurse is evaluating the red cell indices result of a patient's laboratory report. Which of the following interpretations is correct related to a low mean corpuscular volume (MCV)?
- A. Hypochromic red blood cells (RBCs)
- B. Inadequate numbers of RBCs
- C. Low hemoglobin in the RBCs
- D. Small size of the RBCs
Correct Answer: D
Rationale: The MCV is low when the RBCs are smaller than normal. Inadequate numbers of RBCs are an indication of anemia. Low levels of hemoglobin in the RBCs and hypochromic RBCs result in a low mean corpuscular hemoglobin (MCH).
The nurse is reviewing laboratory data for an older-adult patient. Which of the following results should be of most concern?
- A. White blood cell (WBC) count of 3.5 x 10^9/L
- B. Hematocrit of 37%
- C. Platelet count of 400 x 10^9/L
- D. Hemoglobin of 118 g/L
Correct Answer: A
Rationale: The total WBC count is not usually affected by aging, and the low WBC here would indicate that the patient's immune function may be compromised. The platelet count is normal. The slight decrease in hemoglobin and hematocrit is not unusual for an older patient.
The nurse is caring for a patient who is receiving heparin. Which of the following laboratory tests should the nurse monitor?
- A. Prothrombin time (PT)
- B. Fibrin degradation products (FDP)
- C. International normalized ratio (INR)
- D. Activated partial thromboplastin time (aPTT)
Correct Answer: D
Rationale: aPTT testing is used to determine whether heparin is at a therapeutic level. FDP is useful in diagnosis of problems such as disseminated intravascular coagulation (DIC). PT and INR are most commonly used to test for therapeutic levels of warfarin.
The nurse is caring for a patient with pancytopenia of unknown origin who is confused and is scheduled for the following diagnostic tests. Which of the following tests should the nurse contact the patient's family member to obtain a signed consent form?
- A. ABO blood typing
- B. Bone marrow biopsy
- C. Abdominal ultrasound
- D. Complete blood count (CBC)
Correct Answer: B
Rationale: Bone marrow biopsy is a minor surgical procedure that requires the patient or guardian to sign a surgical consent form. The other procedures do not require a signed consent by the patient or family.
The nurse is reviewing the complete blood count (CBC) for a patient admitted with abdominal pain. Which of the following information will be most important for the nurse to communicate to the health care provider?
- A. Monocytes 4%
- B. Hemoglobin 116 g/L
- C. Platelet count 44 x 10^9/L
- D. White blood cells 13.5 x 10^9/L
Correct Answer: D
Rationale: The elevation in WBCs indicates that an abdominal infection may be the cause of the patient's pain and that further diagnostic testing is needed. The monocytes are at a normal level. The slight decreases in hemoglobin and platelet count also would be reported but would not require any immediate action.