Nokea
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.
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The nurse is caring for a patient whose complete blood count (CBC) and differential indicate that the patient is neutropenic. Which of the following actions should the nurse include in the plan of care?
- A. Avoid intramuscular injections
- B. Encourage increased oral fluids
- C. Check temperature every 4 hours
- D. Increase intake of iron-rich foods
Correct Answer: C
Rationale: Neutropenic patients are at high risk for infection and sepsis and should be monitored frequently for signs of infection. The other actions would not address the patient's neutropenia.
The nurse is caring for a patient who had an intraoperative hemorrhage 12 hours ago. Which of the following laboratory results should the nurse anticipate?
- A. Hematocrit of 45%
- B. Hemoglobin of 132 g/L
- C. Decreased white blood cell (WBC) count
- D. Elevated reticulocyte count
Correct Answer: D
Rationale: Hemorrhage causes the release of more immature RBCs from the bone marrow into the circulation. The hematocrit and hemoglobin levels are normal. The WBC count is not affected by bleeding.
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.
While examining the lymph nodes during physical assessment, the nurse would be most concerned about which of the following findings?
- A. A 2-cm nontender supraclavicular node
- B. A 1-cm mobile and nontender axillary node
- C. An inability to palpate any superficial lymph nodes
- D. Firm inguinal nodes in a patient with an infected foot
Correct Answer: A
Rationale: Enlarged and nontender nodes are most suggestive of malignancy such as lymphoma. Firm nodes are an expected finding in an area of infection. The superficial lymph nodes are usually not palpable in adults, but if they are palpable, they are normally 0.5-1 cm and nontender.
The nurse is obtaining a health history from a patient and notes numerous petechiae. Which of the following assessments should the nurse anticipate?
- A. Bruising on the skin
- B. Pinpoint purplish-red lesions
- C. Small focal red lesions
- D. Brown spots on mucous membranes
Correct Answer: B
Rationale: Petechiae are small, purplish-red lesions. Ecchymosis is bruising on the skin. Small focal red lesions are telangiectasia. Purpura are small hemorrhages on the skin or mucous membranes resulting in a rash of purple, red, or brown spots.