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The nurse caring for a client diagnosed with metastatic cancer of the bone is exhibiting mental confusion and a BP of 150/100. Which laboratory value would correlate with the client's symptoms reflecting a common complication with this diagnosis?
- A. Potassium 5.2 mEq/L
- B. Calcium 13 mg/dL
- C. Inorganic phosphorus 1.7 mEq/L
- D. Sodium 138 mEq/L
Correct Answer: B
Rationale: Bone metastasis often causes hypercalcemia (calcium 13 mg/dL is elevated), leading to confusion and hypertension. The other values are normal or unrelated.
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While reviewing the chart of a client with a history of hepatitis B, the nurse finds a serologic marker of HBsAg. The nurse recognizes that the client:
- A. Has chronic hepatitis B
- B. Has recovered from hepatitis B infection
- C. Has immunity to infection with hepatitis C
- D. Has no chance of spreading the infection to others
Correct Answer: A
Rationale: Presence of HBsAg indicates active hepatitis B infection, either acute or chronic, and potential infectivity.
The nurse is assessing a newborn in the well-baby nursery. Which finding should alert the nurse to the possibility of a cardiac anomaly?
- A. Diminished femoral pulses
- B. Harlequin's sign
- C. Circumoral pallor
- D. Acrocyanosis
Correct Answer: A
Rationale: Diminished femoral pulses suggest coarctation of the aorta, a cardiac anomaly, requiring further evaluation.
The nurse is at the nurses' station charting when a physician comes up and says, 'Since you are already logged into the computer, I need you to look up some labs on a client.' The client is not cared for by this nurse. Which response by the nurse is most appropriate?
- A. Let me check that for you in a moment.
- B. Why don't you call the lab? That will be quicker.
- C. That is not my client, but I will get his nurse for you.
- D. I can't do that because of HIPAA, but I will let the charge nurse look it up.
Correct Answer: D
Rationale: Accessing a client's lab results without authorization violates HIPAA, as the nurse is not assigned to the client. The charge nurse can ensure proper access.
Which of the following roommates would be most suitable for the client with myasthenia gravis?
- A. A client with hypothyroidism
- B. A client with Crohn's disease
- C. A client with pylonephritis
- D. A client with bronchitis
Correct Answer: A
Rationale: Hypothyroidism poses no infection risk, unlike pyelonephritis or bronchitis.
A client has immune thrombocytopenic purpura. The client's platelet count is 19,000. Which initial treatment does the nurse expect?
- A. Splenectomy
- B. Immunosuppressive therapy
- C. Observation only
- D. Platelet administration
Correct Answer: B
Rationale: For ITP with a platelet count of 19,000, immunosuppressive therapy (B), like corticosteroids, is typically initial to increase platelet production. Splenectomy (A) is later, observation (C) is risky, and platelets (D) are less effective.