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 {"dropdown-group-1":"A","dropdown-group-2":"E"}

Explanation

Correct choices are; Metabolic acidosis:

This can occur due to the client's diarrhea, leading to loss of bicarbonate (HCO3-) through the gastrointestinal tract. The ABG results show a pH slightly below normal (7.33) and a decreased bicarbonate level (19 mEq/L), indicative of metabolic acidosis.

Hypernatremia:

The client's sodium level is elevated at 149 mEq/L (normal range is 136-145 mEq/L). This indicates hypernatremia, which could be due to dehydration from diarrhea and possibly inadequate fluid intake.

A. Metolazone B. Furosemide C. Hydrochlorothiazide D. Spironolactone

Correct Answer is D

Explanation

A. Metolazone is a thiazide-like diuretic that works primarily in the distal convoluted tubule of the nephron. It can lead to hyponatremia due to its mechanism of increasing sodium and water excretion. However, it is not typically associated with hyperkalemia.
B. Furosemide is a loop diuretic that acts on the ascending loop of Henle. It primarily causes loss of sodium, potassium, and chloride ions. While it can lead to hypokalemia (low potassium levels) due to increased potassium excretion, it does not typically cause hyperkalemia or hyponatremia.
C. Hydrochlorothiazide is a thiazide diuretic that acts on the distal convoluted tubule. It can cause hyponatremia due to increased sodium and water excretion. It may also lead to hypokalemia but is not typically associated with hyperkalemia.
D. Spironolactone is a potassium-sparing diuretic that works by antagonizing aldosterone receptors in the distal nephron, leading to retention of potassium and excretion of sodium. It can cause hyperkalemia due to its potassium-sparing effects. Additionally, it may also lead to hyponatremia, although less commonly than thiazide diuretics.

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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

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"E"}

Explanation

A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat having actions should the nurse explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?

Correct Answer is D

Explanation

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