Nokea
Laboratory reference ranges
Hemoglobin
Male: 14.0–18.0 g/dL
(140–180 g/L)
Female: 12.0–16.0 g/dL
(120–160 g/L)
WBC
5000–10,000/mm³
(5–10 × 10⁹/L)
The nurse is collecting data from a client with acute diverticulitis. Which of the following findings would be essential to follow up?
- A. abdominal pain has progressed to the left upper quadrant
- B. hemoglobin of 11.2 g/dL (112 g/L)
- C. lying on side with knees drawn up to abdomen and trunk flexed
- D. WBC count of 12,000/mm³ (12 x 10â¹/L)
Correct Answer: A
Rationale: Pain progressing to the left upper quadrant in diverticulitis is concerning for complications like perforation or abscess, requiring follow-up. Mild anemia and flexed positioning are common, and a moderately elevated WBC is expected in acute inflammation.
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An older adult client is to receive an antibiotic, gentamicin. What diagnostic finding indicates the client may have difficulty excreting the medication?
- A. High gastric pH
- B. High serum creatinine
- C. Low serum albumin
- D. Low serum blood urea nitrogen
Correct Answer: B
Rationale: An elevated serum creatinine indicates reduced renal function. Reduced renal function will delay the excretion of many medications.
Which client condition is concerning and requires further nursing observation and intervention? Select all that apply.
- A. Client with asthma exacerbation and blood pressure is 150/90 mm Hg
- B. Client with spinal cord injury and blood pressure is 50/60 mm Hg
- C. Client with coronary artery disease on metoprolol, pulse is 62/min
- D. Elderly client with black stool; pulse is 112/min
- E. Neonate crying inconsolably at feeding time; pulse is 160/min
Correct Answer: B,D,E
Rationale: Concerning conditions include: spinal cord injury with hypotension suggesting neurogenic shock; black stool and tachycardia indicating possible GI bleeding; and inconsolable neonate with tachycardia suggesting distress. Asthma with hypertension and stable pulse on metoprolol are less urgent.
An adult comes to the clinic with complaints of frequency and burning on urination. The nurse expects that what test will be ordered for the client?
- A. Clean catch urine for culture and sensitivity
- B. CBC and electrolytes
- C. Cystoscopy
- D. Strain of all urine for calculi
Correct Answer: A
Rationale: Frequency and burning suggest urinary tract infection; a clean catch urine culture identifies the causative organism and antibiotic sensitivity. CBC, cystoscopy, or straining are less immediate.
A client with Alzheimer disease is admitted to the hospital. The client's adult child says to the nurse, 'I really want to continue caring for my mother at home, but she has become agitated and restless at night. I am awake most of the night, feel exhausted, and do not know what to do.' What is the best response by the nurse?
- A. Do not let your mother take naps in the afternoon.'
- B. Our social worker can discuss supportive options with you.'
- C. We can ask the health care provider for medication that will help your mother sleep.'
- D. Your mother should be cared for in a skilled nursing facility.'
Correct Answer: B
Rationale: Referring to a social worker provides access to resources like respite care or home support, addressing the caregiver's exhaustion. Limiting naps or medication may help but are narrow, and suggesting a facility dismisses the caregiver's wishes.
After passing a nasogastric (NG) tube in an adult, the nurse checks for proper placement by doing which of the following?
- A. Injecting air into the NG tube and listening with a stethoscope over the stomach for a 'swoosh'
- B. Putting the end of the NG tube in a glass of water and observing for bubbles
- C. Asking the client if the tube is comfortable
- D. Aspirating contents and checking the pH
Correct Answer: D
Rationale: Aspirating gastric contents and checking pH (typically 1-5 for stomach) is the most reliable method to confirm NG tube placement in the stomach. Air injection is less definitive, water bubbling is unsafe, and comfort does not confirm placement.