Laboratory reference ranges
CD4+ T lymphocyte cells
600-1500 cells/μL
Hemoglobin A1c
Good diabetic control
<7%
Fair diabetic control
8%-9%
Poor diabetic control
>9%
Platelets
150,000-400,000/mm3
(150-400 × 109/L)
Glucose (fasting)
70-110 mg/dL
(3.9-6.1 mmol/L)
The nurse reviews new laboratory results for assigned clients. Which finding is the priority for the nurse to report to the supervising registered nurse?
- A. CD4+ cell count of 600 cells/uL in a client with HIV and oral candidiasis who is receiving PO fluconazole
- B. Hemoglobin A1c of 7.3% in a client with type 2 diabetes and pneumonia who is receiving IV levofloxacin heparin infusion
- C. Serum glucose of 65 mg/dL (3.61 mmol/L) in a client with radiation enteritis who is receiving total parenteral nutrition
Correct Answer: C
Rationale: A serum glucose of 65 mg/dL indicates hypoglycemia, which is critical in a client on total parenteral nutrition, as it may require immediate adjustment of glucose infusion or administration of dextrose.
You may also like to solve these questions
A student nurse is preparing to administer the hepatitis B vaccine to a newborn. Which statement by the student nurse requires the preceptor to provide further teaching?
- A. A 5/8-inch, 25-gauge needle is appropriate for intramuscular injection in newborns.
- B. I will clean the injection site with an antiseptic swab before administration.
- C. I will draw the medication into a 1-mL syringe.
- D. The medication should be administered into the deltoid muscle.
Correct Answer: D
Rationale: The deltoid muscle is not developed enough in newborns for intramuscular injections. The hepatitis B vaccine should be administered in the anterolateral thigh.
Which of the following conditions is most likely related to the development of renal calculi?
- A. Gout
- B. Pancreatitis
- C. Fractured femur
- D. Disc disease
Correct Answer: A
Rationale: Gout increases uric acid levels, which can lead to uric acid kidney stones, a common type of renal calculi.
A client is receiving nitroprusside IV for the treatment of acute heart failure with pulmonary edema. What diagnostic lab value should the nurse monitor when a client is receiving this medication?
- A. Potassium level
- B. Arterial blood gasses
- C. Blood urea nitrogen
- D. Thiocyanate
Correct Answer: D
Rationale: Thiocyanate. Nitroprusside metabolism increases thiocyanate levels, which can lead to cyanide toxicity if elevated.
The client has just returned from having a cast placed on the right forearm and is found putting a lead pencil in the cast to 'reach the itch.' What is the nurse's priority action?
- A. Offer the client a straw to reach the itch instead of a lead pencil
- B. Perform a peripheral neurovascular check of the casted extremity
- C. Pour a generous amount of baby powder or corn starch in the cast to reach the itch
- D. Review appropriate itch relief technique using the cool setting of a hair dryer
Correct Answer: D
Rationale: Using a hair dryer on a cool setting is a safe and effective way to relieve itching without risking skin damage or cast integrity, unlike inserting objects or powders.
The nurse is caring for a client with a vascular access for hemodialysis. Which of these findings necessitates immediate action by the nurse?
- A. pruritic rash
- B. dry, hacking cough
- C. chronic fatigue
- D. elevated temperature
Correct Answer: D
Rationale: It is a priority to report this finding since clients on hemodialysis are prone to infection, and the first sign is an elevated temperature.
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