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 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.

A. Warfarin B. Simethicone C. Simvastatin D. Enoxaparin

Correct Answer is C

Explanation

A. Warfarin is an anticoagulant used to prevent blood clots. While it may be prescribed for certain patients at risk for stroke, it is not typically the first-line medication for managing TIA or hyperlipidemia. It is more often used in patients with specific types of atrial fibrillation or mechanical heart valves.
B. Simethicone is an anti-foaming agent used to relieve gas and bloating. It does not have any role in managing hyperlipidemia or preventing strokes. Thus, this option is not relevant to the client's condition.
C. Simvastatin is a statin medication used to lower cholesterol levels and reduce the risk of cardiovascular events, including stroke. For a client with hyperlipidemia and a history of TIA, simvastatin would be an appropriate medication to help manage cholesterol and decrease the risk of future ischemic events.
D. Enoxaparin is a low-molecular-weight heparin used for anticoagulation, often in the context of deep vein thrombosis or pulmonary embolism. It may not be the first choice for TIA management. While it has its uses in preventing clot formation, it is not the standard treatment for a patient who has had a TIA.

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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

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

The client diagnosed with hyperlipidemia has experienced a transient ischemic attack (TIA). Which medication would the nurse anticipate being ordered for the client on discharge?

Correct Answer is C

Explanation

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