A nurse is caring for a client.
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Medication Administration Record:
- Budesonide 6 mg PO daily.
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Laboratory Results:
- Hematocrit (Hct): 47% (Normal range: 37% to 52%)
- Hemoglobin (Hgb): 16 g/dL (Normal range: 12 to 18 g/dL)
- Potassium: 3.6 mEq/L (Normal range: 3.5 to 5.0 mEq/L)
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History and Physical:
- BMI: 16 (Reference Range:18.5 - 24.9)
- History of type 2 diabetes mellitus.
- Nonsmoker.
- New diagnosis of Crohn's disease.
Click to highlight the findings that increase the client's susceptibility to infection.
To deselect a finding, click on the finding again.
Budesonide 6 mg PO daily
BMI: 16
History of type 2 diabetes mellitus
New diagnosis of Crohn's disease
Hematocrit (Hct): 47%
Hemoglobin (Hgb): 16 g/dL
Potassium: 3.6 mEq/L
The Correct Answer is ["A","B","C","D"]
Findings that Could Increase Susceptibility to Infection:
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Budesonide 6 mg PO daily:
- Explanation: Budesonide is a corticosteroid used to reduce inflammation, often prescribed for conditions like Crohn's disease. While it helps manage inflammation, corticosteroids also suppress the immune system. This immunosuppressive effect can increase the client's susceptibility to infections.
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BMI of 16:
- Explanation: A BMI of 16 is considered underweight. Malnutrition or being underweight can weaken the immune system, making a person more susceptible to infections because their body lacks the necessary nutrients and energy to support immune function.
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History of Type 2 Diabetes Mellitus:
- Explanation: Diabetes, particularly if not well-controlled, can impair the immune system and increase the risk of infections. High blood sugar levels can hinder the function of immune cells, making it easier for infections to develop and harder for the body to fight them.
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New Diagnosis of Crohn's Disease:
- Explanation: Crohn's disease is an inflammatory bowel disease that causes inflammation of the digestive tract. This chronic inflammation can affect the body's ability to absorb nutrients, leading to nutritional deficiencies that impair the immune system. Additionally, the disease itself, especially when active, can increase the risk of infection.
Findings That Do Not Increase Susceptibility to Infection:
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Hematocrit (Hct) of 47%:
- Explanation: The Hct level is within the normal range of 37% to 52%. It measures the percentage of red blood cells in the blood. Since it's normal, it does not indicate an increased risk of infection.
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Hemoglobin (Hgb) of 16 g/dL:
- Explanation: The Hgb level is also within the normal range of 12 to 18 g/dL. Hemoglobin is a protein in red blood cells that carries oxygen. This normal level does not suggest a higher risk of infection.
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Potassium level of 3.6 mEq/L:
- Explanation: Potassium levels are within the normal range of 3.5 to 5.0 mEq/L. This electrolyte level is unrelated to infection risk in the context provided.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
"The use of social media is not included in the COE.”. This statement is not accurate. The use of social media is addressed in the Code of Ethics (COE) for nurses. The COE provides guidance on how nurses should maintain professional boundaries and ethical behavior in the digital age, which includes considerations for social media use.
Choice B rationale:
"Professional expectations are included in the COE.”. This statement is correct. The Code of Ethics (COE) for nurses outlines the professional expectations and standards that nurses are expected to adhere to. It provides guidance on ethical conduct, accountability, and the responsibilities of nurses in their practice.
Choice C rationale:
"Student nurses are not held accountable to COE.”. This statement is not accurate. Student nurses are expected to adhere to the same ethical standards outlined in the Code of Ethics (COE) as registered nurses. While there may be some variations in practice expectations based on the level of training, ethical principles apply to all nurses, including student nurses.
Choice D rationale:
"Criteria for obtaining licensure is included in the COE.”. This statement is not accurate. The Code of Ethics (COE) primarily focuses on ethical principles, professional behavior, and the responsibilities of nurses in their practice. It does not typically include criteria for obtaining licensure, as licensure requirements are determined by licensing boards and regulatory bodies.
Correct Answer is B
Explanation
Choice A rationale:
Quality of practice involves the nurse's competence in providing care to patients and ensuring that the care meets established standards. Violating the quality of practice standard would typically involve issues related to the quality and safety of care provided. In this scenario, the nurse's violation is related to accessing a client's medical record without being involved in their care, which is an ethical breach rather than a violation of the quality of practice standard.
Choice B rationale:
Code of ethics is the standard of professional performance that the nurse is violating. Accessing a client's medical record without being involved in their care is a violation of the ethical principles outlined in the Code of Ethics for Nurses. This action breaches patient confidentiality and privacy, which are fundamental ethical obligations for nurses.
Choice C rationale:
Collaboration involves working effectively with other healthcare professionals to provide optimal patient care. Violations of the collaboration standard would typically involve issues related to teamwork, communication, and interdisciplinary relationships. The scenario described does not pertain to collaboration but rather concerns ethical conduct.
Choice D rationale:
Evidence-based practice refers to the integration of current research evidence into clinical decision-making and patient care. Violations of evidence-based practice would involve not following the latest research and best practices in patient care. In this case, the nurse's violation is related to ethical principles and patient privacy rather than evidence-based practice.
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