VS and Lab reference intervals

72) The nurse is caring for a client with a diagnosis of cancer who is immunosuppressed. The nurse would consider implementing neutropenic precautions if the client's white blood cell count was which value? 1. 2000 cells/mm3 2. 5800 cells/mm3 3. 8400 cells/mm3 4. 11,500 cells/mm3

1) 2000 cells - The normal WBC count ranges from 5,000 to 10,000

68) A client with a history of cardiac disease is due for a morning dose of furosemide (lasix). Which serum potassium level, if noted in the client's laboratory report, should be reported before administering the dose of furosemide? 1. 3.2 mEq/L 2. 3.8 mEq/L 3. 4.2 mEq/L 4. 4.8 mEq/L

1. 3.2 mEq - The normal serum potassium level in the adult is 3.5-5.0. Administering furosimide to a client with low K+ and a hx of cardiac problems could precipitate ventricular dysrhythmias.

70) The nurse is caring for a client who takes ibuprofen for pain. The nurse is gathering information on the clients medication hx and determines it is nessessary to contact the HCP if the client is also taking which medications? Select all that apply 1) Warfarin 2) Glimepiride 3) Amlodipine 4) Simvistatin 5) Hydrochlorothyazide

123 - NSAIDs can amplify the effects of anticoaugulants, therefore these meds should not be taken together

69) Several laboratory tests are prescribed for a client, and the nurse reviews the results of the tests. Which abnormal laboratory test results should the nurse report? Select all that apply. 1. Platelets 35000 2. Sodium 150 3. Potassium 5.0 4. Segmented Neutrophils, 40% 5. Serum creatinine, 1 mg/dL 6. White blood cells, 3000 cells/mm3

1246 The normal values include the following: Platlets 150,000-400,000; Sodium 135-145; K+ 3.5-5.0; seg. neutrophils 60%-70%; Serum creatinine 0.6-1.3; white blood cells 5,000-10,000

74) The nurse is caring for a postoperative patient who is receiving demand dose hydromorphone via a PCA for pain control. The nurse enters the clients room and finds the client drowsy and records the following VS: pulse 52; BP 101/58; RR 11; and Spo2 93% on 3 L via nasal cannula. Which action should the nurse take next? 1) Document the findings 2) Attempt to arouse the patient 3) Contact the HCP immediately 4) Check the medication administration hx in the PCA pump

2) Attempt to arouse the patient - The primary concern with opioid analgesics is resp depression and hypotension. Based on the assessment findings the nurse should suspect overdose. Nurse should attempt to arouse the patient first then reassess the VS

66) The nurse is explaining the appropriate methods for measuring an accurate temperature to an unlicensed assistive personnel. Which method if noted by the UAP as being an appropriate method indicates the need for further teaching 1) Taking a rectal temperature for a client who has undergone nasal surgury 2) Taking an oral temperature for a client with a cough and nasal congestion 3) Taking an axillary temperature for a client who has just consumed hot coffee 4) Taking a temporal temperature on the neck behind the ear for a client who is diaphoretic

2) Taking an oral temperature for a client with a cough and nasal congestion - An oral temp should be avoided if the client has nasal congestion.

65) A client has been admitted to the hospital for urinary tract infection and dehydration. The nurse determines that the client has received adequate volume replacement if the blood urea nitrogen level drops to which value? 1. 3 mg/dL 2. 15 mg/dL 3. 29 mg/dL 4. 35 mg/dL

2. 15 mg/dL - The normal BUN level is 6-20 values of 29 and 35 reflect continued dehydration. A value of 3 reflects a lower than normal value which may occur with fluid overload

63) A client with atrial fibrillation who is receiving maintenance therapy of warfarin sodium (Coumadin) has a prothrombin time (PT) of 35 seconds and INR of 3.5 On the basis of the prothrombin time, the nurse anticipates which prescription? 1. Adding a dose of heparin sodium 2. Holding the next dose of warfarin 3. Increasing the next dose of warfarin 4. Administering the next dose of warfarin

2. Holding the next dose of warfarin - The normal PT is 11-12.5 seconds. The normal INR is 2-3. Because the values are high the nurse should anticipate that the client would not recieve further doses at this time.

75) An adult female client has a hemoglobin level of 10.8 g/dL. The nurse interprets that this result is most likely caused by which condition noted in the client's history? 1. Dehydration 2. Heart failure 3. Iron deficiency anemia 4. Chronic obstructive pulmonary disease

3) Iron Deficiency Anemia - The normal hemoglobin level for an adult femal is 12-16.

64) A staff nurse is precepting a new graduate nurse and is assigned to care for a client with chronic pain. Which statement if made by the new graduate nurse indicartes the need for further teaching reguarding pain management? 1) I will be sure to ask my client what his pain level is on a scale of 0-10 2) I know that I should follow up after giving medication to make sure it is effective. 3) I know that pain in the older client might manifest as sleep disturbances or depression 4) I will be sure to cue in to any indicators that the client may be exaggerating Their pain

4) I will be sure to cue in to any indicators that the client may be exaggerating their pain - Pain is a highly individual experience and the new graduate nurse should not assume that the client is exaggerating his pain. Rather the nurse should frequently assess the pain and intervene

67) A client is recieving continuous IV infusion of heparin sodium to treat DVT the clients aPTT is 65 seconds the nurse anticipates that which action is needed. 1) DC the heparin infusion 2) Increasing the rate of the heparin infusion 3) Decreasing the rate of the heparin infusion 4) Leaving the rate of the heparin infusion as is

4) Leaving the rate of the heparin infusion as is - The normal aPTT varies btw 28 and 35 seconds depending on the type of activator used in testing. The theraputic dose of heparin for treatment of DVT is to keep the aPTT btw 42-52.2 and 70-87.5 times the normal. This means that the patients level should not be below 42 seconds or greater than 87 seconds

76) A client with a history of gastrointestinal bleeding has a platelet count of 300,000 cells/mm3. The nurse should take which action after seeing the laboratory results? 1. Report the abnormally low count 2. Report the abnormally high count 3. Place the client on bleeding precautions 4. Place the normal report in the client's medical record

4) Place the normal report in the clients medical record - A normal platlet count ranges from 150,000-400,000

71) A client with diabetes mellitus has a glycosylated hemoglobin A1c level of 9%. On the basis of this test result, the nurse plans to teach the client about the need for which measure? 1. Avoiding infection 2. Taking in adequate fluids 3. Preventing and recognizing hypoglycemia 4. Preventing and recognizing hyperglycemia

4) Preventing and recognizing hyperglycemia - the normal reference range for the glycosated hemoglobin A1c is 4.0% to 6.0%. This test measures the amount of glucose that has become permanently bound to the RBCs from circulating glucose.

"73. A client brought to the emergency department states that he has accidentally been taking two times his prescribed dose of warfarin (Coumadin) for the past week. After noting that the client has no evidence of obvious bleeding, the nurse plans to do which of the following? 1. Prepare to administer an antidote. 2. Draw a sample for type and crossmatch and transfuse the client. 3. Draw a sample for an activated partial thromboplastin time (aPTT) level. 4. Draw a sample for prothrombin time (PT) and international normalized ratio (INR)."

4. Draw a sample for PT and INR - The action the nurse should take is to draw a sample for PT and INR to determine the clients anticoagulantion status and risk for bleeding.