The practical nurse (PN) reviews the laboratory results of an elderly female client who is one day postoperative for a right total hip replacement (THR).

Which serum value result has the greatest implication for client safety?

Reference ranges

Hemoglobin (Hgb) [12 to 16 g/dL (120 to 160 g/L)]

Potassium (K+) [3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]

Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]

Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]

Sodium 130 mEq/L.

Hemoglobin 8.9 grams/dL.

Potassium 3.4 mEq/L

Blood urea nitrogen 20 mg/dL.

Answer and Explanation

The Correct Answer is B

A.   Sodium level of 130 mEq/L is slightly below the lower limit of the reference range but might not have as immediate an impact on safety as a critically low hemoglobin level.
B.   Hemoglobin of 8.9 grams/dL is significantly below the normal range and indicates a substantial drop in red blood cells, which can lead to impaired oxygen transport and potentially severe postoperative complications like inadequate tissue perfusion and oxygenation.
C.   Potassium level of 3.4 mEq/L is slightly below the lower limit of the reference range but might not pose an immediate threat compared to a critically low hemoglobin level.
D.   Blood urea nitrogen (BUN) of 20 mg/dL is at the upper limit of the reference range but might not have an immediate implication for client safety compared to a critically low hemoglobin level.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Contacting the healthcare provider to clarify the prescription is essential to ensure the correct dosage for the child. It allows for immediate resolution and prevents potential harm from an incorrect dosage.
B. Requesting verification from the charge nurse might be helpful but doesn’t address the issue of the potentially incorrect prescription dosage.
C. Instructing the pharmacy to send an accurate child's dosage is a good step after clarification but doesn't address the immediate concern of the potentially incorrect prescription.
D. Asking another nurse about the administration of adult dosages to children is relevant, but the immediate action should be clarifying the prescription directly with the healthcare provider.

A. Slightly raised rash with ragged edges. B. Red, hot, and swollen joints. C. Heart rate 110 beats/minute. D. Pulse oximetry of 88% O2 saturation.

Correct Answer is ["B","D"]

No explanation

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Naxlex Comprehensive Predictor Exams

The practical nurse (PN) believes that a prescription for a child is incorrect because the dosage prescribed is the usual adult dosage. Which action should the PN take?

Correct Answer is A

Explanation

A child diagnosed with strep throat 3 days ago enters the clinic crying hysterically. The parent tells the practical nurse (PN) that the child screams in pain even with a light touch. The child is short of breath and anxious. Which manifestations warrant immediate intervention by the PN?

Correct Answer is ["B","D"]

A female client who is scheduled to be discharged within several hours shows the practical nurse (PN) a knife on her tray and states that she could use it to cut herself. What intervention is most important for the PN to implement?

The practical nurse (PN) is caring for a newborn whose mother has poorly controlled type 1 diabetes mellitus and observes the newborn is grunting with mild sternal retractions. The PN should recognize the newborn is exhibiting signs of which condition?

The practical nurse (PN) is assisting with preparation of a client for fecal diversion surgery. While inserting an indwelling urinary catheter, the client asks if the surgical opening will be visible. Which action should the PN implement?

A client who was recently diagnosed with atrial fibrillation is receiving warfarin. To see the drug's effectiveness, which laboratory finding should the practical (PN) review?

The practical nurse (PN) is charting vital signs on a hand-written flow sheet and realizes that an error has been made. What should the PN do to rectify this error?

During a clinic visit, the practical nurse (PN) observes an infant sucking on a pacifier that is made from a bottle nipple and stuffed with cotton. What should the PM do?

The practical nurse (PN) notices that one of the unlicensed assistive personnel (UAP) working in the long term care facility consistently records subnormal temperatures when using a tympanic thermometer. Which action should the PN take first?

The practical nurse (PN) is caring for a client newly diagnosed with diabetes mellitus. Which finding indicates that the PN should obtain a capillary glucose measurement to assess for hypoglycemia?