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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Correct Answer is D

Explanation

A. Term 6, Premature 3, Abortion 3, Living 2. This choice is incorrect because it counts each miscarriage as both a term and a premature birth. A term birth is one that occurs after the completion of the 37th week of gestation. A premature birth is one that occurs before the completion of the 37th week of gestation. A miscarriage is a pregnancy loss that occurs before the completion of the 20th week of gestation.

B. Term 2, Premature 3, Abortion 3, Living 2. This choice is incorrect because it counts each miscarriage as a premature birth. A miscarriage is not a premature birth because it occurs before the viability of the fetus.

C. Term 2, Premature 1, Abortion 0, Living 3. This choice is incorrect because it does not count the miscarriages as abortions. An abortion is any pregnancy loss that occurs before the completion of the 20th week of gestation, regardless of whether it is spontaneous or induced.

D. Term 3, Premature 0, Abortion 3, Living 2. This choice is correct because it accurately reflects the client's obstetrical history. The client has had three term births (two living children and one current pregnancy), no premature births, three abortions (all miscarriages in the first trimester), and two living children.

A. "We can never tell. People with cancer react differently to chemotherapy." B. "It depends on the amount of drug you receive with your particular treatment." C. "Hair loss is not usually permanent, but the color and texture may change when it grows back." D. "It is likely that your hair will grow back, but if it does not there are very good wigs available."

Correct Answer is C

Explanation

A. This response is too vague and does not provide reassurance or accurate education for the client.
B. While the amount and type of drug can influence side effects, this response does not directly answer the client’s concern about regrowth.
C. Hair typically grows back after chemotherapy, although changes in color or texture are common. This response provides realistic reassurance and accurate information.
D. Although offering wigs may be helpful, this response does not address the client’s direct concern about whether her hair will return.

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A female client is scheduled to begin chemotherapy for breast cancer. She tells the practical nurse (PN) that the healthcare provider explained that her hair is likely to fall out as a result of the treatment. The client asks the PN if her hair will grow back. Which response is best for the

Correct Answer is C

Explanation

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?

During a daily assessment in the nursery, the practical nurse (PN) notices three large bluishblack areas on the back and buttocks of an African-American infant. Which action should the PN take?

The practical nurse (PN) determines that a client who is one day postpartum has a moderate amount of lochia rubra and the uterus is firm, dextroverted, and three fingerbreadths above the umbilicus. Which should be the PN's initial action?

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The practical nurse (PN) is assisting with the 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?

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What is most important for the practical nurse (PN) to include when performing pain assessment after giving an analgesic?