A nurse is reviewing the diagnostic test results of an older adult female client who is preoperative for a knee arthroplasty. The nurse should notify the surgeon of which of the following results?

Hematocrit 40%

Creatinine 0.9 mg/dL

WBC count 20,000/mm3

Potassium 3.8 mEq/L

Answer and Explanation

The Correct Answer is C

A.   A hematocrit of 40% is within the normal range for females, which is typically around 37-47%. This result is not concerning and does not typically require immediate notification to the surgeon.
B.   A creatinine level of 0.9 mg/dL is within the normal range for adults (normal range varies slightly among laboratories but is generally around 0.5-1.1 mg/dL). This result indicates normal kidney function and does not require immediate notification.
C.   A white blood cell (WBC) count of 20,000/mm3 is elevated above the normal range, which is typically between 4,500-11,000/mm3. An elevated WBC count could indicate infection or inflammation. Given the client is preoperative, an elevated WBC count may suggest an underlying infection that needs to be addressed before proceeding with surgery. The nurse should notify the surgeon promptly so appropriate evaluation and management can be initiated.
D.   A potassium level of 3.8 mEq/L is within the normal range (normal range is generally 3.5-5.0 mEq/L). This result is not concerning and does not require immediate notification to the surgeon.

Nursing Test Bank

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Correct Answer is A

Explanation

A. Thrombocytopenia (low platelet count) predisposes the client to spontaneous bleeding. This can manifest as petechiae (small red or purple spots on the skin), purpura (larger areas of purple discoloration), mucosal bleeding (such as nosebleeds or bleeding gums), or internal bleeding (such as gastrointestinal or intracranial bleeding). Monitoring for signs of bleeding is essential to promptly intervene and prevent complications.
B. While infections can occur in any client, a low platelet count does not directly predispose the client to infection. Thrombocytopenia primarily affects hemostasis rather than immune function.
C. Oliguria refers to decreased urine output, typically less than 400 mL/day in adults. It is not directly related to thrombocytopenia but may occur in conditions affecting kidney function or fluid balance.
D. Hyperactive deep tendon reflexes can indicate neurological conditions or electrolyte imbalances but are not associated with thrombocytopenia.

A. Elevated magnesium level B. Decreased calcium level C. Decreased potassium level D. Elevated sodium level

Correct Answer is C

Explanation

A. Postoperative ileus and significant drainage via an NG tube are more likely to lead to electrolyte losses rather than elevated levels. Elevated magnesium levels are less common and typically associated with conditions such as renal failure or excessive magnesium intake.
B. Calcium levels can be affected by gastrointestinal losses, including drainage via an NG tube. Significant fluid loss can lead to hemoconcentration, potentially causing a relative increase in calcium levels initially. However, prolonged fluid loss can lead to overall depletion of electrolytes, including calcium.
C. When fluids are lost through the NG tube, potassium, which is an intracellular electrolyte, can be lost in large amounts. Prolonged drainage can lead to hypokalemia (decreased potassium levels), which can result in muscle weakness, cardiac dysrhythmias, and other serious complications.
D. Elevated sodium levels (hypernatremia) are more commonly associated with dehydration or excessive sodium intake rather than drainage via an NG tube. In this scenario, sodium levels are less likely to be affected compared to potassium.

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A nurse is reviewing the diagnostic test results of an older adult female client who is preoperative for a knee arthroplasty. The nurse should notify the surgeon of which of the following results?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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