A client is post-op nephrectomy for renal cancer. Which lab results would cause most concern for the nurse?

Table 34.1 Review of Normal Ranges for Complete Blood Cell Counts (Adult)

Blood Cell

Normal Ranges

Red blood cells (mature, circulating)

Male 4.51-6.01 million/mm3

Female: 4.01-5.51 million/mm3

Hemoglobin

Adult (15-64 yr)

Male 14-17.3 g/dL

Female 11.7-15.5 g/dL

Hematocrit

42% -52% in males

36% -48% in females

Reticulocytes

0.5% -2.5% of total RBC count

White blood cells (total)

4.5-11.1 103/mm3

Neutrophils

59%

Bands 3%

Segs-56%

Eosinophils

2.7%

Basophils

0.5%

Lymphocytes

34%

Monocytes

4%

Platelets

150,000-450,000/mm3

Hemoglobin of 14 g/dL

Platelet count 150,000 mm3

White blood cell count 17,000 mm3

Neutrophils 59%

Answer and Explanation

The Correct Answer is C

A.   This value is within the normal range for adult males (14-17.3 g/dL) and borderline for females (11.7- 15.5 g/dL). While the specific context of the patient (e.g., gender) matters, generally, a hemoglobin level of 14 g/dL would not typically cause concern.

B.   A platelet count of 150,000/mm³ is at the lower limit of normal (150,000-450,000/mm³). While this may be concerning in certain clinical contexts, it is still within the acceptable range and would not typically raise alarm for a post-op nephrectomy patient unless there are other indications of bleeding or clotting issues.
C.   This white blood cell count is elevated (normal range is 4.5-11.1 x 10³/mm³). An elevated WBC count can indicate an infection, inflammation, or a response to surgery, which is particularly concerning post- operatively. This result would warrant further investigation to rule out infection, which is critical for recovery.
D.   The neutrophil percentage of 59% is within the normal range (typically around 40-70% for total WBCs). While it is slightly elevated, it is not concerning on its own without additional context, especially since it may be elevated in response to surgery or stress.

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Correct Answer is C

Explanation

A. While having multiple sexual partners is associated with an increased risk of sexually transmitted infections (STIs), it is not considered a significant risk factor for uterine cancer specifically. STIs can contribute to other reproductive cancers, such as cervical cancer, but they are not directly linked to the development of uterine cancer.
B. Smoking is a risk factor for various cancers, including cervical and lung cancers, but its association with uterine cancer is not as strong. While some studies suggest a potential link, it is not recognized as a primary risk factor for uterine cancer.
C. Prolonged exposure to unopposed estrogen (estrogen not balanced by progesterone) is the primary risk factor for uterine cancer. This can occur in situations such as obesity (where adipose tissue produces estrogen), hormone replacement therapy without progesterone, and certain medical conditions like polycystic ovary syndrome (PCOS).
D. Having multiple pregnancies is generally considered to have a protective effect against uterine cancer. Pregnancy reduces the number of menstrual cycles a woman has over her lifetime, which can lead to lower lifetime exposure to estrogen.

A. "Cancers of the reproductive tract are slow-growing and respond well to treatment." B. "The 5-year survival rate is about 75%, so her odds are pretty good." C. "When cervical cancer is detected early and treated aggressively, the cure rate is very high." D. "Saying cancer is curable means that 50% of all women with cancer survive at least 5 years."

Correct Answer is C

Explanation

A. While it is true that some cancers of the reproductive tract can be slow-growing and may respond well to treatment, this statement is overly generalized. It does not specifically address the prognosis or treatment success associated with cervical carcinoma in situ.
B. This statement provides a statistic but may not accurately reflect the prognosis for cervical carcinoma in situ, which is typically higher than 75% when detected and treated early. This response could also imply that the survival rate for invasive cervical cancer is the same, which could lead to misunderstanding.
C. Cervical carcinoma in situ is a pre-invasive stage of cervical cancer, and when it is detected early, the treatment is usually very effective, leading to a high cure rate. This statement reassures the husband that the prognosis is good, given that early detection and treatment are key factors.
D. The term "curable" implies a much better prognosis than a mere 50% survival rate, which may refer to various cancers and does not specifically apply to cervical carcinoma in situ. This response does not provide the husband with the clarity he needs about his wife's condition.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male 4.51-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-15.5 g/dL
Hematocrit	42% -52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 103/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%
Platelets	150,000-450,000/mm3

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Naxlex Comprehensive Predictor Exams

A client asks the nurse to explain risk factors for uterine cancer. The nurse explains that the number one risk factor is:

Correct Answer is C

Explanation

The husband of a client with cervical carcinoma in situ says to the nurse, "The doctor just told my wife that her cancer is curable. Is the doctor just trying to make us feel better?" The nurse's most accurate response would be:

Correct Answer is C

Explanation

Which nursing intervention(s) should be employed when caring for the bone marrow donor immediately following a bone marrow aspiration? (SELECT ALL THAT APPLY)

The nurse, caring for a client diagnosed with testicular cancer, should anticipate a medical prescription for which of the following tumor marker studies? A/An:

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The nurse is assessing a post-op thyroidectomy patient for bleeding. Which finding would indicate bleeding at the surgical site?

The client is diagnosed with a transient ischemic attack (TIA) and is prescribed clopidogrel. Which statement would indicate the medication education has been effective for this client? The client states, "Clopidogrel