A nurse on a pediatric unit is reviewing the laboratory results for a group of clients. Which of the following results should the nurse identify as the priority?
An adolescent who has iron-deficiency anemia and an Hgb level of 11 g/dL (10 to 15.5 g/dL)
A school-age child who has diabetes mellitus and an HbA1c of 8% (less than 7%)
A toddler who has moderate dehydration and an RBC count of 5.6/mm3 (4 to 5.5/mm3)
A preschooler who has cystic fibrosis-related diabetes and a WBC count of 15,000/mm3 (5,000 to 10,000/mm3)
The Correct Answer is D
A. An adolescent who has iron-deficiency anemia and an Hgb level of 11 g/dL (10 to 15.5 g/dL):
An Hgb level of 11 g/dL in an adolescent with iron-deficiency anemia is within the expected range for someone with this condition. While iron-deficiency anemia requires management, it is not an urgent or critical condition requiring immediate intervention.
B. A school-age child who has diabetes mellitus and an HbA1c of 8% (less than 7%):
An HbA1c level of 8% in a child with diabetes mellitus indicates poor glycemic control and may increase the risk of long-term complications. While it requires attention and adjustment of the treatment plan, it is not an urgent or critical condition requiring immediate intervention.
C. A toddler who has moderate dehydration and an RBC count of 5.6/mm3 (4 to 5.5/mm3):
Moderate dehydration in a toddler is a concerning finding that requires prompt intervention to restore fluid balance and prevent complications. However, the RBC count of 5.6/mm3 is within the normal range and does not indicate an urgent or critical condition.
D. A preschooler who has cystic fibrosis-related diabetes and a WBC count of 15,000/mm3 (5,000 to 10,000/mm3):
A WBC count of 15,000/mm3 in a preschooler with cystic fibrosis-related diabetes may indicate an infection or inflammatory process. Elevated WBC count warrants further assessment and possible intervention to identify and treat the underlying cause, making this the priority.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Depressed scalp veins: This is an incorrect choice. In hydrocephalus, there is increased pressure within the skull due to the accumulation of cerebrospinal fluid (CSF). This increased pressure typically leads to distended scalp veins rather than depressed ones.
B. Sunken anterior fontanels: This is an incorrect choice. The fontanel, also known as the soft spot on an infant's head, may actually bulge rather than appear sunken in cases of hydrocephalus due to increased intracranial pressure.
C.Bulging eyes:In individuals with hydrocephalus, especially infants and young children, bulging eyes can sometimes occur.The increased pressure inside the skull can affect various structures within the brain, including the optic nerve and the muscles that control eye movement. This can lead to a condition called papilledema, where the optic nerve becomes swollen due to the pressure. Papilledema can cause changes in vision and, in some cases, contribute to the appearance of bulging eyes.
D.Separated cranial sutures:The separation of cranial sutures in hydrocephalus occurs due to the increased pressure from the excess CSF. This pressure can cause the bones of the skull to move apart, leading to visible gaps or widening of the sutures. Clinically, this can be observed through imaging studies such as CT scans or MRI.
Correct Answer is A
Explanation
A. "What are your reasons for making this decision today?"
This response demonstrates active listening and allows the parent to express their reasons for wanting to discontinue treatment. It opens up a dialogue between the nurse and the parent, which is important for understanding their perspective.
B. "You should discuss your concerns with your child's provider."
While it's important for the parent to communicate with the child's healthcare provider, this response may come across as dismissive of the parent's concerns and decision-making process.
C. "You should give the treatment a chance to work before giving up."
This response may seem judgmental and dismissive of the parent's feelings and autonomy. It does not address the parent's concerns and may further strain the nurse-parent relationship.
D. "Do you need assistance gathering your child's belongings to return home?"
This response is practical but does not address the underlying reasons for the parent's desire to discontinue treatment. It's important for the nurse to engage in therapeutic communication and explore the parent's concerns further.
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