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A nurse is reviewing a client's 0800 laboratory values at 1100. The nurse notes that the client received heparin at 1000. Which of the following laboratory values warrants an incident report?

INR 1.6

WBC 6,000/mm3

Hgb 16 g/dL

aPTT 90 seconds

Answer and Explanation

The Correct Answer is D

Choice A rationale:

An INR of 1.6 is slightly elevated but does not necessarily warrant an incident report.

Choice B rationale:

A WBC count of 6,000/mm3 is within a normal range and would not warrant an incident report.

Choice C rationale:

A hemoglobin level of 16 g/dL is within a normal range and does not warrant an incident report.

Choice D rationale:

An aPTT of 90 seconds is significantly prolonged and may indicate excessive anticoagulation from the heparin administration. This could potentially be a safety concern and would warrant an incident report for further evaluation.

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Correct Answer is D

Explanation

A: Flushing an IV line with dextrose 5% in water before and after medication administration is a common practice to ensure that the medication is delivered properly and to prevent interactions in the IV line. This would not typically require an incident report.
B: An absolute neutrophil count of 2.500/mm3 is within the normal range for patients undergoing chemotherapy and would not typically necessitate an incident report.
C: Having chemotherapy 12 hours before the administration of filgrastim does not contraindicate its use and is within the appropriate time frame as filgrastim is often given after chemotherapy to help recover white blood cell counts.
D: According to the guidelines, filgrastim should be stored in the refrigerator and allowing it to sit at room temperature for 2 hours could compromise its effectiveness. This is a deviation from the medication's storage requirements and could potentially harm the patient, thus an incident report should be filed.

A. The client should be treated by giving potassium by IV bolus. B. Another formulation of potassium should be given IV. C. Potassium chloride should be diluted in dextrose 5% in water. D. The potassium infusion rate is too rapid.

Correct Answer is D

Explanation

Choice A rationale:

IV bolus administration of potassium is not appropriate due to the risk of cardiac arrhythmias.

Choice B rationale:

The formulation of potassium (potassium chloride) is appropriate for IV administration.

Choice C rationale:

Potassium chloride is typically diluted in normal saline (0.9% sodium chloride) for IV administration, not dextrose.

Choice D rationale:

The prescribed infusion rate of 30 mEq of potassium chloride over 30 minutes is too rapid and could lead to adverse effects, such as cardiac arrhythmias. The nurse should clarify the prescription and discuss a slower infusion rate with the provider.

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A nurse is reviewing a client's 0800 laboratory values at 1100. The nurse notes that the client received heparin at 1000. Which of the following laboratory values warrants an incident report?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse recently administered filgrastim intravenously to a client who has ccer and is receiving cytotoxic chemotherapy. For which of the following data, discovered after the medication was administered, should the nurse file an incident report?

Correct Answer is D

Explanation

A nurse is caring for a client who is to receive potassium replacement. The provider's prescription reads, "Potassium chloride 30 mEq in 0.9% sodium chloride 100 mL IV over 30 min." For which of the following reasons should the nurse clarify this prescription with the provider?

Correct Answer is D

Explanation

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